Conceptual map illustrating the connections among nonhumannature,ecosystem services,environmental ethics,environmental justice, and public healthEnvironmental health indicator (2016). It consists of three categories: health impacts, air quality, and water and sanitation. The health impacts category includes the environmental risk exposure indicator.
Environmental health was defined in a 1989 document by theWorld 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]
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."[5][6][7]
The termenvironmental medicine may be seen as a medical specialty, or branch of the broader field of environmental health.[8][9] Terminology is not fully established, and in many European countries they are used interchangeably.[10]
Other terms referring to or concerning environmental health include environmental public health and health protection.[11]
Five basic disciplines generally contribute to the field of environmental health, with some overlap between them:
Environmental epidemiology studies the relationship between environmental exposures (including exposure to chemicals, radiation, microbiological agents, etc.) and human health. Observational studies, which simply observe exposures that people have already experienced, are common in environmental epidemiology because humans cannot ethically be exposed to agents that are known or suspected to cause disease. While the inability to use experimental study designs is a limitation of environmental epidemiology, this discipline directly observes effects on human health rather than estimating effects from animal studies.[12]Environmental epidemiology is the study of the effect on human health of physical, biologic, and chemical factors in the external environment, broadly conceived. Also, examining specific populations or communities exposed to different ambient environments, Epidemiology in our environment aims to clarify the relationship that exist between physical, biologic or chemical factors and human health.[13]
Toxicology studies how environmental exposures lead to specific health outcomes, generally in animals, as a means to understand possible health outcomes in humans. Toxicology has the advantage of being able to conduct randomized controlled trials and other experimental studies because they can use animal subjects. However, there are many differences in animal and human biology, and there can be a lot of uncertainty when interpreting the results ofanimal studies for their implications for human health.[14]
Exposure science studies human exposure to environmental contaminants by both identifying and quantifying exposures. Exposure science can be used to support environmental epidemiology by better describing environmental exposures that may lead to a particular health outcome, identify common exposures whose health outcomes may be better understood through a toxicology study, or can be used in a risk assessment to determine whether current levels of exposure might exceed recommended levels. Exposure science has the advantage of being able to very accurately quantify exposures to specific chemicals, but it does not generate any information about health outcomes like environmental epidemiology or toxicology.[15]
Environmental engineering applies scientific and engineering principles for protection of human populations from the effects of adverse environmental factors; protection of environments from potentially deleterious effects of natural and human activities; and general improvement of environmental quality.[16]
Environmental law includes the network of treaties, statutes, regulations, common and customary laws addressing the effects of human activity on the natural environment.[17][18]
Information from epidemiology, toxicology, and exposure science can be combined to conduct arisk assessment for specific chemicals, mixtures of chemicals or other risk factors to determine whether an exposure poses significant risk to human health (exposure would likely result in the development ofpollution-related diseases). This can in turn be used to develop and implementenvironmental health policy that, for example, regulates chemical emissions, or imposes standards for propersanitation.[19] Actions of engineering and law can be combined to providerisk management to minimize, monitor, and otherwise manage the impact of exposure to protect human health to achieve the objectives of environmental health policy.
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.[20] Pediatric environmental health is based on the recognition that children are not "little adults." Infants and children have unique patterns of exposure andvulnerabilities. Environmental risks of infants and children are qualitatively and quantitatively different from those of adults. Pediatric environmental health is highlyinterdisciplinary. It spans and brings together general pediatrics and numerous pediatric subspecialties as well asepidemiology,occupational andenvironmental medicine,medical toxicology,industrial hygiene, andexposure science.
Overview of main health effects on humans from some common types of pollution[21][22][23]FEMA/EPA Hazardous Materials Team removing hazards left in the wake ofHurricane Katrina, 2005Lecture of Joyeeta Gupta (University of Amsterdam) on environmental health
According to recent estimates in Europe, about 5 to 10% ofdisability-adjusted life years (DALYs) lost are due to environmental causes. By far the most important factor is fineparticulate matter pollution in urban air.[24] Similarly, environmental exposures have been estimated to contribute to 4.9 million (8.7%) deaths and 86 million (5.7%)DALYs globally.[25] In the United States,Superfund sites created by various companies have been found to be hazardous to human and environmental health in nearby communities. It was this perceived threat, raising the specter of miscarriages, mutations, birth defects, and cancers that most frightened the public.[26]
Air pollution is globally responsible for over 6.5 million deaths each year, as of 2022.[27][28] Air pollution is often a risk-factor for diseases likelung cancer, respiratory infections,asthma,heart disease, and other forms of respiratory-related illnesses.[29] Reducing air pollution, and thus developing air quality, has been found to decrease adult mortality.[30]
A Mumbai factory releasing air pollution.
Common products responsible for emissions includeroad traffic, energy production, household combustion, aviation andmotor vehicles, and other forms of pollutants.[31][32] 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.[33]
Air pollution is associated with adverse health effects like respiratory andcardiovascular diseases,cancer, related illnesses, and even death.[34] The risk of air pollution is determined by the pollutant's hazard and the amount of exposure that affects a person.[35] 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.[35] Environmental health officials work to detect individuals who are at higher risks of consuming air pollution, detect risk factors present in communities, work to decrease overall community exposure.[36]
Household air pollution contributes to diseases that kill almost 4.3 million people every year, as of 2014.[37] Indoor air pollution contributes to risk factors for diseases like heart disease,pulmonary disease,stroke,pneumonia, and other associated illnesses.[37] For vulnerable populations, such as children and elderly populations, who spend large amounts of their time indoors, poor indoor air quality can be dangerous.[38]
Burning fuels likecoal orkerosene inside homes can cause dangerous chemicals to be released into the air.[37] Dampness andmold in houses can cause diseases, but few studies have been performed on mold in schools and workplaces.[39]Environmental tobacco smoke is considered to be a leading contributor to indoor air pollution since exposure to second and third-hand smoke is a common risk factor.[40] Tobacco smoke contains over 60carcinogens, where 18% areknown human carcinogens.[41] Exposure to these chemicals can lead to exacerbation of asthma, the development of cardiovascular diseases and cardiopulmonary diseases, and an increase in the likelihood of cancer development.[42]
Climate change, in addition to its other effects, makesextreme weather events more likely, including ozone smog events, dust storms, and elevatedaerosol levels, all due to extreme heat,drought, winds, and rainfall.[43][44] Theseextreme weather events can increase the likelihood ofundernutrition, mortality,food insecurity, and climate-sensitive infectious diseases in vulnerable populations.[45] The effects of climate change are felt by the whole world, but disproportionately affect disadvantaged populations who are subject toclimate change vulnerability.[46]
Water runoff in Maryland, USA.
Climate impacts can affect exposure towater-borne pathogens through increased rates of runoff, frequent heavy rains, and the effects of severe storms.[47] Extreme weather events andstorm surges can also exceed the capacity of waterinfrastructure, which can increase the likelihood that populations will be exposed to these contaminants.[47][48] 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.[49]
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.[46]
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 most affected. These marginalized groups are frequently put next to pollution sources like major roadways, toxic waste sites, landfills, and chemical plants.[50] 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.[51]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.[51] Likewise, in a 2022 study, it was shown that implementing policy changes that favor wealth redistribution could double as climate change mitigation measures.[52] For populations who are not subject to wealth redistribution measures, this means more money will flow into their communities while climate effects are mitigated.[51][52]
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 likehearing impairment, sleep disturbances,cardiovascular problems,annoyance, problems withcommunication and other diseases.[53] For Americanminorities that live in neighborhoods of lowsocioeconomic status, they often experience higher levels of noise pollution compared to their higher socioeconomic counterparts.[54]
Noise pollution can cause orexacerbate cardiovascular diseases, which can further attribute to a larger range of diseases, increasestress levels, and causesleep disturbances.[54] Noise pollution is also responsible for many reported cases of hearing loss,tinnitus, and other forms ofhypersensitivity(stress/irritability) or lack thereof to sound(present or subconscious from continuous exposure).[54] 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.[54]
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.[55] This is consistent with research that suggests that children who are exposed to regularaircraft noise "have inadequate performance on standardised achievement tests."[56]
Exposure to persistent noise pollution can cause one to develop hearing impairments, like tinnitus or impaired speech discrimination.[57] One of the largest factors in worsened mental health due to noise pollution isannoyance.[58][59] Annoyance due to environmental factors has been found to increase stress reactions and overall feelings ofstress among adults.[53] The level of annoyance felt by an individual varies, but contributes to worsened mental health significantly.[59]
Noise exposure also contributes to sleep disturbances, which can cause daytime sleepiness and an overall lack of sleep, which contributes to worsened health.[59] 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.
Access to safedrinking water is considered a "basic human need for health and well-being" by theUnited Nations.[60] According to their reports, over 2 billion people worldwide live without access to safe drinking water.[61] In 2017, almost 22 million Americans drank from water systems that were in violation of public health standards.[62] Globally, over 2 billion people drinkfeces-contaminated water, which poses the greatest threat to drinking water safety.[63] Contaminated drinking water could transmit diseases likecholera,dysentery,typhoid,diarrhea andpolio.[63]
Harmful chemicals in drinking water can negatively affect health. Unsafe water management practices can increase the prevalence ofwater-borne diseases and sanitation-related illnesses.[64][65] Inadequatedisinfecting of wastewater in industrial and agricultural centers can also infect hundreds of millions of people with contaminated water.[63] Chemicals likefluoride andarsenic 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.[63]
In America, communities of color can be subject to poor-quality water.[66] In communities in America with large Hispanic and black populations, there is a correlated rise inSDWA health violations.[66] Populations who have experienced lack of safe drinking water, like populations inFlint, Michigan, are more likely to distrusttap water in their communities.[49] Populations to experience this are commonly low-income, communities of color.[67]
Hazardous materials management, includinghazardous waste management, contaminated site remediation, the prevention of leaks fromunderground 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.[68]
According to a study done inAustria, people who live near industrial sites are "more often unemployed, have lower educations levels, and are twice as likely to be immigrants.[69] With the interest of environmental health in mind, theResource Conservation and Recovery Act was passed in the United States in 1976 that covered how to properly manage hazardous waste.[70]
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 toEnvironmental Health and Safety Specialists,Waste collectors, Medical Professionals, and Emergency Responders.[71] Handling waste, especially hazardous materials is considered one of the most dangerous occupations in the world.[72] 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.[73] This emphasizes the importance of training, safety protocols, and the use ofpersonal protective equipment for those working with hazardous waste.
Humans are exposed to toxic chemicals and microplastics at all stages in the plastics life cycle.
The effects ofmicroplastics on human health are a growing concern and an actively increasing area of research. Tiny particles known asmicroplastics, have been found in various environmental and biological matrices, including air, water, food, and human tissues. Microplastics, defined as plastic fragments smaller than 5 millimeters (mm), and even smaller particles such as nanoplastics, particles smaller than 1000 nanometers (nm) (0.001 mm or 1 micrometer [μm]), have raised concerns impacting human health.[74][75] 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 underexplored. 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.[76][77]
Plastics continue to accumulate in landfills and oceans, leading to pollution that negatively affects 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[78] and inhalation, with estimates ranging from 39,000 to 52,000 particles per person annually.[citation needed] Additionally, the presence of MPs in human feces suggests widespread exposure and absorption.[79]
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.[80] NPs have been found in drinking water, food, and air, making human exposure ubiquitous.[81]
Contaminated or polluted soil directly affects human health through direct contact with soil or via inhalation of soil contaminants that have vaporized; potentially greater threats are posed by the infiltration of soil contamination into groundwateraquifers used for human consumption, sometimes in areas apparently far removed from any apparent source of above-ground contamination. Toxic metals can also make their way up the food chain through plants that reside in soils containing high concentrations of heavy metals.[82] This tends to result in the development ofpollution-related diseases.
Most exposure is accidental, and exposure can happen through:[83]
Ingesting dust or soil directly
Ingesting food or vegetables grown in contaminated soil or with foods in contact with contaminants
Skin contact with dust or soil
Vapors from the soil
Inhaling clouds of dust while working in soils or windy environments
However, some studies estimate that 90% of exposure is through eating contaminated food.[83]
The Toxicology and Environmental Health Information Program (TEHIP)[84] is a comprehensive toxicology and environmental health web site that includes open access to resources produced by US government agencies and organizations, maintained under the umbrella of the Specialized Information Service at theUnited States National Library of Medicine. TEHIP was responsible for theToxicology Data Network (TOXNET),[85] an integrated system of toxicology and environmental health databases including theHazardous Substances Data Bank, that was open access. TOXNET was retired in 2019.[86]
There are many environmental health mapping tools.TOXMAP is ageographic information system (GIS) from the Division of Specialized Information Services[87] of the United States National Library of Medicine (NLM) that uses maps of the United States to help users visually explore data from the United States Environmental Protection Agency's (EPA)Toxics Release Inventory andSuperfund Basic Research Programs. TOXMAP is a resource funded by the US federal government. TOXMAP's chemical and environmental health information is taken from the NLM's Toxicology Data Network (TOXNET)[88] andPubMed, and from other authoritative sources.
Environmental health professionals may be known asenvironmental health officers, public health inspectors, environmental health specialists or environmental health practitioners. Researchers and policy-makers also play important roles in how environmental health is practiced in the field. In many European countries, physicians and veterinarians are involved in environmental health.[89] Many countries require graduate degrees and professionallicenses to practice environmental health.[90]
The environmental healthprofession had its modern-day roots in the sanitary and public health movement of the United Kingdom. This was epitomized bySir Edwin Chadwick, who was instrumental in the repeal of thepoor laws, and in 1884 was the founding president of the Association of Public Sanitary Inspectors, now called theChartered Institute of Environmental Health.[91]
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