10/10/2016
Over 80 per cent of the disease and injury conditions monitored by WHO are influenced somehow by environmental or occupational factors.
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| Mrs. Maria Neira - Director for Public Health, Social and Environmental Determinants of Health, World Health Organization |
As our world faces an unprecedented epidemic of noncommunicable diseases (NCDs), health and environment policymakers need to understand how health risks are exacerbated by air pollution, as well as more broadly by unhealthy home and urban environments.
Some 3.7 million deaths globally are attributed to outdoor air pollution. Among the key sources are traffic emissions, power generation, outdoor waste, biomass burning and the use of energy in buildings. Another 4.3 million deaths are linked to household air pollution, mostly from exposures to smoke emissions from rudimentary biomass and coal cookstoves and fires, upon which nearly 3 billion people worldwide primarily depend. Many people are exposed to both indoor and outdoor air pollution. Due to this overlap, mortality attributed to the two sources cannot simply be added together, hence the total estimate of around 7 million deaths in 2012.
Most morbidity and mortality assessments related to air pollution are made on the basis of airborne concentrations of PM2.5- (particulate matter less than 2.5 microns (µm) in diameter). Meanwhile, ground level ozone, formed from a mix of urban air pollution emissions, is a factor in chronic asthma and respiratory disease.
Many of the air pollutants that are most harmful to health also damage the climate. These include the so-called short-lived climate pollutants such as ozone and black carbon (the sooty component of small particulate matter that is emitted by both diesel engines and cookstoves) that get their name from their short lifespan in the atmosphere. Cleaning up these, in particular, can generate immediate health and near-term climate benefits.
Many air pollution sources also generate other health risks. Unbridled urban traffic, for example, exacerbates the risk of injury and creates barriers to walking and cycling, which in turn inhibits people’s access to outdoor space for physical activity.
Households with inefficient cookstoves are often poor, and may be vulnerable to a range of other environmental health risks, including lack of clean drinking water, sanitation and structural deficits that make inhabitants more vulnerable to extreme weather or natural disasters related to climate change. The need for ensuring structurally safe construction in rapidly developing cities has been particularly evident in the aftermath of Nepal’s recent earthquake, where widespread building collapses have claimed thousands of lives.
Unhealthy diets may include excessive consumption of processed foods and red meats that may both be “carbon intensive” and increase risks of obesity and obesity-related NCDs. Dietary choices may, in turn, be heavily influenced by urban environmental factors such as the decline of neighbourhood fresh food markets and the predominance of fast food chains.
Unhealthy urban and rural environments also remain a major source of communicable diseases. Indoor smoke from rudimentary cookstoves, for example, is a cause of over one-half of childhood pneumonia deaths. Unsafe drinking water, sanitation and hygiene (WASH) remains a factor in 58 per cent of under-five deaths from diarrhoeal disease despite significant declines in both WASH-related and overall mortality. Tuberculosis is transmitted in crowded housing with inadequate ventilation. Vector-borne diseases, such as malaria and dengue, may be combated through environmental measures like screens on doors, windows and water containers, as well as sustainable irrigation. Undernourished or malnourished children are more vulnerable to a range of infectious diseases. Changing climate conditions-leading to drought, floods, increased heat and changed patterns of infectious disease transmission-can also increase vulnerabilities.
All in all, WHO estimates that about one-quarter of the global burden of death and disease is due to unhealthy environmental factors that could be addressed with proven, affordable development strategies. Over 80 per cent of the disease and injury conditions monitored by WHO are influenced somehow by environmental or occupational factors.
While framing the problems is an important first step, doing something about them is the greater long-term challenge. Public policies can help shape a healthy environment in which to live, work and raise families through all stages of the life cycle. WHO works to promote such policies for primary prevention in housing, energy, transport and food production through a range of upstream activities such as:
Quantifying death, disease and disability from different environmental and, where feasible, social risks. WHO is updating its (2005) estimates of the proportion of diseases caused by environmental and occupational factors through a systematic review and synthesis of the literature on risk conditions and diseases, as well as of evidence about available interventions.
Health-linked sustainability indicators. WHO has documented health-linked indicators that could contribute to monitoring post-2015 Sustainable Development Goals. Examples include reduced urban air pollution concentrations as an indicator for healthy and sustainable cities; reduced household air pollution as an indicator for “sustainable energy”; and reduced childhood stunting and obesity as dual indicators of improved nutrition from sustainable food production.
WHO norms and guidelines. WHO guidelines for indoor air quality, household fuel combustion, ambient air pollution concentrations, safe drinking water, radiation and chemical exposures are used by countries around the world as the basis for national legislation, standards and enforcement.
Leadership and advocacy. We join with our fellow United Nations agencies, national governments and ministries, and civil society in campaigns and coalitions. Examples include the UNEP-hosted Climate and Clean Air Coalition to Reduce Short-lived Climate Pollutants, where WHO is a leader of a new health initiative. WHO has also long been active in United Nations-supported campaigns to phase out lead in gasoline and paint; end the use of asbestos; eliminate mercury from medical devices; and support safer management of chemicals.
Together, all these activities touch every one across the planet-rich and poor, newborns and elderly. They help support health and well-being in our journey through life by avoiding and eliminating unnecessary illness, injury and death. This is the healthy heartbeat of sustainable development.
Hoàng Đàn
(UNEP source)
