Environmental Engineering Reference
In-Depth Information
The mortality can be expected to shift more to noncommunicable causes in the
developing countries as social and economic conditions improve and communi-
cable diseases are brought under control. This section discusses some background
issues, prevention and control, legislation, and types of noncommunicable dis-
eases associated with the environment.
Treatment of the environment complements treatment of the individual but
requires more effort and knowledge. The total environment is one of the most
important determinants of health. A review of more than 10 years of research
conducted in Buffalo, New York, showed that the overall death rate for peo-
ple living in heavily polluted areas was twice as high, and the death rates for
tuberculosis and stomach cancer three times as high, as the rates in less pol-
luted areas.
62
Rene Dubos points out that “many of man's medical problems
have their origin in the biological and mental adaptive responses that allowed
him earlier in life to cope with environmental threats. All too often the wis-
dom of the body is a shortsighted wisdom.”
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In reference to air pollution, he
adds that “while the inflammatory response is protective (adaptive) at the time it
occurs, it may, if continuously called into play over long periods of time, result
in chronic pathological states, such as emphysema, fibrosis, and otherwise aging
phenomena.”
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Human adjustment to environmental pollutants and emotional stresses due to
crowding and other factors can result in later disease and misery with reduced
potential for longevity and a productive life.
64
In an address to the Sierra Club, EPA Administrator Barbara Blum
stated
65
:
Inner-city people — white, yellow, brown and back — suffer to an alarming degree
from what are euphemistically known as diseases of adaptation. These are not
healthy adaptations, but diseases and chronic conditions resulting from living with
bad air, polluted water, excessive noise, and continual stress. Hypertension, heart
disease, chronic bronchitis, emphysema, sight and hearing impairment, cancer, and
congenital anomalies are all roughly 50 percent higher (for inner-city people) than
the level for suburbanites. Behavioral, neurological and mental disorders are about
double.
Whereas microbiological causes of most communicable diseases are known and
are under control or being brought under control in many parts of the world
(with some possible exceptions such as malaria and schistosomiasis), the phys-
iologic and toxicologic effects on human health of the presence or absence of
certain chemicals in air, water, and food in trace amounts have not yet been
clearly demonstrated. The cumulative body burden of all deleterious substances,
especially organic and inorganic chemicals, gaining access to the body must be
examined both individually and in combination. The synergistic, additive, and
neutralizing effects must be learned in order that the most effective preventive
measures may be applied. Some elements, such as fluorine for the control of
tooth decay, iodine to control goiter, and iron to control iron deficiency anemia,
have been recognized as being beneficial in proper amounts. But the action of
trace amounts ingested individually and in combination of the pollutants shown
