Occupational and

Environmental Health
Overview
Fakultas Kedokteran
Universitas Sriwijaya

The Scope of Public

Health
Public Health: Combination of science,
practical skills and beliefs directed to the
maintenance and improvement of the
health of the people.
Goals of Public Health determined by:
Values of Society (child abuse, violence
on women)
Knowledge (tele-medicine, water
purification, vaccination)
Ability to resolve perceived public health
problems.

Ilmu kesehatan
masyarakat :
Ilmu & Seni yang bertujuan mencegah
timbulnya penyakit , memperpanjang usia
hidup & mempertinggi usia kesehatan
dengan usaha masyarakat yg terorganisir
untuk sanitasi ling, pengendalian peny.
Menular, pendidikan hygiene perorangan,
mengorganisir pelayanan medis &
perawatan agar dapat dilakukan diagnosa
dini, pengobatan & pencegahan,
Membangun mekanisme sosial, shga setiap
insan dpt menikmati standar kehidupan yg
cukup baik untuk dpt memelihara
kesehatan.

The basic six :

APHA

Pencatatan dan analisa data

Pendidikan kesehatan & diseminasi informasi
Pengawasan, pengaturan, pelayanan kes.ling
Adm & Yankes
Yankes
Koordinasi Sumber daya Kesehatan

EMERSON & LUGINBUHL

Statistik Vital
Pendidikan kesehatan
kesling
Pemberantasan peny. Menular
Kesejahteraan Ibu & Anak
Pengendalian Peny. Kronis
Laboratorium Kesehatan
WHO
Pemeliharaan dokumen Kesehatan
Pendidikan kesehatan
Kesling
Pemberantasan peny. Menular
Kesejahteraan Ibu & Anak
Yanmed & perawatan kesehatan.

Ways to promote good

health:
Safe environment (physical, chemical,
biological)
Enhance immunity to infection (vaccination,
nutrition, physical fitness)
Behave sensibly (drugs and alcohol,
exercise, safe sex, stress management);
Satisfactory nutrition (well balance diet)
Well born children (KIA)
Prudent health care (cautious in adopting
new technology)

Env. and. Occ Health

defined
Occupational and Environmental Health is the
multidiciplinary approach to the recognition,
diagnosis, treatment and prevention and control of
diseases, injuries, and other adverse health
conditions resulting from hazardous expsoures in
the workplace, the home, or the community. (Levy
and Wegman, et al 2006).
Ilmu Kesehatan Kerja adl : Bagian dari ilmu Kesmasy
yg mengkaji secara multidisiplinear pengenalan,
diagnosis, pengobatan, dan pengendalian penyakit
terkait pekerjaan, kecelakaan & berbagai keadaan
lainnya yg terkait pekerjaan.

Examples of Hazardous
Exposures
Contamination of air, water and soil, by a
factory where workers are also exssed.
Agriculture workers application of pesticides
that may contaminate surface and ground
water.
Workers bringing asbestos, lead and other
hazardous materials home on their work cloth,
skin and hair.
Exposure of workers and community residents
to hazardous wastes that have been
inapproppriately disposed of by industries.

Environmental and
Occupational Health
Hazards
Natural and anthropogenic sources.
Biological (bacteria, viruses, parasites, BBP
etc.).
Chemical hazards: heavy metals, solvents,
pesticides, carcinogens.
Physical hazards: noise, vibration, thermal,
radiation, illumination.
Mechanical (motor vehicles, workplace injury)
Ergonomics: repetitive, awkward positions.
Psycho-social: stress, lifestyles.

HEALTH and ENVIRONMENT

Ecosystem: a system of dynamic interdependent
relationship among living organisms and their physical
environment.
It is a bounded entity that has self-stabilizing mechanism
(Gaia Hypothesis: earth has global homeostatic
mechanism).
Stable and balance ecosystem will survive longest
(Watershed and water supply);
Ecosystem capacity is not unlimited (carrying capacity)

waste (water, soil, air);

Material and energy consumption;
Availability of arable land, fresh water;
Collapse of ecosystem (e.g. traffic);

The law of minimum (Justus von Liebig).

HEALTH and
ENVIRONMENT
F (human health)= G (DNA) + E (P,C,B)
Impediments to health: Poverty, Poor living
and working condition, lack of education
Social and Economic condition.
Health is only possible where resources
available to meet human needs and where
living and working environment is protected
from life-threatening and health-threatening
pollutants, pathogens and physical hazards.
Message: Health professional have a special
role in the environmental health but they need
to work with all groups.

Scale and Nature of Human

Activities (agricultural,
industrial, energy production,
urbanization)

HEALTH

Physical and
Chemical
Environment (air,
water, soil, food)

Biological Environment:
pathogens, vectors and
Habitats.

Interaction of Human Activities and Environment

Top Risk Factors Leading to

Disease, Disability, or Death
(behavior)

Developing
Countries

Underweight
Unsafe sex
Unsafe water,
sanitation and
hygiene
Indoor smoke
Deficiency vit and min
High blood pressure
Tobacco
High cholestrol.

Developed Countries

Tobacco
High blood pressure
Alcohol
High cholestrol
High body mass index
Low fruit and
vegetable intake
Physical inactivity
Illicit drugs
Unsafe sex
Fe Deficiency

Ref. Murphy, E.M (2005). Promoting Healthy Behavior. Population

Reference Bureau. Washington DC, USA.

Biological Hazards
Plants, insects, rodents, fungi, bacteria, viruses,
toxins, allergens.
Prion (disease producing protein particle) mad
cow.
Five major killers: respiratory infection, diarrhea,
TB, Malaria, Measles.
Water pollution by human excreta is the main
pathway of cholera, dysentery, typhoid, hepatitisA and Schistosomiasis.
Environmental changes: ebola, malaria, Avian Flu,
etc.
HIV/Aids and re-emerged of TB.

Chemical Hazards
10 millions chemicals synthesized, 1 % used
commercially;
3000 chemicals enter the market annually,
1% hazards known.
Most chemicals not adequately tested on
their toxicity;
Inorganic: corrosive materials, metals;
Organics: Hydrocarbons (aliphatic and
aromatic), Halogenated Hc, Alcohols,
Glycols and derivates, Organic solvents
(benzene, trichlorethylene).
Pesticides (organo-chlorine, organophosphorous, Carbamate)

Chemical Hazards: Routes of

Absorption, Distribution and
Excretion of Toxic Substances
Media: Water, Air, Soil, Drugs
Skin

Respirator
y

GI. Tract

Tract
Other
Organs

BLOOD

Liver

Kidney
Sweat

Hair

Urine

Feces

Physical Hazards
Noise:

Occupational Exposure: Noise Induced Hearing

loss;
Ambient Noise: Nuisance;

Vibration:

Hand arm vibration syndrome;

Whole body;

Thermal: Heat related disorders: Stroke, exhaustion,

cramps, syncope; Frostbite.
Barometric pressure: Hyperbaric, aerospace medicine.
Radiation:

Ionizing: Alpha, Beta, Gammas, Neutron, X-rays

Non Ionizing: UV, IR, Lasers, Microwave, Radio

Mechanical and Ergonomics

Hazards
Physical Injury:
Traffic;
Workplace.
Home and recreation.
Ergonomics
Designing workplace that can be
modified or adapted to the needs of
individual workers.
Cumulative Trauma Disorders (eg. Carpal
Tunnel Syndrome)
Frequency, Strength, position.

Psycho Social
Stress:

Depression;
Suicide;
Substance abuse;
Violence
Psycho somatic
diseases.

Stressors:
Family related;
Work related:
Interpersonal,
Organizational.

Batasan Risk Assesment

Pemeriksaan yang teliti dari apa yang
dapat mengancam kesehatan atau
keselamatan manusia untuk menilai
apakah upaya pencegahan sudah
memadai atau harus lebih ditingkatkan.
Karakteristik yg sistematik dan ilmiah
dari berbagai bahaya kesehatan
potensial yang memberi paparan
terhadap manusia.

Prevention and Control Of

Exposure
Risk assessment:
Hazards
identification
Exposure
assessment
Risk characterization
Risk Management
Risk evaluation
Control of exposure
Monitoring

Prevention and control of

exposure
Control at the source:
Substitution eg. Solvent
based to water based;
Engineering control;
Exhaust ventilation.
Control along the path:
General ventilation;
Protective barrier.
Control at the person:
Personal Protective
Equipment
Training
Administrative control (eg.
Working time)
Secondary Prevention
(early detection)

Healthy People 2010, USA

Environmental Health

Outdoor Air Quality

Water Quality
Toxics and Wastes
Healthy Homes and Healty
Communities
Infrastructure and Surveillance
Global Env Health.

Additional Challenges for

Developing Countries

Export of Hazards
Infrastructures and Human Resources
Trans-national Problem
Relationships between Workplace and
Home Environment
Economic Development - rapid
industrialization, urbanization.
OH/EH Services and Primary Health Care.

Topik Diskusi ttg. Keslingker

Quality Air, ambient and indoor.
Domestic Waste Management;
Excreta Disposals;
Water Supply Sanitation;
Housing and Health
Food Sanitation;
Vector Control;
Environmental Pollution and Health
Workers Health Surveillance
Emergency Response Plan
Public Health Risk Assessment.

Student Projects
Domestic Waste Management;
Excreta Disposals;
Liquid Industrial waste;
Air quality (ambient);
Noise quality (ambient);
Water quality (stream);
Water Quality (surface non stream);
Work related diseases;
Industrial Noise;
Canteen Hygiene;
Food Safety;
Vector Control: mosquitoes.
Housing and health
Indoor Air Quality
Chemcal managemet in the work place.