health envir
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Environmental health
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Environmental hazards are
responsible for as much as a
quarter of the total burden of
disease world-wide, and morethan one-third of the burden
among children.
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Heading that list are diarrhoea,lower respiratory infections,
various forms of unintentionalinjuries and malaria.
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The disease burden is much
higher in the developing world,although in the case of certain
non-communicable diseases,such as cardiovascular diseases
and cancers, the per capita
disease burden is larger in
developed countries.
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Health impacts of environmentalhazards run across more than 80
diseases and types of injury.
Well-targeted interventions can
prevent much of this
environmental risk.
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Worldwide, as many as 13million deaths could be
prevented every year by making
our environments healthier.
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Environmental health addresses all
the physical, chemical, and
biological factors external to aperson, and all the related factors
impacting behaviours.
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It encompasses the assessment and
control of those environmentalfactors that can potentially affect
health.
It is targeted towards preventing
disease and creating health-supportive environments.
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This definition excludes
behaviour not related to
environment, as well as
behaviour related to the social
and cultural environment, andgenetics.
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Indoor air pollution and health
Fact sheet N292
September 2011
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Around 3 billion people cook and
heat their homes using open firesand leaky stoves burning biomass(wood, animal dung and crop waste)
and coal.
Nearly 2 million people die
prematurely from illness attributableto indoor air pollution fromhousehold solid fuel use.
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Nearly 50% of pneumonia deaths
among children under five are
due to particulate matter inhaled
from indoor air pollution.
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More than 1 million people a year
die from chronic obstructiverespiratory disease (COPD) that
develop due to exposure to such
indoor air pollution.
Both women and men exposed toheavy indoor smoke are 2-3 times
more likely to develop COPD.
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IONIZING RADIATION, HEALTH EFFECTSAND PROTECTIVE MEASURES
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Ionizing radiation is a type of
energy released by atoms in theform of electromagnetic
waves or particles.
People are exposed on a daily basis
to natural sources of ionizingradiation, as well as human-made
ionizing radiation sources.
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Ionizing radiation has many
beneficial applications, includinguses in medicine, industry,
agriculture and research. As the use
of ionizing radiation increases, so
does the potential for health
hazards if not properly used orcontained.
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Acute health effects such as skinburns or acute radiation syndrome
can occur when radiation doses
exceed certain levels. Low doses ofionizing radiation can increase the
risk of longer term effects such ascancer.
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Air quality and healthFact sheet N313
Updated September 2011
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Air pollution is a majorenvironmental risk to health.
By reducing air pollution levels, we
can help countries reduce the global
burden of disease from respiratoryinfections, heart disease, and lung
cancer.
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The lower the levels of air pollution in acity, the better respiratory (both long-
and short-term), and cardiovascular
health of the population will be.
Indoor air pollution is estimated to
cause approximately 2 million
premature deaths mostly in developing
countries.
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Almost half of these deaths are due topneumonia in children under 5 years ofage.
Urban outdoor air pollution isestimated to cause 1.3 million deathsworldwide per year.
Those living in middle-income countriesdisproportionately experience this
burden.
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Exposure to air pollutants is largely beyondthe control of individuals and requires action
by public authorities at the national, regional
and even international levels
The WHO Air quality guidelines represent the
most widely agreed and up-to-date
assessment of health effects of air pollution,
recommending targets for air quality at whichthe health risks are significantly reduced.
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The Guidelines indicate that byreducing particulate matter (PM10)
pollution from 70 to 20 micrograms
per cubic metre, we can cut airquality related deaths by around
15%.
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Electromagnetic fields and
public health: mobile phonesFact sheet N193June 2011
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Mobile phone use is ubiquitous with
an estimated 4.6 billionsubscriptions globally.
The electromagnetic fields produced
by mobile phones are classified by
the International Agency forResearch on Cancer as possibly
carcinogenic to humans.
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Studies are ongoing to more fully
assess potential long-termeffects of mobile phone use.
WHO will conduct a formal risk
assessment of all studied healthoutcomes from radiofrequency
fields exposure by 2012.
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Environmental andoccupational cancersFact sheet N350
March 2011
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Cancer is a leading cause of death
worldwide, with 12.7 million newcases and 7.6 million deaths in 2008.
Globally, 19% of all cancers are
attributable to the environment,
including work setting resulting in1.3 million deaths each year.
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WHO has classified 107 agents,
mixtures, and exposure situations ascarcinogenic to humans.
External environmental causes of cancerare factors in the environment that
increase risk of cancer such as air
pollution, UV radiation and indoorradon.
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Every tenth lung cancer death isclosely related to risks in the
workplace.
Lung cancer, mesothelioma, and
bladder cancer are among the mostcommon types of occupational
cancers.
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Asbestos: elimination of
asbestos-related diseasesFact sheet N343July 2010
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About 125 million people in the world
are exposed to asbestos at theworkplace.
According to WHO estimates, more than107 000 people die each year from
asbestos-related lung cancer,
mesothelioma and asbestosis resultingfrom occupational exposure.
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Dioxins and their effects on
human healthFact sheet N225May 2010
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Dioxins are a group of chemically-related
compounds that are persistentenvironmental pollutants.
Dioxins are found throughout the worldin the environment and they accumulate
in the food chain, mainly in the fatty
tissue of animals.
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More than 90% of human exposure isthrough food, mainly meat and dairy
products, fish and shellfish.
Many national authorities have
programmes in place to monitor the
food supply.
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Dioxins are highly toxic and cancause reproductive and
developmental problems, damage
the immune system, interfere withhormones and also cause cancer.
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Due to the omnipresence of dioxins, all
people have background exposure,which is not expected to affect human
health.
However, due to the highly toxic
potential of this class of compounds,
efforts need to be undertaken to reducecurrent background exposure.
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Prevention or reduction of humanexposure is best done via source-
directed measures, i.e. strict control
of industrial processes to reduceformation of dioxins as much as
possible.
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Sunbeds, tanning and UV
exposureFact sheet N287Interim revision April 2010
The key reasons why regulations are
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The key reasons why regulations are
necessary
Increase in the number of unsupervised
commercial sunbeds - Without trained staff
and adequate health care advice, the
potential for harm to the uninformed
consumer is much greater. This, combined
with competitive pricing strategies such as
unlimited sessions within a specific timeframe, increases the likelihood of skin
damage.
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High intensity of UV output - Some machines
have the capacity to emit very high levels of
UV, many times stronger than the midday
summer sun in most countries.
In a largely unregulated industry where
training of staff is not mandatory, this
increases the health risks considerably.
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Exposure time and intervals between tanning
sessions - Reasonable sunbed use includes
keeping to recommended exposure times
(which depends on the type of machine used)
and having sufficiently long breaks between
tanning sessions.
Normally at least 48 hours are needed
between tanning sessions for repair of UV-induced DNA damage in skin cells
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Eyewear - UV protective eyewear (such as
goggles) must be worn during tanning
sessions to protect the eyes.
Effect of certain drugs and cosmetics - Some
drugs, for example anti-depressants,
antibiotics, psoralens, antifungals, and
antidiabetics as well as some cosmetics make
the skin more photosensitive and thereforedecrease the time it takes for the skin to
burn.
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The size of the skin area exposed - Modern
clam-type sunbeds and canopies can expose
more skin area to UV than outdoor situations,
therefore increasing the health risk.
Here young people, , are more sensitive to
UV-induced damage from this "all-over"
tanning.
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Climate change and healthFact sheet N266
January 2010
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Climate change affects the fundamental
requirements for health clean air, safedrinking water, sufficient food and
secure shelter.
The global warming that has occurred
since the 1970s was causing over 140
000 excess deaths annually by the year2004.
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Many of the major killers such asdiarrhoeal diseases, malnutrition,
malaria and dengue are highly
climate-sensitive and are expectedto worsen as the climate changes.
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Areas with weak health infrastructure
mostly in developing countries will be the
least able to cope without assistance to
prepare and respond.
Reducing emissions of greenhouse gases
through better transport, food and energy-
use choices can result in improved health.
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Radon and cancerFact sheet N291Updated September 2009
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Radon is the second most important
cause of lung cancer in many countries.
Radon is estimated to cause between 3%
and 14% of all lung cancers, dependingon the average radon level in a country.
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Radon is much more likely to causelung cancer in people who smoke,
and is the primary cause of lung
cancer among non-smokers.
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Radon-induced lung cancers are mainlycaused by low and moderate rather than
by high radon concentrations, because
of the large number of people exposedto indoor radon in homes with such low
concentrations.
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The lower the radon concentration
in a home, the lower the risk as
there is no known threshold belowwhich radon exposures carries no
risk.
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Waste from health-care activitiesFact sheet N253
November 2011
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Of the total amount of waste generatedby health-care activities, about 80% is
general waste.
The remaining 20% is considered
hazardous material that may be
infectious, toxic or radioactive.
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Every year an estimated 16 000million injections are administered
worldwide, but not all of the
needles and syringes are properlydisposed of afterwards.
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Health-care waste contains
potentially harmful microorganisms
which can infect hospital patients,health-care workers and the general
public.
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Ultraviolet radiation and human healthFact sheet N 305
December 2009
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Skin cancer is caused primarily byexposure to ultraviolet (UV)
radiation either from the sun or
from artificial sources such assunbeds.
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Globally in 2000, over 200 000 cases of
melanoma were diagnosed and there
were 65 000 melanoma-associated
deaths.
Excessive sun exposure in children and
adolescents is likely to contribute to skin
cancer in later life.
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Worldwide approximately 18 million
people are blind as a result of cataracts,
of these 5% of all cataract related
disease burden is directly attributable to
UV radiation exposure.
Sun protection is recommended when
the ultraviolet index is 3 and above.
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Electromagnetic fields and public health
Base stations and wireless technologiesFact sheet N304
May 2006
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Mobile telephony is now commonplacearound the world.
This wireless technology relies upon anextensive network of fixed antennas, or
base stations, relaying information with
radiofrequency (RF) signals.
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Over 1.4 million base stations existworldwide and the number is
increasing significantly with the
introduction of third generationtechnology.
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Other wireless networks that allow high-speed internet access and services, such
as wireless local area networks (WLANs),
are also increasingly common in homes,offices, and many public areas (airports,
schools, residential and urban areas).
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As the number of base stations andlocal wireless networks increases, so
does the RF exposure of the
population.
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Recent surveys have shown that the RFexposures from base stations range from
0.002% to 2% of the levels of
international exposure guidelines,depending on a variety of factors such as
the proximity to the antenna and the
surrounding environment.
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This is lower or comparable to RF
exposures from radio or television
broadcast transmitters.
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Health effects of the Chernobyl accident:
an overviewFact sheet N 303
April 2006
Background
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On 26 April 1986, explosions at reactor
number four of the nuclear power plant at
Chernobyl in Ukraine, a Republic of theformer Soviet Union at that time, led to huge
releases of radioactive materials into the
atmosphere. These materials were depositedmainly over countries in Europe, but
especially over large areas of Belarus, the
Russian Federation and Ukraine.
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Electromagnetic fields and public healthStatic electric and magnetic fieldsFact sheet N299March 2006
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Technologies using static fields are
increasingly being exploited in selected
industries, such as medicine with magneticresonance imaging (MRI), transportation
systems that use direct current (DC) or static
magnetic fields and high-energy physicsresearch facilities. As the field strength of the
static field increases, so does the potential for
a variety of interactions with the body.
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The International EMF Project of the World
Health Organization (WHO) has recently
reviewed the health implications of highstatic field exposure and highlighted the
importance of public health protection for
medical staff and patients (particularlychildren and pregnant women) and workers
in industries producing high field magnets
(Environmental Health Criteria, 2006).
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Electromagnetic fields and public health
Electromagnetic hypersensitivityFact sheet N296 December 2005
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As societies industrialize and the
technological revolution continues,
there has been an unprecedentedincrease in the number and diversity
of electromagnetic field (EMF)
sources.
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These sources include video displayunits (VDUs) associated with
computers, mobile phones and their
base stations. While these deviceshave made our life richer, safer and
easier, they have been accompanied
by concerns about possible health
risks due to their EMF emissions.
For some time a number of individuals have
d f h l h bl h
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reported a variety of health problems that
they relate to exposure to EMF. While some
individuals report mild symptoms and reactby avoiding the fields as best they can, others
are so severely affected that they cease work
and change their entire lifestyle. This reputedsensitivity to EMF has been generally termed
electromagnetic hypersensitivity or EHS.
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LegionellosisFact sheet N285
History and overview
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Legionellosis is a serious and sometimes fatal
form of pneumonia. It is caused by the
bacterium Legionella pneumophila and other
legionella species. These bacteria are found
naturally in the environment and thrive inwarm water and warm damp places. They are
commonly found in lakes, rivers, creeks, hot
springs and other bodies of water. They canalso be found in soil and potting mix.
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The bacterium Legionella pneumophila was
first identified in 1977, as the cause of an
outbreak of severe pneumonia in aconvention centre in the USA in 1976. It has
since been associated with outbreaks linked
to poorly maintained artificial water systems,particularly cooling towers or evaporative
condensers associated with air conditioning
and industrial cooling, hot and cold watersystems in public and private buildings, and
whirlpool spas.
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Health-care waste managementTo reduce the burden of disease, health-
care waste needs sound management,
including alternatives to incinerationFact sheet N281October 2011
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In the last few years there has been growing
controversy over the incineration of health-
care waste. Under some circumstances,including when wastes are incinerated at low
temperatures or when plastics that contain
polyvinyl chloride (PVC) are incinerated,dioxins and furans and other toxic air
pollutants may be produced as emissions
and/or in bottom or fly ash (ash that iscarried by air and exhaust gases up the
incinerator stack).
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Exposure to dioxins, furans and
co-planar PCBs may lead to
adverse health effects.
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Depleted uraniumFact sheet N257Revised January 2003
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Metallic uranium (U) is a silver-white,
lustrous, dense, weakly radioactive
element.
It is ubiquitous throughout the naturalenvironment, and is found in varying but
small amounts in rocks, soils, water, air,
plants, animals and in all human beings.
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Natural uranium consists of amixture of three radioactive
isotopes which are identified by the
mass numbers 238U (99.27% bymass), 235U (0.72%) and 234U
(0.0054%).
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On average, approximately 90 g(micrograms) of uranium exists in
the human body from normal
intakes of water, food and air. About66% is found in the skeleton, 16% in
the liver, 8% in the kidneys and 10%
in other tissues.
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Uranium is used primarily in nuclear
power plants. However, most
reactors require uranium in whichthe 235U content is enriched from
0.72% to about 1.5-3%.