Water, sanitation, hygiene environmental health水卫生卫生和环境卫生.pptVIP

Water, sanitation, hygiene environmental health Pete Kolsky Energy and Water Department Outline Some facts about water, san and health Historical evolution Classification by transmission The Literature of impact studies The nature of the problem Conclusions for practitioners Some water, sanitation and health numbers Faecal-oral (focus of this presentation) Diarrhoeal disease 2 million deaths/year from diarrhoea, mostly under 5 Jumbo jet crash every hour and a half… One billion cases/year 4.3% of Burden of Disease DALYs 88% (?) attributable to inadequate WSH 1/3 of developing world pop’n carry intestinal worms 200 million infected by schistosomiasis (bilharzia) 6-9 million blind from trachoma (1/4 reduced by adequate water supply) Natural chemical hazards Arsenic Skin lesions, various cancers “20 to 60” million exposed in Bangladesh Major problem other parts of S. Asia, also Argentina, Chile, China, Hungary, Mexico, Peru Fluorosis Dental damage, crippling bone damage “affects millions” (WHO) but often of mild form Historical evolution: water quality and health John Snow Cholera Broad Street Pump 1854 Water Companies Studies William Budd Typhoid in 1850s-60s Koch Cholera vs. Pettenkoffer Hamburg/Altona 1892 1937 Croydon Typhoid And many more… Characteristics of these (and other) waterborne outbreaks True outbreaks…sudden spikes Very visible and dramatic!! Politically hot! Common source…the water supply If you’re a water engineer…you don’t want one on your watch! Cholera is the water engineer’s best friend…Money for chlorine suddenly becomes available… Until 1970s, water quality dominated environmental health perception of diarrhoea Classifications of disease Classification usually by organism (viral, bacterial, etc) or organ (diseases of head, heart, liver etc.) Classification by transmission route Bradley’s great innovation in 1970s If you know how it’s spread, you k