1. Determinant of health, pollution and regulations ( 管理 ) on health William W. Au, Ph.D. wau@stu.edu.cn

2. Topics for the lecture Criteria ( 标准 ) that determine health Major regulations ( 控制 ) are often initiated after serious disasters Pollutions (air, soil and water) on health, their monitoring and regulations

3. Definition of health Health: The ability to identify and to realize aspirations ( 愿望 ), to satisfy needs, and to change or cope with the environment. Health is therefore a resource ( 资源 ) for everyday life, not the objective of living. WHO, 1986.

4. Determinants of health Social and economic environment (e.g. distribution of income) Physical environment (e.g. air quality and housing) Personal health practices (?) Individual capacity ( 能力 ) and coping ( 应 付 ) skills (?) Health services (?)

5. Three levels of impact of disease on humans Impairment ( 损害 ): any loss of psychological, physiological or anatomical structure or function, e.g. blindness Disability ( 残疾 ): restriction/inability to perform normal activities, e.g. driving a car due to blindness Handicap ( 障碍 ): inability to function well in a society, e.g. to earn a living due to certain abnormalities.

6. The three levels of disease prevention Primary: reduce risk factors for disease, especially susceptible sub- populations; vaccination. Secondary: screening and testing for early detection Tertiary: diagnosis ( 诊断 ) and treatment

7. Major laws that protect our health Laws on air, soil and water pollution are usually initiated after having disastrous ( 灾难 ) events

8. The air pollution disaster in London in 1952 After the industrial revolution, air pollution in London was terribly bad Very cold from December 5 – 9, cold air interacted with smoke from burning high sulfur coal to cause an inversion of the smoke; visibility was less than 10 feet Those with respiratory diseases were most severely affected

9. Air pollution in the London Fog disaster

10. London Fog disaster and air pollution legislation ( 法律 ) 1.London Fog disaster, Dec., 1952 2.UK air pollution legislation, 1956 3.US Clean Air Act, 1972, amended in 1974, 1977 and 1990. 4.Major regulatory agencies in USA: Environmental Protection Agency (EPA), Occupational Safety and Health Agency (OSHA), and State, County and City agencies

12. The river that burned 1.The river in Ohio caught fire in 1969 2.Why did the river burn? 3.The disastrous event gained national attention and led to the creation of the Clean Water Act, 1972 and EPA 4.1974: Safe Drinking Water Act

13. Problems with contaminants via the food chain and regulations: mercury ( 汞，水银 )

14. A patient with Minamata disease, Japan

17. The mercury contamination problem 1.Cases of cerebral palsy were discovered in 1953 in Japan and the environmental cause was identified in 1959 2.Mercury discharge, bioaccumulation and consumption of fish 3.Regulation of air and water pollution, food advisory

19. Management of air pollution and the benefits

20. National Ambient Air Quality Standards Pollutants StandardsAverage times CO 9 ppm8 hours Lead 1.5 μg/m 3 Quarterly NO 2 0.053 ppmAnnual PM 10 150 μg/m 3 24 hours PM 2.5 65 μg/m 3 24 hours Ozone 0.08 ppm8 hours SO 2 0.14 ppm24 hours

21. How small are PM10 and PM2.5?

22. Success of NAAQS on air pollution

23. Success of air pollution controls on fetal and child health 1.Prevented 15,000 premature ( 过早 ) death 2.Prevented 350,000 cases of asthma ( 哮 喘 ) 3.Prevented 1 million cases of significantly decreased lung function in children

24. Water pollutants and their impact on health

25. Drinking water and public health regulation 氯化

26. Conclusion of the lecture Understand what determines health and what environmental factors undermine health Understand the toxicity of pollutants and their specific impact on health Involvement of regulatory agencies, industry and informed consumers for promotion of health