Environmental Health: Pollutions Hazards and Prevention

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 Environmental Health:

Pollutions Hazards and Prevention

Prof Emeritus Lt. Gen. Mahmud Ahmad Akhtar
Former Surgeon General Army / DGMS (IS)

In Pakistan drinking water and air pollutions cause enormous morbidity and mortality in all the age groups-children below the age five are the main victims. Sound and light pollutions are also hazard contributors. Pakistan has the worst health indicators in the developing world baring a few sub-Saharan countries. These can be minimized as done by Sri Lanka and other SAARC countries. The health indicators of Sri Lanka and Cuba are now matching the advanced developed countries of the world. In Pakistan the posh and gated communities forming about 5% of Pakistan’s population suffer the least hazards, while about 95% of the population living in the rural areas, slums of cities and in the backwards areas like Southern Punjab, Baluchistan, FATA, KPK, Northern areas and AK-(the real Pakistan) are inflicted the maximum hazards and sufferings.

For prevention, first and foremost health and education should be accorded top priority. It is well known that awareness and education of the population helps a lot in improving health indicators. In Pakistan health and education are grossly neglected - are allocated the lowest budget while luxurious projects like metros, orange lines serving a small segment of the population get the top priority, receiving substantial funds.

Drinking water is polluted with bacteria, viruses, protozoa, helminthes etc. from excreta of all sorts also from wastes containing industrial and toxic chemicals. At many rural areas, human beings and animals drink water from the same ponds. Water and sewerage system pipe lines are defectively inter connected causing pollution of drinking water. Industrial wastes without treatment are drained into water channels. Open defecation is another source of contamination.  It is a sad reality that in 2016 as many as 25 million Pakistanis practice open defecation, being the fifth largest, population of open-defecators of the world.

More than 40% of hospital admissions and deaths are due to water borne diseases. Unfortunately in Pakistan every day 110 children die due to diarrhoeas, gastro-enteritis, approximately 400,000 a year. Diseases like viral hepatitis, dysenteries, typhoid fever are endemic. These add to the burden of malnutrition causing stunting affecting the physical and mental development of children, jeopardizing not only their future but also of the nation. Securing Pakistan’s present and future requires an effective and equitable investment in the most disadvantaged and marginalized children, National economy is adversely affected with low agriculture and industrial output. Metallic contamination, in addition to causing gastro-intestinal (G.I) and systemic disturbances is also a cause of GI carcinomas.   

Resolution of the problem lies in providing the population, potable water safe disposal of waste products, practicing hygienic measures of proper hand washing with soap not antibacterial ones and sanitizers which cause the problem of bacterial resistance.

Water filtration plants should be provided and properly maintained. People should be educated to use boiled water. It has been estimated that a one dollar investment in sanitation would earn seven dollars’ worth of benefits but our rulers run projects like Metro on losses and subsidies with an eye on capturing votes. It is pertinent to mention that “Rota Virus” a preventable cause of diarrhoeas in children by immunization with ‘Rota Virus’ vaccine which is a vaccine part of the immunization schedule amongst the “SAARC” but not of Pakistan. This should be provided in Pakistan.

Regarding air pollution the cities of Pakistan like Lahore, Karachi are amongst the ten most polluted cities of the world. Children are uniquely vulnerable to the air pollution as their lungs are developing. A large number of children die due to pneumonia. Death toll due to pneumonia has been found to be higher than deaths due to malaria, tuberculosis, HIV together. Early exposure to toxic air has life-long consequences. The World Health Organization has pinned PM 2.5 particle, the most dangerous amongst the pollutants. These are released from the fossil fuel combustion of vehicles, generators and industry. The ultra filtrate particles enter the blood-stream through lungs causing cardio-vascular diseases and increasing the risk of heart failures and strokes in addition to causing severe respiratory problems like asthma, pneumonias, chronic obstructive lung disease etc. Many studies have suggested a link between air-pollution and cognitive functions. Air pollution further compounds the problem, of stunting which affects 45% children in Pakistan - highest among the SAARC countries.

Numerous studies connecting chronic exposure of air pollution and increased incidence of miscarriage and early labour in pregnant women have been published. Pakistan has the highest still-birth rate in the world. The low birth weight leads to metabolic syndrome, consisting of diabetes mellitus, hypertension, hyper-dyslipidemias, heart attacks, strokes, renal failures and fatty liver. The custom of providing poor diet to a female child is also a major factor. People should be made aware and educated about the benefits of providing quality nutritious diet to girls. Early marriages should be prohibited by law, population explosion should be checked by adopting effective population planning.

Recently there have been formation of smog blankets enveloping cities in Pakistani, Indian Punjab and Haryana states. The burning of paddy straw by farmers for harvesting is an easily correctable cause of air pollution, fog, smog etc. This should receive attention of the concerned Governments. The burning of solid waste instead of proper treatment and disposal in another remediable cause. This is very common all over the country. Hospital waste disposal is also a serious issue needing urgent attention. Burning of fuel inside the rooms without proper ventilation, inhalation at 2nd hand nicotine smoke and smoke from poorly maintained vehicles engines are permanent causes of air pollution. By strictly implementing the laws, situation can be mitigated; coal fired plants should be eliminated. For electricity generation renewable energy systems be employed. Pakistan is suffering from double whammy, increase of vehicles and all around falling of trees. Tree plantations and reforestation should be done. Local varieties of trees with large bio-mass to sequestrate harmful gasses should be planted and not foreign water guzzling varieties with poor bio-mass which is being done. Defective tree pruning is done defecting reducing bio-mass. Flu and pneumonia vaccinations should be timely carried out - during smog season, masks should be used, outdoor activities avoided, rooms should be properly ventilated, air purifiers should be used.

Sound pollution is another serious hazard - least recognized. In addition to causing deafness disorders is linked to hypertension, heart attacks, strokes, renal failures, mental disorders etc. The studies have clearly established links. Sound pollution is caused by sounding of vehicles horns, from their exhaust systems not equipped to prevent loud noise. Electricity generators, ventilation systems, home appliances add to sound pollution. There is a loud playing of music in buses, cars, shops and at all sorts of celebrations weddings etc. loud music equals to happiness. In the streets there are shouting peddlers, hawkers, vendors and sounds of herds of live-stock. Railway lines and aerodromes close to built in areas are sources of high sound pollution in addition to air pollutions by their emissions. These should be built far away from the human settlements. The recent studies have found that headphones may not restrict volume as much as makers claim therefore parents should take precautions to limit in the duration and volume of sound for their children.

Pakistan has tremendous potential to garner cheap electricity from hydro-electric projects but due to destructive politics, dams are not developed. India got 20% of Indus basin water and produced over sixteen thousand mega watts of electricity while Pakistan out of 80% share of water has generated less than five thousand mega watts. New York Times in one of the editorials said that “Pakistani’s worst enemies are Pakistani themselves”.

Light pollution has become another health-hazard. Too much light exposure particularly at night especially blue light that comes from LED and screen has resulted in profound changes in human behavior and created hazards to health. Children are more vulnerable therefore screening time should be limited. Light exposure at night by prolonged night time interferes both with soundness of sleep and its duration i.e. (quality and quantity). Exposure to artificial light has been linked to increased incidence of obesity. It disrupts metabolic functions as a result of disruption of circadian rhythm leading to pre-diabetes and diabetes-mellitus. Recent research links night-time light exposure to high-blood pressure likely through light’s suppressive effect on melatonin hormone and also independent of melatonin. These lead to the increased incidence of coronary heart disease and strokes. Increased incidence of breast carcinoma has been linked to night-time light exposure, resultant of melatonin suppression and disturbance of circadian rhythms. Mental disorders like anxiety, panic attacks, and depression are linked with sleep disturbances.

Plenty of exposure to day-light boosts attention and alertness, improving mood and cognitive functions, strengthens circadian rhythm and helps in sleeping better at night. Exposure to artificial light during daytime is a cause of developing myopic vision while exposure to natural light prevents it. Light pollution at night also disturbs bird’s life rhythm, also.

In conclusion, prevention of pollution of water, air, sound and light are vital measures for the prevention of diseases and the promotion of health. Prevention is not only better than cure- in fact it is the only cure and the real cost-effectives cure. Good nutrition, sleep and exercise are the basic pillars of good health - the basis of natural life-style therapy. In order to achieve these goals, Pakistan should become a democratic social welfare state as envisaged by the founder of the state - follow the pro-peoples policies and not the pro-elite policies.    

"Pollution- hazards and prevention- under Air Pollution. Recent research has shown that pollution of atmosphere with diesel, garbage etc. damages olfactory nerves/pathway resulting in the loss of sense of smell, consequently loss of taste. Patient eats high salt and fatty food, resulting in obesity, hypertension, metabolic syndrome and their complications/ sequelae. These are common in poor communities. London's mayor Sadiq Khan has taken actions to reduce the impurities caused by the use of diesel engines. People exposed to these pollutants also suffer from mental disorders- anxiety, depression and dementia. They also do not smell gas leaks, smoke and other hazards. Clues of clues- we should make cities more green to protect our sense of smell.

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