Air and Water Pollution: Burden and Strategies for Control

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Environmental pollution has many facets, and the resultant
health risks include diseases in almost all organ systems. Thus,
a chapter on air and water pollution control links with chapters
on, for instance, diarrheal diseases (chapter 19), respiratory
diseases in children and adults (chapters 25 and 35), cancers
(chapter 29), neurological disorders (chapter 32), and cardiovascular disease (chapter 33), as well as with a number of chapters dealing with health care issues.
NATURE, CAUSES, AND BURDEN OF AIR
AND WATER POLLUTION
Each pollutant has its own health risk profile, which makes
summarizing all relevant information into a short chapter difficult. Nevertheless, public health practitioners and decision
makers in developing countries need to be aware of the potential health risks caused by air and water pollution and to know
where to find the more detailed information required to handle
a specific situation. This chapter will not repeat the discussion
about indoor air pollution caused by biomass burning
(chapter 42) and water pollution caused by poor sanitation at
the household level (chapter 41), but it will focus on the problems caused by air and water pollution at the community,
country, and global levels.
Estimates indicate that the proportion of the global burden
of disease associated with environmental pollution hazards
ranges from 23 percent (WHO 1997) to 30 percent (Smith,
Corvalan, and Kjellstrom 1999). These estimates include
infectious diseases related to drinking water, sanitation, and
food hygiene; respiratory diseases related to severe indoor air
pollution from biomass burning; and vectorborne diseases
with a major environmental component, such as malaria.
These three types of diseases each contribute approximately
6 percent to the updated estimate of the global burden of disease (WHO 2002).
As the World Health Organization (WHO) points out, outdoor air pollution contributes as much as 0.6 to 1.4 percent of
the burden of disease in developing regions, and other pollution, such as lead in water, air, and soil, may contribute 0.9 percent (WHO 2002). These numbers may look small, but the
contribution from most risk factors other than the “top 10” is
within the 0.5 to 1.0 percent range (WHO 2002).
Because of space limitations, this chapter can give only
selected examples of air and water pollution health concerns.
Other information sources on environmental health include
Yassi and others (2001) and the Web sites of or major reference
works by WHO, the United Nations Environment Programme
(UNEP), Division of Technology, Industry, and Economics
(http://www.uneptie.org/); the International Labour Organization (ILO), the United Nations Industrial Development
Organization (UNIDO; http://www.unido.org/), and other relevant agencies.
Table 43.1 indicates some of the industrial sectors that can
pose significant environmental and occupational health risks
to populations in developing countries. Clearly, disease control
measures for people working in or living around a smelter may
be quite different from those for people living near a tannery or
a brewery. For detailed information about industry-specific
Chapter 43
Air and Water Pollution: Burden
and Strategies for Control
Tord Kjellstrom, Madhumita Lodh, Tony McMichael, Geetha
Ranmuthugala, Rupendra Shrestha, and Sally Kingsland