ENVIRONMENTAL HEALTH – HYGIENE Edited by ĽUDmila ŠevčÍKovÁ First edition Comenius University in Bratislava Slovakia 2015 HEALTHHEALTH PROMOTION PROMOTION ANDAND HEALTHHEALTH COMMUNICATION COMMUNICATION EditedEdited by by VOJTECVOJTECH OZOROVSKÝH OZOROVSKÝ FirstFirst edition edition ComeniusComenius University University in Bratislava, in Bratislava, Slovakia Slovakia 2015 2015 ModernéModerné vzdelávanie vzdelávanie pre vedomostnú prepre vedomostnúvedomostnú spoločnosť/Projekt spoločnosť/Projekt spoločnosť/Projekt je spolufinancovaný je je spolufinancovaný spolufinancovaný zo zdrojov zo zo zdrojov zdrojov EÚ EÚ EÚ ŠEVčÍKOVÁ, Ľ. (ED.) ENVIRONMENTAL HEALTH - HYGIENE First edition Comenius University in Bratislava, Slovakia, 2015, 253 pages. © Prof. Ľudmila Ševčíková, MD, PhD Assoc. Prof. Ľubica Argalášová, MD, PhD, MPH Prof. Vladimír Bencko, MD, DSc Shelby Davies Assoc. Prof. Jana Jurkovičová, MD, PhD Prof. Cyril Klement, MD, PhD Helena Rapantová, MD, PhD Prof. Michael Weitzman, MD 2015 Reviewers Prof. Vladimír Bencko, MD, DSc Assoc. Prof. Eleonóra Fabiánová, MD, PhD Assoc. Prof. Kvetoslava Rimárová, MD, PhD Proofreading Ing. Janka Bábelová, PhD. Ing. Anna Cibulková ISBN 978-80-223-3930-8 Printed by KO& KA in Bratislava This textbook was prepared and published within the project “MPH curriculum development at Comenius University in Bratislava in English language”, ITMS code: 26140230009, funded by European Social Fund -Operational Programme Education (ESF – OPV). Recipient of the ESF: Comenius University in Bratislava, Faculty of Medi- cine. Head of the project: Prof. Ľudmila Ševčíková, MD, PhD This textbook is from the series of textbooks listed below. The aim of the textbooks, funded by ESF-OPE, is to provide students of the study program Master of Public Health (MPH) at Comenius University in Bratislava with information and knowledge of public health issues. Biology and Genetics for Public Health, Pharmacology in Public Health Basics of Clinical Microbiology and Immunology for MPH Students Occupational Health, Toxicology Nutrition and Food Safety in Public Health Epidemiology for Study of Public Health Vol.1. Epidemiology for Study of Public Health Vol.2. Introductory Biostatistics Social Medicine Health Promotion and Health Communication Public Health Ethics – Selected Issues An Introduction to Public Health Law Healthcare Management Information Technologies in Medicine, Medical Information Systems and eHealth Management of Information Systems Projects in Transition to Knowledge Management Authors Prof. Ľudmila Ševčíková, MD, PhD Institute of Hygiene, Faculty of Medicine, Comenius University in Bratislava Assoc. Prof. Ľubica Argalášová, MD, PhD, MPH Institute of Hygiene, Faculty of Medicine, Comenius University in Bratislava Prof. Vladimír Bencko, MD, DSc Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University in Prague Shelby Davies Departments of Pediatrics and Environmental Medicine, New York University Langone Medical Center Assoc. Prof. Jana Jurkovičová, MD, PhD Institute of Hygiene, Faculty of Medicine, Comenius University in Bratislava Prof. Cyril Klement, MD, PhD Regional Authority of Public Health, Banska Bystrica Helena Rapantová, MD, PhD Institute of Hygiene, Faculty of Medicine, Comenius University in Bratislava Prof. Michael Weitzman, MD Departments of Pediatrics and Environmental Medicine, New York University Langone Medical Center Contents Preface . 11 1 Environmental Health / Hygiene Basic terminology (Ľudmila Ševčíková) . 12 1.1 EnviroNmental health - inTroduction . 12 1.2 DISEASES prevention and health promotion. 16 1.2.1 Diseases prevention . 17 1.2.2 Health promotion interventions . 18 1.3 GLOBAL health priorities . 21 1.4 The Millennium Development Goals . 22 2 BASIC ENVIRONMENTAL HEALTH FACTORS (Ľubica Argalášová) . 25 2.1 TYPES AND SOURCES OF ENVIRONMENTAL HAZARDS . 25 2.2 AIR . 26 2.2.1 Chemical properties of the air . 26 2.2.2 Physical properties of the air . 28 2.2.3 Biological properties of the air. 29 2.2.4 Air pollution . 29 2.2.4.1 Traditional air pollutants . 30 2.2.4.2 Polycyclic aromatic hydrocarbons (PAHs) . 36 2.2.4.3 Volatile organic compounds (VOC) and other chemicals . 36 2.2.4.4 Indoor air pollutants and health effects . 38 2.2.4.5 Global atmospheric issues. 38 2.2.4.6 Control of air pollution . 39 2. 3 ENVIRONMENTAL NOISE . 40 2.4 WATER. 46 2.4.1 Water sources . 46 2.4.2 Water pollution . 49 2.4.2.1 Communicable diseases associated with water . 49 2.4.2.2 Chemical and radioactive constituents of water supplies . 51 2.4.3 Drinking water quality guidelines, criteria and standards . 58 2.4.4 Bottled drinking water. 61 2.4.5 Water supplies . 62 2.4.6 Hygienic protection of water sources . 62 2.4.6.1 Underground water sources. 63 2.4.6.2 Surface water sources . 64 2.4.7 Water conditioning. 64 2.4.8 Waste waters and health hazards . 65 2.4.9 Bathing, recreational water . 66 5 2.4.9.1 Coastal and fresh waters . 66 2.4.9.2 Swimming pools, spas, and similar recreational water environments . 67 2.5 SOIL . 68 2.5.1 Soil pollution . 69 2.5.1.1 Soil pollution by biological agents . 69 2.5.1.2 Contamination of the soil by toxic chemicals . 70 2.5.1.3 Assessment and control of soil pollution . 71 2.6 SOLID WASTES . 71 2.6.1 Health effects of solid wastes . 73 2.6.2 Hazardous wastes . 73 2.6.3 Waste management . 74 3 RADIATION AND HEALTH HAZARDS (Ľubica Argalášová) . 79 3.1 IONIZING RADIATION . 79 3.1.1 Basic terminology and definitions . 79 3.1.2 Radiation sources and levels . 83 3.2 BIOLOGICAL EFFECTS OF IONIZING RADIATION . 84 3.2.1 Acute radiation syndrome . 85 3.2.2 Chronic deterministic effects . 86 3.2.3 Health effects other than cancer . 86 3.2.4 Cancer . 87 3.3 EXAMPLES OF RADIATION EXPOSURE . 87 3.4 HEALTH PROTECTION OF CITIZENS FROM ACCIDENTAL RELEASE OF RADIOACTIVE SUBSTANCES. 89 3.5 SYSTEM OF RADIOLOGICAL PROTECTION . 92 3.5.1 Dose limits . 93 3.5.2 Radiation to occupationally exposed persons . 94 3.5.3 Radiation to patients from medical uses of radiation . 94 3.6 MONITORING REQUIREMENTS AT NORMAL RADIATION LOAD AND AT RADIATION THREAT. 96 3.7 RADIOACTIVE WASTES . 97 3.8 TRANSPORT OF RADIOACTIVE MATERIALS . 97 3.9 RADON . 98 3.9.1 Physical and chemical properties . 98 3.9.2 Exposure and distribution . 99 3.9.3 Health effects . 100 3.9.4 Protection and prevention . 101 4 CHILDREN’S AND YOUTH’S HEALTH PROMOTION AND PROTECTION (Ľudmila Ševčíková) . 104 4.1 Physical and psychical development of children and youth and primary prevention . 105 4.2 CHILDREN’S AND YOUTH HEALTH AND ENVIRONMENT (Ľudmila Ševčíková) . 112 4.2.1 Children’s Environmental Health Indicators . 113 4.2.2 Health hazards and strategies to improve health in adolescents . 118 6 4.3 IMPORTANT ENVIRONMENTAL RISK FACTORS IN CHILDREN AND ADOLESCENTS IN PREVENTIVE PEDIATRIC HEALTH CARE (Michael Weitzman and Shelby Davies) . 121 4.3.1 Recommendations for preventive pediatric health care . 121 4.3.2 Two most ubiquitous and dangerous toxic exposures of children in the home - smoke and lead exposure . 123 4.3.3.1 Second and thirdhand smoke exposure in children and adolescents . 123 4.3.3.2 Lead exposure in children and adolescents. 124 4.4 Hygienic requirements on the organization and equipment of child’s collective facilities (Ľudmila Ševčíková) . 129 4.4.1 Day nursery, kindergarten – nursery school . 129 4.4.2 Prevention of communicable diseases in children facilities . 130 4.5 Hygienic requirements on educational process in children and adolescents (Ľudmila Ševčíková) . 132 4.5.1 Requirements for the organization of the educational process . 135 4.5.2 The healthy school . 137 5 Hospital hygiene (Ľubica Argalášová) . 141 5.1 Risk factors in hospitals and protection of health . 141 5.1.1 Problems of infectious diseases . 141 5.1.2 Effects of ionizing radiation and other types of radiation . 146 5.1.3 Unfavorable effect of chemical substances . 146 5.1.4 Psychosocial problems . 147 5.1.5 Issues on occupational physical load . 148 5.1.6 The risk of an accident and a menace to personal safety . 149 5.2 REQUIREMENTS ON HEALTH CARE FACILITIES . 149 5.3 HEALTH CARE WASTES . 151 5.4 OUTPATIENT DEPARTMENTS . 152 5.5 DEPARTMENTS OF STOMATOLOGY. 152 6 HOUSING AND HEALTH (Ľubica Argalášová) . 154 6.1 DEFINITIONS . 154 6.2 THE PROCESS OF Urbanization AND THE RISK OF HEALTH . 155 6.3 HOUSING, HEALTH, RISK FACTORS . 156 6.3.1 Physical and chemical hazards. 157 6.3.2 Biological hazards . 159 6.3.3 Psychosocial and socioeconomic conditions and mental health . 160 6.3.4 Sick building syndrome and building-related illness . 161 6.4 SPECIAL HOUSING NEEDS. 161 6.5 HEALTHY COMMUNITIES AND HEALTHY CITIES . 162 7 CHRONIC NON-COMMUNICABLE DISEASES PREVENTION (Jana Jurkovičová) . 164 7.1 CARDIOVASCULAR DISEASES PREVENTION . 164 7.1.1 Cardiovascular diseases risk factors . 168 7.1.2 Nutrition in cardiovascular prevention . 173 7 7.1.2.1 Dietary pattern in cardiovascular prevention . 174 7.2 CANCER PREVENTION . 175 7.2.1 Cancer risk factors. 177 7.2.2 The most frequent types of cancers . 179 7.2.3 General recommendations in cancer prevention . 181 7.3 diabetes and diabetic COmplicatiOns preVentiON . 181 7.4 osteoporosis prevention . ..