Essentials of Environmental

Health

Titiek Berniyanti
 Kesehatan Lingkungan merujuk pada
kharakteristik kondisi lingkungan yang dapat
mengganggu kesehatan, terutama aspek :
 Gaya hidup
Miras, rokok, narkoba, makanan
berlemak, dsb.
 Bahan toksik
mikroorganisme patogen, logam
berat, B3 dsb.
 Bahaya fisik
kebisingan, sinar ultra-violet,
debu di udara
 Keadaan lainnya
kondisi tropis, adat kebiasaan yang tidak
sejalan dengan konsep kesehatan, dll.
 Status kesehatan merupakan refleksi dari hasil
akhir interaksi kompleks antara sistem biologis
internal dan sistem lingkungan eksternal secara
keseluruhan;
 Sistem penyangga kehidupan menyediakan
kebutuhan dasaraktivitas manusia;
 Akibat aktivitas manusia (industri, pertanian,
transportasi, pemukiman, dsb) menghasilkan
limbah dan residu;
 Limbah dan residu selanjutnya mempengaruhi
sistem penyangga kehidupan dan juga kesehatan
manusia.
 Sistem Residu
Penyangga dan
Kehidupan Limbah

Aktivitas
Manusia

Bahaya
Lingkungan
 Aktivitas manusia
Terutama pembangunan industri, transportasi
dan pemukiman menghasilkan limbah yang
menurunkan kualitas lingkungan

 Aktivitas Alam
Letusan gunung berapi, banjir, badai, gempa
bumi merubah kualitas air, udara, tanah,
makanan, vektor atau manusia sendiri

 Komponen lingkungan bertindak sebagai

media atau perantara terjadinya penyakit di
masyarakat
 Upaya Kesehatan Lingkungan

Sumber Komponen
Masyarakat
Perubahan Lingkungan Efek
Sasaran
Primer Air
Aktivitas Udara Sehat
Umur
manusia Tanah atau
Kelamin
atau Makanan Sakit
Lokasi
alamiah Vektor

Sumber Perubahan
Sekunder

Model hubungan interaksi komponen lingkungan

dengan manusia
 ASPEK ASPEK KESEHATAN
LINGKUNGAN
1. Epidemiologi lingkungan
2. Toksikologi lingkungan
3. Engeniering Lingkungan
4. Kedokteran Pencegahan
5. Hukum
Aspects of Environmental Health
Environmental epidemiology
Hubungan antara paparan suatu agen
lingkungan dengan urutan
perkembangan suatu penyakit
(Associations between exposure to
environmental agents and subsequent
development of disease)
 Agent/Faktor penyebab Host(person)
Biological, chemical, physical Age, race, sex, habit Genetic,
Mechanical, Nutrient personality Defense
mechanism

Environment: Perilaku, Budaya, Faktor fisiologis,

Unsur Ekologi, Biological, chemical, physical
Mechanical, nutrient, social, psychologic
 Environmental toxicology

− Mekanisme sebab akibat antara

paparan dan urutan perkembangan
suatu penyakit (Causal mechanisms
between exposure and subsequent
development of disease)
 Environmental toxicology
SEMUA ZAT BERACUN ATAUPUN
METABOLITNYA AKAN KEMBALI MEMASUKI
LINGKUNGAN, SHG KUALITAS LINGKUNGAN
AKAN BERTAMBAH BURUK DENGAN
TERDAPATNYA BERBAGAI RACUN.

ILMU YANG MEMPELAJARI SECARA

KUALITATIF DAN KUANTITATIF PENGARUH
JELEK DARI BAHAN KIMIAWI, FISIS, DAN
BIOLOGIS THD SIS TEM BIOLOGIS
Environmental toxicology focuses on effects
of chemical poisons released into the
environment.
Toxicology :The study of poisonous
substances and their effects on humans and
other organisms
Toxicologists assess and compare toxic
agents, or toxicants, for their toxicity, the
degree of harm a substance can inflict.
Environmental engineering

Faktor faktor yang mengatur dan

mengurangi paparan

Factors that govern and reduce

Exposure
Program
Environmental Engineering mendukung
riset riset engineering supports innovative
science-based engineering research and
education with the goals of:
 restoring and maintaining the chemical,
physical, and biological quality of the Nation’s
water, air and land environment
 preventing human exposure to toxic chemicals
and pathogenic bacteria
 achieving sustainable development of natural
resources.
Environmental engineers study the
effect of technological advances on the
environment. To do so, they conduct
hazardous-waste management studies
to evaluate the significance of such
hazards, advise on treatment and
containment, and develop regulations
to prevent mishaps.
Environmental engineers also
design municipal water
supply and industrial wastewater
treatmentsystems[1][2] as well as address
local and worldwide environmental issues
such as the effects of acid rain, global
warming, ozone depletion, water pollution
and air pollution from automobile
exhausts and industrial sources
is the integration
of science and engineering principles
to improve the natural environment (air, water,
and/or land resources),
to provide healthy water, air, and land for human
habitation (house or home) and for other organisms,
and
to remediate pollution sites.
Preventive medicine
- Factors that govern and reduce
disease development
Law
−Development of appropriate
Legislation to protect Public health
4 Lines Defence Against
Diseases
FIRST LINE OF DEFENCE AGAINST DISEASE:
ENVIRONMENTAL MANAGEMENT
 Water quality management
 Human waste disposal
 Solid and hazardous waste
management
 Vector control
 Milk sanitation
 Food quality management
 Occupation health practice
 Interstate and international travel
sanitation
 Air pollution control
 Water pollution control
 Environmental safety and accident
prevention
 Noise pollution
 Housing hygiene
 Radiological health control
 Recreational sanitation
 Institutional environmental
management
 Land use management
 Product safety and consumer
protection
 Environmental planning
 SECOND LINE OF DEFENSE AGAINST DISEASE:
PUBLIC HEALTH AND PREVENTIVE MEDICINE
 Proper nutrition
 Good person hygiene practices
 The body’s reflexes, chemicals and
barriers
 Routine medical and dental check-ups
 Application of health education
strategies
◦ Information
◦ Education
◦ Advocacy
◦ Alternatives
◦ legislation
 THIRD LINE OF DEFENSE AGAINST DISEASE:
PUBLIC HEALTH AND PREVENTATIVE
MEDICINE
 Phagocytosis-is the primary cellular
defense against pathogens
◦ Invasion of host cells
◦ Inflammation response
 Reddening of affected area
 Capillary dilation
 Leakage of plasma and blood components
 Increase in body temperature
 Pain
 Destruction of pathogen
 Creation of memory cells
 Increased response time and efficacy during
next pathogenic attack
 Immunity
◦ Cellular response to an antigen
◦ Two types based on mode of acquisition
 Active
 Antibodies generated from the host
own body as a result of foreign antigen
stimulation
 Passive
 Antibodies generated from another
host body and transferred to the
intended host body
 FOURTH LINE OF DEFENSE AGAINST DISEASE:
CURATIVE MEDICINE
 Surgical procedures

 Drug therapy

 Radiation therapy

 Laboratory confirmation and diagnosis

 Corrective therapy
 Health is defined as the complete physical,
mental and social wellbeing and not just the
absence of disease
 The determinants of health are genetic,
medical care, lifestyle and environment
 The causative agents of disease are physical,
chemical and biological
 Environmental health is concerned with
controlling these causative agents and
safeguarding the public’s health and
wellbeing
 Lorenz, N. Davis, D.L. 1981. Nostrand
ReinholdStrategies for Public Health:
Promoting Health and Preventing Disease.
New York: Van
 Morgan, M.T. 2003. Environmental Health.
California: Thomson Learning.
PARADIGMA KESEHATAN LINGKUNGAN
MANAJEMEN
WAHANA MASYARAKAT/KEPEN
SUMBER TRANSISI PENYAKIT DUDUKAN
PENYAKIT
• UDARA
‐ALAMIAH • SEX SEHAT
• AIR
‐MAN MADE • TANAH • BUDAYA
•MAKANAN • PERILAKU
• MANUSIA •GIZI SAKIT
• BINATANG • Hb

AGEN PENYAKIT
● FISIKA
• KIMIA
• BIOLOGI
SIMPUL 1 SIMPUL 3 SIMPUL 4
SIMPUL 2

VARIABEL BERPENGARUH LAINNYA

 􀂃 Sumber penyakit adalah titik yang secara
konstan mengeluarkan atau meng ”emisikan”
agents penyakit.
􀂃 Agents penyakit adalah komponen
lingkungan yang dapat menimbulkan
gangguan penyakit melalui kontak secara
langsung atau melalui media perantara (yang
juga komponen lingkungan).
 􀂃 Udara
􀂃 Air
􀂃 Tanah/Pangan
􀂃 Binatang/serangga
􀂃 Manusia/langsung
Media transmisi tidak akan memiliki potensi
penyakit kalau didalamnya tidak mengandung
bibit penyakit atau agent penyakit.
 􀂃 Perilaku pemajanan adalah jumlah kontak
antara manusia dengan komponen lingkungan
yang mengandung potensi bahaya penyakit
􀂃 Agent penyakit dengan atau tanpa
menumpang komponen lingkungan lain,
masuk kedalam tubuh melalui satu proses
yang kita kenal sebagai proses ”hubungan
interaktif”
”
 􀂃 Hubungan interaktif antara
komponen
lingkungan dengan penduduk berikut
perilakunya, dapat diukur dalam konsep
yang
disebut sebagai perilaku pemajanan atau
“behavioural exposure”
 interaktif antara penduduk dengan
lingkungan yang memiliki potensi bahaya
gangguan kesehatan.
􀂃 Bisa kelainan bentuk, kelainan fungsi,
kelainan genetik, sebagai hasil interaksi
dengan lingkungan, baik lingkungan fisik
maupun sosial.
 Environment
(Physical, biological and psychosocial)

Human activities health of individual