Environmental Health Science环境卫生学概要环境卫生学概要Department of Environmental Health ScienceSchool of Public Health and Tropical Medicine 环境卫生学系 周宏伟 1医学预防医学导论You cannot select your genome but you can change your environment医学预防医学导论医学预防医学导论什么是环境卫生？什么是环境卫生？n环境卫生是指城市空间环境的卫生。主要包括城市街巷、道路、公共场所、水域等区域的环境整洁，城市垃圾、粪便等生活废弃物收集、清除、运输、中转、处理、处置、综合利用，城市环境卫生设施规划、建设等。 文章来源：（ 淄博市党员干部现代远程教育中心 ）医学预防医学导论一、环境卫生学定义一、环境卫生学定义医学预防医学导论定义1n研研究究自自然然环环境境和和生生活活环环境境与与人人群群健健康康的的关关系系，解解释释环环境境因因素素对对人人群群健健康康影影响响的的发发生生、发发展展规规律律，为为充充分分利利用用环环境境有有益益因因素素和和控控制制环环境境有有害害因因素素提提出出卫卫生生要要求求和和预预防防对对策策，增增进进人人体体健健康康，提高整体人群健康水平的科学。提高整体人群健康水平的科学。n是是预预防防医医学学的的重重要要分分支支学学科科，也也是是环环境境科科学学不不可缺少的重要组成部分。可缺少的重要组成部分。陈学敏，杨克敌陈学敏，杨克敌医学预防医学导论Definition 2nIn its broadest sense, environmental health is the segment of public health that is concerned with assessing, understanding, and controlling the impacts of people on their environment and the impacts of the environment on them.-Moeller D.W. Environmental Health医学预防医学导论二、环境对健康的影响到底有多大？二、环境对健康的影响到底有多大？医学预防医学导论通过健康环境预防疾病通过健康环境预防疾病:对疾病的环境负对疾病的环境负担的估计担的估计 Preventing disease through healthy environments: Towards an estimate of the environmental burden of diseaseWHO 2006医学预防医学导论估计全球疾病负担的估计全球疾病负担的24%24%和全部死亡的和全部死亡的23%23%可归因于环境因素。可归因于环境因素。n最大绝对负担可归因于可改变的环境因素的疾病包最大绝对负担可归因于可改变的环境因素的疾病包括：括：腹泻、下呼吸道感染、腹泻、下呼吸道感染、“其它其它”意外伤害和疟意外伤害和疟疾。疾。n地区差异地区差异q传染病和伤害给发展中地区造成极其沉重的负担传染病和伤害给发展中地区造成极其沉重的负担q在可归因于环境的非传染病的分值上，发达国家与发展中在可归因于环境的非传染病的分值上，发达国家与发展中国家的整体差异不明显国家的整体差异不明显q发达国家，可归因于环境的心血管疾病和癌症负担较大。发达国家，可归因于环境的心血管疾病和癌症负担较大。n儿童儿童承担了过分沉重的环境性健康负担（承担了过分沉重的环境性健康负担（高高4 4倍）倍）。医学预防医学导论三、环境卫生学研究内容医学预防医学导论研究内容研究内容n大气、水体、土壤与健康；n饮水卫生与健康；n住宅以及室内环境与健康；n公共场所卫生；n人居环境与健康；n家用化学物品、个人用品与健康；n环境质量评价和健康危险度评价；n环境卫生监督与卫生管理；n灾害卫生；n全球环境变化与健康。医学预防医学导论环境卫生学课程内容nThe Scope/ Toxicology/ Epidemiology/ The work place/ Air in the home and community/ Food/ Drinking water/ Liquid waste/ Solid waste/ Rodents and insects/ Injury control/ Electromagnetic radiation/ Environmental economics/ Environmental law/ Standards/ Monitoring/ Risk assessment/ Energy/ Disasters/ A global viewMoeller DW Environmental Health医学预防医学导论四、环境卫生学发展简史医学预防医学导论环境卫生学形成（环境卫生学形成（Environmental Hygiene)Environmental Hygiene)n19世纪后形成世纪后形成q德国Max von Penttenkofer (1818-1901)首次提出肠伤寒和霍乱等传染病的流行与空气、水以及食物等生活环境有关；q1865年在德国慕尼黑大学开设卫生学讲座，以空气、水、食物、住宅、土壤等为研究对象，采用物理和化学方法，开展了空气中二氧化碳浓度测定方法的研究，称为实验卫生学(experimental hygiene)。q其后，卫生学的发展进入新阶段，实现了专业分化，产生了环境卫生学等多种专门学科。医学预防医学导论环境卫生学发展环境卫生学发展n近几十年来，环境科学学科蓬勃发展，形成与传统的环境卫生学在研究内容上相互交叉的学科：q环境工程学、环境化学、环境生物学、环境管理学、环境毒理学n环境卫生学的研究内容从强调hygiene逐渐转变为以健康(health)为核心。nEnvironmental Health Scienceq环境科学和公共卫生学（Public Health)的交叉学科。医学预防医学导论发展方向发展方向n加强环境污染对人体健康影响的调查研究。n加强对环境污染物在低剂量、长时间作用下的健康效应研究n加大环境因素与传染病发生和流行关系的研究。n开拓环境卫生研究和环境卫生工作的新领域。n做好突发公共卫生事件应急处理的科学技术和人才储备。医学预防医学导论五、环境卫生学核心概念医学预防医学导论The 5 Core Concepts医学预防医学导论医学预防医学导论A Toxic Word GameToxic means _.Toxic_ is the study of poisons.Toxic_ is a measure of how dangerous a chemical is.poisonous or dangerousologyity医学预防医学导论A Toxicity ScaleToxicity RatingSignal Words on PackageSymbol on Package Highly ToxicDANGER or POISON Moderately ToxicWARNING Slightly ToxicCAUTION Not Toxicnone医学预防医学导论How would you rate these products?Toxicity Rating Highly Toxic Moderately Toxic Slightly Toxic Not Toxic医学预防医学导论And the answers areToxicity RatingHighly ToxicModerately ToxicSlightly ToxicNot Toxic医学预防医学导论医学预防医学导论Exposure （暴露） isThe total amount of a hazard that comes in direct contact with your body.医学预防医学导论The 3 parts of exposureTheSourceof the hazard(bus exhaust)TheEnvironmentalPathway(air)TheContact(inhaled fumes)医学预防医学导论Which route will the hazards take?医学预防医学导论Route #1: Inhalation （呼吸）Inhalation:Breathing. When chemicals enter the body through this route of exposure, they can get stuck in the lungs and/or be taken up into the bloodstream. 医学预防医学导论Route #2: Ingestion （消化道）Ingestion:Swallowing (usually by eating or drinking). When chemicals enter the body through this route of exposure, they can easily be taken up into the bloodstream. 医学预防医学导论Route #3: Dermal Absorption （皮肤）Dermal Absorption:Absorbing a chemical through any part of the skin, including the eyes. When chemicals come in contact with the skin, they can sometimes enter the bloodstream through this route of exposure.医学预防医学导论南方医科大学公共卫生与热带医学学院 环境卫生学系 周宏伟 32barrierArea (m2)Thickness (m)Weight (kg)Daily exposure (kg)Skin 210012-16variableGI tract20010-1273-4Lungs1400.2-0.40.8-0.924医学预防医学导论医学预防医学导论ExposureXXWhat is dose(剂量)?XXXXXX = hazardDoseDose is the amount of a hazard that actually enters your body.XXXXXX医学预防医学导论Dose can depend onDuration of Exposure:How long?Frequency of Exposure: How often?Body Size:How big or small are you?MLSS医学预防医学导论Duration of Exposuremight not have any harmful effects.30 minutes of sun exposure医学预防医学导论Duration of Exposuremight be very harmful indeed!But 4 hours of sun exposure医学预防医学导论The larger the dose, the more extreme the response will be.Dose/Response Relationship(剂量反应关系)1 can of pop in 15 minutes3 cans of pop in 15 minutes医学预防医学导论 不同化学物有不同类型剂量不同化学物有不同类型剂量- -反应关系反应关系饮用水中氟含量和龋齿数、氟斑牙的关系饮用水中氟含量和龋齿数、氟斑牙的关系饮用水中氟含量和龋齿数、氟斑牙的关系饮用水中氟含量和龋齿数、氟斑牙的关系医学预防医学导论三种化合物的剂量反应关系三种化合物的剂量反应关系n有阈值化合物n无阈值化合物n必需微量元素医学预防医学导论医学预防医学导论Individual Susceptibility （个体易感性）Why are these people more likely to be harmed by exposure to a hazard than the man below?医学预防医学导论Individual SusceptibilityPregnant women and their developing babiesElderly people whose defense mechanisms are less efficientInfants and children who are still developingSick people who have weakened immune systems医学预防医学导论Genes & SusceptibilityYour genes can also make you more or less susceptible to harm from an environmental hazard. For example, some people are more likely to get sick when they are exposed to certain kinds of pesticides.医学预防医学导论医学预防医学导论Risks & Benefits （风险效益）What are the risks and benefits when grape growers use pesticides on their crops?医学预防医学导论Risks & BenefitsRISKSBENEFITSNo bugs!Better looking fruit that is more visually appealingBigger crops so farmers can make more profitPeople ingest pesticides with the fruit and get sickPesticides get into dirt and waterAnimals ingest pesticides and get sick医学预防医学导论小节n环境卫生学定义nWHO 2006报告n环境卫生学研究内容n环境卫生学发展n环境卫生学5大核心概念医学预防医学导论What are the risks & benefits?1 12 23 3医学预防医学导论Thank you50医学预防医学导论