The environments in which we live and work are not always the benign and supportive settings we often believe them to be. Some are to varying degrees pathological and threatening to our health. Ironically most people remain more concerned about the epidemic of lifestyle diseases or a possible pandemic of influenza, than they do about the links between environmental exposures and human health.
The recently released WHO report - Preventing Disease through Healthy Environments: Towards an Estimate of the Environmental Burden of Disease, confirms what many of us have known for some time, that the environment plays a major role in our health and is a major provocateur of death and disease.
According to this report, almost one-quarter of all global disease and 23 per cent of all deaths are caused by preventable environmental exposures, as is 33 per cent of disease in children under five: and the environment in one way or another significantly affects more than 80 per cent of diseases, such as heart disease, diarrhoeal diseases, lower respiratory infections, chronic pulmonary disease, cancer, road traffic accidents and unintentional accidents.
These environments include physical, biologic, chemical and built hazards that directly affect our health. The report states that approximately 13 million deaths are due to preventable environmental factors, and most significantly almost one-third of all deaths in developing countries fall into this category.
If we add infections like HIV-AIDs, the death toll probably creeps closer to 20 million. In the case of diarrhoeal diseases, responsible for almost two million deaths annually in the world, an estimated 94 per cent of such deaths are due to preventable environmental causes, such as unsafe water sources and unsanitary and unhygienic living conditions.
But what about Australia: what role does the environment play in our health today?
Well in the first instance, the health of Indigenous Australians more resembles the developing world than contemporary Australia. For many communities, living and working conditions remain impoverished, damp, cold, stressful and hazardous to health. Life expectancy remains at least 20 years lower than that of the total population; age-standardised death rates are between 2-4 times higher; and environmentally triggered diseases rank as important producers of death and disease. In some cases, infections such as trachoma, which disappeared from the non-Indigenous population over 100 years ago, remain entrenched among remote communities.
For all Australians, the workplace environment remains in many cases extremely hazardous to our health. There are probably about 2,900 deaths as a result of injuries or diseases acquired in the workplace every year in Australia, 85 per cent of which result from occupationally acquired diseases. More than 650,000 Australians suffer non-fatal workplace-related injuries or illnesses, and “blue collar” workers, such as labourers, drivers, plant and machine operators, probably account for about three quarters of all these cases even though they only comprise about one third of Australia’s workforce.
There are now far more deaths in the workplace than there are on Australian roads. Clearly the workplace environment needs to be accorded much higher social and political priority.
And our hospitals aren’t much safer. Hospital acquired infections are becoming a growth industry. Probably one out of every ten Australians entering hospital for a surgical procedure will leave with a hospital acquired infection. Possibly there are as many as 10,000 deaths every year from this source.
What an irony that in these days of high technology and high quality medical care, that our hospitals often belie their real purpose and cause ill health and death.
The homes we live in also contribute to our health. Asthma in particular is intimately linked to the indoor environment, in that the disease can be exacerbated by the way we heat and carpet our homes, and dry our clothes, the propensity for our homes to be damp and closed up during the day often supporting a variety of moulds and fungi, and our close association with domestic pets, all contribute to Australians having one of the highest asthma rates in the world.
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