ENVIRONMENT Community Health Nursing


“The surroundings or conditions in which a person, animal, or plant lives or operates.”




    Environmental health addresses all the physical, chemical, and biological factors external to a person, and all the related factors impacting behaviors. It encompass the assessment and control of those environmental factors that can potentially affect health. It is targeted towards preventing disease and creating health-supportive environments.

  • Air, water, soil, housing, climate, geography, heat, light, noise, debris, radiation, etc.


  • Man, viruses, microbial agents, insects, rodents, animals and plants, etc.


  • Cultural values, customs, beliefs, habits, attitudes, morals, religion, education, lifestyles, community life, health services, social and political organization.



  • “Disease is defined as a condition in which body health is impaired.”
  • OR
  • “Disease result from complex interaction between man, and agent and the environment. From ecological point of view disease is defined as “Maladjustment of the
  • human organism to the environment”.


  • Environment
  • (Physical, biological and psychosocial)
  • Human activities 
  •                       h
  • Health of individual



  • Why we need environmental health
  • To create and maintain ecological conditions that will promote health and prevent disease.
  • One of the important public health care element is safe drinking water and sanitation.
  • More than billion of people in developing countries lacked access to safe drinking water and adequate system for disposing of their excreta.
  • Faeces deposited near homes, contaminated drinking water, fish from polluted rivers and agriculture produce fertilizer with human waste are all health hazards.
  • Water quantity is as important as water quality.



  • Lack of water supply and sanitation risk for diarrhea, intestinal worm infestation, schistosomiasis ,skin and eye infections .
  • Achievement of health for all is concerned with healthy environment.
  • Much of the ill health in Pakistan is due to poor environmental sanitation, that is unsafe water, polluted soil, unhygienic disposal of human excreta and refuse, poor housing, and rodents.
  • Air pollution is also is a growing concern in many cities.
  • High mortality, morbidity and poor standards of health care are largely due to defective environmental sanitation.
  • Good environmental health is vital for the prevention of disease and promotion of health.  


  • The  “  IPREPARE  ”  Model
    Environmental Health Assessment
  • Environmental hazards may be:
  •  Biological
  •  Chemical
  •  Physical
  •  Psychological
  •  Sociological, Or
  • Site And Location Hazards.
  • “These are living organisms or their products that are harmful to humans”
  • A. Water-borne diseases are diseases that are transmitted in drinking water. Examples are:
  • polio virus, hepatitis A virus, Salmonella, Shigella, cholera, amoebic dysentery and Giardia.
  • These disease organisms are shed into the water in feces, and can produce illness in those who consume untreated, contaminated water.
  • Our municipal water treatment facilities are usually able to purify water by removing these agents or killing them by disinfecting the water.

  • B. Food-borne diseases
             “are diseases transmitted in or on food”

  • 1. Examples of food-borne agents are the bacteria Salmonella, , Escherichia coli, as well as other agents.

  • 2. To protect against food-borne diseases, sanitarians from         local health departments routinely inspect food service establishments (restaurants) and to verify that food is being stored and handled properly.

  • C. Vector-borne diseases
  • “are those transmitted by insects or other arthropods”
    1. Examples are Malaria , Dengue , Plague , etc.
    2. Improper environmental management can cause vector-borne disease outbreaks.
  • II. Chemical hazards
  • “result from mismanagement or misuse of chemicals resulting in an unacceptable risk to human health”
  • A. Pesticides are chemicals
  • that have been manufactured for the purpose of reducing populations of undesirable organisms (pests)
  • 1. Examples of categories of pesticides are herbicides and insecticides.
    2. Most pesticides kill non-target organisms as well as the target, or pest species.
    3. The wise use of pesticides can protect human health and agricultural crops.
  • 4. Misuse of pesticides can result in illness and death.
    5. Some of the pesticides developed earlier in the 20th Century, such as DDT, were persistent, that is they remained in the environment for months or years after their initial use.



  • B. Environmental tobacco smoke (ETS)


  • “is an environmental hazard produced by millions that smoke”
  • 1. Diseases associated with ETS include lung cancer and perhaps heart disease.
    2. ETS contains 4, 000 substances.
    3. ETS  classified as a Class A carcinogen.
    4. Smoking has been increasingly restricted from public buildings and from many private work sites.
  • C. Led
  • “is a naturally occurring element that is used  in the manufacturing of many industrial and domestic products”
  • 1-Health problems associated with the over exposure to led are anemia, birth defects, bone damage, neurological damage, kidney damage etc.
    2. Exposure is by ingestion and inhalation.
    3. Children are particularly at risk from eating  peeling led paint.
     5. Occupational exposure is a major source of led intake for adults.
  • 2-Solutions for the prevention of led poisoning include education, regulation, and prudent behavior.

  • II. Physical hazards
  • “Include airborne particles, humidity, equipment design and radiation”
  • Radon contamination
  •  results from over exposure to radon gas.
  • 1.Radon gas arises naturally from the earth and sometimes occurs at dangerous levels in buildings and homes.


  • 2.Breathing in radon gas can cause lung cancer.


  • 3.Homes can be tested for the presence of radon gas.

 Ultraviolet radiation reaches humans as short wave length energy that can damage cells by ionization.
1. One result of over exposure to UV radiation is skin cancer.

2. People should reduce their exposure to UV radiation.

     a. Stay inside

     b. Wear protective clothes or sunscreen

III.Psychological hazards
are environmental factors that produce psychological changes expressed as stress, depression, hysteria.



  • IV. Sociological hazards


  • Are those that result from living in a society where one experiences noise, lack of privacy and overcrowding.
  • Population growth may be a sociological hazard.
  • V. Site and Location Hazards
     Natural disasters are geographical events of such magnitude to communities that they produce significant damage and injuries.

    1. Examples are cyclones, earthquakes, floods, hurricane, tornado, typhoon, and volcanic eruptions.
    2. The magnitude of devastation of these events can sometimes be great.
    3. Biological, psychological and sociological hazards may increase following a natural disaster

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