WHY IS ENVIRONMENTAL HEALTH, THE MOTHER OF ALL PROFESSIONS?

WHY IS ENVIRONMENTAL HEALTH, THE MOTHER OF ALL PROFESSIONS?

ENVIRONMENTAL HEALTH comprises of the *Environment and Health*, which simply implies *the Healthiness of the Environment*.

What does the Environment entailed?
The Environment is the sum total of Biotic(living) and Abiotic(non living) factors.

A Doctor cares for the unhealthy people,
A Lawyer defends people right,
An Accountant is in charge of people money,
An Engineer is to repair or maintain machineries/construction,

While

*An Environmental Health Officer is saddled with the promotion and maintenance of the highest degree of physical, mental and social well being of a Doctor, Lawyer, Nurse, Engineer, Accountant, Surveyor, Carpenter, President, Senators, Honourables, and the whole population via the detection and abatement of public health nuisances/hazards that has the potential of deteriorating the state of health of all, including the immediate environment.

HISTORY OF ENVIRONMENTAL HEALTH PROFESSION

The history of and the development of Environmental Health are unique and complex in every country of the world. It is not possible to assign a specific date from which problems relating to environment started. However, the need to control the environment in the interest of public health has been evolving for a long time. For convenience,it has been possible to divide the evolution of environmental health control into four time zone in which time can be assigned.

First, the agricultural revolution following Malthus observation (1750-1850). The period was characterized by low living standard among the farmers who lived in overcrowded damped houses, bearing large number of children, and eating poor diet. There was also marked increase in the number and incidences of diseases and deaths, poor domestic environment and low life expectancy.

Second is the industrial revolution of 1850-1900, which witnessed the beginning of industrial pollution as a result of using rudimentary machines and unprocessed toxic substances for industrial processes.

The third is the period between 1900 and 1945, while the fourth is 1945 to the present date.

The initial phases of sanitary activities centered on keeping human excreta out of food. Indeed, about 10,000 BC, nomadic hunters simply left their wastes and move to another location. Today, the field covers an imposing spectrum of activities of high technical and scientific dimension. The trend has been to draw away from activities, which involve repair, correction and enforcement toward programmes that are proactive and promotive in nature. Until recently, public health activities have been based upon negative concept, resulting in programmes designed to attack things that have gone wrong like isolating infected person, filling decayed tooth or purifying polluted water. Now, environmental health principles are focused on maintenance of cleanliness, promoting hygiene practices and prevention of ill health.

*Environmental health programme (EHP) being perfected today started during the industrial revolution of the 18th and 19th centuries following the mass migration of people from rural areas to the cities in search of jobs. Living conditions then became poor and outbreak of several communicable diseases with high morbidity and mortality became rampant. In 1842, Edwin Chadwick of Great Britain, a Lawyer by profession spearheaded the Poor Law Commission, which enquired into the sanitary condition of the labouring classes. The report of the Commission recognized the association between the general environment of the dreadful living conditions of the poor and the development of illness. This led to the enactment of the 1848 Public Health Act, which was borne out of the desire to control these environmental conditions and abate them. !!!!!!!!!!!!!!*

In Nigeria, the development of environmental health has had a more challenging history. As far back as the 18th century the Colonial government took the issue of preventive health services serious because of the need to prevent the breeding of mosquitoes, which was a major killer of the colonial settlers. They introduced the then Sanitary Inspectors to the Colony of Lagos. The position of the Sanitary Officer was a very top position in the then Colonial government. That was why the Senior Municipal Sanitary Officer was statutorily made a member of the Legislative Council in 1913 on the amalgamation of both the Southern and Northern Protectorates of Nigeria, (Akinyede, 1957).

*The present day environmental health services in Nigeria started in 1920s, when Dr. Isaac Ladipo Oluwole came back from Britain as a Public Health Physician. He was the first African Medical Officer of Health (MOH) in the Lagos Colony, who also pioneered the establishment of School Health Services using the then Sanitary Attendants. His focus then was on inspection of schools and vaccination of school children in their school. He also started the first Nigerian School of Hygiene at Yaba, Lagos in 1920 (now School of Health Technology), where qualified persons from all over Nigeria were trained as Sanitary Inspectors. At the end of their training, they obtained the Diploma of the Royal Institute of Health (R.I.H) London, which was later changed to Royal Society of Health (R.S.H) Diploma, London. The work of Sanitary Inspectors was greatly noticed during the outbreak of bubonic plagues in 1924, when Dr. Oluwole revitalized Port Health Services and Sanitary Inspection of Ships and Port premises.*

Their impact was much felt during the control of yaws of 1930 and small pox of 1970s. Since then the development of environmental health in Nigeria has continued to increase in terms of the number of practitioners trained and number of schools training the practitioners.

To a greater extent, the development of environmental health in Nigeria has been retarded due to the dominant influence of the medical profession, which assumed superiority and erroneously annexed every thing health into medical practice. Again unlike in other countries where people other that physicians initiated some environmental health control; in Nigeria, environmental health services was initiated by a physician.

This strange marriage existed for so long that it was nearly impossible to established or convince any one that environmental health was a profession. Whereas WHO has recognized environmental health as a profession, it was totally impossible to say so among policy makers in the health sector in Nigeria.

The development of environmental health profession started in Britain in 1877, when the Royal Sanitary Institute was established. Even in Britain, environmental health was not recognized as a profession till late 1956.

In Nigeria environmental health has existed as an occupation since the days of colonial administration when the practitioners were known as Inspector of Nuisance.

Despite their contribution to environmental health control in the 1920s to early 1980s, there was nothing to suggest that this group of health workers merited professional recognition.

CORE DISCIPLINES OF ENVIRONMENTAL HEALTH

Five basic disciplines generally contribute to the field of environmental health: *environmental epidemiology, toxicology, exposure science, environmental engineering, and environmental law.*

Each of these disciplines contributes different information to describe problems and solutions in environmental health, but there is some overlap among them.

1.Environmental epidemiology

studies the relationship between environmental exposures (including exposure to chemicals, radiation, microbiological agents, etc.) and human health. Observational studies, which simply observe exposures that people have already experienced, are common in environmental epidemiology because humans cannot ethically be exposed to agents that are known or suspected to cause disease. While the inability to use experimental study designs is a limitation of environmental epidemiology, this discipline directly observes effects on human health rather than estimating effects from animal studies.

2. *Toxicology

studies how environmental exposures lead to specific health outcomes, generally in animals, as a means to understand possible health outcomes in humans. Toxicology has the advantage of being able to conduct randomized controlled trials and other experimental studies because they can use animal subjects. However there are many differences in animal and human biology, and there can be a lot of uncertainty when interpreting the results of animal studies for their implications for human health.

3. *Exposure science

studies human exposure to environmental contaminants by both identifying and quantifying exposures. Exposure science can be used to support environmental epidemiology by better describing environmental exposures that may lead to a particular health outcome, identify common exposures whose health outcomes may be better understood through a toxicology study, or can be used in a risk assessment to determine whether current levels of exposure might exceed recommended levels. Exposure science has the advantage of being able to very accurately quantify exposures to specific chemicals, but it does not generate any information about health outcomes like environmental epidemiology or toxicology.

4. *Environmental engineering

 applies scientific and engineering principles for protection of human populations from the effects of adverse environmental factors; protection of environments from potentially deleterious effects of natural and human activities; and general improvement of environmental quality.

5. *Environmental law

includes the network of treaties, statutes, regulations, common and customary laws addressing the effects of human activity on the natural environment.

*Information from epidemiology, toxicology, and exposure science can be combined to conduct a risk assessment for specific chemicals, mixtures of chemicals or other risk factors to determine whether an exposure poses significant risk to human health (exposure would likely result in the development of pollution-related diseases). This can in turn be used to develop and implement environmental health policy that, for example, regulates chemical emissions, or imposes standards for proper sanitation.*

Actions of engineering and law can be combined to provide risk management to minimize, monitor, and otherwise manage the impact of exposure to protect human health to achieve the objectives of environmental health policy.

PROBLEMS FACING ENVIRONMENTAL HEALTH SERVICES IN NIGERIA

With the good vision and mission of ENVIRONMENTAL HEALTH PROFESSION, it is faced with numerous problems which aren't limited to;

1. Inadequate EHOs in practice,
2. Bribery and Corruption among Officers,
3. Lack of contemporary knowledge among Officers,
4. Lack of modern Environmental surveillance gadgets,
5. Political instability and Will,
6. Inadequate training and retraining of EHOs,
7. Absence of good record keeping,
8. Laziness to work among EHOs,
9. Inadequate funding of Environmental Services,

Etc

REMEDIES TO THE IDENTIFIED PROBLEMS

1. Recruitment of more competent EHOs,
2. Curbing of Bribery and corruption among EHOs,
3. Updating of obsolete knowledge,
4. Provision of modern day gadgets / equipments in discharge of Environmental Services,
5. Proper training and retraining of EHOs by appropriate authorities,
6. Encouraging good record keeping of all Environmental related issues,
7. Sanctioning of non ready to work Officers,
8. Proper funding,
9. Proper enforcement of Environmental Laws,

Etc

CONCLUSION AND RECOMMENDATION

In today politics, it's glaring that all other professions want to hijack one or two duties of ENVIRONMENTAL HEALTH Professionals.

And I will pen down on the following recommendations;

Involvement of Environmental Health Professionals in promulgation of Environmental or Sanitation Laws,

Proper stating of duties of all cadres,

Employment of more Certified (by WAHEB) and licensed (by EHORECON) Environmental Health Officers in discharge of Environmental Health Services,

Compliance with the ratio of an EHO to 8,000 population by World Health Organization,

Proper mobilization and Equipping of EHOs with modern day Environmental Services equipments,

Proper enforcement of Environmental Laws.
[3/30, 7:30 AM] SAN DIRECTOR SODEKE: *REFERENCES*

Environmental Health Officers Registration Council of Nigeria (EHORECON).

https://www.neha.org/about-neha/definitions-environmental-health 

Novice, Robert (editor) (1999-03-29). "Overview of the environment and health in Europe in the 1990s" (PDF). World Health Organization.

WHO (n.d.). "Health topics: Environmental health". Retrieved 10 January 2015.

"Job Profiles: Environmental health officer". National Careers Service (UK). Retrieved 17 August 2014.

"Canadian Institute of Public Health Inspectors". Retrieved 4 February 2015.

California Health and Safety Code, section 106615(e)

Environmental Health: from Global to Local (2 Editor= Howard Frumkin ed.). San Francisco: John Wiley & Sons. 2010.

National and regional story (Netherlands) - Environmental burden of disease in Europe: the Abode project. EEA.