Environmental Health and Sanitation Study Guide

ENVIRONMENTAL HEALTH AND SANITATION

Overview of the Occupational Health Office (EOHO)

  • The EOHO operates under the National Center for Disease Prevention and Control Program of the Department of Health (DOH).
  • Main Responsibilities:
    • Promoting healthy environmental conditions.
    • Preventing environmental-related diseases through appropriate sanitation strategies.

Sanitation Strategies

  • Strategies aimed at reducing environmental health issues include:
    • Water Quality Surveillance: Continuous monitoring of the water supply to ensure safety.
    • Evaluation of Food Establishments: Regular checks to ensure compliance with health standards.
    • Solid and Liquid Waste Management: Implementation of proper disposal and recycling practices.
    • Sanitation of Public Places: Maintaining cleanliness and hygiene in communal areas.
    • Management of Disaster Areas: Ensuring sanitary conditions during and after disasters.
    • Impact Assessment of Environmentally Critical Projects: Evaluating potential health impacts before project implementation.
    • Enforcement of Sanitation Laws: Upholding regulations related to environmental health.

Technical Assistance Programs

  • The DOH's Centers for Health and Development (CHDs) provide technical assistance on various sanitation programs across regions.
  • Focus on eliminating and controlling environmental factors that contribute to disease transmission, especially in households.

Emerging Environmental Health Programs

  • The EOHO conceptualizes new programs to address emerging health problems, which include:
    • Water for Life: Initiative aimed at improving access to safe drinking water.
    • Hospital Waste Management: Strategies for managing waste generated in healthcare facilities.
    • Urban Health and National Projects: Health initiatives that specifically target urban populations.
    • Pasig River Rehabilitation Project: Focused on environmental cleanup and restoration initiatives.

Major Environmental Health Concerns

  • Prevalence of Diarrheal Diseases:
    • Leading cause of morbidity in the general population of the Philippines.
  • Other sanitation-related diseases include:
    • Pneumonia
    • Tuberculosis
    • Intestinal parasitism
    • Schistosomiasis
    • Malaria
    • Infectious hepatitis
    • Filariasis
    • Dengue hemorrhagic fever
  • Many of these diseases can be controlled or eradicated through programs that incorporate environmental sanitation components.

Sanitation Code of the Philippines

  • The EOHO has the authority to act on all issues related to health and the environment under the comprehensive Sanitation Code of the Philippines (P.O. 856, 1978).
  • Emphasizes the need for standardization and intensification of health and sanitation program implementation alongside enforcing police power for improved quality of life.

Water Supply Sanitation Program

  • Increase in access to safe water supply sources.
  • Existing issues include:
    • Insufficient knowledge and inappropriate handling practices leading to water contamination.
    • Access to drinking water from older pipes remains a significant problem.
Types of Water Facilities
  • Approved Types:
    • Level I (Point Source):
    • A protected well or developed spring with an outlet, lacking a distribution system, typically serves 15 to 25 households within a radius of 250 meters.
    • Yield: 40-140 liters/minute.
    • Level II (Communal Faucet System or Stand-Posts):
    • Involves a source, reservoir, piped distribution network, and communal faucets located within 25 meters of the farthest household.
    • Designed to deliver 40-80 liters/capita/day to approximately 100 households.
    • Level III (Waterworks System or Individual House Connections):
    • A piped distribution system connecting individual household taps, geared towards urban areas and generally requiring minimal treatment.
Unapproved Water Sources
  • Sources considered risky include:
    • Open dug wells
    • Unimproved springs
    • Wells needing priming
  • Must be treated before consumption; communities are encouraged to convert to approved water supply facilities.
Access & Surveillance Policies
  • Every household is entitled to adequate safe drinking water.
  • Each municipality must formulate an operational plan for water quality and surveillance annually, with assistance from CHDs and adherence to National Standards for Drinking Water.
  • Water quality assessments conducted only by accredited private or government labs.
Certification & Disinfection Guidelines
  • Certification of potability required by the Secretary of Health or local health authority.
  • Disinfection mandatory under specific circumstances:
    • Newly constructed or repaired water supply facilities.
    • Facilities testing positive for bacteria.
    • Containers from environments susceptible to recontamination (e.g., open wells, unimproved springs).
Waterworks Construction Requirements
  • Construction of well sites requires prior approval from the Secretary of Health.
  • Compliance with DOH sanitary norms is essential.
  • Systems must guarantee safe, potable water while maintaining appropriate pressure in distribution lines.

Proper Excreta and Sewage Disposal Program

  • Increased access to sanitary toilet facilities, but still a high number of users lacking access.
  • Health surveys indicate underutilization of existing sanitary facilities.
Approved Types of Toilet Facilities
  • Type I: Non-water carriage toilets (e.g., pit latrines).
  • Type II: Facilities requiring small amounts of water (e.g., pour-flush toilets).
  • Type III: Water carriage types connected to septic tanks or sewer systems.
Rural Emphasis
  • Continued focus on blind drainage in rural settings until improved sewage facilities are established.
  • Promotion of conventional sewage facilities in urban areas.

Food Sanitation Program

  • Rapid changes in Filipino eating habits, particularly the rise of fast food, increase the risk of food-borne infections due to unsanitary handling.
  • Public health initiatives are necessary to balance economic conditions affecting food safety.
Food Establishment Policies
  • Regular appraisal of sanitary conditions includes inspections of food sources, containers, and transport vehicles.
  • Compliance with sanitary permits and health certificate provisions for food handlers is essential.
  • Use of the Formalin Ether Concentration Technique for stool analysis in food handlers to identify parasitic infections.
  • Enforcement of destruction or banning of food unfit for consumption.
Food Safety Rights
  • Right Source:
    • Buy fresh and non-expired products, avoid defective packaging, and ensure clean water usage.
  • Right Preparation:
    • Prevent cross-contamination, ensure proper washing of raw foods, and maintain hygiene.
  • Right Cooking:
    • Cook food thoroughly to at least 70 degrees Celsius.
  • Right Storage:
    • Follow safe temperature storage guidelines; no food should be left at room temperature for over 2 hours.

Waste Management Program

  • Issues with combining infectious hospital waste with municipal waste systems; very few hospitals are equipped with proper treatment facilities.
Hospital Waste Management Policies
  • Hospitals are required to implement waste management programs as a condition for licensing.
  • Adoption of appropriate technologies for waste handling is necessary, along with staff training on waste management practices.
  • Awareness campaigns regarding health hazards from improper waste management are mandatory.

Legislation and Regulations

  • The enactment of R.A. 8749 prohibits incineration for waste disposal in hospitals; local ordinances should regulate the collection and disposal of waste.

Environmental Pollution Management

  • Urban development elevates environmental hazards, necessitating effective health services to mitigate associated risks.
  • Ongoing research into the health impacts of environmental degradation is critical.

Recent National and International Environmental Laws

  • Significant laws include:
    • Stockholm Convention on Persistent Organic Pollutants (2001): Ban on certain harmful chemicals and pesticides.
    • R.A. 6969 Toxic Substances Act (1990): Regulation of toxic chemicals and nuclear waste.
    • R.A. 8749 Clean Air Act (1999): Management of air pollution; incineration is prohibited.
    • R.A. 9003 Ecological Solid Waste Management Act (2000): Promotion of community-based waste management initiatives.
    • R.A. 9275 Clean Water Act (2004): Establishment of wastewater treatment requirements.

Nursing Responsibilities & Activities

  • Public health nurses play a crucial role in health education and community outreach.
  • Active participation in training sessions and workshops focused on environmental health is strongly encouraged.
  • Responsibilities may encompass:
    • Facilitating community sanitation campaigns.
    • Participating in research and implementing sanitation codes.
    • Assisting disaster management efforts.

Conclusion

  • A comprehensive and coordinated approach is essential to address environmental health issues, making it a core priority within national public health agendas.