Chapter 9 ~ Impact of Environmental Health on Public Health

Public health is a very broad field that covers several fields of science, technology, mathematics, engineering, nutrition, health, transportation, education, medicine, politics, environmental health, hazards, infectious diseases, pandemics, the quality of air, soil, and water, etc. All these fields interact with each other and are interdependent on the quality of other fields at any given point of time. Hence, public health is considered a model interdisciplinary subject.

According to their website on environmental health [opens in a new tab], the American Public Health Association (APHA) defines environmental health as the branch of public health that focuses on the relationships between people and their environment, promotes human health and well-being, and fosters healthy and safe communities. Environmental health is a key part of any comprehensive public health system. The field works to advance policies and programs to reduce chemical and other environmental exposures in the air, water, soil and food to protect people and provide communities with healthier environments. APHA defines public health as a science-based, evidence-backed field that strives to give everyone a safe place to live, learn, work, and play. The Centers for Disease Control and Prevention (CDC) defines public health as the science of protecting and improving the health of people and their communities at their website: What is Public Health? [opens in a new tab].

The environmental consequences of any human population are a function of several interacting factors, but two are especially important: the number of people and their per capita environmental impact. The per capita impact is related to both the lifestyles of individual people and the level of technological development of their society. These both affect the use of natural resources, the production of wastes, and the degradation of ecosystems (source: Chapter 10; B. Freedman).

Often, the risks to humans exposed to chemicals are interpreted differently from those of other species, particularly wild animals and plants. This is because the prevailing cultural attitudes place much greater value on the life and health of individual people than on those of other species. As such, there is a special reluctance, both social and regulatory, to permit human exposure to many kinds of potentially toxic chemicals. However, regulations and guidelines tend to be considerably less strict for human exposures that occur in a workplace, as compared with non-occupational exposures. This recognizes the fact that considerable risks are inherent in the activities and environmental conditions of many occupations. Particularly significant hazards confront firefighters, police officers, members of the armed forces, operators of heavy machinery, and workers in chemical industries. Within limits, chemical exposures associated with earning a living are generally interpreted as a “cost of doing business” and may therefore be judged to be acceptable. Such attitudes can, however, change markedly over time. Certain occupational hazards that were once considered routine and tolerable are now viewed as unacceptable. For instance, when synthetic organic insecticides, such as DDT (dichlorodiphenyltrichloroethane), were first introduced in the mid-1940s and 1950s, people were remarkably casual about using them. Workers often applied these insecticides with only minimal attention to avoiding exposure to themselves and others. Only later did society understand the health and environmental impacts.

In addition, many people willingly choose to expose themselves to toxicologically significant doses of certain chemicals. These choices include taking up hazardous occupations, smoking cigarettes, and ingesting medicines and recreational drugs. The consequences of these sorts of “voluntary” exposures are interpreted using criteria that are different from those applied to “involuntary” ones (source: Chapter 15; B. Freedman).

In this chapter, we explain how the quality of environmental health impacts public health. Here is a list of environmental health aspects we narrate and discuss their impact on public health: (a) Air Quality, (b) Water Quality, (c) Soil Quality, (d) Environmental Hazards and Toxins, (e) Indoor Environmental Quality, (f) Outdoor Environmental Quality, (g) Impact on Economy, and (h) Role of Government on Environmental and Public Health Policies and Regulations.

Air Quality

About 78% of the mass of the atmosphere is composed of nitrogen gas (N₂), while 21% is oxygen (O₂), 0.9% argon (Ar), and 0.04% carbon dioxide (CO₂). The rest is various trace gases, including potentially toxic ones such as ozone (O₃) and sulfur dioxide (SO₂). The atmosphere also contains highly variable concentrations of water vapor, which can range from only 0.01% in frigid winter air in the Arctic to 5% in warm, humid tropical air. Per the World Health Organization (WHO), Billions of people are breathing unhealthy air around the world.

Pollution is not only caused by human activities—in some cases, it is a purely natural phenomenon. “Natural” sources of pollution include emissions of particulates and gases such as sulfur dioxide from volcanoes, seeps of petroleum on the ocean floor, high concentrations of metals in certain soils and rocks, and the heat of geothermal springs. Natural pollution may cause severe ecological changes (which humans may view as being a kind of damage). The effects can be as intense as those caused by anthropogenic pollution.

How to Improve Air Quality

Air quality could be improved by the reduction of deforestation, soil erosion, burning of fossil fuels, and wild forest fires. Freedman suggested the following procedures to improve the air quality:

• Switching from coal, which is a relatively “dirty” fossil fuel, to “cleaner” ones such as natural gas or oil, or to alternative energy technologies such as nuclear power and hydroelectricity
• Constructing tall smokestacks to spread emissions over a much wider area so that ground-level exposures become less common and less intense—this tactic is the “dilution solution to pollution”
• Centralizing energy production in large power plants to replace much of the relatively dirty and inefficient burning of coal in home fireplaces and furnaces, thereby permitting better control of emissions
• Treating waste gases to remove some of their pollutant content, thereby reducing emissions to the atmosphere.

Impact

Auto exhaust fumes, smoking and secondhand smoking, laboratory solvents, and particulate matter released into air from the mining industry will cause severe and chronic health problems such as asthma, bronchitis, emphysema, lung cancer, etc., to humans depending on the length and exposure levels.

Yet gaseous NO and N₂O are air pollutants if they occur in high concentrations, especially in sunny environments where they are involved in the photochemical production of toxic ozone. Furthermore, large amounts of NO³⁻ and NH⁴⁺ in rain and snow may contribute to acid rain.

Carbon dioxide is one of the most important plant nutrients because carbon comprises about half of plant biomass. But this critical nutrient occurs in a relatively small atmospheric concentration—only about 0.04%. However, the concentration of CO₂ in the atmosphere has increased by about 45% during the past two centuries, and it continues to increase. This well-documented change is contributing to global warming, an important environmental problem.

Impacts from recent climate-related extremes, such as heat waves, droughts, floods, cyclones, and forest fires, reveal significant vulnerability and exposure of some ecosystems and many human systems to current climate variability. Climate-related hazards exacerbate other stressors, often with negative outcomes for livelihoods, especially for people living in poverty. Poor people are affected by effects on livelihood, reduced crop yields, or destruction of homes, as well as indirectly by increased food prices and insecurity.

Water Quality

Water is needed by natural ecosystems for the metabolic needs of organisms, for cooling, and as a ubiquitous solvent that allows water-soluble nutrients to be absorbed by organisms. Water is also required by people for use in agriculture, industry, and recreation. Unfortunately, in many regions, water and its biological resources (such as algae, fish, etc.) have been used excessively, and water quality has been degraded through point and non-points sources of pollution (source: Chapter 3; B. Freedman). According to the World Health Organization, 10% of the world population do not have improved water quality resources.

Impact

The use of agricultural fertilizer can result in concentrations of NO³⁻ in drinking water that are high enough to be toxic to humans, especially to infants. We also know that plants can take up gaseous NO and N₂O from the atmosphere and use them as nutrients, along with NO³⁻ and NH⁴⁺ from precipitation and soil water and alters water pH.

Eutrophication, or excessive productivity of waterbodies due to thick mats of algal blooms, is another environmental problem related to an excessive supply of nutrients—Phosphorus and Nitrogen (Figure 9.3). It is most often caused by an excess of PO₄³⁻, usually because of sewage dumping or runoff from fertilized agricultural land. Highly eutrophic lakes are degraded ecologically and may no longer be useful as a source of drinking water or for recreation. Excessive eutrophication results in death of organisms such as fish and causes skin rashes, dermatitis, conjunctivitis, etc., in humans

Certain species of amoebae (Kingdom Protista) are parasites of animals, including amoebic dysentery in humans. The ciliate Giardia causes a water-borne disease known as hiker’s diarrhea (or beaver fever), the risk of which is a reason why even the cleanest-looking natural water should be boiled or otherwise disinfected before drinking.

In a detailed review of several research articles in water quality and human health, Lin et al. (2022) concluded that most of the sewage generated by human activities into natural water bodies without treatment resulted in more than 50 diseases. Among these 80% of diseases and 50% of child deaths worldwide are related to poor water quality.

An additional case of natural pollution involves certain species of marine phytoplankton that occasionally become abundant and cause ecological damage by forming algal blooms. In events called toxic blooms, these algae release biochemical compounds that are poisonous to a broad range of animals that are exposed through the food chains and food webs; in some instances, they may reach humans through biomagnification and cause illnesses such as paralytic shellfish poisoning (PSP). In some cases, humpback whales have died at sea after eating fish polluted with saxitoxin, a potent neurotoxin synthesized by dinoflagellate algae. The algal toxins are also a risk to people eating fish polluted by this and other chemicals, such as domoic acid. Exposure to this compound affects the brain, causing seizures and possibly death in sea lions and even in humans. Research and discussion of naturally occurring pollution is useful and informative in environmental science.

Soil Quality

Soil is a complex and variable mixture of fragmented rock, organic matter, moisture, gases, and living organisms that covers almost all terrestrial landscapes. Soil provides mechanical support for growing, even for trees as tall as 100 m. Soil also stores water and nutrients for use by plants and provides habitat for the many organisms that are active in the decomposition of dead biomass and the recycling of its nutrient content. Soil is a component of all terrestrial ecosystems, but it is also in itself a dynamic ecosystem with a variety of physicochemical factors such as depth, temperature, moisture, pH, dissolved gases, biota such as insects, earthworms, nematodes or roundworms, etc. The soil ecosystem is extremely important. Terrestrial plants obtain their water and much of the nutrients they need from the soil, absorbing them through their roots. Soil also provides habitat for a great diversity of animals and microorganisms that play a crucial role in litter decomposition and nutrient cycling (source: Chapter 5; B. Freedman).

According to Munzel et al. (2023), healthy soil plays a critical role in human and ecosystem health. Healthy soil is needed to grow crops, plants and animals in general, pollinators, provide quality and healthy and nutritious food, and to sustain populations. It stores water and prevents floods. It captures carbon and slows global climate change.

Impact

Munzel et al. (2023) have summarized the poor health quality of soil and its impact on human health in the figure below, which explains the impact of specific chemicals in soil on various organs and organ systems of the human body. Soil pollution due to a variety of inorganic and organic chemicals is a great and growing threat to human health. It results in food crop contamination and disease. Soil pollutants wash into rivers, causing water pollution. Deforestation causes soil erosion. Pollution of air, water, and soil is responsible for at least 9 million deaths each year. More than 60% of pollution-related disease and death is due to cardiovascular disease.

Environmental Hazards and Toxins

Environmental hazards are broadly divided into biological, physical, and chemical hazards caused by natural and or anthropogenic (man-made) means. Details are explained in chapter 6 of this OER’s Environmental Science textbook.

Impact

A prolonged intensification of stress in the environment by a variety of biological, chemical, physical, natural, and anthropogenic hazards will cause both short- and long-term damage to public health. Consider, for example, the release of toxic fumes or gases or metals into the atmosphere or soil or water will result in toxic effects to environmental and public health. For instance, a case in which a new metal smelter is constructed in a forested landscape. If the smelter emits toxic sulfur dioxide gas, the toxic stress will damage the tree-sized plants of the forest and eventually cause them to give way to shrub-sized and herbaceous vegetation. If the long-term stress is extremely severe, the landscape could entirely lose its vegetation. This kind of ecological damage involves changes in the composition and dominance of species in communities, in the spatial distribution of biomass, and in functions such as productivity, litter decomposition, and nutrient cycling (source: Chapters 16 and 18; B. Freedman).

The hazardous substances and conditions in the environment impact public health by causing human illness, diseases, and death due to the excessive release of toxic gasses such as CO₂, CO, SO₂, etc. They will also negatively affect the loss of habitats, life forms, and biodiversity. Additionally, they cause chronic respiratory and heart diseases.

In fact, metals such as aluminum, cadmium, copper, iron, lead, mercury, and zinc are present in all parts of the environment. Some of these such as copper, iron, nickel, and zinc are essential in trace concentrations in living organisms. Although all metals (and any other chemicals) are potentially toxic, they must be present in a high enough concentration for a long enough period of time to actually poison organisms and cause ecological damage—chronic toxicity. In other words, the exposure must exceed biological tolerances before damage is caused and pollution can be said to occur (source: B. Freedman).

Lead

Lead and lead compounds are listed as “reasonably anticipated to be a human carcinogen.” It can affect almost every organ and system in your body. It can be equally harmful if breathed or swallowed. The part of the body most sensitive to lead exposure is the central nervous system, especially in children, who are more vulnerable to lead poisoning than adults. A child who swallows large amounts of lead can develop brain damage that can cause convulsions and death; the child can also develop blood anemia, kidney damage, colic, and muscle weakness. Repeated low levels of exposure to lead can alter a child’s normal mental and physical growth and result in learning or behavioral problems. Exposure to high levels of lead for pregnant women can cause miscarriage, premature births, and smaller babies. Repeated or chronic exposure can cause lead to accumulate in your body, leading to lead poisoning (source: B. Freedman; Health Effects of Lead Exposure | Lead | CDC).

Acute toxicity is defined as occurring when a short-term exposure to a chemical in a high concentration results in biochemical or anatomical damages or even death (a common acute endpoint). Chronic toxicity involves a longer-term exposure to low to moderate concentrations of a chemical. Over time, chronic exposures may cause biochemical or anatomical damage, or perhaps a lethal condition such as cancer (source: B. Freedman).

Indoor Environmental Quality

The indoor environment of residential and office buildings are often contaminated by gases and fumes. For example, space heaters, furnaces, and fireplaces burning wood, kerosene, or fuel oil may emit carbon monoxide into the indoor environment. All high-temperature combustions emit nitric oxide, and many synthetic materials and fabrics vent formaldehyde and other organic vapors. These chemicals can accumulate if indoor air is not exchanged frequently with cleaner, outdoor air (source: Chapter 16; B. Freedman).

Impact

Indoor pollution and toxins released from space heaters, furnaces, fireplaces burning wood, kerosene, nitric oxide, organic vapors, etc., cause health problems and loss of man hours, productivity, and even death.

Outdoor Environmental Quality

For instance, the smoking of tobacco is a leading source of easily avoidable air pollution. People inhale a great variety of toxic gases and fumes when they smoke tobacco (and also marijuana). In addition, non-smokers are indirectly exposed to lower concentrations of those chemicals because of the lingering residues of “second-hand smoke” that may occur in indoor atmospheres (source: Chapter 16; B. Freedman).

Impact

Smoking is also the most important cause of preventable diseases, especially lung cancer and heart disease. Smog causes a significant number of problems and toxicity to vegetation, erodes building surfaces and metal sculptures due to acid rain, heart, and lung problems such as asthma, bronchitis, emphysema, etc., in vulnerable populations. Poor outdoor air quality due to excessive exhausts from automobiles, wildfires, industries, etc., aggravates asthma, wheezing, cough, etc.

Impact on Economy

A prolonged drought can have a serious economic impact on a community. Increased demand for water and electricity may result in shortages of resources. Moreover, food shortages may occur if agricultural production is damaged or destroyed by a loss of crops or livestock.

Soil is economically important because it critically influences the kinds of agricultural crops that can be grown (see details in chapter 14; B. Freedman). Some of the most productive agricultural soils are alluvial deposits found along rivers and their deltas, where periodic flooding and silt deposition bring in abundant supplies of nutrients (source: Chapter 5; B. Freedman). Overflooding due to hurricanes and forest fires damages soil nutrients by erosion.

Fungi are ecologically important because they are excellent decomposers, allowing nutrients to be recycled and reducing the accumulation of dead biomass. Various kinds of fungi are economically important because they spoil stored grain and other foods, are parasites of agricultural or forestry plants, or cause diseases in humans and other animals. Ringworm is a disease of the skin, usually the scalp, which is caused by various fungi. The chestnut blight fungus (Endothia parasitica) was accidentally introduced to North America and wiped out the native chestnut (Castanea dentata), which used to be a prominent and valuable tree in eastern forests. The Dutch elm disease fungus (Ceratocystis ulmi) is another introduced pathogen that is killing elm trees (especially white elm, Ulmus americana).

Economically useful fungi include a few species of yeast that can ferment sugars under anaerobic (O₂-deficient) conditions, yielding gaseous CO₂ and ethanol. Carbon dioxide raises bread dough prior to baking, while brewers take advantage of the alcohol production to make beer and wine. Other fungi are used to manufacture cheese, soy sauce, tofu, food additives such as citric acid, and antibiotics such as penicillin (source: Chapter 7; B. Freedman).

Excessive deforestation over the decades results in loss of vegetation, biodiversity, migration of wildlife, increase in carbon dioxide levels in the atmosphere, increased levels of hunting, etc., and impacts the local, national, and global environmental health, economy, and consequently, public health.

Sustainable economic development and technology involves the following actions for the environmental and public health:

• increasing the efficiency of use of non-renewable resources—for example, by recycling and re-using metals and other materials.
• increasing the use of renewable materials in the economy, such as products manufactured from trees or agricultural biomass.
• rapidly increasing the use of renewable sources of energy, such as electricity generated using hydro, solar, wind, or biomass technologies.
• improving social equity, ultimately to such a degree that all citizens have access to the necessities and amenities of life such as clean air, water, housing, energy, education and healthcare facilities, and accessibility for vaccinations for infectious diseases and pandemics COVID-19.
• reduction of pollution and improvement of ecological and human health effects.
• reduction or elimination of disturbances that cause damage to natural ecosystems.
• preserve the natural habitats to protect biodiversity.
• address and implement the policies to reduce the social effects of environmental damage, including unacceptable economic disparities (source: Chapter 12; B. Freedman).

Role of Government Regulations and Policies for Environmental and Public Health

The U.S. Department of Agriculture, the federal agency with responsibility for regulating pesticides before the formation of the U.S. Environmental Protection Agency (EPA) in 1970, began regulatory actions in the late 1950s and 1960s to prohibit many of Dichloro-diphenyl-trichloro-ethane’s (DDT) uses because of mounting evidence of the pesticide’s declining benefits and environmental and toxicological effects. The publication in 1962 of Rachel Carson’s Silent Spring stimulated widespread public concern over the dangers of improper pesticide use and the need for better pesticide controls.

In 1972, EPA issued a cancellation order for DDT based on its adverse environmental effects, such as those to wildlife (such as the Bald Eagle), as well as its potential human health risks. Since then, studies have continued, and a relationship between DDT exposure and reproductive effects in humans is suspected, based on studies in animals. Exposure to high doses, human symptoms can include vomiting, tremors or shakiness, and seizures. In addition, some animals exposed to DDT in studies developed liver tumors. As a result, today, DDT is classified as a probable human carcinogen by U.S. and international authorities.

Louisiana Perspective

The state of Louisiana is rich in natural resources, cultural and ethnic diversity, oil industry, sea food industry, music, tourism, etc. Environmental health plays a critical role on public health in the state of Louisiana as any other geographic location on the planet earth. Louisiana Department of Health (LDH) has database and well-versed information on a wide range of environmental and public health topics such as obesity, asthma, cancer, diabetes, birth defects, lead poisoning and screening, birth outcomes, Chronic Obstructive Pulmonary Disease (COPD), heart attack, heat stress, hypertension, kidney disease, occupational health, climate change, drinking water and air quality, etc., and subsections of these topics.

Chronic Kidney Disease (CKD)

On their website, the National Kidney Foundation lists forever chemicals  and heavy metals along with other air quality factors like smoking and air pollution [opens in a new tab] as possible contributors to kidney disease. These factors require more analysis and study to see if there are connections that might help us to prevent kidney disease sooner.

Obesity

Obesity prevalence decreased as level of education increased. Adults without a high school diploma or equivalent had the highest prevalence of obesity (37.6%), followed by adults with some college education (35.9%) or high school graduates (35.7%), and then by college graduates (27.2%). Young adults were half as likely to have obesity as middle-aged adults. Adults aged 18–24 had the lowest prevalence of obesity (20.5%) compared to adults aged 45–54, who had the highest prevalence (39.9%). Three states (Louisiana, Oklahoma, and West Virginia) had an obesity prevalence of 40% or greater.

Cancer

People are at risk of dying due to cancer, heart disease, strokes, diabetes, etc., mostly caused by tobacco and obesity and a variety of chemicals, namely benzene, formaldehyde, ethylene oxide, etc., released into the air from industries. One of the locations in Louisiana is Cancer Alley, which is called Chemical Corridor or a Cancer Cluster—an 85-mile long stretch from New Orleans to Baton Rouge. Please explore the details on causes, consequences, and prevention of a variety of cancer illnesses caused by environmental health reasons following the listed links [all open in new tabs]:

• Breast Cancer | Louisiana Cancer Prevention and Control Programs
• Risk Factors | Louisiana Cancer Prevention and Control Programs
• State Data | Louisiana | American Lung Association
• Environmental Health and How It Can Effect Your Health

Water Quality

Saltwater intrusion, inorganic and organic pollutants in Louisiana drinking water, and its health consequences are crucial to address and rectify for public health and safety. Here are some sources where details are narrated for the public to be aware of and understand [all links open in new tabs]:

• ‘Everything out the faucet is salt’: Louisianans Struggle as Drinking Water Crisis Persists
• ‘These levels are crazy’: Louisiana Tap Water Sees Huge Spike in Toxic Chemicals
• Drinking Water Quality | La Dept. of Health

Chapter Summary

Environmental health covers a wide range of topics such as air quality, water quality, soil quality, human populations, environmental hazards, toxicology, government regulations and policies, and many more. This is one of the branches of public health that explains how the environment and its health plays a critical role on public health either directly or indirectly and either positively or negatively. In this chapter, we presented and explained the intricacies of these very important topics with specific examples and resources.

Review Questions

1. What is the difference between environmental health and public health? Explain with examples.
2. List 4 environmental health factors that can impact public health.
3. Explain, with examples, how air, water, and soil quality are interconnected globally.
4. Define eutrophication. Explain how the formation of algal blooms affects the fish death.
5. How soil texture and its quality plays a critical role in human and ecosystem health?
6. What are the trace metals that are essential for living beings? Explain their specific role.

Critical Thinking /Questions for Discussion

1. How does air quality impact public health? Explain with a couple of examples.
2. Explain how the government at national, state, and local levels plays a role in regulating environmental and public health issues.
3. How does water, air, and soil quality affect environmental and public health in the state of Louisiana?
4. Explain the interrelationship between soil quality and public health.
5. Explain how clean energy resources and strategies improve public health.
6. Discuss, with examples, the main effects of soil contaminants on human health.

Key Terms

• Environmental health – the branch of public health that focuses on the relationships between people and their environment, promotes human health and well-being, and fosters healthy and safe communities.
• Public health – an interdisciplinary field looking at disease prevention and improving quality of life through physical, psychological, and social wellbeing.
• Impact – the consequence of an environmental health aspect on individuals, society, and/or the environment.
• Biodiversity – the richness of biological variation, including genetic variability as well as species and community richness.
• Dose – the amount of exposure to chemicals or other toxins over a known period of time.
• Air quality – a complex mixture and nature of inorganic and organic gases, particles, nutrients, and moisture in different geographic locations.
• Water quality – a complex mixture and nature of inorganic and organic nutrients, organic matter, gases, and living organisms in different aquatic (water) habitats.
• Soil quality – a complex mixture and nature of fragmented rock, organic matter, moisture, gases, and living organisms that covers almost all of Earth’s terrestrial landscapes.

Attributions

Asbestos Toxicity: Cover Page | Environmental Medicine | ATSDR (cdc.gov)

Bill Freedman. Environmental Science—A Canadian Perspective (Pressbooks)

IPCC (Intergovernmental Panel on Climate Change). 2014b. Summary for Policymakers. Pp. 1–32 in: Climate Change 2014: Impacts, Adaptation, and Vulnerability. Part A: Global and Sectoral Aspects. IPCC, Cambridge, UK. http://www.ipcc.ch/report/ar5/wg2/

WHO/UNICEF Drinking-Water. [(accessed on 27 August 2023)]; Available online: https://www.who.int/news-room/fact-sheets/detail/drinking-water

Patrick Levallois and Cristina M. Villanueva. 2019. Drinking Water Quality and Human Health: An Editorial. Int J Environ Res Public Health. 2019 Feb; 16(4): 631. doi: 10.3390/ijerph16040631 [(accessed on 27 August 2023)

Li Lin, Haoran Yang, and Xiaocang Xu. 2022. Effects of Water Pollution on Human Health and Disease Heterogeneity: A Review. Front. Environ. Sci., 30 June 2022. Sec. Water and Wastewater Management. Volume 10 – 2022. (https://doi.org/10.3389/fenvs.2022.880246) [(accessed on 27 August 2023).

Agency for Toxic Substances and Disease Registry. Annual Report 2018: Protecting People from Harmful Environmental Exposures. https://www.atsdr.cdc.gov/2018atsdrannualreport/index.html [(accessed on 27 August 2023).

Campanale, C., Dierkes, G., Massarelli, C., Bagnuolo, G., and Uricchio, V. F. A relevant screening of organic contaminants present on freshwater and pre-production microplastics. Toxics 2020;8:100. [PMC free article] [PubMed] [Google Scholar] [(accessed on 27 August 2023).

References Cited and Further Reading

• Sola Maji: Clean and Sustainable Drinking Water in Western Kenya – YouTube
• Lead Paint in American Housing – 50 Years of Peeling Away the Problem – YouTube
• Air and Water Quality | County Health Rankings & Roadmaps
• Drinking Water Quality and Public Health | SpringerLink
• The Influence of Soils on Human Health | Learn Science at Scitable (nature.com)
• Soil and water pollution and human health: what should cardiologists worry about? – PMC (nih.gov)
• Soil Health | Natural Resources Conservation Service (usda.gov)
• Indoor Environments and Health: Moving Into the 21st Century – PMC (nih.gov)
• The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes – PMC (nih.gov)
• Improving Health and Wellness through Access to Nature (apha.org)
• Spending at least 120 minutes a week in nature is associated with good health and wellbeing | Scientific Reports
• Eutrophication and Public Health | SpringerLink
• Drinking Water and Public Health in the United States (apha.org)
• Globally, 3 billion people at health risk due to scarce data on water quality (unep.org)
• Global Water Quality and Health Research | School of Public Health | University of Illinois Chicago (uic.edu)
• Systems of Waste Management from Sustainability: A Comprehensive Foundation by Tom Theis and Jonathan Tomkin, Editors (CC-BY). Download for free at CNX.
• Solid Waste form AP Environmental Science by University of California College Prep (CC-BY). Download for free at CNX.
• Additional sources: This Is Public Health – YouTube