TRANSBOUNDARY & GLOBAL

HEALTH CONCERNS
Department of Public Health
Faculty of Medicine - Padjadjaran University
Bandung

GLOBAL CHANGES
POSITIVE, e.g.:
Improved
communication
Expanding trade
Introduction of new
technologies
NEGATIVE, e.g.:
Ozone depletion
The greenhouse effect
Deforestation &
desertification
Loss of biodiversity
Interregional transport
of pollution
Large scale of resource
depletion
In the past, most of those env. hazards & the effects
of env. pollution were treated as local issues & were
generally handled on a local level by PH authorities
In recent years, the scope of env. issues has
broadened considerably & there is no clear dividing
line b/w problems that used to be considered PH
problems & those that involve large-scale ecological
change
Rapid technological development in the developed
world introduces new potential hazards in a
society in which environmental degradation is
historically severe but coming under relative
control

In developing countries:
rapid population growth
industrial development
Accelerate existing environmental degradation
Aggravating factors in developing
countries
Poverty
Urbanization w/o adequate infrastructure
Rural development policies that do not
strengthen local economies
Limited economic base that is too often
dependent on commodity prices
The problem of env. degradation has become
global in 3 distinct senses:
There is now imbalance on the level of entire global
systems, e.g. climate
The distribution of familiar env. problems, e.g. air
pollution has become much more widespread &
regionalized until these problems are encountered
worldwide & not just in areas of development & urban
growth
The economic & political systems that operate to
create & sustain these problems have become global to
the extent that the world is rapidly becoming one large
market economy, beyond the capacity of governments
to regulate effectively
Health Consequences of War
Modern conventional warfare
Chemical warfare
Biological warfare
Nuclear warfare
Guerrilla warfare
Terrorism
Civilian deaths compose 90% or all deaths in
twentieth-century wars (Garfield & Neugut,
1997)
The war & trade sanctions cause a threefold
increase in mortality among Iraqi children under
5 years of age (Ascherio et al., 1992)
The emphasis in modern warfare became
disruption of the economy & civil society, not
merely the defeat of troops & the destruction of
military targets
OZONE DEPLETION & UV
RADIATION
Stratosphere: O
2
+ UV O
3
(accumulated over time to
absorb UV radiation & act as a partial screen that protects
the surface of the earth from higher levels of exposure)
UV-A, UV-B, UV-C
Ozone levels in the stratosphere are decreasing at several
locations, esp. North & South poles
Role of CFCs : release chlorine by photolysis. Free chlorine
scavenges & destroys ozone (1 to 10,000)
Source of CFCs : industries, refrigeration, AC, aerosols as
propellants
Half-life: > 75 years
Human health effects of ozone
depletion
Non-melanoma skin cancer, esp. Squamous
Cell Ca & actinic keratitis
Malignant melanoma
Cataract
Retinal degeneration
Impaired immunological responses
Accelerated aging of skin
Pterygia
POTENTIAL EFFECTS OF
CLIMATE CHANGES
Heat stress
Natural weather disasters
Vector distribution
Local food shortages
Flooding


THE GREENHOUSE EFFECT
The infrared radiation passes through the
atmosphere
The atmosphere insulates the heat
created when the infrared radiation is
absorbed
The CO
2
, water vapor & other gases trap
the heat
Please visit:
http://www.who.int/mediacentre/factsheets/fs266/en/
(Climate and Health)
OTHER ISSUES
Deforestation
Desertification
Loss of biodiversity
Acid precipitation
Trans-boundary movement of hazardous
waste
Natural & technological disasters
Thank you
Required reading:
Yassi A, Kjellstrm T, de Kok T, Guidotti
TL. Basic environmental health.
Chapter 11: Transboundary & Global
Health Concerns. New York: Oxford
University Press, 2001