I. e.g.

, Industrial sources  waste water

 treatment  release in the
Environmental Health ENVIRONMENTAL HEALTH environment (rivers and waterways);
Protection • A branch of public health that under R.A. 9275 or “Clean Water Act
deals with the study of preventing of 2004”
OVERVIEW
illnesses by managing the
• 1. Community Water and Waste environment and changing people’s • 3. Increasing the person’s
Management behavior to reduce exposure to resistance to infectious diseases.
• 2. Social Importance of Water to the biological and non-biological agents. e.g., Expanded Program for
Community Immunization (EPI) and Nutrition 
• 3. Epidemiology of Infectious and Toxic Maternal and child health program.
• Environment health problems
Agents in Water
- involve air, land, water, and noise
3.1 Distribution and trends
3.2 Mapping the future
pollution. ENVIRONMENTAL AND
3.3 Water consumption - most are result of man’s lifestyle OCCUPATIONAL HEALTH OFFICE
3.4 Etiology and effects of toxic agents and behavior, and lack of concern for (EOHO)
3.5 Waterborne infectious diseases the future generations.
• 4. Sources of Water - other causes: waste products of • Under the National Center for
4.1 Groundwater supplies modernization and globalization. Disease Prevention and Control
4.2 Surface water supplies - effects  depletion of ozone layer Program of the DOH.
4.3 Addition of fluorides • Responsible for the promotion of
and greenhouse effect or global
• 5. Testing of water healthy environmental conditions
warming, depletion and pollution of
5.1 The coliform test
water supply, the denudation of and prevention of environmental
5.2 The chlorine test
forests, health and sanitation related diseases through appropriate
• 6. Regulation of water supplies
6.1 Safe drinking water legislation problems. sanitation strategies:
• 7. Drinking Water in Development 1. Water quality surveillance
Countries 2. Evaluation of food establishments
THE ECOLOGICAL
• 8. Community Wastes 3. Proper solid and liquid waste
TRIAD
8.1 Nitrogen cycle management
• 9. Sewage Disposal 4. Sanitation of public places
9.1 Sewage treatment • Man – manipulates the
5. Sanitation management of
9.2 Lagoon treatment environment to prevent contracting
disaster areas
9.3 Financing sewage treatment the disease by blocking disease
6. Impact assessment of
9.4 Regulation of sewage disposal agents from entering and attacking
9.5 Septic tanks
environmentally critical projects
his body.
9.6 Pit latrines 7. Enforcement of sanitation laws,
9.7 Cities without sewer systems rules, regulations, and standards.
• Failure to keep the environment
9.8 Stream Pollution
9.9 Solid wastes
clean and healthy  provides good • TWO DIVISIONS:
9.10 Residential, Occupational, and breeding place for the disease
Recreational Environments agents or vectors to live, propagate  1. Water and Sanitation Division
attack the man (host)  disease. 2. Health Care Waste and
Toxic/Hazardous Division
OBJECTIVES
PREVENTIVE STRATEGIES BASED
• 1. Discussed practices of promoting
ON ECOLOGICAL TRIAD • PROGRAMS/PROJECTS:
health by protecting environment.
• 2. Describe the effects of pollution in • 1. Change people’s behavior  - Water for Life
water reserve. manipulate the environment  - Hospital Waste Management
• 3. Identified sources of water. - Urban Health and National Projects
reduce exposure to biological and
• 4. Listed the importance of having non-biological disease agents - Pasig River Rehabilitation Project
good water sources. *e.g. People adopt food safety
• 5. Discussed health resources and practices such as proper
services that may be of help to the ENVIRONMENTAL SANITATION
handwashing before cooking and
community. eating and the use of safe drinking • The study of all factors in man’s
• 6. Followed the directions in stool
water for cooking and drinking physical environment which may
collection and processing as one of the
. negatively
components of health service for the
community. • 2. Manipulate the environment  affect his health and well-being.
prevent production or presence of
disease agents. • Environment factors:
1. Water supply sanitation
2. Solid waste management
3. Food sanitation
4. Proper housing • Functions: • Republic Act 6969
5. Radiological protection
1. Formulate policies and guidelines - “Toxic Substances and Nuclear
6. Stream pollution
and develop programs for Waste Control Act of 1990”
7. Proper excreta disposal
environmental health protection - regulates the importation, use,
8. Insect vector and rodent control.
2. Coordinate, monitor, and evaluate movement, treatment and disposal
9. Air pollution
EH programs and development of toxic
10. Noise
projects. chemicals and hazardous and
11. Institutional sanitation
3. Undertake information nuclear wastes in the Philippines.
dissemination and education
PRIORITY ENVIRONMENTAL campaigns on EH programs.
4. Coordinate, assist and/or support • Republic Act 8749
HEALTH ISSUES
the conduct of research and relevant - “Clean Air Act of 1999”
• identified by discussion groups and activities for environmental - Provides a comprehensive air
government agencies. maintenance and protection. pollution management and control
program to achieve and maintain
1. Biologically-dead rivers due to healthy air.
water pollution • 5 sectors
2. Presence of smoke belching motor • Republic Act 8749
- Solid waste
vehicles  air pollution
- Water
3. Rapid population growth - Section 20  bans the use of
4. Inadequate sewerage system and
- Air incineration for municipal, bio-
sludge management system for - Occupational health medical and hazardous wastes but
septic tanks - Toxic and hazardous waste allows the traditional method of
5. Inadequate monitoring of drinking small-scale community burning.
sources - all motor vehicles are required to
6. Absence of a rationalized land use LAWS AND POLICIES THAT pass the smoke emission test prior
plan AFFECT ENVIRONMENTAL to registration
HEALTH AND SANITATION - Phasing out leaded gasoline by the
7. Improper and indiscriminate end of the year 2000
disposal of solid and liquid wastes. • Senate Resolution 676 - Lowering the sulfur content of all
and etc. automotive diesel fuel
- Bans the use of persistent organic
Environmental Sanitation pollutants (POPs) in households and - Decreasing the aromatic and
industries. benzene levels in unleaded gasoline
• Key areas of improvement: - Banning of smoking in public places
1. Specific policies and legislation for - POPs  contains “Dirty Dozen” of including public transport in order to
environmental health pesticides, industrial chemicals and prevent indoor pollution due to
2. Institutional development and unintentional products of burning second-hand smoke.
intersectoral collaboration which are:
3. Human resource development
1. Pesticides • Republic act 9003
4. Monitoring and surveillance
5. Integration of health and – Aldrin and dieldrin, endrin, - Ecological Solid Waste
environment in international and chlordane, heptachlor, dichloro- Management Act of 2000
regional agreements. diphenyl trichloroethane (DDT), - Declares the adoption of a
hexachlorobenzene, mirex, and systematic, comprehensive and
INTER-AGENCY COMMITTEE ON toxaphene ecological solid waste management
ENVIRONMENTAL HEALTH program as a policy of the state
(IACEH) 2. Industrial chemicals – using the community based-
polychlorinated biphenyls and approach and mandating waste
• Executive Order 489 of 1991 Hexachlorobenzene diversion through composting and
- Chairman  secretary of health
recycling.
- Vice chairman  secretary of DENR
3. Unintentional byproducts of
- Composed of 11 members (DPWH,
burning
DILG, DA, DTI, DOTC, DOST, DOLE, • Republic Act 9275
NEDA, PIA) – dioxins and furans (caused by
burning plastics). - “Clean Water Act of 2004”
- Aims to establish wastewater distribution system generally
treatment facilities that will clean adaptable for rural areas where the
waste houses are thinly scattered.
water before it is released into the • Serves 15-25 households
bodies of water like rivers and seas.
- Requires the LGUs to form Water b. Communal faucet system or
Management Areas that will manage stand-posts type
waste water in their respective • Composed of a source, a reservoir,
areas. a piped distribution network; and
communal faucets.
• Supplemental IRR of Chapter II • Suitable for rural areas where
of Sanitation Code of the household are clustered densely.
Philippines • Serves an average of 100
households.
- Water refilling stations should
regularly monitor their drinking c. Waterworks system or
water quality using the following
individual house connections
schedules:
type
1. Monthly for bacteriological quality
• Composed of source, a reservoir, a
2. Every six months for physical and
piped distribution network, and
chemical properties
household taps.
3. Annually, for biological quality,
• Suitable for densely population
and radiological properties when
urban areas and requires minimum
need arises.
treatment or disinfection.
- Water analysis procedures should
be done only in DOH-accredited
laboratories and water quality Unapproved Types of Water
should follow the Philippine National Supply
Standards for Drinking Water • Water coming from doubtful
(PNSDW). sources (unless treated through
proper container disinfection) –
• Presidential Decree 856 open dug wells, unimproved springs,
and wells that need priming.
- Supplemental IRR of Chapter XVII
on Sewage Collection and Disposal Access to Safe and Potable
and Excreta Disposal and Drainage of Drinking Water
the Sanitation Code of the
• Certificate of Potability of an
Philippines
Existing Water Source – issued by
the department of health.
- Regulates and provides proper
guidelines for LGUs and
Water Quality and Monitoring
establishments involved in
desludging, collection, handling, and Surveillance
transport and disposal of domestic • Municipal LGU thru RHU 
sludge from cesspools, communal, formulate an operational plan for
septic tanks, domestic sewage quality and surveillance yearly using
treatment plants/facilities and area program-based approach
seepage from household septic • Water Examination
tanks. – performed only in duly accredited
(DOH) government and private
laboratories.
WATER SUPPLY SANITATION - should meet provisions of the
PROGRAM National Standards for Drinking
Water
Approved Types of Water Supply - done every year

a. Level 1 or Point Source Type

• a covered well or a developed
spring with an outlet but without
II.) • an enteric fever characterized by
systemic illness along with
Water Supply Sanitation
abdominal pain and fever in a "step-
Program ladder" pattern.
• a disease caused by Salmonella
Water Supply and Sanitation- typhi bacteria. e. Giardiasis
related Diseases • spread through sewage
• Cholera contamination of food or water and
• Typhoid fever through person-to- person contact. • A diarrheal disease caused by a
• Shigellosis • sustained fever (one that doesn’t tiny parasite/protozoan Giardia
• Diarrheagenic E. coli infection come and go) that can be as high as lamblia.
• Giardiasis 103–104°F (39–40°C), weakness, • spreads easily and can spread from
• Cryptosporidiosis stomach pain, headache, diarrhea or person to person or through
• Hepatitis A constipation, cough, loss of appetite. contaminated water, food, surfaces,
Some will develop a rash of flat, or objects.
rose- colored spots. • most common way people get sick
is by swallowing contaminated
c. Shigellosis drinking water or recreational water
(for example, lakes, rivers, or pools).
• Some have no symptoms at all, if
• an intestinal infection caused by a develops it include diarrhea, gas,
genus of bacteria known as shigella foul-smelling, greasy stools (poop)
(Shigella that tend to float, stomach cramps
sonnei, Shigella flexneri, Shigella or pain, upset stomach or nausea,
boydii, Shigella dysenteriae – vomiting, dehydration (loss of fluids).
deadly).
• Manifestations are diarrhea that
can be bloody, fever, stomach pain, f. Cryptosporidiosis
a. Cholera
feeling the need to pass stool (poop)
even when the bowels are empty • A diarrheal disease that is caused
(tenesmus) by a microscopic parasite
• spread easily; it takes just a small Cryptosporidium.
number of bacteria to make • people with weakened immune
someone ill. systems, symptoms can be severe
• an acute, diarrheal illness caused
• Transmission thru consumption of and could lead to severe or life-
by infection of the intestine caused
contaminated food and water. threatening illness
by the bacteria Vibrio cholera
• Source of transmission is from the • Several community-wide outbreaks
• Transmitted by drinking water or
stool of infected person. of cryptosporidiosis have been linked
eating food contaminated with
to contaminated drinking municipal
cholera bacteria.
d. Diarrheagenic E. coli infection water or recreational water
• Source of contamination - feces of
• Transmission is thru consumption
an infected person that
of contaminated (stool) food and
contaminates water or food
water.
• Infected people will develop severe
• Manifestations include watery
symptoms such as watery diarrhea,
diarrhea (most common), stomach
vomiting, and leg cramps. Rapid loss
• an intestinal infection caused by six cramps or pain, dehydration, nausea,
of body fluids leads to dehydration
pathotypes: enterohemorrhagic E. vomiting, fever, and weight loss.
and shock.
coli (EHEC), Enterotoxigenic E. coli
* Without treatment, death can
(ETEC), Enteropathogenic E. coli g. Hepatitis A
occur within hours.
(EPEC), Enteroaggregative E. coli
(EAEC), Enteroinvasive E. coli (EIEC),
b. Typhoid fever and Diffusely adherent E. coli (DAEC) • a vaccine-preventable liver
• Transmission is thru the infection caused by the hepatitis A
consumption of contaminated food virus (HAV).
and water. • found in the stool and blood of
• Source of transmission is from the people who are infected
stool of infected people.
• transmission thru close personal Approved Types of Toilet Facilities as some bacteria that may be
contact with an infected person or isolated from environmental
through sources.
eating contaminated food or drink.
• Manifestations include fatigue, Approved Types of Toilet Facilities
nausea, stomach pain, and jaundice. a. Level 1 • presence of total coliforms may or
• Non water carriage toilet facility may not indicate faecal
Water Sources Requiring - no need to wash the waste into the contamination.
Disinfection receiving space
1. Newly constructed water supply - Ex. Pit latrines and reed odorless • Extreme cases, high count for the
facilities. earth closet total coliform group may be
2. Water supply facility that has been associated with a low, or even zero,
repaired/improved. • Pour flush toilets and aqua privies count for thermotolerant coliforms 
3. Water supply source found to be - require small amount of water to would not necessarily indicate the
positive bacteriologically by wash the waste into the receiving presence of faecal contamination 
laboratory analysis. space. due to entry of soil or organic matter
4. Container disinfection of drinking into the water
water collected from water facilities b. Level 2 • grown in or on a medium
subject to • Includes on site toilet facilities of containing lactose, at a temperature
contamination like open dug wells, the water carriage type with water of 35 or 37 °C.
unimproved springs and surface sealed and flush type with septic • provisionally identified by the
water. vault/tank disposal facilities. production of acid and gas from the
fermentation of
Household Water Treatment c. Level 3 lactose.
1. Boiling – heating to boiling point • Water carriage type of toilet • Lactose Broth
to destroy pathogenic facilities connected to septic tanks • Brilliant green lactose bile
microorganisms. and/or to sewerage systems broth
connected to treatment plants.
2. Chemical coagulation – use of
aluminum sulfate to coagulate 2. Thermotolerant (faecal) coliforms
Testing of Water
suspended materials in water.
• Term “faecal coliform”  coliform
Coliform Test organisms which grow at 44 or 44.5
3. Filtration – use of sand, piece of
• analyse for indicator organisms that C and ferment lactose to produce
cloth or any other material for filter
inhabit the gut in large numbers and are acid and gas.
to remove suspended materials from
excreted in human faeces  the presence • presence  nearly always indicates
water.
is evidence of faecal contamination  a faecal contamination.
risk that pathogens are present. • more than 95 per cent isolated
4. Softening – boiling or adding • If indicator organisms are present in from water  gut organism
certain chemicals to reduce calcium large numbers  contamination is Escherichia coli definitive proof of
and magnesium salts which cause considered to be recent and/or severe.
faecal contamination.
water to be “hard”. • Bacteria in water are, in general, not
• grown on media containing
present individually, but as clumps or in
association with particulate matter. lactose, at a temperature of 44 or
5. Chlorination – adding chlorine to
• When enumerating bacteria in water it 44.5 °C.
water to kill pathogenic
is not the number of individual bacteria • provisionally identified by the
microorganisms.
present which are counted, but the production of acid and gas from the
a. Buy commercial chlorine solution number of clumps of bacteria or the fermentation of lactose.
(6-10% sodium hypochlorite) particles and their associated bacteria. • Lactose Broth
b. Prepare chlorine stock solution by
• Brilliant green lactose bile
adding 1 tsp. of commercial chlorine Indicator Organisms broth
solution to 1 L of water.
c. Disinfect drinking water by adding 1. Total coliforms
3. Faecal streptococci
3 teaspoonfuls of chlorine stock
• large group of Gram-negative, rod- • presence = evidence of faecal
solution to 4 liters of water.
shaped bacteria that share several contamination
• tend to persist longer in the
Proper Excreta Disposal Program characteristics. environment than thermotolerant or
• includes thermotolerant coliforms total coliforms and are highly
Status – In 2003, 66.8% has access to resistant to drying
and bacteria of faecal origin, as well
adequate excreta disposal facilities.
• possible to isolate faecal • incubated for 24 + 2 hr at 35 + 0.5 EPA and International Agency for
streptococci from water that degrees C  transfer one or more typical Research on Cancer.
contains few or no thermotolerant colonies (nucleated, with or without • Point sources of environmental
metallic sheen) to a lauryl tryptose broth pollution  mining, foundries and
coliforms.
fermentation tube and a nutrient agar smelters, and other metal-based
• grow in or on a medium containing
slant  incubated at 35 + 0.5 degrees C industrial operations.
sodium azide, at a temperature of for • Heavy metals – affect cellular organelles
37-44 °C. 24 + 2 hr, or for 48 + 3 hr if gas is not and components such as cell membrane,
• usually detected by the reduction of a produced. mitochondrial, lysosome, endoplasmic
dye (generally a tetrazolium-containing • From the agar slants corresponding to reticulum, nuclei, and some enzymes
compound) or the hydrolysis of esculin. the fermentation tubes in which gas involved in metabolism, detoxification,
• Routine methods may give “false formation occurs, gram-stained samples and damage repair
positives” and additional confirmatory are examined microspically • Metal ions  interact with cell
tests may be required. • formation of gas in the fermentation components such as DNA and nuclear
tube and the presence of gram-negative, proteins, causing DNA damage and
Methods for Analysis non-spore-forming, rod-shaped bacteria conformational changes that may lead to
in the agar culture may be considered a cell cycle modulation, carcinogenesis or
satisfactorily completed test. apoptosis
1. Multiple Fermentation • Arsenic, cadmium, chromium, lead,
Technique and mercury  production of reactive
2. Membrane-Filter Technique
• used to determine the presence of a oxygen species (ROS)  oxidative stress 
• used to determine the presence of a
member of the coliform group in ground toxicity and carcinogenicity.
member of a coliform group in
water and surface water.
wastewater and ground water.
• a three-stage procedure in which the
• coliform group analyzed in this Heavy Metals of Public Health
results are statistically expressed in
terms of the Most Probable Number
procedure includes all of the organisms Significance
that produce a colony with a golden- 1. Arsenic
(MPN).
green metallic sheen within 24 hr of
• These stages -- the presumptive stage, • ubiquitous element that is detected at
inoculation.
confirmed stage, and completed test low concentrations
• A predetermined amount of sample is
• environmental pollution  a result of
filtered through a membrane filter which
a. Presumptive Stage retains the bacteria found in the sample.
natural phenomena such as volcanic
• A series of lauryl tryptose broth eruptions and soil erosion, and
• water is drawn through a special
primary fermentation tubes are anthropogenic activities
porous membrane designed to trap
inoculated with • arsenic-containing compounds are
microorganisms larger than 0.45 μm.
graduated quantities of the sample to be produced industrially, insecticides,
• Afterward, the filter is applied to the
tested. herbicides, fungicides, algicides, wood
surface of Endo agar plates and
• incubated at 35 + 0.5 degrees Celcius preservatives, and dye-stuffs.
incubated for 24 hours.
for 24 + 2hr, at which time the tubes are • several million people are exposed to
examined for gas formation. arsenic chronically throughout the world
Heavy Metals of Public Health thru contamination of ground water.
• Formation of gas in any amount within
48 + 3 hr is positive. Significance. • Exposure - via the oral route (ingestion)
• Heavy metals - naturally occurring - main, inhalation, dermal contact, and
elements that have a high atomic weight the parenteral route to some extent
b. Confirm Stage
and a density at least 5 times greater • pesticide application or waste disposal
• used on all primary fermentation tubes
than that of water. in soil can produce much higher values of
showing gas formation during the 24-hr
and 48-hr periods arsenic
• industrial, domestic, agricultural, • Occupations with much exposure -
• Fermentation tubes containing brilliant
medical and technological applications  vineyards, ceramics, glass-making,
green lactose bile broth are inoculated
led to their wide distribution in the smelting, refining of metallic ores,
with medium from the tubes showing a
environment  potential effects on pesticide manufacturing and application,
positive result in the presumptive test.
human health and the environment. wood preservation, semiconductor
• incubated for 48 + 3 hr at 35 + 0.5
degrees Celcius. Formation of gas at any manufacturing.
• Toxicity – depends on dose, route of • Reported conditions with exposure -
time in the tube indicates a positive
exposure, and chemical species, as well as the cardiovascular and peripheral vascular
confirmed test. age, gender, genetics, and nutritional status of
disease, developmental anomalies,
exposed individuals.
neurologic and neurobehavioral.
c. Completed Stage • Metals with high degree of toxicity -
disorders, diabetes, hearing loss, portal
• performed on all samples showing a arsenic, cadmium, chromium, lead, and
fibrosis, hematologic disorders (anemia,
positive result in the confirmed test. mercury  priority metals with public
leukopenia and eosinophilia) and
• used also as a quality control measure health significance.
carcinoma.
on 20% of all samples analyzed. • Heavy metals – systemic toxicants 
• One or more plates of eosin methylene multiple organ damage, even at lower
2. Cadmium
blue are streaked with sample to be levels of exposure.
• environmental and occupational
analyzed. • Heavy metals  classified as human
concern.
carcinogens (known or probable) (US
• widely distributed in the earth's crust, • naturally occurring bluish-gray metal • effects include gastrointestinal toxicity,
highest levels in sedimentary rock present in small amounts in the earth’s neurotoxicity, and nephrotoxicity
• major industrial applications - crust • anthropogenic activities contribute
production of alloys, pigments, and • anthropogenic activities such as fossil significantly to environmental
batteries fuels burning, mining, and contamination.
• main routes of exposure to cadmium  manufacturing • severity of adverse health effects is
via inhalation or cigarette smoke, and  contribute to the release of high related to the type of heavy metal and its
ingestion of food. Skin absorption is rare concentrations chemical form, and is also time- and
• currently used in the production of dose-dependent.
• Sources - employment in primary lead-acid batteries, ammunitions, metal • causes long term health problems in
metal industries, eating contaminated products (solder and pipes), and devices human populations.
food, to shield X-rays • co-exposure to metal/metalloid
smoking cigarettes, and working in mixtures of arsenic, lead and cadmium
cadmium-contaminated work places, • largest source of lead poisoning in produced more severe effects at both
with smoking being a major contributor. children  dust and chips from relatively high dose and low dose levels
• Other sources of cadmium - emissions deteriorating lead paint on interior
from industrial activities, including surfaces of the house • chronic low dose exposure to multiple
mining, smelting, and manufacturing of • exposure  occurs mainly via inhalation elements is a major public health
batteries, pigments, stabilizers, and of lead-contaminated dust particles or concern
alloys. aerosols, and ingestion of lead-
• important distribution route  contaminated food, water, and paints Specimen Requirement and Procedure
circulatory system  blood vessels  main • the greatest percentage of lead  taken • can be done indirectly or directly
stream organs of cadmium toxicity. into the kidney, followed by the liver and • Indirect  blood smear with basophilic
• Chronic inhalation  emphysema, the other soft tissues such as heart and stippling for a patient with blue lines at
decrease in olfactory function, decrease brain the base of the gums
bone mineral density and osteoporosis. • nervous system  the most vulnerable - Chronic lead toxicity
• Exposure determined  measuring target of lead poisoning resulting to • Direct/a confirmatory test  analysis of
cadmium levels in blood or urine. headache, poor attention, irritability, loss the suspected metal concentration in the
• Blood cadmium  reflects recent of memory and dullness body
cadmium exposure (from smoking, for • the most systemic toxicant that affects • Samples: blood, urine, hair, and nails.
example). several organs in the body including the • acute, chronic, and prior exposure 
• Cadmium in urine (usually adjusted for kidneys, liver, central nervous system, most, but not all, heavy metals  24-hour
dilution by calculating the hematopoietic system, endocrine urine collection
cadmium/creatinine ratio)  indicates system, and reproductive system • acute and chronic exposures  urine
accumulation, or kidney burden of metal analysis and blood test
cadmium. 5. Mercury • metal concentrations are normally in
• unique in that it exists or is found in the nano and microgram range  careful
3. Chromium nature in three forms (elemental, consideration needs to be taken to
• naturally occurring element present in inorganic, and organic), with each having prevent contamination
the earth’s crust, its own profile of toxicity • Specialized “trace element free” vials
• Sources of exposure - entry into • widespread environmental toxicant should be used
various environmental matrices (air, and pollutant • Blood samples should be taken using a
water, and • utilized in the electrical industry royal blue-capped vial.
soil) from a wide variety of natural and (switches, thermostats, batteries), • Lead  tan top lead-free tube is
anthropogenic sources with the largest dentistry (Dental amalgams), and acceptable.
release coming from industrial numerous industrial processes including • Preferably, samples should be kept
establishments. the production of caustic soda, in nuclear refrigerated.
• Industries with the largest contribution reactors, as antifungal agents
- metal processing, chromate production, for wood processing, as a solvent for Diagnostic Tests
stainless steel welding, and ferrochrome reactive and precious • heavy metal concentrations 
and chrome pigment production. metal, and as a preservative of inductively coupled plasma with mass
• an essential nutrient that plays a role in pharmaceutical products spectrometry (ICP/MS) or atomic
glucose, fat and protein metabolism by • Exposure thru accidents, absorption spectroscopy (AAS)
potentiating the action of insulin environmental pollution, food • ICP/MS is more commonly used due to
• Non-occupational exposure  occurs contamination, dental its low detection limit and ability to
via ingestion of chromium containing care, preventive medical practices, detect multiple elements at once.
food and water industrial and agricultural operations,
• Occupational exposure  occurs via and occupational operations Solid Waste Management/Garbage
inhalation • major sources of chronic, low level Disposal in the
• Exposure cause multiorgan toxicity mercury exposure - dental amalgams and Philippines
such as renal damage, allergy and fish consumption.
• Philippines generates more solid
asthma, and cancer of the respiratory • enters water as a natural process of off-
waste as population increases, living
tract in human gassing from the earth’s crust and also
through industrial pollution standards are enhanced, and urban
4. Lead and rural areas are being developed.
• the country’s waste generation • Ecological Solid Waste Quezon City, which is less than a
steadily increased from 37,427.46 Management Act (RA No. 9003)  kilometer away from
tons per day in enforcement and Metro Manila’s water source, La
2012 to 40,087.45 tons in 2016 - compliance with the law remains a Mesa Dam. - Global Alliance for
Senate Economic Planning Office daunting task due to technical, Incinerator
(SEPO) political, and Alternative Coordinator Ramon
• solid wastes produced by financial limitations of concerned Lopez.
Philippine cities are expected to agencies and [local government units
increase by 165 percent (LGU)],” • Presidential Decree No. 825 (PD
to 77,776 tons by 2025 -- SEPO. No. 825)  enjoins all citizens and
• Residential areas  produce the residents of
greatest number of solid wastes at *“Majority of LGUs have yet to the Philippines, educational
57 percent comply with the provisions of RA institutions and commercial and
• Wastes from commercial 9003, industrial
establishments - 27 percent, particularly on the establishment of establishments to clean their own
• Institutional sources  12 percent local [solid waste management surroundings, as well as the
• Industrial or manufacturing sector (SWM)] canals, roads or streets in their
 4 percent of the total waste immediate premises.
generated *Boards, submission of SWM Plans, • Owners of idle lots in Metro
• The Ecological Solid Waste establishment of [materials- Manila shall keep them clean to
Management Act of 2000 (Republic recovery facilities], and closure of all protect them from becoming
Act 9003) was open and controlled dumpsites.” breeding places of mosquitoes, flies,
approved in January 26, 2001 and mice, rats and other scavengers.
came into effect on February 16, • RA No. 9003 prohibits the use of Otherwise, the government shall
2001. open dumps for solid waste disposal undertake to keep said lots clean at
 systematic administration of and enjoins the LGUs to convert the owners’ expense.
activities which provide for their open dumps into sanitary
segregation landfill. • RA No. 9003
at source, segregated transportation,  prohibits the littering, throwing,
storage, transfer, processing, • Administrative Order No. 50-1998, dumping of waste matters in public
treatment, the Department of Environment and places, or causing or permitting the
and disposal of solid waste and all Natural Resources (DENR) prescribed same.
other waste management activities guidelines for identifying and
which do establishing sanitary  Any person who commits this
not harm the environment. landfills such that, among others: offense shall, upon conviction, be
• local government units (LGUs)  fined for not less than P300 but not
hold the primary responsibility for (a) the site should not be located in more than P1,000, or render
the effective and efficient solid waste existing or proposed residential, community service for not
management. commercial, or urban development less than one day to not more than
• poor solid waste management in areas, and areas with archeological, 15 days to an LGU where such
the Philippines  still prevalent  cultural, and historical importance; prohibited acts are committed.
since open and controlled dumps are (b) the site should not be located in
being used in the country. or up gradient of shallow unconfined • Garbage ending up on streets,
• great threats on the country’s aquifers for drinking water supply; sewages, canals and other
environment and public health that (c) the site should not be located waterways
include: near airports; and  attributed the absence of
(d) the site should not be located in implementing ordinances in some
 a) alteration of physical and soft and settling soils. LGUs residents’ lack of participation
chemical properties of soil due to in promoting solid waste
percolation of landfill gases (CO2 • As of 2018, the DENR’s National management, and the general
and CH4) and leachates from Solid Waste Management public’s limited awareness on waste
unsanitary landfills Commission disclosed disposal and segregation.
and open dumps that a total of 384 open dumps still
operate nationwide except in Metro •“One of the major problems we
 b) objectionable odor; and Manila. encounter until now is the human
 c) soil and groundwater pollution. • LGUs continue to operate landfills and cultural
within environmentally critical areas, behavior. We can’t clean the
such as the Payatas landfill in environment alone.” -Department of
Public Services operations division • Four Rights to Food Safety • Sharps – very hazardous; 1. cuts
technical staff Jayson Umali. and punctures (injuries)
1. Right Source - water boil for 2 - Disease transmission (most
Vector Control Program minutes common - viral blood infections);
• Focuses on sustainable preventive 2. Right Preparation
and vector control measures against 3. Right Cooking • Modes of transmission – contact,
the malaria parasite and mosquito vehicle-borne, airborne (cultures),
vector. 4. Right Storage vector borne.
• Objective  reduce the source of • All wastes that are generated or
infection in the human population by - cooked foods, left not >2 hours in produced as a results of hospital
reducing/eliminating man-vector room temp activities such as diagnosis and
contact and reducing the density of - sealed containers treatment or immunization.
the mosquito vector population. - store foods (if >4-5 hours) in >60
degrees Celsius or <10 degrees
• Measures Celsius
- Infants – fresh Categories
1. Insecticide treatment of - Reheat stored food >70 degrees 1. General waste – from
mosquito nets Celsius housekeeping and administrative
2. House spraying of insecticide on • Potential Hazards – physical, functions; dealt by municipal waste
surfaces (indoor and outdoor) chemical, biological, and ergonomic disposal system.
3. On-stream seeding – larvivorous factors.
fish propagation • Minimize hazards 2. Infectious wastes – contain
4. On-stream clearing – vegetation pathogens; ex. Cultures, excreta,
removal Health Care Waste Management human blood, body fluids,
instruments or materials with
Food Sanitation Program 1. Administrative – ex. Proper and contact with infected individual.
• Emergence of fast-food restaurants regular training
and around the corner food and fruit 2. Engineering – ex. change of Categories
shake process  safer methods 3. Pathological waste – tissues,
stands  exposes the population to 3. Medical – ex. Written organs, human fetus
food-borne infection due to occupational health and safety 4. Sharps – considered as highly
unsanitary and food preparation program – ex. hazardous
Physical exam  pre-employment 5. Pharmaceutical waste – drugs,
• Policies and annual and regular sera, vaccines
1. Food establishments’ appraisal of immunization 6. Genotoxic waste – cytostatic
sanitary conditions: drugs, body from patients subjected
• Persons at risk with cytostatic drugs  teratogenic,
a. Inspection/approval of all food 1. Hospital staffs carcinogenic and mutagenic
sources, containers and transport 2. Patients 7. Chemical waste – discarded solid,
vehicles. 3. Visitors liquid and gaseous chemicals;
4. Orderly hazardous toxic, corrosive,
b. Compliance to sanitary permit 5. Persons transporting and treating flammable, reactive, and genotoxic
requirements for all food medical wastes 8. Wastes with high content of heavy
establishments. 6. General public metals – thermometers – mercury
9. Radioactive waste
C. Provision of updated health • Hazardous nature
certificate for food handlers, cooks, 1. Infectious waste and sharps Waste segregation
and cook-helpers – monitoring the 2. Chemical and pharmaceutical • Segregation – responsibility of
presence of intestinal parasites waste waste producer
(ascaris, amoeba, E. coli, etc.) and 3. Genotoxic wastes • Waste collection – every beginning
bacterial infection (typhoid, cholera, 4. Radioactive waste of the shift
dysentery,
salmonella, and etc.) 1. Infectious wastes and sharps Color Coding Scheme for Health
• Pathogens enters thru  puncture Care Waste
2. DOH Admin. Order No. 1-2006 – or abrasion, mucous membrane,
Formalin Ether Concentration inhalation, and ingestion. Waste Disposal Systems
Technique (FECT) for stool analysis 1. Sanitary Landfill
- keep the waste isolated from the
environment.

2. Safe Burial on Hospital Premises

- in remote locations and rural areas

3. Septic/Concrete Vault
- used sharps and syringes