334 ENVIRONMENTAL HEALTH INTRODUCTION † Definitions “Environmental Health” encompasses what is also known as environmental engineering and sanitation, public health engineering, and sanitary engineering. It is concerned with “the control of all those factors in man’s physical environ- ment which exericise or may exercise a deleterious effect on his physical development, health and survival,” 1 with consideration of the physical, economic and social ‡ impact of the control measures applied. Included is the application of engineering principles to the control, modifi cation or adapta- tion of the physical, chemical, and biological factors of the environment in the interest of man’s health, comfort, and social well-being. The concern is not merely with simple sur- vival and prevention of disease and poisoning, although even these are not entirely under control. In addition, environmen- tal health involves the maintenance of an environment that is suited to man’s effi cient performance, and to the preservation of comfort and enjoyment of living today and in the future. 2,3 The environment is defi ned as the sum of all external infl u- ences and conditions affecting life and the development of an organism. The Committee on Environment of the American Public Health Association goes a step further and says that “The Environment is considered the surroundings in which man lives, works and plays. It encompasses the air he breathes, the water he drinks, the food he consumes and the shelter he provides for his protection against the elements. It also includes the pollutants, waste materials, and other deterimental envi- ronmental factors which adversely affect his life and health.” 4 Scope It is apparent from the above that the fi eld of environmen- tal health covers an extremely broad area of man’s universe. The World Health Organization, the American Public Health Association, and others have suggested what the scope should be and how the programs should be administered. In all instances, a totality is envisioned with consideration of the impact of man on the environment and the impact of the environment on man, with a balanced appraisal and alloca- tion of available resources to both. A report of a WHO expert Committee 5 considers the scope of environmental health to include or relate to the following: 1) Water supplies, with special reference to the pro- vision of adequate quantities of safe water that are readily accessible to the user, and to the planning, design, management, and sanitary surveillance of community water supplies, giving due consider- ation to other essential uses of water resources. 2) Wastewater treatment and water-pollution con- trol, including the collection, treatment, and dis- posal of domestic sewage and other waterborne wastes, and the control of the quality of surface water (including the sea) and ground water. 3) Solid-waste management, including sanitary han- dling and disposal. 4) Vector control, including the control of arthro- pods, molluscs, rodents, and other alternative hosts of disease. 5) Prevention or control of soil pollution by human excreta and by substances detrimental to human, animal, or plant life. 6) Food hygiene, including milk hygiene. 7) Control of air pollution. 8) Radiation control. 9) Occupational health, in particular the control of physical, chemical, and biological hazards. 10) Noise control. 11) Housing and its immediate environment, in par- ticular the public health aspects of residential, public, and institutional buildings. 12) Urban and regional planning. 13) Environmental health aspects of air, sea, or land transport. 14) Accident prevention. 15) Public recreation and tourism, in particular the environmental health aspects of public beaches, swimming pools, camping sites, etc. 16) Sanitation measures associated with epidemics, emergencies, disasters, and migrations of popula- tions. 17) Preventive measures required to ensure that the general environment is free from risk to health. † This chapter is based on material which appears in a book by the author entitled Environmental Engineering and Sanitation, John Wiley & Sons, Inc., New York, NY, 1972. ‡ Includes political, cultural, educational, biological, medical, and public health. © 2006 by Taylor & Francis Group, LLC ENVIRONMENTAL HEALTH 335 The APHA Committee on Environment 4 proposed the fol- lowing program areas and also the planning considerations, and methods to implement programs. Environmental Program Area Wastes 1) Air 2) Sewage and liquid 3) Solid Water Supply Housing and Residential Environment Food and Drugs Radiation Noise Accidents Occupational and Institutional Hazards Vectors Recreation Planning Considerations Health Economic Demographic and Land Use Social Esthetic Resource Conservation (Also manpower, facilities, and services.) Methods and Technics Research Demonstration Education Standards Legislation Inspection Enforcement Planning Evaluation Incentives Systems Analysis The discussions that follow will briefl y review and intro- duce some of the major program areas listed above. Detailed treatment of some of the subject matter can be found in other chapters of this Encyclopedia. ENVIRONMENTAL HEALTH AND ENGINEERING PLANNING The Principle of the Total Environment The central community or city is dependent upon the surrounding areas for its human resources and its economic survival. The surrounding areas are dependent in whole or in part on the central community or city for employment, cultural and other needs. Increasing urbanization is erasing the boundary between the two except for the governmental jurisdictions involved and even these are being blended. The health, welfare, library, police, transportation, recreation, drainage, water, sewerage, and superimposed school sys- tems are examples of combined services now provided in some areas. It is self-evident that regional problems require regional solutions even though operationally individual control may be temporarily required as a political expedi- ent until mutual confi dence is established between adjoining governmental units. This emphasizes however the necessity of interim comprehensive planning so that adjoining govern- mental units may capitalize on improvements and services provided to the long term mutual benefi t of their residents. For no one lives in a vacuum and the interdependency of governmental units must be recognized as a fact of life. Planning and the Planning Process It is important that environmental health and engineering planning take place within the context of comprehensive regional or area wide planning. It is equally important how- ever that comprehensive community planning fully recog- nize the environmental health and engineering functions and needs of the area. As used here, the term planning means the systematic process by which goals (policies) are established, facts are gathered and analyzed, alternative proposals and programs are considered and compared, resources are mea- sured, priorities are established, and recommendations are made for the deployment of resources designed to achieve the established goals. 6 Level of Planning Types of Planning Project. Function. Gen. S ocial Economic Physical B A C Goal FIGURE 1 Types and levels of planning. (Applicable to National, State, Regional and Local planning.) From Joseph A. Salvato, Jr., Environmental Engineering and Sanitation, John Wiley & Sons, Inc., New York, NY, 1972. © 2006 by Taylor & Francis Group, LLC 336 ENVIRONMENTAL HEALTH There are many types and levels of planning for the future ranging from family planning to national plan- planning and three different levels of planning. These are all interdependent. A. General, Overall Policy Planning —Identification of goals, aspirations and realistic objectives. Establishment of functional priorities. B. Functional Planning —Such as for transporta- tion, water supply, wastewater, recreation, air pollution, solid wastes, or medical care facilities in which alternative functional solutions are pre- sented, including consideration of the economic, social and ecological factors, advantages and disadvantages. C. Project Planning —Detailed engineering and architectural specific project plans, specifications, drawing and contracts for bidding. Plan of action. Construction, Operation and Maintenance—Plan adjust- ment as constructed; updating and planning for alterations and new construction. ves an example of the general, overall policy planning process. It recognizes in the process the environ- mental health and engineering goals and objectives, con- siderations, plans, and the implementation programs and devices needed. The next level of planning, depending on the functional priorities established, would be specifi c func- tional planning such as for recreation, transportation, sewer- age, solid wastes, or environmental health. Environmental Health and Engineering Planning Since this chapter deals with environmental health, a report outline for that purpose follows. 1) Letter of transmittal to the contracting agency. 2) Acknowledgments. 3) Table of contents. a) List of tables. b) List of figures. 4) Findings, conclusions, and recommendations. 5) Purpose and scope. 6) Background data and analysis, as applicable, including base maps, reports, and special studies. a) Geography, hydrology, meteorology, geology, and ground water levels. b) Population and characteristics, past, present, future, and density. c) Soils characteristics; flora and fauna. d) Transportation and mobility. Adequacy and effects produced, present and future. e) Residential, industrial, commercial, recre- ational, agricultural, and institutional develop- ment and redevelopment. f) Land use, present and future; spread of blight and obsolescence; inefficient and desirable land uses. g) Drainage, water pollution control, and flood control management. h) Water resources, multi-use planning and devel- opment with priority to water supply, environ- mental impact. i) Air and water pollution, sewerage, and solid wastes management. j) Public utilities and their adequacy—electricity, gas, oil, heat. k) Educational and cultural facilities, size, loca- tion, effects. l) Economic studies—present sources of income, future economic base and balance, labor force, markets, industrial opportunities, retail facili- ties, stability. m) Sociological factors, characteristics, knowl- edge, attitudes; behavior of the people and their expectations. n) Local government and laws, codes ordi- nances. o) Special problems, previous studies and find- ings, background data. 7) Supplementary background environmental health and engineering information. a) Epidemiological survey including mortality, morbidity, births and deaths, and specific inci- dence of diseases; social, economic, and envi- ronmental relationships; also water-, insect-, and food-borne diseases; animal- and animal- related diseases, airborne and air-related diseases, pesti- cide and chemical poisonings; adequacy of data and programs. b) Public water supply, treatment, and distribution including population served, adequacy, opera- tion, quality control, cross-connection control, storage and distribution protection, operator qualifications. For individual systems—popu- lation served, special problems, treatment and costs, adequacy, control of well construction. c) Waste-water collection, treatment and disposal, adequacy of treatment and collection system, population served, operator qualifications; sewer connection control. For individual systems— population served, special problems, control of installations. Water pollution control. d) Solid wastes management—storage, collec- tion, transportation, processing, and disposal; adequacy. e) Air resources management and air pollution control including sources, air quality, emission standards, problems and effects, regulation, and control program. f) Housing and the residential environment— control of new construction, house conservation © 2006 by Taylor & Francis Group, LLC ning for survival. Figure 1 shows three different types of Figure 2 gi ENVIRONMENTAL HEALTH 337 STATEMENT OF GOALS AND OBJECTIVES BASIC STUDIES GENERAL PLANS Base Maps Land Use Maps & Analysis Economic Study Population Environmental Consideration ANALYSIS Re-Evaluation of Goals & Objectives Coordination with other Federal, State, Regional, County, Local, Private Plans Public Information THE PROCESS OF COMPREHENSIVE COMMUNITY PLANNING Land Use Plan Transportation Plan Community Institutions Plan Special Planning Studies and Urban Renewal Plans Environmental Engineering Plans IMPLEMENTATION DEVICES Capital Improvements Programs & Financing Plans Establishment of Priorities Detailed Engineering & Architectural Development Plans Coordination with Governmental and Private Plans Administrative Organization Zoning Ordinance & Map Subdivision Regulations Building Code, Housing Code, Health Code, Other Urban Renewal Program PUBLIC INFORMATION & COMMUNITY ACTION RE-EVALUATION AND CONTINUAL PLANNING IMPLEMENTATION PROGRAMS FIGURE 2 An example of the planning process. From Joseph A. Salvato, Jr., “Environmental Health and Community Planning,” Journal of the Urban Planning and Development Division, ASCE, Vol. 94, No. UPI, Proc. Paper 6084, August 1968, pp. 22–30. © 2006 by Taylor & Francis Group, LLC 338 ENVIRONMENTAL HEALTH and rehabilitation, enforcement of housing occupancy and maintenance code, effective- ness of zoning controls, and urban renewal. Realty subdivision and mobile home park development and control, also effect of devel- opment on the regional surroundings and effect of the region on the subdivision, including the environmental impact of the subdivision. g) Recreation facilities and open space planning, including suitability of water quality and ade- quacy of sewerage, solid waste disposal, water supply, food service, rest rooms, safety, and other facilities. h) Food protection program—adequacy from source to point of consumption. i) Nuclear energy development, radioisotope and radiation environmental control including fallout, air, water, food, and land contamination; thermal energy utilization or dissipation, and waste dis- posal; naturally occurring radioactive materials; air, water, plant, and animal surveillance; federal and state control programs, standards; site selec- tion and environmental impact, plant design and operation control; emergency plans. j) Planning for drainage, flood control, and land use management. k) Public health institutions and adequacy of medical care facilities such as hospitals, nurs- ing homes, public health centers, clinics, mental health centers, rehabilitation centers, service agencies. l) Noise and vibration abatement and control. m) Noxious weed, insect, rodent, and other vermin control, including disease vectors and nuisance arthropods; regulation, control, and surveillance including pesticide use for control of, aquatic and terrestrial plants, and vectors; federal, state, and local programs; and effects of water, recreation, housing, and other land resource development. n) Natural and manmade hazards including safety, slides, earthquakes, brush and forest fires, reservoirs, tides, sand storms, hurricanes, tornadoes, high rainfall, fog and dampness, high winds, gas and high tension transmission lines, storage and disposal of explosive and flammable substances and other hazardous materials. o) Aesthetic considerations, also wooded and scenic areas, prevailing winds, and sunshine. p) Laws, codes, ordinances, rules, and regulations. q) Environmental health and quality protection; adequacy of organization and administration. 8) The comprehensive regional plan. a) Alternative solutions and plans. b) Economic, social, and ecologic evaluation of alternatives. c) The recommended regional plan. d) Site development and reuse plans. 9) Administration and financing. a) Public information. b) Administrative arrangements, management, and costs. c) Financing methods—general obligation bonds, revenue bonds, special assessment bonds; taxes, grants, incentives, federal, and state acid. d) Cost distribution, service charges, and rates. Capital costs—property, equipment, structures, engineering, and legal services; annual costs to repay capital costs, principal and interest, taxes. Regular and special charges and rates. e) Legislation, standards, inspection, and enforce- ment. f) Evaluation, research, and re-planning. 10) Appendices a) Applicable laws. b) Special data. c) Charts, tables, illustrations. 11) Glossary. 12) References. HEALTH ASPECTS Life Expectancy The life expectancy at birth has varied with time, geography, and with the extent to which available knowledge concern- shows the trend in life expectancy with time. The gains in life expectancy between 1900 and 1968 shown in Table 1a have occurred mostly in the early years, 21 years at birth and 15.5 years at age 5, reducing to 4.8 years at age 45 and 2.4 years at age 70. The life expectancy gains are due to better sanitation and nutrition and to the conquest of the major epi- demic and infectious diseases including immunization and chemotherapy. they show the changes in major causes of death in 1900 related to 1960 and the net reduction in total death rate. Table 2a shows the leading causes of death as of 1967. The leveling off that is apparent in the United States is due to our inability thus far to identify the causes and to control the chronic, non-infectious diseases such as heart disease and cancer. Communicable Disease Control Although the communicable diseases as causes of death have been largely brought under control in the more advanced countries, this is not the case in the undeveloped areas of the world. Even in the so-called advanced countries, illnesses associated with contaminated drinking water and food are not uncommon. © 2006 by Taylor & Francis Group, LLC ing disease prevention and control could be applied. Table 1 The vital statistics in Table 2 are of interest in that ENVIRONMENTAL HEALTH 339 Between 1946 and 1960 a total of 228 waterborne out- breaks with 25,984 cases were reported in the United States. 7 An outbreak in California involving Salmonella typhimurium affected an estimated 18,000 persons in a population of 130,000. 8 An explosive epidemic of infectious hepatitis in India with about 29,300 cases of jaundice was attributed to inadequate chlorination and poor operation control. 9 Sewage normally contains organisms causing various types of diarrhea, dysentery, infectious hepatitis, salmonella infections, and many other illnesses. It becomes obvious that all sewage should be considered presumptively contaminated, beyond any reasonable doubt, with disease producing organisms. The mere exposure of sewage on the surface of the ground, such as from TABLE 1 Life expectancy at birth Period or year Life expectancy Neanderthal man (50,000 BC–35,000 BC) 29.4 a Upper paleolithic (600,000 BC–15,000 BC) 32.4 a Mesolithic 31.5 a Neolithic anatolia (12,000 BC–10,000 BC) 38.2 a Bronze age—Austria 38 a Greece classical (700 BC–460 BC) 35 a Classical Roman (700 BC–200 AD) 32 a Roman empire (27 BC–395 AD) 24 1000 32 England (1276) 48 a England (1376–1400) 38 a 1690 33.5 1800 35 1850 40 1870 40 1880 45 1900 48 1910 50 1920 54 1930 59 1940 63 1950 66 1960 68 1970 71 Note: The 1970 life expectancy reported by the United Nations for Sweden was 71.9 for males and 76.5 for females and for the United States 67.0 for males and 74.2 for females. a E. S. Deevy, Jr., “The Human Population,” Scientifi c American, Vol. 203, No. 3, September 1960, p. 200. Life expectancy fi gures from 1690 to 1970 are for the United States. TABLE 1a Increase in life expectancy between 1900 and 1968 at selected ages a Age Years added Age Years added 0 21 45 4.8 1 15.5 55 3.6 5 12.0 60 3.1 15 10.4 65 2.7 25 8.8 70 2.4 35 6.7 75 2.0 a Reference: The New York Encyclopedic Almanac 1971, New York, NY, p. 496. TABLE 2 Selected vital statistics—deaths per 100,000 in the United States Cause Death rate for year 1900 1950–60 Pneumonia and infl uenza 202 32 Tuberculosis 195 7 Diphtheria 40 0ϩ Measles 14 0.2 Diarrhea 110 — Typhoid 31 0ϩ Malignant neoplasms 64 150 Cardiovascular and renal diseases 345 520 All causes 1719 934 TABLE 2b Leading causes of death—deaths per 100,000 population in the United States Cause Death rate Diseases of the heart 364.5 Cancer 157.2 Cerebral hemorrhage (stroke) 102.2 Accidents 57.2 Motor vehicle 26.8 All others 30.4 Pneumonia and infl uenza 28.8 Certain diseases of early infancy 24.4 Arteriosclerosis 19.0 Diabetes mellitus 17.7 Other diseases of the circulatory system 15.1 Other bronchopulmonic diseases 14.8 Cirrhosis of liver 14.1 Suicide 10.8 Congenital malformations 8.8 Homicide 6.8 Other hypertensive disease 5.6 Other and ill-defi ned 88.7 Total of all causes 9.537 From U.S. Public Health Service, 1967. © 2006 by Taylor & Francis Group, LLC 340 ENVIRONMENTAL HEALTH an overfl owing cesspool or septic tank system, or its improper treatment and disposal into a stream or lake, immediately sets the stage for possible disease transmission. The means may be a child’s ball, the house fl y, or ingestion of contaminated water or food. Sanitary safeguards, including adequate water treatment, must therefore be always maintained if the water- and fi lthborne diseases are to be held in check. It may appear inconceivable, but there are still many urban areas, as well as suburban areas, in the United States and abroad where the discharge of raw or inadequately treated sewage to roadside ditches and streams is commonplace. Although the disease hazard is ever present, the public pressure for sewage treatment and water pollution abatement stems more from aes- thetic, recreational, and related economic considerations rather than from actual disease hazard and transmission. As a matter of fact, a critical reappraisal may be in order to review current expenditures and perhaps achieve a better balance in the allo- cation of public funds for the public good. Whereas a safe and adequate water supply is taken for granted by most people in the United States, for about 2 bil- lion people, about two thirds of the world’s population, this is still a dream. The availability of any reasonably clean water in less developed areas of the world just to wash and bathe would go a long way toward the reduction of such scourges as sca- bies and other skin diseases, yaws and trachoma, and the high infant mortality. The lack of a safe water makes commonplace high incidences of shigellosis, amebiasis, schistosomiasis, leptospirosis, infectious hepatitis, typhoid, and paratyphoid. 10 Between 1923 and 1937 there were an average of 43 milkborne outbreaks with 1724 cases and 47 deaths reported each year in the United States. Between 1938 and 1956 an average of 24 milkborne outbreaks per year with 980 cases and 5 deaths were reported to the U.S. Public Health Service. Between 1957 and 1960 the outbreaks averaged 9 and the cases 151 per year. There were no deaths reported since 1949. The success achieved in the control of milkborne illnesses can be attributed to the practical elimination of the sale of raw milk, greatly improved equipment and to effective con- trol over the pasteurization of milk and milk products. Whereas milkborne diseases have been brought under con- trol, foodborne illnesses remain unnecessarily high. Between 1938 and 1956 there were reported 4647 outbreaks, 179,773 cases and 439 deaths. In 1967, there were still 273 outbreaks reported with 22,171 cases and 15 deaths. The major bacteria related to foodborne illnesses in recent years (1967–68) are Salmonella, C. perfringens, and Staphylococcus. Banquets accounted for over half of the illnesses reported with schools and restaurants making up most of the rest. The largest number of outbreaks occurred in the home. 11 In addition to waterborne and foodborne diseases, con- sideration should be given to the environmental related respi- ratory diseases, the insectborne diseases and zoonoses, and the many miscellaneous diseases. These too must be con- trolled to the extent possible where indicated. The common cold, encephalitides, malaria, rabies, and disabilities related to air pollution are examples. More effect must be directed to the total environmental pressures and insults to which the body is subjected. The cumulative body burden of all deleterious substances gaining access to the body through the air, food, drink, and skin must be examined both individually and in combination. The syner- gistic effects and neutralizing effects must be learned in order that proper preventive measures may be applied. It has been diffi cult to determine the effects of the presence or absence of certain trace elements in air, water, and food on human health. Some elements such as fl uorine for the control of tooth decay, iodine to control goiter, and iron to control iron-defi ciency anemia have been recognized as being benefi cial in proper amounts. But the action of trace amounts ingested individu- ally and in combination of lead, cadmium zinc, hexavalent chromium, nickel, mercury, manganese, and other chemicals are often insidious. The effects are extended in time to the point where direct relationship with morbidity and mortality is diffi cult to prove in view of the many possible intervening and confusing factors. Some may even prove to be benefi cial. Mercury A brief discussion of one of these metals, namely mercury, is of interest. The poisoning associated with (a) the consump- tion of mercury contaminated fi sh in Japan between 1953 and 1964; (b) bread made from mercury-contaminated wheat seed in West Pakistan in 1961, in Central Iraq in 1960 and 1965, and in Panorama, Guatemala in 1963 and 1964; (c) pork from hogs fed methylmercury treated seed in Alamogordo, New Mexico; and (d) methylmercury treated seed eaten by birds in Sweden, directed worldwide attention to this prob- lem. The discovery of moderate amounts of mercury in tuna and most fresh water fi sh, and relatively large amounts in swordfi sh, by many investigators in 1969 and 1970 tended to further dramatize the problem. 12, 13,14 The organic methylmercury forms of mercury are highly toxic. Depending on the concentration and intake, it can cause unusual weakness, fatigue and apathy followed by neurological disorders. Numbness around the mouth, loss of side vision, poor coordination in speech and gait, tremors of hands, irritability and depression are additional symptoms leading possibly to blindness, paralysis, and death. The mer- cury also attacks vital organs such as the liver and kidney. It concentrates in the fetus and can cause birth defects. Mercury has an estimated biological half-life of 70 to 74 days in man, depending on such factors as age, size, and metabolism, and is excreted mostly in the feces at the rate of about one percent per day. Mercury persists in large fi sh such as pike one to two years. Mercury is ubiquitous in the environment. The sources are both natural and manmade. Natural sources are leachings and volatilization from mercury containing geological formations. Manmade sources are waste discharges from chloralkali and pulp manufacturing plants, mining, chemical manufacture and formulation, the manufacture of mercury seals and controls, treated seeds, combustion of fossil fuels, fallout, and surface runoff. The mercury ends up in lakes, streams and tidal waters, and in the bottom mud and sludge deposits. Microorganisms and macroorganisms in water and bottom deposits can transform metallic mercury, inorganic © 2006 by Taylor & Francis Group, LLC ENVIRONMENTAL HEALTH 341 divalent mercury, phenylmercury, and alkoxialkylmercury into methylmercury. The methylmercury thus formed, and perhaps other types, in addition to that discharged in wastewa- ters, are assimilated and accumulated by aquatic and marine life such as plankton, small fi sh, and large fi sh. Alkaline waters tend to favor production of the more volatile dimeth- ylmercury, but acid waters are believed to favor retention of the dimethyl form in the bottom deposits. Under anaerobic conditions, the inorganic mercury ions are precipitated to insoluble mercury sulfi de in the presence of hydrogen sul- fi de. The process of methylation will continue as long as organisms are present and they have access to mercury. The form of mercury in fi sh has been found to be practically all methylmercury and there is indication that a signifi cant part of the mercury found in eggs and meat is in the form of methylmercury. The amount of mercury in canned tuna fi sh has averaged 0.32 ppm, in fresh swordfi sh 0.93 ppm, in freshwater fi sh 0.42 ppm (up to 1.4 and 2.0 ppm in a few large fi sh such as Walleyed Pike), and as high as 8 to 23 ppm in fi sh taken from heavily contaminated waters. The mercury in urban air has been in the range of 0.02 to 0.2 m g per cu m, in drinking water less than 0.001 ppm, and in rain water about 0.2 to 0.5 ppb ( m g/1). Reports from Sweden and Denmark (1967–69) indicate a mercury concentration of 3 to 8 ppb (ng/gm) in pork chops, 9 to 21 ppb in pig’s liver, 2 to 5 ppb in beef fi llet, 9 to 14 ppb in hen’s eggs, and 0.40 to 8.4 ppm in pike. In view of the potential hazards involved, steps have been taken to provide standards or guidelines for mercury. The maximum allowable concentration for 8 hour occupational exposure has been set at 0.1 mg metallic vapor and inorganic compounds of mercury per cubic meter of air. For organic mer- cury the threshold limit is 0.01 mg per cu m of air. A maximum allowable steady intake (ADI) of 0.03 mg for a 70 kg man is proposed, which would provide a safety factor of ten. If fi sh containing 0.5 ppm mercury (the actionable level) were eaten daily, the limit of 0.03 mg would be reached by the daily con- sumption of 60 gm (about 2 ounces) of fi sh. 13 The proposed standard for drinking water is 0.002 ppm. A standard for food has not yet been established; 0.05 ppm has been mentioned. There is no evidence to show that the mercury in the cur- rent daily dietary intake has caused any harm, although appar- ent health does not indicate possible non-detectable effects on brain cells or other tissues. Nevertheless, from a conservative health standpoint, it has been recommended that pregnant women not eat any canned tuna or swordfi sh. Also implied is caution against the steady eating of large fresh water fi sh or other large saltwater fi sh. The general population should probably not eat more than one fi sh meal per week. The identifi cation of mercury as coming from manmade and natural sources requires that every effort be made to eliminate mercury discharges to the environment. At the same time the air, drinking water, food, fi sh, and other wild- life, aquatic plants and animals, surface runoff and leach- ates, precipitation, surface waters, and man himself should be monitored. This should be done not only for mercury, but also for other potentially toxic and deleterious chemi- cals. Further research and studies are needed to determine the subtle and actual effects of mercury and other metals, as normally found, on man and his environment. WATER SUPPLY A primary requisite for good health is an adequate supply of water that is of satisfactory sanitary quality. It is also important that the water be attractive and palatable to induce its use; for otherwise, water of doubtful quality from some nearby unpro- tected stream, well or spring may be used. Where a municipal water supply as available, it should be used as such supplies are usually under competent supervision, ample in quantity and also provide fi re protection. However, this is not always the case. Because of the excellent water service generally available in the United States, the people and public offi cials have tended to become complacent and take for granted their water supply. As a result, in some instances, funds have been diverted to other more popular causes rather than to mainte- nance, opeation, and upgrading of the water supply system. Status of Water Supply A survey 15 made by the Public Health Service in 1962 is of interest in pointing out the number and type of public water supplies in the United States and populations served. It was reported that there were 19,236 public water supplies serving approximately 150,000,000 people; 75% were ground water supplies, 18% were surface water supplies, and 7% were a combination. Of signifi cance is the fi nding that 75,000,000 people in communities under 100,000 population were served by 18,873 public water supplies, and 77,000,000 people in communities over 100,000 were served by 399 public water supplies. Also, of the 19,236 supplies, 85% served communi- ties of 5,000 or less. The information emphasizes the need for giving at least equal attention to small public water supplies as is given to large supplies. In addition, millions of people on vacation in relatively uncontrolled rural environments depend on small water supplies which often are not under close surveillance. The Public Health Service completed a study in 1970 covering 969 small to large public surface and ground water supply systems serving 18,200,000 persons (12% of the total United States population served by public water supplies) and 84 special systems serving trailer and mobile home parks, institutions, and tourist accommodations. 16 Although the drinking water supplies in the United States rank among the best in the world, the study showed the need for improve- ments. Based on the 1962 USPHS Drinking Water Standards it was found that in 16% of the 1969 communities surveyed the water quality exceeded one or more of the mandatory limits established for coliform organisms (120), fl uoride (24), lead (14). It is of interest to note that of the 120 sys- tems that exceeded the coliform standard, 108 served popu- lations of 5,000 or less and that 63 of these were located in a state where disinfection was not frequently practiced or was inadequate. An additional 25% of the systems exceeded the recommended limits for iron (96), total dissolved solids (95), © 2006 by Taylor & Francis Group, LLC 342 ENVIRONMENTAL HEALTH Ground-water supply to lakes, streams, oceans Percolation Ground-water storage Rock Soil Ground-water discharge Supply to vegetation Dug well Driven well Clay Surface runoff Spring River, lake, ocean Evaporation from water surfaces (Warm air) Transpiration from vegetation Evaporation from soil and surfaces Evaporation from vegetation Evaporation while falling Precipitation (cool air) Rain-sleet-hail-snow-dew Clouds Rain clouds Atmospheric vapors Moisture in transportation and in storage Infiltration Drilled Well FIGURE 3 The hydrologic or water cycle. From Joseph A. Salvato, Jr., Environmental Engineering and Sanitation, John Wiley & Sons, Inc., New York, NY, 1972. © 2006 by Taylor & Francis Group, LLC ENVIRONMENTAL HEALTH 343 TABLE 3 (continued) Surface water criteria for public water supplies DDT a 0.042 do Dieldrin a 0.017 do Endrin a 0.001 do Heptachlor a 0.018 do Heptachlor epoxide a 0.018 do Lindane a 0.056 do Methoxychlor a 0.035 do Organic phosphates 0.1c do plus carbamates a Toxaphene a 0.005 do Herbicides: 2, 4-D plus 2, 4, 5-T, plus 2, 4, 5-TP a 0.1 do Phenols a 0.001 do Radio activity: (pc/1) (pc/1) Gross beta a 1000 Ͻ100 Radium-226 a 3 Ͻ1 Strontium-90 a 10 Ͻ2 a The defi ned treatment process has little effect on this constituent. (Coagulation, sedimentation, paid rapid fi ltration and chlorination.) + No concensus on a single numerical value which is applicable throughout b Microbiological limits are monthly arithmetic averages based upon an adequate number of samples. Total coliform limit may be relaxed if fecal coliform concentration does not exceed the specifi ed limit. c As parathion in cholinesterase inhibition. It may be necessary to resort to even lower concentrations for some compounds or mixtures. (Permissible levels are based upon the recommendations of the Public Health Service Advisory Committee on Use of the PHS Drinking Water Standards.) From Water Quality Criteria, Report of the National Advisory Committee to the Secretary of the Interior, April 1, 1968, Washington, DC, p. 20. TABLE 3 Surface water criteria for public water supplies Constituent or characteristic Permissible criteria Desirable criteria Organic chemicals: Color (color units) 75 Ͻ10 Odor ϩ Virtually absent Temperature a do ϩ Turbidity do Virtually absent Microbiological: Coliform organisms 10,000/100 mlb Ͻ100/100 mlb Fecal coliforms 2000/100 mlb Ͻ20/100 mlb Inorganic chemicals: (mg/l) (mg/l) Alkalinity ϩϩ Ammonia 0.5 (as N) Ͻ0.01 Arsenic a 0.05 Absent Barium a 1.0 do Boron a 1.0 do Cadmium a 0.01 do Chloride a 250 Ͻ25 Chromium, a hexavalent 0.05 Absent Coppera 1.0 Virtually absent Dissolved oxygen ³4 (monthly mean) Near saturation ³3 (individual sample) Fluoride a ϩϩ Hardness a do do Iron (fi lterable) 0.3 Virtually absent Lead a 0.05 Absent Manganese a (fi lterable) 0.05 do Nitrates plus nitrites a 10 (as N) Virtually absent pH (range) 6.0-8.5 ϩ Phosphorus a ϩ do Selenium a 0.01 Absent Silver a 0.05 do Sulfate a 250 Ͼ50 Total dissolved solids a 500 Ͻ200 (fi lterable residue) Uranyl ion a 5 Absent Zinc a 5 Virtually absent Organic chemicals: Carbon chloroform 0.15 Ͻ0.04 extract a (CCE) Cyanide a 0.20 Absent Methylene blue active 0.5 Virtually absent substances a Oil and grease a Virtually absent Absent Pesticides: Aldrin a 0.017 do Chlordane a 0.003 do (continued) manganese (90), fl uoride (52), sulfate (25), nitrate (19). The study also showed that 56% of the systems were defi cient in one or more of the following: source protection; disin- fection or control of disinfection; clarifi cation (removal of suspended matter) or control of clarifi cation; and pressure in the distribution system. It was also reported that 90% of the systems did not have suffi cient samples collected for bacte- riological surveillance; 56% of the systems had not been sur- veyed by the state or local health department within the last three years; in 54%, cross-connection prevention ordinances were lacking; in 89%, reinspection of existing construction was lacking; in 61%, the operators had not received any water treatment training; in 77%, the operators were defi - cient in training for microbiological work and 46% of those who needed chemistry training did not have any. Finally, the smaller communities had more water quality problems and defi ciencies than the larger ones, showing the advisability of consolidation and regionalization where this is feasible. Water Cycle The movement of water from the atmosphere to the earth and back again to the atmosphere can be best illustrated by the © 2006 by Taylor & Francis Group, LLC the country. See reference. [...]... insect and rodent prevalence, type of rock and soil, availability and adequacy of public utilities, the need for a separate power plant, and water-, sewage-, or wastetreatment works and special air pollution control equipment should all be considered and evaluated before selecting a site for a particular use 358 ENVIRONMENTAL HEALTH Engineering and Architectural Considerations The design of structures and. .. wells; rock and sand or earth springs, and infiltration galleries Figure 4 shows details of well and spring construction and sanitary protection Standards for well construction are given in AWWA Standard for Deep Wells, AWWA A 100–66 published by the American Water Works Association and in Recommended State Legislation and Regulations, Department of Health, Education, and Welfare, Public Health Service,... and by acquisition of adequate sites at least 5 years prior to anticipated needs and use The availability of federal and state funds for planning for collection, treatment, and disposal of refuse on an area-wide basis such as a county should be explored The planning will require an engineering analysis of alternative sites including population projections, volume, and characteristics of all types of. .. fields, and other sources of pollution Wells should not be located downgrade so as to be in the direct line of drainage from sources of pollution Concrete Mix one bag of cement, 2 cu ft of sand, and 3 cu ft of gravel Then add 5 gal of water, for moist sand, and mix again Water Treatment As an aid in determining the treatment that should be given water to make it safe to drink, the United States Public Health. .. Hydrology Handbook Manual 28, A Soc of Civil Engrs., N.Y., 1949 18 Public Health Service Drinking Water Standards 1962 PHS Pub 956, U.S Department of Health, Education and Welfare, Washington, D.C 19 Glossary Water and Wastewater Control Engineering, APHA, ASCE, AWWA, WPCF, 1969 20 Manual of Recommended Water-Sanitation Practice, Recommended by the United States Public Health Service, 1946, Public Health. .. and harborage for rats, flies, and other vermin It is unsightly, an odor and smoke nuisance, a fire hazard, and often a cause of water pollution It should be eliminated or its operation changed to a sanitary landfill Hog Feeding Where garbage is fed to hogs, careful suspervision is necessary The spread of trichinosis in man, hog © 2006 by Taylor & Francis Group, LLC 353 cholera, the virus of foot -and- mouth... of earth at the end of each day or more frequently in a manner which prevents environmental pollution.25 The cost of sanitary landfill versus incineration for various populations is shown in Figure 12 Social and political factors An important aspect of refuse disposal site selection, in addition to engineering factors, is the evaluation of public reaction and education of the public so that understanding... It recognizes the extent of present and future service areas, the established water quality and effluent standards, and the alternative solutions with their first costs and total annual costs This information is needed to assist local of cials in making a decision to proceed with the design and construction of a specific sewerage system and treatment plant 350 ENVIRONMENTAL HEALTH These are essential... types of solid wastes to be handled, cost of land and site preparation, © 2006 by Taylor & Francis Group, LLC expected life of the site, haul distances from the sources of refuse to the site, cost of operation, and possible value of the finished sites Consideration would be given to the climate of the region, prevailing winds, zoning ordinances, geology, and topography Location and drainage to prevent surface... knowledge and plans developed to show how it is proposed to reclaim or improve and reuse the site upon completion This should include talks, slides, news releases, question and answer presentations, and inspection of good operations Artist’s renderings are very helpful in explaining construction methods and final use of the land Figures 13 and 14 show the area and trench sanitary landfill methods 356 ENVIRONMENTAL . deaths, and specific inci- dence of diseases; social, economic, and envi- ronmental relationships; also water-, insect-, and food-borne diseases; animal- and animal- related diseases, airborne and. densifi ca- tion, composting, separation, treatment, and energy con- version. Disposal shows the environmental inter-relation of air, land, and water, and the place of salvage and recyl- ing. All. 334 ENVIRONMENTAL HEALTH INTRODUCTION † Definitions Environmental Health encompasses what is also known as environmental engineering and sanitation, public health engineering, and