Environmental health issues in selected

vulnerable population – elderly and aged.

Define the major types, sources, and environmental distribution

of environmental agents which can impact the health of elderly.

Describe how these agents interact with biological systems, and

describe the mechanisms by which they exert adverse effects on

elderly.

Improve (enhance) quality of life in order to reach optimal

health.

Extend life expectancy → ↓ premature mortality caused by

chronic & acute diseases

Promote safe and secure environment free from environmental

hazards.

The term “elderly” can refer to anyone who has reached

certain age.

Aging is a natural process that generally includes a

change in abilities. For example, vision, touch, hearing,

bone density, balance and gait, and memory all tend to

decline with age (Public health agency of Canada, 2008).

Aging is a pattern of life changes that occurs as one

grows older.

Thus, older people can be considered vulnerable

population due to in part to these physical and cognitive

changes.

Copyright © 2010 Pearson Education, Inc.

SUCCESSFUL AGING Avoid serious, debilitating diseases and

disability.

Engage independently in most normal activities

of daily living.

Maintain cognitive function.

Able to cope with physical, social, biological,

emotional, economical and environmental

changes

Sense of control of their lives

• In 2015, c.900 million people worldwide will be 60 and

older

• By 2050 projected total is nearly 2 billion - 1 in every 5 of

the earth’s inhabitants,.

Clean air

Safe and sufficient water

Proper housing

Safe and adequate food

Safe and peaceful settlements

Stable global environment

Lack of proper Housing Infrastructure can be a environmental hazards for the older people.

Potential environmental and safety hazards in a home include;

- Dim or unclearly marked light switches

- Unclear or obstructed pathways

- Carpet edges

- Loose throw rugs or mats

- Unsteady furniture or stepping stools

- Too low or wobbly toilet stools

- Slippery floor area

- Slippery bath & shower surface

- No grab bars in the bathroom

Lilia

n N

CONT..

Overcrowding is a recurrent problem, where more than

one person per room compared to developed countries.

The correlation between lack of appropriate housing and

chronic health condition is significant. Inadequate

housing can be associated with a host of health problems.

For example, crowed living conditions can lead to the

transmission of infectious diseases such as TB, hepatitis

A and can also increase risk for injuries, mental health

problems, family tension and violence.

(Gill et al, 199)

WATER QUALITY

Older adults have a reduced immune function and are more

susceptible to infection. As a result, microbial contamination

of drinking water often causes gastrointestinal illness,

particularly among elderly. (Health Canada, 2008).

Drinking Water can also be contaminated with chemicals from

natural and anthropogenic sources.

Older people maybe more sensitive to high explosives to

chemical contamination due to physiological changes.

Eg, ↑ level of arsenic has been liked to arthrosclerosis and

vascular disease and long term exposure to high levels of

arsenic can cause cardiovascular problems and the likelihood

of developing diabetes (Health Canada, 2008).

Nutrition

It is neglected especially those living alone or

with low income.

Factors affecting nutritional status of elderly:

1) Age related changes

2) Psychosocial factors

3) Economic factors

4) Cultural factors

Age related changes

↓ Taste & smell

↓ Visual acuity

Loss of teeth & poor fitting denture

↓ Gastric secretion→ influence in absorption

of B12, folic acid& iron.

Food remain longer time in stomach + ↓

gastric secretion will lead to indigestion &

feeling of fullness.

Psychosocial factors

Depression is common ( losses, death,

retirement, change of body appearance,

impaired vision &poor physical fitness) this

will lead to lack of interest in eating&

anorexia and ↓ food intake.

Living alone also will lead to lack of

incentive to cook & eat.

Economic Factors

Low income

Limited access to food and food

choices

Inadequate facilities to food storage

and preparation

Cultural factors

Eating habits may miss certain food group

as vegetarians.

Avoid eating foods that are prepared by

young woman. Eg. Highlands region

Avoid eating certain food group that

abnormal in shape and resemble a human

features. Eg. Double banana, yam with

human finger.

AIR POLLUTION

There are two measures to air pollution

1. Indoor pollution

2. Outdoor pollution

Either indoor or outdoor, air pollution can affect the

elderly due to their weak immune system which makes

them venerable to air pollutants.

INDOOR POLLUTION

Older adults spends 90% of their time indoor

environment include, radon, second-hand smoke. Carbon

monoxide contaminant laden dust, mould, pesticides,

chemicals from cleaning products and building materials,

wood burning, stoves.

Indoor air pollutants can aggravate pre-existing condition

such as asthma, obstructive pulmonary disease,

depending on type of pollutants, may contribute to other

health effects (Health Canada, 2008).

CONT….

Environmental exposure in home care settings and

institutional care settings also need to be examined

because older people living in home care or institutional

care have increased vulnerability and sensitivities

towards environmental risks due to other health

conditions; therefore, environmental exposure within the

home care and institutional care settings need to be

addressed.

These exposures include; household cleaning products,

moulds, and other indoor air contaminants.

CLIMATE CHANGE

Changes to climate are likely to result in warmer

temperatures and thermal stress, poorer quality

air and water, more floods, and droughts and

extreme weather condition, greater incidences of

vector-borne diseases; more water and food

contamination; increased exposure radiation;

increased vulnerability of subpopulations (

including children, elderly, disabled and poor

communities.

EXTREME TEMPERATURE

The body’s capacity to adapt with extreme

temperature declines with aging, thus older

adults are particularly vulnerable to excessive

health and cold events.

Their capacity to take personal actions to protect

themselves from against extreme temperatures is

also reduced.

Extreme temperature can also cause social

disruption and impact quality of life as older

adults are forced to change living patterns in

order to respond to abrupt climatic changes.

CONT…

Extreme temperature events and excess rainfall can create conditions that are favorable to the abundance, range, growth, survival and dissemination of infectious agents.

Older adults with low incomes may not have enough air conditioning to effectively adapt to extreme heat events (Health Canada, 2008).

Because older adults are particularly vulnerable to extreme weather, they are especially at risk of the effects of climate change. The impacts of change may include changes in precipitations , rising sea levels, changes in the distribution and viability of species, including disease vectors.

Extreme temperature events and excess rainfall can create conditions that are favorable to the abundance, range, growth, survival and dissemination of infectious agents , particularly water-born related infections and food-born disease, which put older adults at further risks of adverse health impacts (Health Canada, 2008).

RADIATION

Chronic exposure to the sun (UV) radiation is

associated with an increased risk of skin cancer

(Health Canada, 2008). Compare to young people,

the skin cells in older people are less able to

repair the DNA damage that is caused by sun

exposure.

There is also evidence to suggest hat cumulative

exposure to low levels f UV_B radiation can

result in developing cataracts, a major form of

blindness in older adults (Health Canada, 2008).

SUMMARY

Environmental contaminants are just one category of health determinants of health, but unlike genetics they are a largely preventable factor and thus many environmental health risks are essentially avoidable.

Environmental health intervention could provide very beneficial outcomes. Preventing or reducing environmental exposures can lower the incidences of environmentally- mediated diseases where environmental exposure and their harmful effects are largely beyond their control individuals, environmental health problem must be addressed at the largely societal level.

Human needs and wants drive choices that produce environmental impacts which, in turn, may result in adverse health consequences.

Finally, exposure to environmental contaminants can be reduced to a certain extent if the individual is provided with enough information and has the capacity to appropriately act on that information.

“

When you give it to the OLDER

people, they give back.

An elder or senior has enough life

experiences to have something to

offer to young generation and can

be considered “experts of life”

Stiegelbaner, 1996

REFERENCE

American Academy of Family Physicians (2005). Determine Your Nutritional Health. Retrieved September 17, 2007 from www.aafp.org/PreBuilt/NSI_DETERMINE.pdf American College of Sports Medicine’s Strategic Health Initiative on Aging. Five steps to eating better. Retrieved September 1, 2007 from http://www.agingblueprint.org/PDFs/Eat_Better.pdf Cassel, C. (1999). The practical guide to aging. New York, NY.: New York University. Environmental and Occupational Health +plus. (2006). Reviewing of the Human Biomonitoring Studies of Environmental Contaminants in Canada 1990-2005. Ottawa, Canada: Health Canada, Committee on Health and Environment Health Canada. (2008). Health of Older Adults and the Environment

Discussion Paper.Ottawa, Canada.