ENVIRONMENTAL POLLUTION AND ITS PREVENTION

ENVIRONMENTAL POLLUTION
AND ITS PREVENTION
Unit_1

INTRODUCTION
Just as a weed is ‘a plant out of place’, a pollutant is ‘a
chemical out of place’, and ‘pollution’ is ‘resource out of
place’. Oil enclosed within a tanker is not a pollutant’;
spilled into the environment, however, it may be a
pollutant although doing harm involves more than being
out of place. A small oil spill may go unnoticed, but a
large one can be disastrous.

Science: is defined as the growth and improvement of
innovative ideas through application of proper technical
sense, observation, experimentation and documentation. Any
branch of science which links research with the requirements
of mankind is known as ‘Applied science’.
‘Engineering: It is the application, under constraints, of
scientific principles to Planning, Design, Construction and
Operation of equipment, systems, processes and structures,
for the benefit of the society.

ENVIRONMENTAL ENGINEERING
It is the branch of engineering, which looks at environmental
problems in its technological, ecological, social and economic
dimensions in order to promote sustainable development for a
sustainable environment.
a) The term ‘Environmental Engineering’ implicates that engineers
show responsibility to solve environmental problems (which are
in its highly emotional state) related to ‘air’, ‘water’, ‘land’, and
‘space’.

b) ‘Environmental Engineering’ is the application of engineering principles,
under constraints (shortage of funds, PET constraint, DTF, inadequate space,
political bias) to the protection and enhancement of the quality of
Environment, public health and welfare of all living organisms.
c) Broadly speaking, ‘Environment’ means surroundings of all living
organisms – micro or macro. ‘Environment’ includes broad categories as air,
water, land, pond, streams, lakes, forests and man subsidized ecosystems
which constitute the totality of the surroundings.

d) ‘Pollute’ means ‘to make foul’ or ‘unclean’ with waste
material. ‘Pollution’ means contamination of air, soil or water by
discharge of harmful substances. Pollution is greatest near the
source. Cumulative impacts are a result of our individual actions
– be it small or big.
e) The major task of environmental engineers is to protect public
health by preserving and enhancing the environment. They are
engaged in designing various pollution control equipment and
devices, construction, installation, implementation and operation
of environmentally-related procedures.

THE PROFESSION/DISCIPLINE OF
ENVIRONMENTAL ENGINEERING
Environmental Engineering includes all aspects of nature and so is
one of the noblest professions. The major outcome of this course is
the dramatic increase in the number of students who equip
themselves with the knowledge of environmental regulations, as
well as pollution prevention and control concepts and technology
The objectives of this discipline are as follows:
1. To educate students on the real costs of operating processes that
release pollutants to the environment. This means considering not
just waste treatment costs, but also the costs of dealing with
regulations, with the community, with potential future liabilities,
etc.

2. To provide students with an awareness of strategies for
minimizing or reducing the environmental impact of a given
industrial chemical process.
3. To give students the opportunity to work on the design of
processes using new technologies those which completely
eliminates pollutants at the source.

THE ROLE OF ENVIRONMENTAL ENGINEER IN
ENVIRONMENTAL PROTECTION
Environmental Engineers primarily deal with structures (ex. water
structures, efflux stacks), control equipment and systems that are
designed to protect and enhance the quality of the Environment, health
of the living organisms and their welfare.
The Environmental Engineer designs, constructs, and operates water
treatment plants, wastewater treatment plants, protects terrestrial and
aquatic ecosystems, informs the general public about health effects of
pollution and safeguards them from possible threats.

Environmental Engineer to bring knowledgeable in mathematical and
physical sciences, and acquires knowledge in the field of
‘environmental electro chemistry’, ‘air quality control’, ‘water quality
control’, ‘impact assessment’, ‘microbiology and ecology’, ‘wastewater
treatment’, ‘management’, ‘estimating and costing’, ‘modelling’, etc.
An Environmental Engineer can capacitate to bring in work harmony
and inter-coordination between urban development authorities and water
supply- sewerage boards, and the general NGOs to safeguard natural
public infrastructures like, lakes, ponds, urban forestry, ground water
and all lung spaces of the city.

ECONOMIC GROWTH, ECONOMIC DEVELOPMENT
AND ENVIRONMENTAL QUALITY
The terms ‘economic growth’ and ‘economic development’ are
look alike synonyms with a hairline demarcation between the
two.
‘Economic development’ deals with the problem of
underdeveloped/developing countries,
whereas ‘Economic growth’ deals with the problem of
developed countries.

The problems of underdeveloped and developing countries
are concerned with the development of unused resources,
advanced developed countries are related to ‘economic
growth’, with most of their resources known of its uses and
utilized to a considerable/maximum extent; still going further
to explore the unused resources (brain, mineral, and food
resources) in developing countries for use, or even destroy it
and at the same time saving their own resources for their
future generations to privilege.

The objective of considering ‘Environment’ as part of
‘Development’ is to achieve the following:
 Sustainable environment and development.
 Prevention and elimination of long – term environmental side effects by
incorporating mitigation measures during the process (internalizing external
effects) so that the remedies do not become unmanageable and prohibitive in
the long time run. For ex. continuous application of partially treated
wastewaters on land; biodegradable plastics; exploitation of non-renewable
energy resources; application of pesticides on soil.
Economic development and environmental quality are two sides of same coin.
Residual discharges like solid liquid or gaseous reduce the quality of
environment

Our Environment and its quality
 During the 5 million years of human existence, we lived in this thin crust of air, soil and
water. Initially, resources were seen plenty without limits, gradually man evolved conquering
nature to its maximum possible outnumbering 10 billion and became a sole ecological
dominant of the earth.
 Surviving this number requires exploitation of the resources. All production and
consumption activities utilize the assimilative capacity of the land, air and water,
environments. While the services rendered by these environments are essential inputs in to
these activities, traditionally no prices have been placed upon these factor inputs;
 it is considered to be available free of cost, exploited it beyond its assimilative and carrying
capacities, and so, we see today, a completely degraded and deteriorated and damaged
environment.
 Environmental quality varies both in time and space – because of time variations in the
assimilative capacities of environmental media (air, water and soil), and in the generation of
discharge of residuals Huge investment may be required to reinstate the lost environmental
quality of environmental media

VICIOUS CIRCLE OF ENVIRONMENTAL POVERTY
Vicious circle of Environmental poverty (VCOEP) applies to a circular
constellation of forces tending to react on one another so as to keep the
country/state/region/globe and the welfare of the masses in a state of
poverty with respect to the richness (health and wealth) and ecological
diversity of the environment.
Environmental poverty refers to the inability of the nation to safeguard
its resources and invest on pollution prevention and control measures
to secure the minimum well-being of the masses.

UNIT 2:
PROACTIVE AND REACTIVE
ENVIRONMENTAL
LEGISLATION/POLICY.

INTRODUCTION
Proactive environmental policies
focus on environmental problem-solving based upon
'anticipate and prevent' rather than 'react and treat'. It
is like solving raw materials that produce less or no
waste after the product manufactured

2.2 PROACTIVE AND REACTIVE ENVIRONMENTAL
LEGISLATION / POLICIES
Environmental technologies can be classified into three groups
(1)Pollution control technologies that prevent the direct release of
hazardous emissions into the air, waters, or soil (end-of-the-pipe
technologies).
(2)Off-site recycling and waste treatment technologies include treatment
of effluent in collective waste waters treatment plants, the clean up of
polluted soils, and the upgrading of solid wastes.
(3)Process-integrated changes in production technologies, input material
changes, and good housekeeping, which are all focused on reducing
the amounts of pollutants and wastes generated during production.

2.3 POLLUTION PREVENTION HIERARCHY
 Pollution prevention is an essential tool in achieving and maintaining the
balance that allows sustainability. Pollution Prevention (P2) refers to any
practice, which, at the source, eliminates the quantity and toxicity of hazardous
and non-hazardous waste released/applied into the environment. P2 is also
known as ‘source reduction’. ‘Waste minimization’ generally refers to waste
reduction after generation.
 P2 is generally more cost-effective and environmentally preferable when
compared to programs such as recycling, landfilling, remediation, and
decontamination, which focus on handling previously produced waste

The objectives
 P2 are: to establish a mechanism to develop pollution prevention
policies on a broad base of local support; to develop methods to
educate corporates and the public in pollution prevention concepts
and in application of those concepts in to daily activities; to provide
technical assistance to small businesses implementing pollution
prevention programs; to promote evaluation of innovative pollution
prevention techniques and technologies; and finally report results
with sufficient detail to allow others to duplicate activities with
confidence

2.4 PROACTIVE AND PASSIVE ENVIRONMENTAL
MANAGEMENT POLICIES
 /proactive environmental policies (PEP) focus on environmental problemsolving
based upon ‘anticipate and prevent’ rather than ‘react and treat’.

 It is like selecting raw materials that produce less or no waste after the product are
manufactured.
 Promoting PEP can result from raw material conservation, reductions in water and
energy consumption, elimination of use of toxic and dangerous raw materials, and a
reduction in the quantity and toxicity of all emissions and wastes at the source,
reduction in the environmental, health and safety impacts over the entire life cycle of
products, from raw materials extraction, through manufacturing and end use, to
disposal. The various environmental management paradigms that can be seen with
time is shown in Fig. 2.2

1. Passive Environmental Management (PEM): These approaches
resulted in massive and uncontrolled contamination of water, air, and land
environments.
2. Reactive Environmental Management (REM)
Even today, most EOP technologies adopted by the corporate industries
of RED and ORANGE categories are not in synchronization with the
characterization of waste discharges. EOP involves building and operating
wastewater treatment plants, air scrubbers, waste incinerators, and
detoxifying facilities, and secured landfills, often at high expense. These
approaches are still seen inefficient because, often conversion of one form
of waste is seen as other forms of waste.

3. Proactive Environmental Management (PREM):
Proactive means ‘predicting before hand’ as to the consequence of a
series of actions that could possible affect the environment due 18 to
the developmental activities involving products and processes. PREM
focuses on ‘waste minimization’ and ‘pollution prevention at the
source’. It involves adopting cleaner production technologies (CPTs),
environmentally sound technologies (ESTs) and best available
technologies (BATs). These technologies are briefly described below.

a) Cleaner Production Technologies (CPTs): Technologies that extract and use
natural resources as efficiently as possible and minimizes release of harmful
components to air and water, and produced durable products which can
recovered or recycled as far as possible, and output achieved with little energy
input.
(b) Environmentally Sound Technologies (ESTs): Technologies that have the
potential for significantly improved environmental performance relative to other
technologies (less polluting, resource use in a sustainable manner, recycle more
of their wastes and products, and handle the residual wastes in a more
environmentally acceptable way than the technologies for which they are
substitutes.
C) Best available technologies (BATs): Best available techniques are the most
effective in achieving a high general level of protection to the environment as a
whole.

In determining the best available techniques, special consideration should be
given to the following items:
1. Use of low-waste technology.
2. Use of less hazardous substances.
3. The furthering of recovery and recycling of substances generated and
used in the process and of waste, where appropriate.
4. Comparable processes, facilities or methods of operation, which have
been tried with success on an industrial scale.

5. Technological advances and changes in scientific knowledge and
understanding.
The nature, effects and emissions concerned
6. The commissioning dates for new or existing installations.
7. The length of time needed to introduce the best available technique.
8. The consumption and nature of raw materials (including water) used
in the process and their energy efficiency.
9. The need to prevent or reduce to a minimum the overall impact on the
environment and the risks to it.
10. The need to prevent accidents and to minimize the consequences for
the environment.
11. The information published by the Commission or by international
organizations

2.5 PREVENTION OF SIGNIFICANT DETERIORATION (PSD)
1. PSD programmes are identified for its application in sensitive areas so that
environmental parameters remain in its pristine state in spite of the industries
commissioned and operated in that area.
2. PSD programs avoid those projects in an area that may cause significant long term
deterioration/impacts on the natural environment affecting air quality, water quality and
soil.
3. PSD programmes allow to go with planning for mixed land uses although non-
compatible. The industries in such pre-designated sensitive areas will have to compulsorily
follow discharge 20 guidelines as specified by the pollution monitoring and control
authorities;

3.2 ENVIRONMENTAL SYSTEMS
The stability of Environmental Systems depends on two main issues: (i)
Assimilative Capacity’, and (ii) Carrying Capacity.
The concept of ‘Assimilative capacity’ in a pollution context is about the
ability of an ecosystem to cope up with certain levels of waste discharges
without suffering any significant deleterious biological effects.
Carrying capacities of an urban environment is assessed in terms of the
regenerative capacities of its various supportive resources as well as its
capacity for assimilation of wastes generated by its population and activities.

3.3 WATER POLLUTION CONCEPT AND TREATMENT
IN URBAN SYSTEMS
 1. Wastewater Treatment Plants (WWTPs). The main goal of a WWTP is to reduce the
pollution level of urban and industrial wastewaters, prior to its discharge in to the
environment, be it land or water. Wastewater treatment involves complete or partial
reduction parameter values by select method of treatment.
 2. discharge standards prescribed by the pollution control authorities; for ex. BOD5 – 20
mg/L, COD – 250 mg/L, pH between 6 and 9, for disposal in to water.
 3. A wastewater treatment facility (WWTF) is part of an urban water system, which
consists of a catchment area (households, industry, roads, etc.), a sewer system and
receiving water. As shown in Fig. 3.1, these so called sub-systems of an urban
wastewater system are subject to multiple and often complicated interactions
 4. Wastewater treatment plants (WWTPs) may generate a large amount of a byproduct
called sludge (basically a liquid mixture of microorganisms and particulate organic
matter), which must also be treated. Thickening, stabilization, and dewatering are the
main unit operations that convert the sludge into stable product for ultimate disposal.

3.3.1 Treatment alternatives
Biological treatment based upon the degrading capacity of
natural bacterial populations is a common practice for
municipal and industrial wastes.

3.4 AIR POLLUTION
 Earlier developmental projects were checked before taking it up for the following:
 1. Technical feasibility
 2. Social benefits, and
 3. Benefit cost ratio (BCR)
 If projects/developmental activities were found technically feasible, had social benefits
and the BCR greater than 1, such projects were implemented, not taking in to account
the impacts of such projects on the environment.
 A monopolist/proponent maximizes financial benefits from the project making use of
the scarce natural resources completely neglecting and forgetting the social and
environmental losses.
 This has resulted in irreversibly degraded environments; few examples include –
 mining projects, wastewater discharge in to still water bodies, and continuous
application of partially treated wastewater on land .

1. Bhopal gas tragedy – India (1984)
The Bhopal gas episode occurred in 1984 in Madhya Pradesh, India. The MICL plant
was manufacturing batteries, metals, plastics, carbamate, sevin carbaryl - pesticide using
MIC. The Environmental protection Act (EPA) was enacted in 1986, indicating the
reactive attitude of the planning and pollution control authorities.
1.Leakage at the MIC plant killing several people
2.Intermix of non-compatible land use (residential-industrial land use)
3.Ineffectiveness of the land use planning departments and the pollution control
authorities
4.Meteorological parameters – forgotten
5.Deliberately ignorant Government & industrialist – safety devices such as scrubbers
meant for neutralization of MIC gas (in the event of a leak) were not working; flare
towers were not repaired for long time.

2. Los Angeles smog
 The Los-Angeles city/basin has mountain on three sides and on one side the
Pacific Ocean. It is like a city in huge crucible. Temperature inversions aloft
encase the city in its own fumes within the large crucible - a complex
photochemistry takes place ‘The Smog’.

 The city in the valley
 Contaminated air in a huge crucible
 Smog development
 Shallow mixing height (prevents mixing of air pollutants)
 Uncontrolled vehicle use
 Frequent temperature inversions This has been a clear example of a planning error.

3.The Taj Mahal - India
 The lost marvel? One of the architectural wonders of the world is in India. It
is ignored by the Central Government since its creation from the
environmental point of view (earlier the Taj was bright white by appearance;
now it is turned pale yellow). Such deliberate ignorance by the political
network is another planning error and an ignored monument.
 Unplanned activities around this wonder of the world
 The Belganj railway station, coal shunting yard, the Mathura refineries
 One should recall that long back in Greece, a sacred architectural monument
was physically moved inside a museum to minimize the effect of traffic
pollutants on the architectural grandeur.

4.Meuse valley fog (1930):
 air pollution disaster - Dec 1 – 5, 1930 Meuse valley is
surrounded by hills on all sides with fertilizer industries, glass
manufacturing, sulfuric acid, zinc, steel manufacturing units
and a thermal power plant, etc. The weather was characterized
by anticyclone (high pressure area) conditions with high
atmospheric pressures and very feeble (1–3 km/h) easterly wind
that blew from the city of Liege into the narrow valley, which
had 90–120 m hills on each side. These conditions produced a
persistent fog.


Cont..,
 Planning error, valley (narrow topography) between Huy and Leige
 30 substances from 27 factories – CO2, CO, H2S, HCl, HC, NH3, etc. o
Inversion prevailed for over 3 days
 Fog occurred 5 times before – 1901, 1911, 1917, 1919, 1930 o Water saturated
and virtually motionless atmosphere
 Fog covered a large part of Belgium (Huy and Leige),
 Congestion in the tracheal mucosa and large bronchi
 Pure carbon dust particles (0.5 – 1.5 m) found within alveoli.

5. Love Canal – New York Incident
This is an example of ‘Time pollution’. William Love (an Engineer) dug a canal
to generate and supply power to New York; due to miscalculations in invert
levels, the canal was abandoned. Later, this canal was used as a waste dump site
for disposal of wastes (outsourcing of wastes from industries – presently seen
practiced in India) which were traditionally practiced. As time ticked (~50 years
later), the city land use spread in all directions covering the old dump site. Poorly
engineered hazardous waste disposal sites late in the 1970s oozed off toxins from
the soil in to backyards and basements. Fifty years later, people and children were
exposed to toxins and radiations from soil and were affected. Living proved very
costly.

Conti..,
 A case of time pollution
 Historical methods of poorly engineered waste dump sites
 Children were exposed to radiations from soil

 On observing such tragedies, mishaps and accidents that have occurred
over time, the corporates and the Governments thought of introducing the
term ‘Environment’ as an ‘add-on’ component after the benefit cost ratio
(BCR) as the fourth component. Environment was never a top priority; it
was last in the list .

3.4.1 Emission Density zoning
 Consideration of air pollution factors early in the planning process can result in
land use plans.

 which supplement traditional physical control measures, and inherently overcome
some of the technological and economic limitations of these measures.

 The integration of air pollution control into the long-range land use planning
process of a region involves the determination of the most effective combinations
of emission control legislation, zoning ordinances, highway routing, stack
emission control devices, etc.


Conti..,
 to prevent the creation of source clusters as the region grows, and to insure patterns
of residential, commercial, and industrial development and transportation networks
consistent with the maintenance of air quality standards.

 The concept of emission-density zoning can serve as the foundation for the practical
application of land use planning to air pollution control.

 The first step in the development of emission-density regulations will be the
determination of the existing land use patterns in the region.

3.5 ENVIRONMENTAL INDICES
3.5.1 Air quality depreciation index
 The air quality depreciation index, attempts to measure deterioration in
air quality on an arbitrary scale that ranges between 0 and -10. An index
value of ‘0’ represents most desirable air quality having no depreciation
from the best possible air quality with respect to the pollutants under
consideration while an index value of -10 represents maximum
depreciation or worst air quality. Index values from 0 towards -10,
represent successive depreciation in air quality from the most desirable
value. The air quality depreciation index is defined as follows:
 (go through slm for formulas )

UNIT 4: ENVIRONMENTAL LEGISLATION

4.2 ENVIRONMENTAL LEGISLATION
 The original Indian Constitution of 1950 did not have any provision directly dealing with
environmental pollution. The 42nd amendment of the Indian Constitution passed in 1976
inserted Article 48A and 51A (g) which states:
 It shall be the duty of every citizen of India to protect and improve the national
environment, including forests, lakes, rivers and wildlife and to have compassion for
living creatures.
 The language of the Directive principles of State Policy (Article 47) also contains a
specific provision, which commits the State to protect the Environment. India has become
on of the few countries in the world to enshrine in its Constitution a commitment to
environmental protection and improvement.
 The first public interest litigation filed in the Apex court was M C Mehta vs. Union of
India, resulting in to the initiative called Ganga Action Plan. The constitutional provisions
have initiated the establishment of a comprehensive set of laws for the protection and
improvement of the environment.

Legislations are in existence in India for industrial
pollution control. The major Acts, Notifications, Rules
and Amendments are as under:
1. Air:
2. Hazardous Substances:
3. General:
4. Forest and Wildlife:
5. Land Use:
6. Water:

4.3 HUMAN HEALTH
From time to time, many definitions have been offered. Some of them are given below.
a. The condition of being sound in body, mind and spirit, especially freedom from physical
disease or pain.
b. Soundness of body or mind; that condition in which its functions are duly and efficiently
discharged.
c. A condition or quality of the human organism expressing the adequate functioning of the
organism under the given conditions/circumstances both genetic and environmental.
d. A modus vivendi enabling imperfect men to achieve a rewarding and not too painful
existence while they cope up with the imperfect world.
e. Health is a state of relative equilibrium of body, form, and function which results from its
successful dynamic adjustment to forces tending to disturb it. It is not a passive interplay
between body, substance, and forces impinging on it, but an active response of body
forces working towards readjustment.

4.3.1 WHO definition of Health
 The widely accepted definition of Health is that given by the World Health
Organization (1948) in the preamble to its constitution, which is as follows:
 ‘Health is a state of complete physical, mental and social well-being of the individual,
and not merely the absence of disease or infirmity’.
 In recent years, this statement is modified to include the ability to lead a ‘social and
economically productive life.
 The WHO definition of health is said to have limitations and is been criticized for
being too broad as it does not consider the dynamics of living (the changing &
modifying environment).

It is considered by many, as an idealistic situation or goal than a realistic
proposition. It refers to a situation that may exist in some select individuals but not
in everyone all the time.
Some thoughts of negation consider the definition irrelevant to everyday demands
as nobody qualifies to be healthy, i.e. a perfect biological, psychological and social
functioning; in other words – a perfect individual in a perfect environment? It is
also interpreted that if one accepts the definition of health by the WHO, then all are
sick.
A new philosophy of health has evolved over years which states Health as a
fundamental human right; the essence of productive life, and not the result of
increasing expenditure on medical care; health, is central to the concept of quality
of life (QOL); and Health, is a worldwide social goal

4.3.2 Concept of Health
 1. Health simply means ‘absence of disease’ and living in harmony with nature;
health and harmony being considered equivalent. Pain and happiness are equivalent
in spiritual health.
 2. The perception about Health is not the same across the community; it varies
between individuals and various professional groups (health administrators,
biomedical scientists, environmental and public health engineers, urban planners,
social science specialists, ecologists, etc), interpreted and understood in their own
sense, giving rise to confusion about the concept of health. In the present world of a
continuously modified and changing environment with more and more of known
and unknown chemicals being added in to our environment, new concepts of health
may seem to emerge based on new thought patterns of individuals and the masses.

 3. A concept can be considered as the atom or the smallest unit of any knowledge
domain or discipline. The concepts do not exist in isolation; they occur in complex,
multidimensional networks that represent ‘real world-relationships’. For the sake of
understanding, the concept of health can be brought under four categories namely:
a) Biomedical concept
b) Ecological concept,
c) Psychosocial concept, and
d) Holistic concepts.

4.4 HEALTH – DISEASE SPECTRUM
 Health and disease are intricate by nature; the lowest point on the health-disease
spectrum is death, while the highest point on the spectrum is holistic health as
described by the WHO (Fig. 4.1).
 The spectral concept clearly emphasizes that the health of an individual is not static
but highly dynamic which undergoes a process of continuous change, subject to
frequent variations – sometimes mild, sometimes wild.
 Human blood has a pH of ~7.35 – 7.45 (higher health level). Below or above this
range indicate symptoms of disease. Chronic illness can be overcome just by a
small adjustment of the blood pH, slightly alkaline.
 Alkaline foods are recommended by many holistic doctors as an antidote for acidic
body conditions such as acidosis and acid reflux.

4.5 ROLE OF ENVIRONMENTAL PROTECTION
IN INDIA
 The practice of public health has been dynamic in India, and has
witnessed many hurdles in its attempt to affect the lives of the people
of this country. Since independence, major public health problems like
malaria, tuberculosis, leprosy, high maternal and child mortality and
lately, human immunodeficiency virus (HIV) have been addressed
through a concerted action of the government. Social development
coupled with scientific advances and health care has led to a decrease
in the mortality rates and birth rates.

Challenges confronting public health
The new agenda for Public Health in India includes the
epidemiological transition (rising burden of chronic non-communicable
diseases), demographic transition (increasing elderly population) and
environmental changes.
 Silent epidemics: In India, the tobacco-attributable deaths range
from 800,000 to 900,000/year, leading to huge social and economic
losses. Mental, neurological and substance use disorders also cause a
large burden of disease and disability.

Conti..,
 health systems are grappling with the effects of existing communicable
and noncommunicable diseases and also with the increasing burden of
emerging and re-emerging diseases (drug-resistant TB, malaria, SARS,
avian flu and the current H1N1 pandemic). Inadequate financial resources
for the health sector and inefficient utilization result in inequalities in
health.
 The causes of health inequalities lie in the social, economic and political
mechanisms that lead to social stratification according to income,
education, occupation, gender and race or ethnicity. Lack of adequate
progress on these underlying social determinants of health has been
acknowledged as a glaring failure of public health.

Addressing Public Health Issues - The Strategy and
Stakeholders
 Public health is concerned with disease prevention and control at the
population level, through organized efforts and informed choices of
society, organizations, public and private communities and individuals.
 The role of government is crucial for addressing these challenges and
achieving health equity.
 The Ministry of Health and Family Welfare (MOHFW) plays a key role in
guiding India's public health system.

1. Health system strengthening

o Important issues that the health systems must confront are lack of
financial and material resources
o The National Rural Health Mission (NRHM) launched by the
Government of India is a leap forward in establishing effective
integration and convergence of health services and affecting
architectural correction in the health care delivery system in
India.

2. Health information system
o The Integrated Disease Surveillance Project was set up to establish a dedicated
highway of information relating to disease occurrence required for prevention and
containment at the community level, but the slow pace of implementation is due to
poor efforts in involving critical actors outside the public sector.
o Health profiles published by the government should be used to help communities
prioritize their health problems and to inform local decision making.
o Public health laboratories have a good capacity to support the government's diagnostic
and research activities on health risks and threats, but are not being utilized efficiently.
o Mechanisms to monitor epidemiological challenges like mental health, occupational
health and other environment risks are yet to be put in place.

3. Health research system

 There is a need for strengthening research infrastructure in the
departments of community medicine in various institutes and to
foster their partnerships with state health services.

4.Regulation and enforcement in public health
 A good system of regulation is fundamental to successful public health
outcomes. It reduces exposure to disease through enforcement of sanitary
codes, e.g., water quality monitoring, slaughterhouse hygiene and food
safety.
 Revival of public health regulation through concerted efforts by the
government is possible through updation and implementation of public
health laws, 49 consulting stakeholders and increasing public awareness
of existing laws and their enforcement procedures.

5. Health promotion
 Stopping the spread of STDs and HIV/AIDS, helping youth recognize the
dangers of tobacco smoking and promoting physical activity.
 Development of community-wide education programs and other health
promotion activities need to be strengthened.
 To improve the effectiveness of health promotion by extending it to rural areas
as well; observing days like “Diabetes day” and “Heart day” even in villages
will help create awareness at the grassroots level.

6. human resource development and capacity
building
 There are several shortfalls that need to be addressed in the development of
human resources for public health services.
 The Public Health Foundation of India is a positive step to redress the limited
institutional capacity in India by strengthening training, research and policy
development in public health.
 Preservice training is essential to train the medical workforce in public health
leadership and to impart skills required for the practice of public health.

Conti..,
 Changes in the undergraduate curriculum are vital for capacity
building in emerging issues like geriatric care, adolescent health and
mental health.

 Inservice training for medical officers is essential for imparting
management skills and leadership qualities. Equally important is the
need to increase the number of paramedical workers and training
institutes in India.

7. Public health policy
 Identification of health objectives and targets is one of the more
visible strategies to direct the activities of the health sector
 Similarly, in India, we need a road map to “better health for all” that
can be used by states, communities, professional organizations and
all sectors. It will also facilitate changes in resource allocation for
public health .

Scope for further action in the health sector

o School health,: School health programs have become almost
defunct because of administrative, managerial and logistic
problems.

o Mental health,: . Mental health has remained elusive even after
implementing the National Mental Health Program.

Conti..,
o Referral system : in promoting referrals innovative schemes
through public-private partnerships are being tried in various
parts of the country.

o Urban health: the much awaited National Urban Health
Mission might offer solutions with regards to urban health.

4.7 KARNATAKA PUBLIC HEALTH POLICY Within Karnataka
state,
 there is a wide variation in the major population health indicators
across subgroups, regions, and social class. The recommendations
by the subcommittee are grouped under universal healthcare,
improvement of services at secondary and tertiary care, mental
illness services, centres of excellence, integration of AYUSH into
mainstream healthcare services, sustainable low-cost diagnostic
services, State emergency services, screening services, home-based
care, and disaster preparedness.

Conti..,
 Health services require large numbers of well-trained qualified
professionals and workers, with a variety of skills and appropriate
knowledge and attitude for effective healthcare service delivery
 As per the law, MBBS doctors are not permitted to perform most
procedures that would be required at the primary healthcare level.
Therefore, they should be provided adequate opportunity to upgrade
themselves to intermediate specialists

Conti..,
 Healthcare Sector Skill Council training programs are to be utilized
for addressing the shortage of the support staff in healthcare.
 Technology plays a crucial role in healthcare. Medical technology
advancements have enabled physicians to better diagnose and treat
patients.
 Information technology and 51 development of medical devices and
equipment have directly contributed to improving health and
healthcare services.

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