Preventing disease through a better environment: toward estimating the environment-related burden of disease
About 24% of all diseases worldwide are due to exposure to environmental factors. Much of these risks, however, could be prevented through targeted interventions, a new WHO report shows.
More than 33 percent of illnesses in children under age 5 are estimated to be due to environmental factors. Preventing exposure to these risk factors would save an estimated 4 million lives a year among children alone, especially in developing countries.
The report, entitled “Preventing Disease through Better Environment: Toward an Estimate of the Burden of Disease Related to the Environment,” is the most comprehensive and systematic contribution to date on how preventable environmental risk factors can contribute to a wide range of diseases and injuries. The analysis focuses on the environmental causes of disease and how different diseases may be influenced by the environment. The data show how deaths, illness, and disability can be effectively reduced each year through appropriate environmental policy.
According to the report, there are more than 13 million deaths each year from environmental causes that could otherwise be prevented. In the poorest countries, nearly one in three deaths is due to environmental factors. More than 40% of deaths from malaria and about 94% of deaths from diarrheal diseases (two of the world’s leading killers) could be prevented with proper environmental policy.
The four major diseases influenced by poor environmental conditions are diarrhea, lower respiratory tract infections, various forms of unintentional accidents, and malaria. Measures to be taken to reduce the environment-related burden of disease include
- promotion of safe methods of household water storage and hygiene measures
- use of cleaner and safer fuels
- increasing safety in building construction
- judicious use of toxic substances at home and in the workplace
- better management of water resources.
This research, carried out through a systematic literature review and more than 100 interviews with international experts, assessed the impact of known environmental factors on specific diseases. We now have a list of issues from which to develop prevention policies in the field of health and environment”.
Below are the diseases most affected by environmental risk factors, in terms of deaths, morbidity and disability, or Disability Adjusted Life Years (Daly, a unit of measurement that indicates the sum of years of life lost due to premature death and years of productivity lost due to disability):
- diarrhea: 58 million Daly per year, 94% of the disease burden due to diarrheal diseases, mainly linked to contaminated water and poor sanitation and hygiene conditions
- lower respiratory tract infections: 37 million Daly per year, 41% of all cases worldwide, mainly due to indoor and outdoor air pollution
- unintentional accidents other than road traffic accidents: 21 million Daly per year, 44% of all cases worldwide, whose classification includes a wide range of factory and general workplace accidents
- malaria: 19 million Daly per year, 42% of all cases worldwide, mainly as a result of poor water resources, poor hygiene in homes and poor water supply
- road accidents: 15 million Daly per year, 40% of all cases worldwide, mainly as a result of poor urban planning, including transportation
- chronic obstructive pulmonary disease (COPD), a progressively disabling disease characterized by a gradual loss of lung function: 12 million Daly per year, 42% of all cases worldwide, mainly as a result of exposure to dust and fumes in the workplace and other forms of indoor and outdoor air pollution
- perinatal problems: 11 million Dalys per year, 11% of all cases worldwide.
Most of the diseases linked to environmental risk factors are, however, among the major public health problems in general, albeit associated with different levels of mortality. The diseases that by far have the highest mortality related to modifiable environmental risk factors are:
- 2.6 million deaths each year from cardiovascular disease
- 1.7 million deaths per year from diarrheal diseases
- 1.5 million deaths per year from lower respiratory tract infections
- 1.4 million deaths per year due to cancer
- 1.3 million deaths each year due to chronic obstructive pulmonary disease
- 470 thousand deaths per year due to road accidents
- 400 thousand deaths each year from unintentional accidents.
The report shows that in one way or another, the environment significantly influences more than 80% of these major diseases. Moreover, it seems to count only those environmental risks that are actually modifiable through appropriate intervention policies or technologies already available. What share is preventable for each disease is specified.
Preventing millions of otherwise preventable deaths each year requires sectors such as transport, energy, agriculture and industry to work together to reduce the health risks posed by the living environment as much as possible.
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