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    IKGM 1

    Holistic Approach Man And Environment

    Oleh:

    Group C

     Netty Sulis Kurniasari 021211131031 Dania Anggana D 021211131039

    Mohd. Dwira W 021211131032 Willy Wijaya 021211131040

    Sergio Santoso 021211131033 Annete Juwita Yukuri 021211131041

    Anggreta Galuh A 021211131034 Ledy Ana Z 021211131042

    Sheila Filia Suritiono 021211131035 Firsta Maulidya Y 021211131043

    Elva Puspitarini 021211131036 Nisrina Hasna Nabila 021211131044

    Fara Maulida Irtanti 021211131037 Amelia Kristanti R 021211131045

    Agustina Restu N 021211131038

    FACULTY OF DENTISTRY

    AIRLANGGA UNIVERSITY

    SURABAYA

    2012

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    PREFACE

    Praise be to God, for the abundance of blessings, mercy and guidance ofhis paper entitled “Holistic Aproach Man And Environment” can be completed on

    time. This paper was made as a condition to fulfill the group task of subject

    IKGM in the first semester at the Faculty of Dentistry, University of Airlangga.

    On this occasion, the author does not forget to say thanks and

    appreciation as much as possible to: 

    1. Prof. R.M. Coen Pramono Danudiningrat, drg.,SU.,Sp.BM (K) as the Dean of

    the Faculty of Dentistry Airlangga University Surabaya, which has provided anopportunity for the author to follow educational expertise. 

    2. Dr. Titiek Berniyanti, drg., M.Kes. and Lidya Martina Santosa, drg., MS. as

    head lecturer and scenario make of this PBL scenario. 

    Finally, may God always give abundant blessings and grace for all of us.

    Criticisms and suggestions are needed to improve this paper. 

    Surabaya, December 5th 2012

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     ABSTRACT

     Background.  Nutrition and life style can trigger cronic disease. Habits in and

    lazy life style will decrease quality of life. Some food can contribute to decrease

    health quality, being the source of poisonous environment pollutant, some of the

     pollutan is soluble in lipid, and fatty food often contain “persistent organic pollutans” (POPs) in major rate than that vegetable. Modulation from that

     parameter is result from people nutrition that will give impact in biological

     process, and will affect impact in environment pollutant in causes of disease of

    disfunction. . 

     Purpose. The aim of this study was to know about health and disease, how to take

    care the health, prevention and treatment of disease. disease.

     Results. know about good nutrient consuming that can improve human health and

     Nutritional deficiencies can cause diseases. diseases. 

    Conclusion. Pollutant is very dangerous for health and nutriton 

     Keyword s: Antioxidants, diet, disease, environmental, toxicants, nutrition, pollutans,

     prevention.

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    CONTENTS

    COVER

    PREFACE .........................................................................................................i

    ABSTRACT ......................................................................................................ii

    CONTENTS ......................................................................................................iii

    CHAPTER I INTRODUCTION

    1.1  Background ............................................................................1

    1.2  Main Problem .........................................................................2

    1.3 

    Purpose ...................................................................................2

    CHAPTER II LITERATURE REVIEW

    2.1 Function of Nutrition .......... ...................... .......... ....................3  2.2 The Important of Nutrition ....................... .............................8

    2.3 Waste .....................................................................................11

    2.4 Lead Contamination ........... ..................... ........... ....................13

    2.4.1 Lead ...............................................................................13

    2.4.2 Source of Lead Contamination .......................................13

    2.4.3 Effect of Lead Contamination ........................................14

    CHAPTER III CONCEPT OF MAPPING...................................................21

    CHAPTER IV DISCUSSION AND ANALYSIS 4.1 Health .....................................................................................22

    4.1.1 Definition of Health .......................................................22

    4.1.2 Determinants of Health ..................................................22

    4.1.3 Changing Concepts of Health ............ .............................22

    4.2 Nutrition ........... ..................... ........... .............. ........ ................23

    4.3 Diet ........................................................................................25

    4.4 Pollutants .......... ...................... .......... ............. .......... ...............28

    4.5 Environmental Toxicology .......... ................................ ...........32

    4.6 Antioxidant ........... ................................ ..................... ........... ..35

    4.7 Diseases..................................................................................39

    4.8 Factor of Diseases .................... ............ ........... ..................... ...41

    4.9 The Used of Pb in Daily................................ ........... ............. ..50

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    4.10 Impact of Use of Lead (Pb) .......... ................................ ...........53

    4.11 Pb Enters The Body ............ ......................................... ...........56

    4.12 Relation Between Pb Waste With Nutrition ...................... ......57

    CHAPTER V CLOSING 

    5.1 Conclusion ........... ................................ ..................... ........... ..59

    5.2 Suggestion ...................... .......... ............ .................... ............ ..60

    REFERENCES

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    CHAPTER I

    INTRODUCTION

    1.1 Background

     Nutrition and life style can trigger cronic disease. Habits in diet (

    like consumption of fatty food and less consumption of fruits and

    vegetable ), and lazy life style will decrease quality of life. Some food can

    contribute to decrease health quality, by the way being the source of

     poisonous environment pollutant, some of the pollutan is soluble in lipid,

    and fatty food often contain “persistent organic pollutans” (POPs) in major

    rate than that vegetable. Nutrition can resulted lipip milieu, oxidative stress, and antioxidant

    status in cells. Modulation from that parameter is result from people

    nutrition that will give impact in biological process, and will affect impact

    in environment pollutant in causes of disease of disfunction. From that

    reality can concluded that nutrition can modulate toxicinity pollutant

    environment.

    Because of that, in this paper we want to try to know what is the

    factor that causes disease and how can disease occured.

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    1.2  Main Problem

    1.2.1  What is definition of health ?

    1.2.2 

    What is definition of disease ?

    1.2.3  What is the factor that causes disease ?

    1.2.4  How could disease occured ?

    1.2.5 

    What is the effect of using things that contain of lead ?

    1.2.6 

    How is the relationship between lead and nutrition ?

    1.2.7  How is the useful of lead in daily activities, and where is it used in

    the object ?

    1.2.8 

    How is the lead can go into human’s body, and how is effect for

    the health ?

    1.3  Purpose

    1.3.1 

    To know definition of health.

    1.3.2 

    To know definition of disease.

    1.3.3  To know the factor causes disease.

    1.3.4 

    To know how disease occurred.

    1.3.5 

    To know the effect of using things that contain of lead.

    1.3.6 

    To know the relationship between lead and nutrition.

    1.3.7  To know the useful of lead in daily activities, and where is it used

    in the object.

    1.3.8  To know the lead can go into human’s body, and how is effect for

    the health.

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    CHAPTER II

    LITERATURE REVIEW

    2.1. 

    Function Of Nutrition

     Nutrition is the process by which your body uses the foods you eat. It is a

    deciding factor of good health. Food is the major source of all the nutrients a

     body needs. Nutrients are the chemical substances needed to do three things:

    1. 

    Build and maintain body tissues

    2.  Regulate the many body processes performed by the heart, blood, liver,

    kidneys, brain, etc.

    3. 

    Supply energy for body processes and for physical activity

    When food is digested and absorbed, the nutrients are made available for

    the body’s use. Without these nutrients, life would not be possible. Science

    has shown that the human body needs at least 40 different nutrients. Each one

    has specific uses. However, all must work together for growth and health.

    Too much or too little of one nutrient affects the way the others are used.

    Everyone needs the same nutrients, but in different amounts. The amounts

    are determined by each person’s age, sex, size, activity, and state of health.

    All the nutrients can be grouped into these six large classes: water,

    carbohydrates, fats, proteins, vitamins, minerals.

    Except for air, water is the most essential element for life. We can live

    weeks without food, but only a few days without water. All the chemical

    reactions in the body that change food into bone, tissue, and energy require

    water. It is in every cell in the body. It is used to carry nutrients through the body and to carry wastes out of the body. Water also helps keep the body

    temperature the same whether it’s hot or cold outside. About two-thirds of

    your weight is water. Under normal conditions, just the right amount of water

    is kept in the body at all times. Your brain controls this. When you are

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    running low on water, a message is sent to the brain and the brain tells you

    that you’re thirsty. When you’ve gotten too much water, the kidneys get a

    message to start getting rid of the excess. Water is also lost through the skin

    and lungs. Sweating is one way the body keeps a constant temperature. On

    hot, dry days more water is lost than on cool, humid days. Water is replaced

    in two ways. First, the body makes some water. However, it doesn’t make

    enough. The rest comes from food and beverages. Liquids are an easy-to-

    recognize source of water, but solid foods also contain important amounts.

    Meats, fruits, and vegetables are from 60 to 97 percent water. Water is vital

    for life. Elderly or ill people sometimes develop problems controlling water

     balance. However, most people go a lifetime without any problems. Healthy

     people need to follow what their body tells them: when thirsty, drink!

    The carbohydrates that provide nourishment for the body are more

    commonly known as sugar and starches. Another carbohydrate, fiber, does

    not supply nourishment but furnishes roughage needed for proper removal of

    solid wastes from the body. All carbohydrates, except fiber, must be broken

    down by digestion into simple or single sugars before the body can use them.

    The simple sugars are glucose, fructose, and galactose. These single sugars

    are called monosaccharides. The sugars we get from food are mostly double

    sugars, or disaccharides. These disaccharides are sucrose, lactose, and

    maltose. Sucrose, the most common, is table sugar. The sugar in most fruits

    and vegetables is also sucrose. Lactose is the sugar in milk. And maltose is

    malt sugar. Digestion changes the disaccharides to monosaccharides. Starch,

    a complex carbohydrate, is made up of many single sugars. We get starch

    from plants. The seeds of a plant (such as cereal grains) and the roots or

    tubers (such as potatoes) are the richest sources of starch. Digestion changes

    the glucose.

    The major function of carbohydrates is to provide energy for the work of

    the body. This energy is needed to carry on the body processes such as

    heartbeat, muscle contractions, and breathing. It is also needed for activities

    such as walking. Each gram of carbohydrate in food supplies the body with

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    four kilocalories of energy. Carbohydrates also help the body use the other

    nutrients. The body gets its energy from glucose. If your body makes more

    glucose than it can use for energy, the excess is changed into body fat.

    In our weight-conscious society, fats have developed a bad name. The

    truth is, dietary fats are necessary for a healthy body. But just like any good

    thing, it can be overdone. Fats, also called lipids, are many compounds that

    include both fats (lard, shortening, margarine, and butter) and oils.

    Chemically, fats are made up of two substances, fatty acids and glycerol.

    Saturated fats are usually animal fats. This includes the fat in beef, pork,

    lamb, dairy products, and eggs. Saturated fats are solid at room temperature.

    Unsaturated fats are usually vegetable fats. We call them oils because theyare liquid at room temperature. Unsaturated fats are polyunsaturated fats if

    they contain a fatty acid called linoleic acid. Linoleic acid is necessary for

     proper growth and a healthy skin; it is of particular nutritional importance

     because the body cannot make it. It is called an essential fatty acid because

    we must get it from the fats we eat. However, only a small amount of linoleic

    acid is required. Safflower, corn, cottonseed, peanut, and soybean oils are

    especially rich in linoleic acid. The labels on products made from these oils

    often say “high in polyunsaturated” or “high in polyunsaturated fatty acids.”Although we can say that animal fats are saturated and vegetable oils are

    unsaturated, there are some exceptions. Coconut oil is a liquid and a

    vegetable oil, but it is a saturated fat. And chocolate is higher in saturated

    fatty acids than chicken and fish. When oils have been hydrogenated, they

     become more solid. Margarine is an example of a food in which vegetable

    oils are hydrogenated to the consistency of a fat. In the process, the vegetable

    oil becomes more of a saturated fat. Fats have many functions in our bodies.

    They are a concentrated form of energy, supplying a large amount in a small

    amount of food. One gram of fat supplies the body with nine kilocalories of

    energy. We can store this energy as body fat for later use.

    Proteins and water make up most of your body’s weight. Proteins consist

    of many different amino acids. There are about 20 that we know of, and the

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     body can make all but eight of them. These eight are called essential amino

    acids because we must get them from food. For your body to use the proteins

    from the foods you eat, it does two things. First, it breaks down the proteins

    into amino acids. Second, the cells in the body take up those amino acids and

    rearrange them to build body proteins. We get dietary proteins from both

    animal and plant foods. Proteins of animal origin are called complete

     proteins, or high quality proteins, because they contain the eight essential

    amino acids in large enough amounts to meet the body’s needs.

    Proteins from vegetable foods are low in one or more of these essential

    amino acids, although not necessarily the same ones in each case. To be most

     beneficial, the eight essential amino acids must be eaten together and must be

    eaten in the right amounts. The quality of vegetable proteins can be improved

    in two ways:

    1.  If a small amount of animal protein is added to a plant protein, a high

    quality mixture results.

    2.  If two plant proteins that lack different essential amino acids are

    combined, the protein quality improves.

    Proteins that can be combined to produce a high-quality mixture are called

    complementary proteins. These combinations are important for vegetarians

    who need to consider the quality of the proteins they consume, for people

    trying to keep down food costs, and for those trying to reduce their intake of

    animal fat or cholesterol.

    Proteins have almost endless functions in the body. They are needed for

     building new body tissues. During periods of growth, such as infancy,

    childhood, adolescence, and pregnancy, an adequate supply of proteins is

    especially essential. After growth stops, proteins are still necessary to replace

    and repair body tissues. Proteins are also necessary for building essential

     body compounds. An example of an essential compound containing protein is

    hemoglobin. Without protein, the body could not make hemoglobin. And

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    without hemoglobin, the blood would be unable to carry oxygen to the cells.

    Proteins also supply the body with energy, about four kilocalories per gram of

     protein. If not enough carbohydrates and fats are eaten, the body will use

     proteins for energy. Dietary proteins that are not needed to build or repair

    tissue or to provide energy are made into body fat.

    Vitamins are chemical substance in foods and are necessary for the proper

    functioning of the body. Vitamins are used over and over again and are not

    easily used up. You only need a very small amount of each vitamin every

    day. Once your body has what it needs, extra vitamins have no additional

    health benefits. More than 15 different vitamins are needed to keep your body

    healthy. They are classified in two major categories: fat-soluble vitamins and

    water-soluble vitamins. Fat-soluble vitamins are stored in the body. You can

    eat enough today to make up for not having enough yesterday. Since fat-

    soluble vitamins are stored, it is possible to get too much. Water-soluble

    vitamins are not stored to any degree in the body. You have to get a new

    supply daily. Most foods contain a variety of vitamins, but no one food has

    enough of all of them to meet the body’s requirements. Under normal

    circumstances, a diet made up of a variety of foods will supply your vitamin

    needs.

    Minerals make up only about five percent of your body weight. But they

     play an important role in many body functions. More than 15 minerals are

    known to be needed by the body—some in relatively large amounts, such as

    calcium, phosphorus, sodium, chloride, potassium, magnesium, and sulfur.

    Other mineral, called trace minerals—iron, manganese, copper, iodine, zinc,

    cobalt, fluorine, selenium, and perhaps others— are needed in only small

    amounts. Minerals have two general body functions—building and

    regulating. The building function affects the skeleton and all soft tissues. The

    regulating function includes many systems, such as heart beating, blood

    clotting, nerve response maintenance, and oxygen movement from lungs to

    tissues. Though minerals are needed for health, too much can be harmful. If

    all the potassium needed in a day were taken in one dose, severe illness could

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    result. Other minerals can cause illness if as little as twice the amount needed

    for good health is taken. And too much of one mineral may affect the use of

    others. A diet with enough protein foods will probably provide enough of all

    the minerals you need to meet the body’s requirements.

    2.2. THE IMPORTANCE OF NUTRITION

    The importance of food and nutrition in human development is widely

    recognized in both high income and middle to low income countries.

    Malnutrition in all its forms amounts to an intolerable burden not only on

    national health systems but the entire cultural, social and economic fabric of

    nations, and is the greatest impediment to the fulfilment of human potential.

    Investing in nutrition therefore makes economic sense because it reduces

    health care costs, improves productivity and economic growth and promotes

    education, intellectual capacity and social development for present and future

    generations.

     Nutrition is a foundation for development, as is elaborated in the SCN

     brief compilation from 2002, designed to facilitate dialogue between

    nutrition and other development professionals and to make the case for

    integrating nutrition into the work of the development community. Income poverty reduction and increased food production alone will not solve the

    nutrition problems of the poor in low income countries. Tackling global

    nutrition problems is essential for achieving the Millennium Development

    Goals (MDGs).

    Moreover, good nutrition is a human right. Nutrition security encompasses

    many rights, especially the right to adequate food and to the highest attainable

    standard of health. It includes children's rights to food, health and care as well

    as survival and development. Besides that, it comprises women’s right to

    appropriate services in connection with pregnancy, confinement and the post-

    natal period along with adequate nutrition during pregnancy and lactation.

    This is the focus area of the SCN Working Group on Nutrition, Ethics and

    Human Rights and the topic of SCN News No 18 and No 30.

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     Nutrition is ever more important in the light of the recent financial and

    food price crises. These crises increase malnutrition among the most

    vulnerable people in developing countries, with pregnant women and children

     being the hardest hit. The SCN has developed a technical briefing note as

    well as an advocacy note (2 pages) on the nutrition impacts of the global

    financial and food crises. On 14 October 2008, the SCN held a Side Event

    focusing on the Impact of High Food Prices on Nutrition at the 34th Session

    of the Committee on World Food Security (CFS), 14-17 October 2008,FAO,

    Rome.

    These recent crises overlap with and deepen the effects other

    crises. Nutrition remains a concern in emergencies like conflict or natural

    disaster. The SCN Working Group on Nutrition in Emergencies is a very

    active one and has pioneered cooperation and thinking in the field. One recent

    achievement was the community-based treatment of severe malnutrition, such

    as in SCN Nutrition Policy Paper 21. The SCN Secretariat has through

    its Nutrition Information in Crisis Situations (NICS) reported on the nutrition

    situation of refugees, displaced and resident populations affected by a crisis

    since 1993.

    Moreover, undernutrition has adverse intergenerational effects thatsignificantly increase its economic and other social costs. This is elaborated

    in the fourth of the SCN Reports on the World Nutrition Situation as well as

    in the report of the Commission on the Nutrition Challenges of the 21st

    Century. The SCN News No 11 on Maternal and Child Nutrition in 1995 first

     presented the life-cycle approach. The first ever meeting to discuss low birth

    weight and how to prevent it, led to the development of a Nutrition Policy

    Paper No 18. Several SCN Working Groups also focus on nutrition across the

    lifecourse, such as the one on Nutrition Throughout the Lifecycle, or on

    specific stages of the lifecycle, such as the Working Groups on Breastfeeding

    and Complementary Feeding and on Nutrition of School Age Children.

    At the same time the world is also increasingly affected by another sort of

    malnutrition, namely overweight and obesity which as proposed in SCN

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     News No 29 may constitute a new nutritional emergency. The emerging

    global epidemic of non-communicable or chronic diseases is no longer a

     problem restricted to affluent, industrialized countries. It is increasingly

    affecting low income countries and contributing to their existing burden of

    undernutrition. Thus in low income societies, diseases caused by caloric

    inadequacy and deficiency continue to persist, but now co-exist with the

    growing presence of nutrition related chronic diseases; this is the double

     burden of malnutrition. SCN News No 32 and No 33 look at the double

     burden of malnutrition at the global level and in West Africa, respectively.

    Micronutrient deficiencies being the risk factor for many diseases, can

    contribute to high rates of morbidity and mortality and even moderate levels

    of deficiency can have detrimental effects on human health. They are

    widespread in industrialized nations, but even more so in the developing

    regions of the world. Young children and women of reproductive age are

    among those most at risk of developing micronutrient deficiencies. The

    forthcoming Nutrition Policy Paper 22 will present a systematic review of

    multi-micronutrient supplementation during pregnancy in developing

    countries, looking at how these could improve iron status as well as have an

    effect on critical outcomes like birth weight. The three most common forms

    of micronutrient malnutrition are iron, vitamin A and iodine deficiency.

    Measures to correct these major micronutrient deficiencies are well-known.

    The recent SCN News 35 describes how the control of iodine deficiency

    disorders through salt iodization has been a major accomplishment over the

    last decades. Measures to control Vitamin A deficiencies were addressed

    in Nutrition Policy Papers 13 and 14, whereas Nutrition Policy Paper

    9 described measures to control iron deficiencies. Since the inception of the

    SCN a series of different Working Groups have focused on specific

    micronutrients, today the Working Group on Micronutrients cover all aspects

    of vitamin and mineral nutrition.

     Nutritional status is an outcome of a series of determinants clustered into

    food, health and care. Each of these clusters is essential but alone insufficient

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    for achieving nutrition security. The SCN network address the causes of

    malnutrition at the immediate, underlying and basic level. For example,

    the Working Group on Household Food Security is concerned with food

    security of vulnerable households. Others are focusing on interactions

     between nutrition and health, such as the Working Group on Nutrition and

    HIV/AIDS. Reducing malnutrition requires attention to the three areas of

    food, health and care. However, in order to achieve sustainable

    improvements, capacity development is essential. The aim of the Working

    Group on Capacity Development in Food and Nutrition is therefore to assist

    developing regions enhance individual, organizational and institutional

    capacity in the area of food and nutrition. 

    2.3. 

    WASTE

    For these purposes waste is anything which you decide to, or are required to,

    dispose of. This includes items that can be given to someone else or recycled.

    Waste is classified by where it originates from and the properties it contains.

    There are a number of complicated legal definitions, but the general

    framework is as follows.

      Clinical Waste

    Clinical waste is divided into a number of differing categories, and is

    considered in greater detail later on is this manual but is defined as:

     any waste consisting wholly or partly of human or animal tissue, blood or

    other body fluids, excretions, drugs or pharmaceutical products, swabs or

    dressings, syringes, needles or other sharp instruments, being waste which

    unless rendered safe may prove hazardous to any person coming into

    contact with it; and

     

    any waste arising from medical, nursing, dental, veterinary,

     pharmaceutical or similar practices, investigation, treatment, care, teaching

    or research, or the collection of blood for transfusion, being waste which

    may cause infection to any person coming into contact with it.

      Controlled Waste

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    Controlled waste is defined in the Environment Protection Act 1990 and

    the Controlled Waste Regulations 1992 as household, industrial and

    commercial waste or any such wastes that require a waste management

    licence for treatment, transfer or disposal.

      Commercial Waste (Non-municipal)

    Waste arising from premises that are used wholly or mainly for trade,

     business, sport, recreation or entertainment, excluding household and

    industrial waste.

      Household Waste (Municipal)

    Waste from domestic properties including waste from caravans, residential

    homes and premises forming part of an educational establishment and part of

    a hospital or nursing home.  Industrial Waste (Non-municipal)

    Waste from a factory (within the meaning of the Factories Act 1961) or

    from any premises used for, or in connection with provision of public

    transport; public supply of gas, water, electricity or sewerage services; or

     provision to the public of postal or communication services.

     

    Inert Waste

    Waste that does not undergo any significant physical, chemical or

     biological

      Municipal Waste

    This is waste collected on behalf of the local authority. It comprises

    mostly household waste but may include some commercial and industrial.

       Non-municipal Waste

     Non-municipal waste falls into two distinct categories: commercial and

    industrial. These are explained in detail above. They are not usually collected

    as part of the local authority’s responsibility.

     

    Packaging Waste

    Comprises waste arising from "all products made of any materials of any

    nature to be used for the containment, protection, handling, delivery and

     presentation of goods, from raw materials to processed goods, from the

     producer to the user or the consumer"

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      Special Waste

    This is classified as controlled waste because of its properties, but requires

    specialist handling.

    2.4. Lead Contamination

    2.4.1 

    LEAD

    Lead (Pb) is a heavy metal that contained naturally deep in earth crust

    and spread into small pieces trough a natural process including volcano

    eruption and geochemical process. Lead is a soft metal colored blue or ray-

    silver with 327.5 0 C melting point and 1740 0 C boiling point in atm. Pb

    has the biggest atomic number from all steady unsure, that is 82. But, this

    metal is highly toxic. Lead is a metal that can broke human neural systemif it accumulate in the human soft tissue and bone for a long time. Lead

    contained in some isotope: 204Pb (1.4%), 206Pb (24.1%), 207Pb (22.1%),

    and 208Pb (52.4%). 206Pb, 207Pb and 208Pb all of them are radiogenic

    and final product from termination complex chain. This metal is very

    resistant from corrosion so that it’s often accompanied with other fluid

    which is corrosive.

    2.4.2 

    SOURCE OF LEAD CONTAMINATION

    Environmental pollution by lead mostly from human activities that

    extract and exploit the metal. Lead is used for multiple purposes,

    especially as piping materials, additives for gasoline, batteries, pigments

    and ammunition. Potential sources of lead exposure can vary in different

    locations. Humans absorb lead through air, dust, water and food. One

    cause is the presence of lead air pollution. That is due to land transport

    activities that generate pollutants such as CO2, NOx, hydrocarbons, SO2,

    and tetraethyl lead, which is a metal lead (lead) were added to the low-

    quality fuel to lower the octane rating.

    Organic lead compounds such as Pb-tetraethyl and Pb-tetramethyl

    widely used as an additive to gasoline to increase the octane number of the

    economically and is the largest of all lead emissions to the atmosphere.

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    Pb-tetraethyl and Pb-tetramethyl form of a solution to the boiling point of

    each 110 º C and 200 º C. Because of the power of evaporation both

    compounds was lower than the other elements in the gasoline, the gasoline

    evaporation will tend to concentrate the levels of Pb-tetraethyl and Pb-

    tetramethyl. Both of these compounds be decomposed at the boiling point

    in the presence of sunlight and other chemicals in the air such as halogen

    acids or oxidizing agents.

    Lead emissions into the Earth's upper atmosphere and can take the

    form of gas and particles. Lead emissions in the form of gas once

     primarily related emissions come from motor vehicles. Emission is a

     byproduct of combustion occurs in vehicle engines, which are derived

    from compounds Pb-tetramethyl and Pb-tetril are always added to themotor vehicle fuel which serves as antiknock on vehicle engines. Loss of

    lead (Pb) in the event of combustion in the engine that caused the amount

    of lead that is discharged into the air through the exhaust fumes of vehicles

    to be very high. Based on estimates 80-90% lead in ambient air comes

    from burning gasoline is not the same from one place to other place

     because it depends on the density of motor vehicles and efficiency efforts

    to reduce lead content in gasoline.

    2.4.3 Effect Of Lead Contamination

    Lead has many health effects on humans. Overt signs of acute

    intoxication include dullness, restlessnes, irritability, poor attention span,

    headaches, muscle tremor, abdominal cramps, kidney damage,

    hallutinations, and loss of memory, encephalopathy occuring at B-Pb of

    100 – 120 μg/dL, in adults and 80  – 100 μg/dL in children. Signs of

    chronic lead toxicity, including tiredness, sleeplessness, irritability,

    headaches, joint pain, and gastrointestinal sysptoms, lower scores on

     psycometric tests, disturbances in mood, and symptoms of peripheral

    neuropathy were observed in occupationally exposed populations at B-Pb

    of 40 – 60 μg/dL (WHO, 1996). 

    1. 

    Reproductive effects

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    Gonadal dysfunction in men, including depressed sperm counts, has

     been associated with B-Pb of 40 to 50 μg/dL. Reproductive dysfunction

    may also occur in females occupationally exposed to lead (IARC, 1980).

    Low-to-moderate lead exposures may increase the risk for spontaneous

    abortion. In the prospecitive Mexico City Study, a striking dose-response

    relation between B-Pb and risk for spontaneous abortion was found (odds

    ratio 1.8 for every 5 μg/dL increase in blood lead) (Hertz-Picciotto, 2000).

    Two studies reported that women with elevated lead exposure from

    occupational settings are at increased risk of developing infertility

    compared with women with no such exposure (Rom, 1976; Landrigan,

    2000). Studies in Taiwan showed that women with B-Pb greater than 250

    μg/L were associated with a threefold increased risk for infertility.Women´s B-Pb was a significant predictor of the serum estradiol

    concentration (Shu-Hao, 2006). The reproductive effects in men were

    observed in a study in Croatia in 2006 (increase in immature sperm

    concentration, in percentage of pathological sperm, wide sperm, round

    sperm, and short sperm, in serum levels of testosteron and estradiol, and

    decrease in seminal plasma zinc and in serum prolactin. These

    reproductive effects were observed at low-level lead exposure (B-Pb

    median 49 μg/L) common for the general population worldwide

    (Telišman, 2007).

    2. 

     Neurological effects in infants and children

    Acute lead poisoning may produce encephalopathy. Ataxia, altered

    consciousness, and seizures have been reported in children with a B-Pb

    higher than 100 μg/dL (WHO, 1996). The effects of chronic low  – level

    lead poisoning had been addressed through large, complex epidemiologic

    studies. The evidence indicated that young children have subtle

    impairment of neuropsychiatric development when B-Pb is elevated. Few

    studies have examined the long-term effects of childhood lead poisoning.

    A study by White et al. among 34 Boston subjects and 20 matched

    controls, 50 years after diagnosis of symptomatic lead posisoning,

    suggested that a permanent pattern of cognitive dysfunction may result

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    from childhood lead poisoning. The authors suggested that cognitive

    deficits among previously lead-posioned adults may explain lower

    occupational achivement in this group (White, 1993). Risk factors for

    childhood lead exposure are: - second year of life; - history of lead

     poisoning in a sibling or playmate; - history of pica; - living in house built

     before 1960; - parents working in a lead industry; - reside near an active

    lead industry. From autoposy studies in children exposed to lead, it was

    found that there are two types of morphological effects on the central

    nervous system. First, there is a cerebral edema, which may be reversible.

    Second, there is a direct loss of neurons in certain areas of the brain (such

    as gray matter, hypothalamus, and basal ganglia) where neurons are most

    concentrated (Que Hee, 1993).Lanphear et al in 2000 showed that the magnitude of the association

     between concurent B-Pb and academic achivement in 6- and 16-years-olds

    was more steeply inverse when analyses were restricted to children with

    B-Pb < 25 μg/L rather than when analyses included all children with B-Pb

    < 100μg/L (Lanphear, 2000). Assesements that have conducted at older

    ages often have revealed inverse associations between children´s B-Pb and

    their scores, at later ages, on tests of motor development or visual-motor

    skills. Study in the U.S., 1994 and 1995, concluded that B-Pb below100μg/L, were inversely associated with children´s IQ scores at 3 and 5

    years of age, and associated declines in IQ were greater at these

    concentrations than at higher concentrations (Canfield, 2003). The meta-

    analysis of Schwartz (Schwartz, 1994) showed a reduction of 2.6 in IQ

     points for an increase in blood lead of 100 to 200 μg/L. This analysis

    included eight cross-sectional and longitudinal studies, the largest

    longitudinal study being the Port Pirie cohort study in Australia, with

    about 500 participants and a follow-up after several years (Baghurst,

    1992). The meta-analysis also reported that the effect was likely to

    continue between 100 and 50 μg/L, with an even steeper curve. Above a

     blood lead level of 200 μg/L, a loss of 3.5 IQ points has been assumed

    (Fewtrell, 2004).

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    3.  Elevated blood pressure

    Elevated blood presure is another effect seen at low B-Pb. Although in

    a strict sense it is not a health outcome, elevated blood pressure has been

    associated with an increased risk of cardiovascular and cerebrovascular

    disease. The association between the B-Pb and blood pressure is strongest

    for increases in systolic blood pressure in adult males. Systolic and

    diastolic blood pressures have been shown to be higher in lead exposed

    workers than in the control group (Verschoor, 1987), and systolic blood

     pressure was positively correlated with blood lead levels in a number of

    studies (Maheswaran, 1993; Schuhmacher, 1994). Schwartz showed that

    decreases in B-P b from 10 μg/dL to 5 μg/dL were associated with a

    decrease of 1,25 mmHg in systolic blood pressure; other studies founddecreases of 2 mm Hg for reductions in blood lead from 20 μg/dL to 15

    μg/dL, and from 15 μg/dL to 10 μg/dL. In women, the association between

    systolic blood pressure and blood lead is weaker and less – well

    documented (Schwartz, 1994). Large-scale mortality studies of individuals

    in the lead-smelting and battery industries have supported the conection

     between lead and hypertension. In an American population between 1946

    and 1970, most workers had mean B-Pb of 400 – 700 μg/L. Little is known

    about the natural history of the development of hypertension in lead posioning, its pathophysiology and relation to renal effects, and the effects

    of intervention (Dart, 2004). In systematic review of lead exposure and

    cardiovascular diseases in 2007, Navas-Ancien et al found sufficient

    evidence to infer a causal relationship between hypertension and lead

    exposure (Navas-Ancien, 2007).

    4.  Gastrointestinal effects

    One of the earliest clinical signs of lead posisoning can be

    nonspecific, gastrointestinal effects. Symptoms include abdominal pain,

    constipation, cramps, nausea, vomiting, anorexia and weight loss. Lead

    may exert a direct effect on visceral smooth muscle tone and vascular

    supply in the gastrointestinal tract. At higher blood lead levels (> 800

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    μg/L), severe abdominal cramping and constipation may occur (Fischbein,

    1998).

    5. 

    Anaemia

    The haemopoeitic system is very sensitive to the effects of lead, and

    subclinical effects on a number of enzymes involved with haem

     biosynthesis have been seen at very low lead levels. A study from 1968 to

    1969 in Ţerjav, Slovenia, showed an increased number of reticulosits 18.1

    % with adult male and 34 % in adult females (Primerjalna študija

    onesnaţenosti okolja v Zgornji Meţiški dolini med stanji v letih 1989 in

    2001, 2002).

    6. 

    Renal effects

    Acute effects are generally seen on children, when exposure is

     primarily through the oral route, while chronic effects are more common in

    adults, occupationally exposed to lead, where the principal route is

    inhalation.

    Lead accumulates in the proximal tubular cells, a process that explains

    the marked effect on urate excretion. In addition, Fanconi´s syndrome

    (proteinuria, aminoaciduria, and phosphaturia) have been described as the

    result of lead accumulation. Inclusion 16 bodies have been found in renal

    tubular cells. These inclusions may represent the binding of lead by a renal

     binding protein that mitigates the effects of lead. As toxicity progresses,

    chronic interstitial nephritis may develop, in some cases progressing to

    end-stage renal failure (WHO, 1996). Few studies have examined the renal

    effects of lead in children. A study in Romanian children ages 3 to 6 years

    with an average B-Pb of 340 μg/L, showed a significant relationship

     between the BLL and N-acetyl-ß-D-glucosaminidase activity in urine

    (Dart, 2004).

    Blood lead levels, ranging from 23 – 725 μg/L, were shown to

    correlate with measures of glomerular dysfunction in a study of a large

    European population (Staessen, 1992). Low-level exposure to lead has

     been shown to impair renal function and accelerate age-related loss of

    renal function in asymptomatic middle-aged and older men, among whom

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    increased serum creatinine levels were positively correlated with blood

    lead levels (Kim, 1996).

    7. 

    Pulmonary effects

    Although a recent report identified lead pneumoconiosis in lead

    miners, no reports have cited pulmonary dysfunction among other

    intoxiacated populations (Dart, 2004).

    8. 

    Endocrine effects

    Lead causes decreased serum thyroxine levels, effects on adrenal

    hormones, and changes in levels of vitamin D (Dart, 2004). The effects of

    lead on thyroid function have been known for 50 years. The study of

    Slingerland in 1955 (Slingerland, 1955) was the first to show diminished

    iodine uptake by the thyroide gland and Sandstead in 1969 conformed thatresults in rats in an in vivo study (Sandstead, 1969). A study by Dundar et

    al in 2005 showed that long-term low-level lead exposure may lead to

    reduced FT4 (free thyroxine) level without significant changes in

    Thyrotrophin and free triodothyronine levels in adolescents even at low B-

    Pb levels (mean 73 μg/L) (Dundar, 2006). 

    9.  Cancer

    In 1987, the IARC classified lead and inorganic lead compounds as

     possibly carcinogenic to humans (group 2B)“ on the basis of sufficiant

    animal data and insufficiant human data. On the basis of inadequate

    evidence from two epidemiological human studies as well as animal

    studies, organolead compounds were considered as not classifiable as to

    their carcingenicty to humans (group 3). In 2004, the IARC reevaluated

    the potential carcingenic hazards to humans from exposure to inorganic

    lead compounds and reached the following overall evaluations: inorganic

    lead compounds are probably carcinogenic to humans (group 2A), organic

    lead compounds are not calsiffiable as to their carcinogenicity to humans

    (group 3) (IARC, 1980). Lead is weakly mutagenic but exerts pronounced

    indirect genotoxic effects and increases the mutagenicity of other

    mutagens. These indirect genotoxic effects are observed at low, nontoxic

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    concentrations, possibly via interference with DNA repair processes

    (Cornelis, 2005).

    10. 

    Mutagenicity

    Though some research shows lead compounds are capable of inducing

    gene and chromosome mutations, lead is clearly not a powerful mutagen

    nor even a consistent mutagen among various test systems. Lead´s ability

    to interfere with the fidelity of DNA synthesis surely provides a

    mechanistically plausible way by which it may be capable of causing both

    mutation and cancer (Johnson, 1998). However, the in vitro demonstration

    of this infidelity may not apply to intact cells or to the complete organism

    at environmentally relevant concentrations (Hartwig, 1994).

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    CHAPTER 3

    CONCEPT OF MAPPING

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    CHAPTER IV

    DISCUSSION

    4.1 Health

    4.1.1 Definiton of Health

    Health is the level of functional or metabolic efficiency of a

    living being. In humans, it is the general condition of a person's

    mind and body, usually meaning to be free from illness, injury or

     pain. The World Health Organization (WHO) defined health is a

    state of complete physical mental, social, and spiritual well being,

    and not merely the absence of disease (WHO, 1947)

    4.1.2 Determinants of health

    Generally, the context in which an individual lives is of great

    importance for his health status and quality of life. It is increasingly

    recognized that health is maintained and improved not only through

    the advancement and application of health science, but also through

    the efforts and intelligent lifestyle choices of the individual and

    society.

    More specifically, key factors that have been found to influence

    whether people are healthy or unhealthy include :

    1) 

    Genetic = Certain disease might run in your family2)

     

    Behavior such as smoking or using drugs

    3)  Physical environment such as air or water pollution

    4)  Access to health care: for example, lack of transportation to

    the doctor

    5) 

    Income: for example, lack of health insurance

    6)  Education: for example, being unaware of the risks of

    certain behavior

    4.1.3 Changing Concepts of Health

    1) 

     Biomedical Concept

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    Health is the absence of disease. This concept, has the basis

    in the germ theory disease. The criticism against the

     biomedical concept is that it has minimized the role of:

    environmental, social, psychological, economic, cultural,

    and other determinants.

    2) 

     Ecological Concept

    Health is a dynamic equilibrium between man and his

    environment imbalance result of disease. Adaptation of man

    to his environment leads to better health and longer life

    expectancy even in the absence of modern health services.

    3) 

    Psychosocial Concept

    Health is not only a biomedical phenomenon, but one whichis influenced by psychological social, cultural, economical,

     politic factors.

    4) 

     Holistis Concept

    Implies that all sectors of the society have an effect on

    health, in particular, education, communication, agriculture,

    industry, housing, food, etc. Emphasis on promotion and

     protection oh health.

    4.2 Nutrition

    Food is a basic need of a human, human need food to live. Our

    need for food is based on the body’s requirement for nutrients found in

    food, There are categories of nutrients :

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    Source of picture  : http://www.biggerplate.com/mapImages/xl/76ee9e67-3b55-

    4d8e-a088-a878b804c45d.png 

     Carbohydrates

     

    Carohydrates serve one major function in the body : they

     provide energy. Unlike protein and fat, carbohydrates can

     be converted to energy by every cell in the body.

      Of particular importance to people living on low protein

    diets is the fact that carbohydrates, like fat, spare protein

    for use in building and maintaining organs, muscle,

     bones, and the other

      Food that contain carbohydrates : bread, rice, etc

     

    Proteins

      The primary role of proteins is to provide the building

    materials for the various components of the body’s tissue.

      Proteins are also used in energy formation, but this is not

    their primary role.

      Food that contain proteins are egg, meat, etc

     

    Fats When we consumed a fat, we are actually consuming a

     plant or animal’s energy store. In addition to energy, fats

    in food also supply fat-soluable nutrients.

     Vitamins and minerals

     Vitamins and minerals are sometimes referred to as trade

    nutrients and as the micronutrients. Human need them in

    very small amounts, and they are present in food in very

    small amounts. Nonetheless, very small amounts of these

    essential substances have profound effects on body

    functions.

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    4.3 Diet

    During the past decade, rapid expansion in a number of relevant

    scientific fields and, in particular, in the amount of population-based

    epidemiological evidence has helped to clarify the role of diet in

     preventing and controlling morbidity and premature mortality resultingfrom noncommunicable diseases (NCDs).

    Some of the specific dietary components that increase the

     probability of occurrence of these diseases in individuals, and

    interventions to modify their impact, have also been identified.

    Furthermore, rapid changes in diets and lifestyles that have occurred with

    industrialization, urbanization, economic development and market

    globalization, have accelerated over the past decade. This is having a

    significant impact on the health and nutritional status of populations,

     particularly in developing countries and in countries in transition.

    While standards of living have improved, food availability hasexpanded and become more diversified, and access to services has

    increased, there have

    also been significant negative consequences in terms of inappropriate

    dietary patterns, decreased physical activities and increased tobacco use,

    and a corresponding increase in diet-related chronic diseases, especially

    among poor people.

    Food and food products have become commodities produced and

    traded in a market that has expanded from an essentially local base to an

    increasingly global one. Changes in the world food economy are

    reflected in shifting dietary patterns, for example, increased consumptionof energy-dense diets high in fat, particularly saturated fat, and low in

    unrefined carbohydrates.

    These patterns are combined with a decline in energy expenditure

    that is associated with a sedentary lifestyle ---

    motorized transport, labour-saving devices in the home, the phasing out

    of physically demanding manual tasks in the workplace, and leisure time

    that is preponderantly devoted to physically undemanding pastimes.

    Because of these changes in dietary and lifestyle patterns, chronic

     NCDs--- including obesity, diabetes mellitus, cardiovascular disease

    (CVD),

    hypertension and stroke, and some types of cancer --- are becoming

    increasingly significant causes of disability and premature death in both

    developing and newly developed countries, placing additional burdens on

    already overtaxed national health budgets.

    The Consultation provided an opportune moment for FAO and

    WHO to draw on the latest scientific evidence available and to update

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    recommendations for action to governments, international agencies and

    concerned partners in the public and private sectors. The overall aim of

    these recommendations is to implement more effective and sustainable

     policies and strategies to deal with the increasing public health challenges

    related to diet and health.

    The Consultation articulated a new platform, not just of dietary and

    nutrient targets, but of a concept of the human organism’s subtle and

    complex relationship to its environment in relation to chronic diseases.

    The discussions took into account ecological, societal and behavioural

    aspects beyond causative mechanisms. The experts looked at diet within

    the context of the macroeconomic implications of public health

    recommendations on agriculture, and the global supply and demand for

    foodstuffs, both fresh and processed. The role of diet in defining the

    expression of genetic susceptibility to NCDs, the need for responsible

    and creative partnerships with both traditional and non-traditional

     partners, and the importance of addressing the wholelife course, were all

    recognized.

     Nutrition is coming to the fore as a major modifiable determinant

    of chronic disease, with scientific evidence increasingly supporting the

    view that alterations in diet have strong effects, both positive and

    negative, on

    health throughout life. Most importantly, dietary adjustments may not

    only influence present health, but may determine whether or not an

    individual will develop such diseases as cancer, cardiovascular disease

    and diabetes much later in life. However, these concepts have not led to a

    change in policies or in practice. In many developing countries, food policies remain focused only on undernutrition and are not addressing the

     prevention of chronic disease.

    Although the primary purpose of the Consultation was to examine

    and develop recommendations for diet and nutrition in the prevention of

    chronic diseases, the need for sufficient physical activity was also

    discussed and is therefore emphasized in the report. This emphasis is

    consistent with the trend to consider physical activity alongside the

    complex of diet, nutrition and health. Some relevant aspects include:

     

    Energy expenditure through physical activity is an important part

    of the energy balance equation that determines body weight. A

    decrease in energy expenditure through decreased physical activity

    is likely to be one of the major factors contributing to the global

    epidemic of overweight and obesity.

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      Physical activity has great influence on body composition on the

    amount of fat, muscle and bone tissue.

     

    To a large extent, physical activity and nutrients share the same

    metabolic pathways and can interact in various ways that influence

    the risk and pathogenesis of several chronic diseases.

      Cardiovascular fitness and physical activity have been shown to

    reduce significantly the effects of overweight and obesity on health.

      Physical activity and food intake are both specific and mutually

    interacting behaviours that are and can be influenced partly by the

    same measures and policies.

      Lack of physical activity is already a global health hazard and is a

     prevalent and rapidly increasing problem in both developed and

    developing countries, particularly among poor people in large

    cities. In order to achieve the best results in preventing chronic

    diseases, the strategies and policies that are applied must fully

    recognize the essential role of diet, nutrition and physical activity.

    Diet has been known for many years to play a key role as a risk

    factor for chronic diseases. What is apparent at the global level is that

    great changes have swept the entire world since the second half of the

    twentieth century, inducing major modifications in diet, first in industrial

    regions and more recently in developing countries. Traditional, largely

     plantbased diets have been swiftly replaced by high-fat, energy-dense

    diets with a substantial content of animal-based foods. But diet, while

    critical to prevention, is just one risk factor. Physical inactivity, now

    recognized as an increasingly important determinant of health, is the

    result of a progressive shift of lifestyle towards more sedentary patterns,

    in developing countries as much as in industrialized ones.

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    4.4 Pollutants

    A. POLLUTANTS DEFINITION

    Pollutant  is substance or energy introduced into the

    environment that has undesired effects, or adversely affects the

    usefulness of a resource. A pollutant may cause long- or short-term

    damage by changing the growth rate of plant or animal species, or

     by interfering with human amenities, comfort, health, or property

    values. Pollutants may be classified by various criteria:

    (1) By the origin: whether they are natural or man-made

    (synthetic).

    (2) By the effect, regardless of origin: on an organ, specie, or

    ecosystem.

    (3) By the properties: mobility, concentration, persistence,

    toxicity.

    (4) By the controllability: ease or difficulty of removal. Some

     pollutants are biodegradable and therefore will not persist in

    the environment in the long term. However the degradation

     products of some pollutants are themselves polluting such as

    the products DDE and DDD produced from degradation of

    DDT.

    B. Type Of Pollutants

    1. Soil Pollutants

    Soil pollution is the pollution of the Earth's land surfaces.

    According to Green Pack, the most common types of soil

     pollutants are heavy metals such as cadmium, chromium,

    copper, zinc or mercury, pesticides or herbicides, organic

    chemicals, oils and tars, explosive or toxic gases, combustible

    or radioactive materials, biologically active compounds and

    asbestos. These types of pollutants can enter the soil through

     poor agricultural practices, industrial runoff, mining, landfill

    leakage, littering or the improper or illegal dumping of

    household or industrial waste materials

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    2. Air Pollutants

    Air pollution is the pollution of the Earth's atmosphere. The

    U.S. Environmental Protection Agency identifies six types of

    common air pollutants. They include ozone, particulate matter,

    carbon monoxide, nitrogen oxides, sulfur dioxide and lead.

    These and other air pollutants typically enter the atmosphere

    through industrial processes related to the generation of heat

    and power, incineration of solid wastes and transportation.

    According to the University of the Western Cape, emissions

    from vehicles are estimated to be responsible for

    approximately 60% of all air pollution alone and 80% of air

     pollution in cities.

    3. Water Pollutants

    Water pollution is the pollution of the Earth's oceans and

    other water sources. According to the Minnesota Center for

    Environmental Recovery, common types of water pollutants

    include mercury, nitrates, phosphorous, fecal coliform and

     bacterial pollution. These and other types of pollutants enter

    the water supply through industrial waste runoff, sewage

    treatment plants, feedlots, urban and agricultural runoff, septic

    systems and the illegal dumping of solid waste.

    4. Noise Pollutants

     Noise pollution is a form of air pollution related

    specifically to the types of sound present in the atmosphere.

    The Environmental Protection Agency defines a noise

     pollutant as any sound that interferes with normal activities or

    disrupts or diminishes one's quality of life. Noise pollutantscan be present in the home, school, work or the community at

    large. Different types of noise pollutants may include sounds

    generated by aircraft, trains, boats, automobile traffic,

    construction, industrial manufacturing, vehicle alarms or even

    loud music.

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    C. Classification of Pollutants On the Basis of Nature 

    1. On the Basis of Nature 

    Depending upon the nature of the pollutants and their

    interaction with environment process, the pollution caused by

    different agents can be classified into the following categories:

    1) Pollution Caused by Solid Wastes: The solid wastes

    includes the pollutants like garbage, rubbish, ashes,

    large wastes formed due to demolition and construction

     processes, dead animals wastes, agricultural wastes, etc.

    2) Pollution Caused by Liquid Wastes: Oxygen cycle is

    nicely operated in aquatic system maintaining

    ecological balance. That is, the dissolved oxygen is

    used by aquatic living organisms for their respiration

    and in return, these liberate carbon dioxide. Carbon

    dioxide molecules are again used by green plants and

    algae in the process of photosynthesis. During

     photosynthesis, oxygen is again liberated to water

    which remains in dissolved state. However, if some

    organic matter (food for bacteria) enters the water

    course, then bacteria oxidize these materials consuming

    oxygen from water. At such a condition, if the process

    of re-oxygenation is slower than the process of

    deoxygenation, then the river will be devoid of life

    sustaining dissolved oxygen and aquatic living

    organisms will die.The most important source of organic pollutants is

    sewage which contains faecal matter, urine, kitchen

    washing and oil washings. Sewage also contains a large

    number of pathogenic and harmless bacteria. The

    strength of organic waste material of sewage is

    measured in terms of Bio-chemical Oxygen Demand

    (B.O.D). The value is expressed in terms of mg of

    oxygen per litre of waste for 5 days at 20C. If the

    volume of B.O.D. is below 1500mg per litre, the

    sewage is termed as weak waste, if it is 4000mg perlitre, it is medium and above this value it is termed as

    strong waste. However, if liquid industrial wastes

    containing acids, alkalis and poisonous substances enter

    the river, the aquatic life is affected and self-

     purification system of water is impaired. Pesticides and

    herbicides which enter water may kill some organisms

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    or accumulate in fishes which, when consumed by man,

     pass on the chemicals giving rise to cumulative

     poisoning.

    3) Pollution Caused by Gaseous Wastes:  The gaseous

    wastes include Carbon monoxide (CO), Sulphur

    dioxide (SO2), Nitrogen dioxide (NO2), Ozone (O3)

    and smog gases (composed of a complex mixture of

     photochemical oxidation products of hydrocarbons.

    These gases are more abundant in the atmosphere of

    industrial cities.

    2. On the Basis of Decomposition 

    1) Non-Degradable Pollutants: These are not broken down

     by the natural processes like action of microbes. Most of

    these pollutants get accumulated in the environment and

    also get biologically magnified as these moves along the

    food chains in an under-composed state. These may also

    react with other compounds in the environment to produce

    toxins.

    These can be further sub-divided into two more classes:

    i) Waste: e.g., glass, plastic, phenolics, aluminium cans

    ii) Poisons: e.g., radio-active substances, pesticides,

    smog gases, heavy metals like mercury, lead and their

    salts.

    2) Degradable Pollutants or Bio-degradable Pollutants: 

    These are natural organic substances which can be

    decomposed, removed or consumed and thus, reduced to

    acceptable levels either by natural processes like

     biological or microbial action or by some engineered

    systems, like sewage treatment plants. The degradable

     pollutants can be further sub-divided into two categories:

    i) Rapidly Degradable or Non-Persistent Pollutant: 

    The degradation of these pollutants is very faster

     process. For example, the decomposition of sewage

    and wastes of animals and plants is a faster process.

    The domestic sewage can be rapidly decomposed by

    natural processes. However, the problems become

    complicated when the input into environment get

    exceeded of the decomposition or dispersal capacity.

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    ii) Slowly Degradable or Persistent Pollutant: 

    The degradation of these pollutants, is a very slower

     process. It seems as if the amount of pollutant remains

    unchanged with time. For example, degradation of

    synthetic compounds and radio-active elements like

    Iodine 137, Strontium 90 or Plutonium 239 takes a

    longer period of time.

    4.5 Environmental toxicology

    Toxicology is the study of harmful effects of chemicals on

     biological systems.Humans,animal,and plants are increasingly being

    exposed to chemicals in the environment.The ever-increasing use of

    chemicals in industries has also resulteed in further pollution of the

    environment.As toxic chemicals are widespread in the

    environment,there is a potential for these chemicals to cause significant

    damage and harmful effects on human health.In the past three

    decades,the environment.branch of toxicology has assumed a greater

    role in understanding the effects of the chemicals on living

    organisms,especially human.Environmental toxic agents have caused many types of

    diseases especially in high-risk population such as children,pregnant or

    lactating women,geriatrics,and clinical patients.The environmental toxic

    agents are generally found in air.water,soil,and food.Upon exposure to a

    chemical,the first process is absorption of the chemical into the human

     body and distribution to reach the target organ where it can manifest its

    toxicity

    Once in the human body, the chemical an also be metabolized

    either to reduce or to further enhace its toxicity.Some chemicals can be

    stored for manyy years in the body,while orthers are eliminated via theexcretion process.The various classes of toxic stressors found in the

    environment include metals,pesticides,aromatic,and aliphatic

    hydrocarbons,volatile organic compunds,particulates,radiation,and

     biological agents such as mycotoxins and bacterial toxins.

    In order to understand the myriad of public health issues

    related to chemicals in the environment,attempst to understand the

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    acceptable levels of chemical exposure and therefore its regulation ,are

    crucial.Therefore,risk assessment must be carried out to determine the

     probabilityof adverse effects upon exposure to chemicals and how to

    manage this risk.In addition to risk assessment and risk management

    approaches importance of risk communication should be emphasized

    intergrated consideration rather than evaluation on individual items is

    important.Special consideration in evaluating chemical toxicity in the

    environment and the effects on health should be stressed

     

    Types of Toxicants

    1. Carcinogens: ( cause cancer ) 

    A carcinogen is a substance that is capable of

    causing cancer in humans or animals. If a substance is

    known to promote or aggravate cancer, but not necessarily

    cause cancer, it may also be called a carcinogen. Though

    there are many things that are believed to cause cancer, a

    substance is only considered carcinogenic if there is

    significant evidence of its carcinogenicity.

    2. Mutagens: (cause mutations in DNA)

    A mutagen is a substance which increases the

    frequency of mutation in a plant or animal population,

    which can lead to a variety of consequences. Some

    chemicals have mutagenic properties, and radiation such

    as ultraviolet light and x-rays is another common source of

    mutations. Because mutagens can lead to genetic

    mutations, some of them can contribute to the

    development of cancers, making these mutagens

    carcinogenic in addition to mutagenic.

    3. Teratogens: (cause birth defects )

    A teratogen is an agent, which can cause a birth

    defect. It is usually something in the environment that the

    mother may be exposed to during her pregnancy. It could

     be a prescribed medication, a street drug, alcohol use, or a

    disease present in the mother which could increase the

    chance for the baby to be born with a birth defect. About 4

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    to 5 percent of birth defects are caused by exposure to a

    teratogen.

    4. Allergens: ( cause unnecessary immune response )

    An allergen is a substance that can cause an allergic

    reaction. Allergens are substances that, in some people,

    the immune system recognizes as "foreign" or "dangerous"

     but cause no response for most people.

    5. Neurotoxins: (damage nervous system )

    A neurotoxin is a substance which inhibits the

    functions of neurons. Neurons are found throughout the

     brain and nervous system, and the function of these unique

    cells is critical for a variety of tasks, ranging fromautonomic nervous system jobs like swallowing to higher-

    level brain function. Neurotoxins can work in a variety of

    ways, with the danger of exposure varying, depending on

    the neurotoxin involved and the dosage.

    6. Endocrine disruptors: ( interfere with hormones)

    Endocrine disruptors are chemicals that may

    interfere with the body’s endocrine system and produce

    adverse developmental, reproductive, neurological, andimmune effects in both humans and wildlife.

    A wide range of substances, both natural and man-

    made, are thought to cause endocrine disruption, including

     pharmaceuticals, dioxin and dioxin-like compounds,

     polychlorinated biphenyls, DDT and other pesticides, and

     plasticizers such as bisphenol A. Endocrine disruptors may

     be found in many everyday products– including plastic

     bottles, metal food cans, detergents, flame retardants,

    food, toys, cosmetics, and pesticides. The NIEHS supports

    studies to determine whether exposure to endocrine

    disruptors may result in human health effects including

    lowered fertility and an increased incidence of

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    endometriosis and some cancers. Research shows that

    endocrine disruptors may pose the greatest risk during

     prenatal and early postnatal development when organ and

    neural systems are forming.

    4.6 Antioxidant

    Antioxidants are substances that may protect cells from the damage

    caused by unstable molecules known as free radicals. Antioxidants

    interact with and stabilize free radicals and may prevent some of the

    damage free radicals might otherwise cause. Free radical damage may

    lead to cancer. Examples of antioxidants include beta-carotene,

    lycopene, vitamins C, E, A and other substances (Sies, 1997).

    An antioxidant is a molecule capable of slowing orpreventing the

    oxidation of other molecules. Oxidation is a chemical reaction that

    transfers electrons from a substance to an oxidizing agent. Oxidation

    reactions can produce free radicals, which start chain reactions that

    damage cells. Antioxidants terminate these chain reactions by removing

    free radical intermediates and inhibit other oxidation reactions by being

    oxidized themselves. As a result, antioxidants are often reducing

    agents such as thiols, ascorbic acid or polyphenols (Sies) Although

    oxidation reactions are crucial for life, they can also be damaging;

    hence, plants and animals maintain complex systems of multiple types

    of antioxidants, such as glutathione, vitamin C and vitamin E as well as

    enzymes such as catalase, superoxide dismutase and various

     peroxidases.

    Low levels of antioxidants, or inhibition of the antioxidant

    enzymes, causes oxidative stress and may damage or kill cells. As

    oxidative stress might be an important part of many human diseases, the

    use of antioxidants in pharmacology is intensively studied, particularly

    as treatments for stroke and neurodegenerative diseases. However, it is

    unknown whether oxidative stress is the cause or the consequence of

    disease.

    Antioxidants are also widely used as ingredients in dietary

    supplements in the hope of maintaining health and preventing diseases

    such as cancer and coronary heart disease. Although initial studiessuggested that antioxidant supplements might promote health, later

    large clinical trials did not detect any benefit and suggested instead that

    excess supplementation may be harmful.

    In addition to these uses of natural antioxidants in medicine, these

    compounds have many industrial uses, such as preservatives in food

    and cosmetics and preventing the degradation of rubber and gasoline.

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    For many years chemists have known that free radicals cause oxidation

    which can be controlled or prevented by a range of antioxidants

    substances (Bjelakovic et al., 2007).

    It is vital that lubrication oils should remain stable and liquid

    should not dry up like paints. For this reason, such oil usually has small

    quantities of antioxidants such as phenol or amine derivatives, added to

    them. Although plastics are often formed by free radical action, they

    can also be broken down by the same process, so they too, require

     protection by antioxidants like phenols or naphthol. Low density

     polythene is also of protected by

    carbon black which absorbs the ultraviolet light which causes radical

     production (Sies, 1997).

    Antioxidants are abundant in fruits and vegetables, as well as in

    other foods including nuts, grains and some meats, poultry and fish.

    The list below describes food sources of common antioxidants. Beta-

    carotene is found in many foods that are orange in color, including

    sweet potatoes, carrots, cantaloupe, squash, apricots, pumpkin and

    mangoes. Some green, leafy vegetables, including

    collard greens, spinach and kale, are also rich in betacarotene (Borek,

    1991). Lutein, best known for its association with healthy eyes, is

    abundant in green, leafy vegetables such as collard greens, spinach, and

    kale. Lycopene is a potent antioxidant found in tomatoes, watermelon,

    guava, papaya, apricots, pink grapefruit, blood oranges and other foods.

    Estimates suggest 85% of American dietary intake of lycopene comes

    from tomatoes and tomato products (Xianquan et al., 2005;Rodriguez-Amaya, 2003). Selenium is a mineral, not an antioxidant

    nutrient. However, it is a component of antioxidant enzymes. Plant

    foods like rice and wheat are the major dietary sources of

    selenium in most countries. The amount of selenium in soil, which

    varies by region, determines the amount of selenium in the foods grown

    in that soil. Animals that eat grains or plants grown in selenium-rich

    soil have higher levels of selenium in their muscle. In the United

    States,meats and bread are common sources of dietary selenium. Brazil

    nuts also contain large quantities of

    selenium. Vitamin A is found in three main forms: retinol (VitaminA1), 3,4-didehydroretinol (Vitamin A2), and 3-hydroxyretinol (Vitamin

    A3). Foods rich in vitamin A include liver,sweet potatoes, carrots, milk,

    egg yolks and mozzarella cheese (Baublis et al., 2000). Vitamin C is

    also called ascorbic acid and can be found in high abundance in many

    fruits and vegetables and is also found in cereals,

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     beef, poultry, and fish (Antioxidants and Cancer Prevention,

    2007).Vitamin E, also known as alpha-tocopherol, is found in almonds,

    in many oils including wheat germ, safflower, cornand soybean oils,

    and is also found in mangoes, nuts, broccoli, and other foods (Herrera

    and Barbas, 2001).

    A healthy cell has a mortal enemy which is called a "free radical."

    Free radicals constantly seek out healthy cells and attack their

    vulnerable outer membranes eventually causing cellular degeneration

    and death. Free radicals scientists today, carry out the actual destructive

    work in disease, in infection, in stress and in aging. Additionally,free

    radicals can negatively affect athletic performance by

    slowing or halting muscle growth and by lowering aerobic capacity.

    Further, free radicals are known to cause defects in normal RNA as well

    as in life perpetuating DNA, the genetic material of the cells (Warner et

    al.,2004). Normal molecules in the body have two (a paired group)

    electrons in their outer shell. A molecule with a single electron

    (unpaired) in its outer shell is called a free radical. Free radicals occur

    naturally when oxygen in the bloodstream combine with any of a

    diverse group of

    chemicals including those commonly found in polluted air, in

     primary and/or second hand cigarette smoke, in known and damage is

    accelerated by the normal radiation found in sunlight and by increasing

    exercise, especially running and other aerobic activities. This is easy to

    understand in

    that aerobic exercise can increase oxygen consumption ten totwenty times normal values. With more oxygen available in the

     bloodstream; free radical production soars. The direct muscle

    destroying activities of the free radicals continue many hours after

    exercise stops. The destructive effects of free radicals can be prevented

    with the addition of anti-oxidants in the diet or by anti-oxidant

    supplements. A good anti-oxidant complex supplement actually has

    advantages over diet sources in that the complex has many different

    specific types of anti-oxidants which seek out and destroy free

    radicals at many various cellular sites. A single antioxidant, for

    example Vitamin E, only protects the outer fatty layers of the cell. Itwill not stabilize DNA which, for example, is one the main effects of

    the anti-oxidant Vitamin C.

    The process by which different anti-oxidants disperse through the

     bloodstream to protect the cells at different sites is referred to in science

    as "anti-oxidant synergy." When a specific anti-oxidant meets a free

    radical in the bloodstream at its appropriate activity site, it naturally

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    combines with it and coverts the free radical to harmless water and

    oxygen. As a result, as anti-oxidant increases due to the

    supplementation of higher amounts of a greater variety of anti-oxidants,

    cellular damage lessens and performance and health improves. In fact,

    aside from the numerous scientifically compelling studies addressing

    the varied health benefits of anti-oxidant supplementation, there have

     been studies completed, demonstrating a dramatic decrease in injuries

    in athletic

    training with the simple addition of a good anti-oxidant complex

    supplement. The brain is uniquely vulnerable to oxidative injury, due to

    its high metabolic rate and elevated levels of polyunsaturated lipids, the

    target of lipid peroxidation. Consequently, antioxidants are commonly

    used as medications to treat various forms of brain injury.

    Here,superoxide dismutase mimetics, sodium thiopental and

     propofol are used to treat reperfusion injury and traumatic brain

    injury, are being applied in the treatment of stroke. These compounds

    appear to prevent oxidative stress in neurons and prevent apoptosis and

    neurological damage. Antioxidants are also being investigated as

     possible treatments for neurodegenerative diseases such as Alzheimer's

    disease, Parkinson's disease, and amyotrophic

    lateral sclerosis and as a way to prevent noiseinduced hearing loss

    (Warner et al., 2004).

    Antioxidants can cancel out the cell-damaging effects of free

    radicals. Furthermore, people who eat fruits and vegetables, which

    happen to be good sources of antioxidants, have a lower risk of heart

    disease and some neurological diseases and there is evidence that sometypes of vegetables and fruits in general, protect against a number of

    cancers. These observations suggested the idea that antioxidants might

    help prevent these conditions. However, this hypothesis has now been

    tested in

    many clinical trials and does not seem to be true, since antioxidant

    supplements have no clear effect on the risk of chronic diseases such as

    cancer and heart disease.This suggests that other substances in fruit and

    vegetables (possibly flavonoids), or a complex mix of substances, may

    contribute to the better cardiovascular health of those who consume

    more fruit and vegetables. It is thought that oxidation of low densitylipoprotein in the blood contributes to heart disease and initial

    observational studies found that people taking Vitamin E supplements

    had a lower risk of developing heart

    disease. Consequently, at least seven large clinical trials were

    conducted to test the effects of antioxidant supplement with Vitamin E,

    in doses ranging from 50 to 600 mg per day. However, none of these

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    trials found a statistically significant effect of Vitamin E on overall

    number of deaths or on deaths due to heart disease. Further studies have

    also been negative. It is not clear if

    the doses used in these trials or in most dietary supplements are

    capable of producing any significant

    decrease in oxidative stress. Despite the clear role of oxidative

    stress in cardiovascular disease, controlled studies using antioxidant

    vitamins have observed no reduction in either the risk of developing

    heart disease, or the rate of progression of existing disease. While

    several trials have investigated supplements with high doses of

    antioxidants, the "Supplémentation en Vitamines et Mineraux

    Antioxydants" (SU.VI.MAX) study tested the effect of supplementation

    with doses

    comparable to those in a healthy diet. Over 12,500 French men and

    women took either low-dose

    antioxidants (120 mg of ascorbic acid, 30 mg of vitamin E, 6 mg of

     _-carotene, 100 _g of selenium and 20 mg of zinc) or placebo pills for

    an average of 7.5 years. The investigators found there was no

    statistically significant effect of the antioxidants on overall survival,

    cancer, or heart disease. However, in a post-hoc analysis they found a

    31% reduction in the risk of cancer in men, but

    not women. Many nutraceutical and health food companies sell

    formulations of antioxidants as dietary

    supplements and these are widely used in industrialized countries.

    These supplements may include specific antioxidant chemicals, like

    resveratrol (from grape seeds or knotweed roots), combinations ofantioxidants, like the "ACES" products that contain _-carotene

    (provitamin A), vitamin C, vitamin E and selenium, or herbs that

    contain antioxidants - such as green tea and jiaogulan. Although

    some levels of antioxidant vitamins and minerals in the diet are

    required for good health, there is considerable doubt as to whether these

    antioxidant supplements are beneficial or harmful (Warner et al., 2004).

    4.7 

    Diseases

     Definition of disease

    A disease is an abnormal condition affecting the body of an

    organism. It is often construed to be a medical condition associated

    with specific symptoms and signs. It may be caused by external

    factors, such as infectious disease, or it may be caused by internal

    dysfunctions, such as autoimmune diseases.

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    There are four main types of disease