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

PREFACE

Praise be to God, for the abundance of blessings, mercy and guidance of

his 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 an
opportunity 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

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
Keywords: Antioxidants, diet, disease, environmental, toxicants, nutrition, pollutans,
prevention.

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

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

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.

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 humans 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 humans body, and how is effect for

the health.

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 bodys 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 persons 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 its 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

running low on water, a message is sent to the brain and the brain tells you
that youre thirsty. When youve 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 doesnt make
enough. The rest comes from food and beverages. Liquids are an easy-torecognize 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

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 they
are 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 bodys weight. Proteins consist
of many different amino acids. There are about 20 that we know of, and the

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 bodys 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

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 fatsoluble 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 bodys 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 bodysome in relatively large amounts, such as
calcium, phosphorus, sodium, chloride, potassium, magnesium, and sulfur.
Other mineral, called trace mineralsiron, manganese, copper, iodine, zinc,
cobalt, fluorine, selenium, and perhaps others are needed in only small
amounts. Minerals have two general body functionsbuilding 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

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 bodys 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 womens right to
appropriate services in connection with pregnancy, confinement and the postnatal 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.

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 that

significantly 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

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

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

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 authoritys 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"

 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 raysilver 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 system
if 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 its 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 lowquality 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.

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

each 110 C and 200 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 Pbtetramethyl. 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 the
motor 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 g/dL, in adults and 80 100 g/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 g/dL (WHO, 1996).
1. Reproductive effects

Gonadal dysfunction in men, including depressed sperm counts, has

been associated with B-Pb of 40 to 50 g/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 g/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
g/L were associated with a threefold increased risk for infertility.
Womens 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 g/L) common for the general population worldwide
(Teliman, 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 g/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

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 g/L rather than when analyses included all children with B-Pb
< 100g/L (Lanphear, 2000). Assesements that have conducted at older
ages often have revealed inverse associations between childrens 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 below
100g/L, were inversely associated with childrens 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 metaanalysis of Schwartz (Schwartz, 1994) showed a reduction of 2.6 in IQ
points for an increase in blood lead of 100 to 200 g/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 g/L, with an even steeper curve. Above a
blood lead level of 200 g/L, a loss of 3.5 IQ points has been assumed
(Fewtrell, 2004).

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-Pb from 10 g/dL to 5 g/dL were associated with a
decrease of 1,25 mmHg in systolic blood pressure; other studies found
decreases of 2 mm Hg for reductions in blood lead from 20 g/dL to 15
g/dL, and from 15 g/dL to 10 g/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 g/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

g/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 erjav, Slovenia, showed an increased number of reticulosits 18.1
% with adult male and 34 % in adult females (Primerjalna tudija
onesnaenosti okolja v Zgornji Meiki 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, Fanconis 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 g/L, showed a significant relationship
between the BLL and N-acetyl--D-glucosaminidase activity in urine
(Dart, 2004).
Blood lead levels, ranging from 23 725 g/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

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 that
results 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 BPb levels (mean 73 g/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

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. Leads 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).

CHAPTER 3
CONCEPT OF MAPPING

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 family

2)

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

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 which
is 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 bodys requirement for nutrients found in
food, There are categories of nutrients :

Source of picture : http://www.biggerplate.com/mapImages/xl/76ee9e67-3b554d8e-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 bodys 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 animals 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.

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 resulting
from 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 has
expanded 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 consumption
of 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

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 organisms 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.

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.

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

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 pollutants
can 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.

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 per
litre, 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 selfpurification system of water is impaired. Pesticides and
herbicides which enter water may kill some organisms

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.

ii)

4.5

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.

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 the
excretion 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

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,
development

some of them
of

cancers,

can
making

contribute to
these

the

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

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 from
autonomic nervous system jobs like swallowing to higherlevel 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 bodys endocrine system and produce
adverse developmental, reproductive, neurological, and
immune effects in both humans and wildlife.
A wide range of substances, both natural and manmade, 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

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 studies
suggested 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.

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. Betacarotene 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 (Vitamin
A1), 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,

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 to
twenty 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. It
will 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

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 some
types 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 density
lipoprotein 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

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 "Supplmentation 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 of
antioxidants, 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
o 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.

There are four main types of disease :

1)

Pathogenic disease
The pathogenesis of a disease is the mechanism by which
the disease is caused. The term can also be used to describe
the origin and development of the disease and whether it is
acute, chronic or recurrent. Types of pathogenesis include
microbial infection, inflammation, malignancy and tissue
breakdown.

2)

Deficiency disease
A deficiency disease is caused by lack of some nutrient, or
essential component for proper bodily functioning. It means
that an individual is not getting some really important
vitamin or mineral. This can lead to severe consequences
for growth, health, or proper bodily activities.

3)

Hereditary disease
A hereditary disease is a disease which can be passed down
through generations of the same family. For example, if a
man has cystic fibrosis, any children he has might have it
too. These diseases are passed on through generations of
people from their ancestors.

4)

Physiological disease
A physiological disease is a disease in which the organs or
the systems in the body malfunction causing illnesses.
Physiological diseases are caused by a malfunction of
body's organ. Example: asthma, hypertension, diabetes,
glaucoma, stroke

4.8 Factor of Deseases

E
cology
Basically, the environment within the human sphere was
instrumental in the aspects of human life, it should be observed that a
good environment means indicates that health is also good, and also
indicates the good nutrition. Factors affecting too many of the most
common is from food. The food is the only source of energy for
humans (Soemirat, 1994). Because the population continues to grow,
the amount of food production must continue to increase beyond this
population, if food security must be achieved. The problems that arise
can be caused because the quality and quantity of food, it is intended
to obtain energy in order to survive and not to become sick from it.
Thus, food sanitation are very important. Nutritional problems are
disturbances in some ways or the welfare of individuals and society
caused by unmet needs in nutrition from food (Soekirman, 1999).
The ability of humans to change or modify the quality of their
environment depend on the socio-cultural level (Soemirat, 1994).
Ancient societies that lived in the forest and only able to move land
clearing which they live to give protection to their survival, different
case with modern society socioeconomic advanced as we are now able
to change at will whatever we want like a forest or an area used as a
residential dwelling.
Environmental changes like the above that in order to improve
the fate of mankind does not always work well if we do not see how
these processes take place. These processes occur in ecosystems that

follow those changes. If the environment changes in such a way as to

shift the natural ecosystem can no longer maintain the balance, there
will be things that are not desirable such as landslides, floods,
volcanic eruption that could hurt us all together.
Humans as living beings besides utilizing the elements of
nature, they also throw back what they do not wear anymore use back
to nature. This sort of thing could be adversely affected if the amount
of human waste multiply that nature is no longer able to clean it again,
and thus the environment can exist in dirty environments and natural
resources that we use to be dirty and can be bad if we use it. As a
result, human health will be disturbed, so it can clearly be seen that
human survival depends on the presence of interactions in ecosystems.
In ancient times a lot of people show a lack of understanding
of the relationship between human interaction with their environment
and the lack of understanding of human nature themselves, which can
lead to a natural disaster occurs. Civilized human beings which man
would need for power, wealth, knowledge, and satisfaction
continuously evolving, another case with the humans as biological
organisms, which need to eat and drink their own relationships with
human beings as biological organisms cultured were significantly
associated with the desire of power needs can cause damage to the
ecosystem and can disrupt human survival in the search for natural
resources to obtain food and drink.
Environmental pollution as human beings do not consider
there will be a reduction in public health, and therefore efforts in the
health sector needs to be based in knowledge of human ecology. The
understanding of human ecology is the study of the every aspect of
human life (physical, mental, social) and the environment
(biophysical, psychosocial) and is overall synthesis (Boughey, 1973).
According Soemirat, (1994) explained in his book that the relationship
of human ecology with environmental health efforts can be analogous
to the relationship between ecology to agriculture, forestry, and so on.
The food is the only source of energy for humans (Soemirat,
1994). Because the population continues to grow, the amount of food
production must continue to increase beyond this population, if food
security must be achieved. The problems that arise can be caused
because the quality and quantity of food, it is intended to obtain
energy in order to survive and not to become sick from it. Thus, food
sanitation are very important.
When viewed from the quantity, either excess or a deficiency
will lead to nutritional disorders. Diseases associated with obesity
caused by an excessive amount of food, as well as the quality is not

balanced for example heart disease, Diabetes, and High Blood

diseases, as well as malnutrition, there is only a shortage of food
quantity, but also the quality is often lacking. In Indonesia, most of the
acquired disease-related malnutrition, especially in children. Level of
malnutrition among children under five in Indonesia for 1988
approximately 10%. According Soemirat, malnourished state is also
strongly influenced by:
Knowledge of the poor, many beliefs about food, so kids do not get
nutritious food.
Contamination of food and drink a baby due to an unhealthy
environment, a baby suffering from foodborne illness, so the
growth of troubled children.
Priority of life other than nutritious foods have electronics or motor
vehicles which inflicts widespread. Revenue is no longer on the
priority to buy nutritious food.
Food is not only beneficial for humans but also very good for
the growth of other substances such as microbes in the body, so to get
the maximum benefit from food, food hygiene should be maintained.
Health problems caused by foodborne and food poisoning.
Environment around us contribute to major health problems.
We know there are environmental elements into something that could
be useful material for human survival such as land, air, water. Of
elements that man can survive. In relation to the health of the
environment is described that affect the health, in terms of the
environment and the environment in which the food we consume
daily. In connection with that the environment can affect human
nutrition, judging from the food, the food is very important for the
body because the food is a source of energy for humans to do
activities.
Usually people try all sorts of things, can take place that the
environment is not hygienic for example, it can cause a disease that
can inhibit the growth of malnutrition especially in children who are
very vulnerable if it is related to nutrition. Because at the time the
children were in their infancy when body and brain then inhibited
nutrition will also inhibited the growth of his brain.

 Triangle Epidemology
The epidemiologic triangle consists of three components,
with the Host at the top point and the Agent and the Environment at
the other two points of an equilateral triangle. Each component must
be analyzed and understood to comprehend and predict patterns of
disease. Changes in any component will alter the existing equilibrium
to increase or decrease the frequency of a disease. In a steady state of
the triangle, each leg of the component is affecting and being affected
by the other components. If a change occurs in any of the components
sufficient to affect the steady state, changes will occur in one or both
of the other components.
1. Host factors
A. Dietary habit and physical inactivity
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.
Dietary patterns associated with the development of
a disease or disorder are referred to a nutrition risk factors.
The presence of these risk factors increase the likelihood
that a person will develop a particular disease or condition.
For example, diets that are high in animal fat have been
shown ti increase the risk of heart disease and certain types
of cancer. People who consume high-fat diets may not
develop heart disease or cancer, but their chance of
developing one or the other are higher than those of people
who consume less fat.

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.
B.

Physiology condition
The main employers of nutrient are cells. All of the
processes for which nutrient are required occur within cells
or in the fluid that surrounds them. Normal cell functioning
and health are maintained when cells receive the nutrients
and other substances they need and are free from harmful
substances. Disruptions in the availability of nutrient or the
presence of harmful substances in the environment of cells
can initiate disease and disorders that eventually affect
tissues, organs, and systems. Health problems in general
begin with disruptions in the normal activities of cells.
The types and amounts of foods consumed by
people affect the environment of cells and their ability to
function normally. Excessive and inadequate aupplies of
nutrients and other chemical substances produce the
disruptions in cells functions that ultimately become
identified as a health problem. Uite simply, human are as
healthy as their cells.
Source : (Judith E.Brown.1990.The Science of human
Nutrition. Harcourt Brace Juvanovich Publisher.USA)

2.

Agent Factor :
Agent is specific living or inanimate objects that can cause
health problems to hosts. A factor, such as bacteria, whose
presence is essential for the occurrence of a disease, which can
vary in number and virulence. Agent factor consist :

A. Nutrition Factor :
Nutritional deficiencies in the elderly can result from
short-therm or long term ingestion of a diet which is
inadequate in food-energy or lacking in one more specific
nutrients. Under physiological conditions, a diet is dificient if
it does not meet the needsof most healthy individuals of
particular age group. Since the nutritional needs of most
elderlypeople differ from the needs of younger people for
which the RDA are set,and since the elderly differ one from
another in their food-energy and nutrient requirements,
dietary adequacy for the elderly is better defined as a diet
which, for a given individual, prevents malnutrition and
cannot be improved by additions or modifications in the
levels of food energy and nutrient suplied.
Diets which lead to development of nutritional
deficiency are 1) monotonous, 2) low in food energy, 3)
restrictive,and 4) low in nutrient-calorie ratio.
Variety or dietary diversity will increase the quality of
diet, as will calorie adequacy. Conversely , the fewer the
number of foods eaten, the greater the risk that source of
essential nutrients will be excluded or will be enadequate.
Diets igh in sweets or which include heavy daily intake of
alcoholic beverages satisfy the hunger needs of the elderly
without providing needed nutrients.
In the United States, diets of te elderly are often
deficient in folacin. Diets low in food-energy are also low
iron. Elderly persons not consuming milk will have
inadequate intakes of calcium,vitamin D, and riboflavin.

Diseases :
Acute and chronic diseases are likely to reduce food
intakes because of associated loss of appetite (Exton-Smith

and overal,1979; Hodkinson 1980 ). Intake of food is likely

to be markedly reduced or to cease altogether. At the same
time, catabolic effects of diseases increase nutrients
requirements. Nutritional needs for wound healing after
injury orsugary can magnify nutrient deficits. In elderly
surgical patients,protein energy malnutrition is frequently
found both in the pre- and postoperative periods.
Types of nutritional deficiency commonly associated
with these diseases are indicated,together with etiological
factors. Chronic diseases process lead to malnutrition by
impairement of food intake or retention, by causing
maldigestion and malabsorption, by increasing renal losses of
nutrients, and this condition is also brought

about by

decreasing the effociency of nutrient utilization.

B. Chemical Factors
Chemical agents are chemical substances that are
intended for use in warfare or terrorist activities to kill,
seriously injure, or seriously incapacitate people through their
physiological effects. A chemical agent attacks the organs of
the human body in such a way that it prevents those organs
from functioning normally. The results are usually disabling
or

even

fatal.

For

example,

toxic

substances

(carbonmonoksida), asbestos, cobalt or substance Allergan.

C. Physical Factors
For example, radiation and mechanical trauma (a blow,
collision).
D. Biological Causes
a. Metazoans : hookworm, roundworm, schistosomiasis.
b. Protozoa

: Amoeba, malaria.

c. Bacteria

: syphilis, typhoid, pneumonia, tuberculosis

d. Fungi

: histoplasmosis, Taenia pedis

e. Rickettsia

: rocky mountain fever sponted

f. Virus

: measles, smallpox, poliomyelitis

Source : http://www.nlectc.org
( A. M. Lilienfeld, D. E. Lilienfeld. 1980. Foundation of
Epidemolgy. Oxford University Press. USA )
( Abigail L. Russell. 2010. Stethoscopes as A Source of
Hospital-Acquired MRSA. Departmental Honors Thesis The
University of Tennessee at Chattanooga School of Nursing.
U.S )

Environmental Factors
* As extrinsic factors comprising environment of physical, chemical,
biological and social.
* Another approach is the model of wheel
* Approach epidemiological triangle
* Both models mentioned above that the physical, biological and
social can lead to disease.

1. Physical Environment Living & Illness

Physical aspects of the environment, among others,heat, light, air,
water, radiation, atmospheric and pressure. Dg industrial
development, the physical aspect of environment will increased and
will provide human contamination, as an example pollution in London
(1952) which brought death 4000 people. When for years, the air
pollution especially the big city that can cause disease pd channel
breathing.
2. Environmental Biology and Health
In its relation with illness / health, then from biology lingk sector
indivisible within some terms, as follows:
a. Agent infectious ailment
b. Reservoir (human and animal)
c. Disease-carrying vectors (flies, mosquitoes, etc.)
d. Plants and animals

With borne pathogenic agents that water is called water borne.

Water Borne Pathogen Disease

Diseases

Algae

GE virus (gastro enteritis)

Bacterium

Kholera

Parasite

Malaria, worms

Protozoa

Dysentery
Polio, Hepatitis

3. Social Cultural Environment and Health

Socio-cultural environment is an environment that is dynamic and
complex. A particular social

environment does not just give the same

effect to everyone. Social habits will probably influence health thd.

Example: tertt eating habits, how to cook, etc. Factors acceptance of new
ideas and social cooperation can also affect health.
Component Relations Environment, Resources & Health / Diseases
Environment

Source

Diseases

Physical / Chemical:
Radioactive substance
sunshine
noise
vibration

Naturally, nuclear
weapons testing, uranium
mining
natural
Natural, man-made
alat2 building

cancer
genetic disorders
Skin cancer, burns
Increased hearing
threshold, Deaf

Biology:
Fauna-microorganisms
parasite
Vector (mosquito)
Flora: Mushrooms

Human feces sick

human waste
puddle
non hygiene

Infectious diseases
(typhoid, dysentery)
Worms: - bracelet,
mines, pinworms
Dengue fever, malaria
Candidiasis-Vesicolor
(phlegm)

The birth rate increased

unemployment increased
sanitation ugly

Socio-cultural:
overpopulation
poverty
Slum area

Local vibration, whole

body vibration.
infectious diseases
Kantibmas
Infectious diseases,
viruses, parasites.

Environmental Toxicity
Nowadays, there are so many environments that are
inappropriate for people to live in or we could say that the
environments are polluted. The characteristics of polluted
environment are: bad water sanitation, increase number of population,
industrial waste, bad public health services, and too much use of
pestisides. It can be caused by so many factors but mostly it caused by
human itself. If the environment is polluted, automatically its
toxicated too.
It is not able to be refuted again that the environment quality
must be affecting the status of public health. A study implies that a
persons health status is affected by hereditary, nutrition, public health
services, and environment (Lina Tarigan, Repository USU)
Toxins can enter human body by the food that eaten by
humans and it causes many kind of diseases. We should prevent the
toxins from entering our body by keep the environment clean.

http://staff.uny.ac.id/sites/default/files/02%20Kesehatan%20Lingkungan.pdf
http://download.sma1pekalongan.sch.id/umum/file/Media%20Pembelajaran/Biologi/CD%20
MATERI2/PDF/Hub_Ling.pdf

4.9 The Used of Pb in Daily

1

Lipstick
Approximately 55% of the brand of lipstick on the market
turned

out

to

contain

hazardous

materials.

Underwriters

Laboratories in the United States revealed that 12 products in the

tested lipsticks found to contain lead which is a toxic compound.

Although lead is used in low levels, these chemicals are still able to
increase the risk of serious health and can affect mental health.
Lead contained in lipstick can also affect the person's intelligence,
behavior, and even a person's ability to think. In one study also
revealed, including lipstick products containing triclosan could
inhibit the process of muscles, including the heart that receives
signals from the brain. Lead directly does not put lipstick, but
many coloring products use mineral compound that turned out to
contain lead. Naturally, lead can be found contained in the soil,
water and air.

Motor Vehicle Fuel (Gasoline)

Pb-organic compounds, such as tetraethyl Pb-and Pbtetramethyl widely used as an additive to gasoline to increase the
octane number of the economically and is the largest of all Pb
emissions to the atmosphere. Pb emissions into the Earth's upper
atmosphere and can take the form of gas and particles. Pb
emissions in the form of gas once primarily related emissions come
from motor vehicles. Based on estimates of around 80-90% Pb in
ambient air comes from burning gasoline.
Pb as motor vehicle exhaust can be harmful to health and
damaging the environment. Pb inhaled by humans every day will
be absorbed, stored and then accommodated in the blood.
Chemical forms of Pb is an important factor that affects the
properties of Pb in the body. Components such as organic Pb Pb
tetraethil soon be absorbed by the body through the skin and
mucous membranes.
Organic Pb is absorbed mainly through the digestive and
respiratory tract and is a major source of Pb in the body. Not all Pb
sucked or ingested into the body will remain in the body.
Approximately 5-10% of the amount ingested will be absorbed
through the digestive tract, and approximately 30% of the amount
inhaled through the nose will be absorbed through the respiratory

system will stay in the body as it is influenced by the size of the

particles.

Product Toys
Currently popularity is a product said to be children's toys
can cause poisoning in children. At the bottom of many of the
children who had an accident due to unintentional poisoning due to
the use of toy products. One cause of poisoning in children is a
product used toys contain toxic materials that can damage the
health of children and even in adults. Product examples are toys
that are dangerous products containing lead (Plumbum). The use of
paint (dye) which contain lead in children's products that aim to
paint the toys that attract the attention of children. Furthermore
tools for painting (drawing) like crayons and colored pencils are
also thought to contain lead, for example, is colored pencils,
crayons, plastic baby products, and products in the form of jewelry
(necklace, bracelet or ring).

Lead can be loose as dust on the surface of the toys for the
toy is used as normal especially if there is radiation or heating,
especially in the sun. Lead is a chemical which is very harmful to
the health of children, several studies have shown that lead
exposure even at low levels can interfere with intellectual and
development of children and infants. Children are more potential
lead poisoning than adults. This is because the nature of the
children's curiosity is high, they will lick, chew toys or even put it
into his mouth.

Material Packer Food

A number of materials are used as packaging is not
completely secure. Director of the Controlled Products and
Hazardous Materials Agency of Drug and Food Control (BPOM)

said that some packers are a health risk if the substances in it

contaminate the food. Packaging materials that include plastic type
polymer polyvinyl chloride (PVC). Form a thin clear plastic PVC
containing metal one is lead (Pb).
hg
These materials can cause cancer, can disrupt the endocrine
system, causing a decrease in IQ, and cause kidney damage. Secure
packaging is made of glass and ceramics. If you choose plastic,
you should choose between food packaging with a sign in the form
of a glass and fork symbol on the packaging. Reduce the use of
PVC, do not use brightly colored packaging, avoid plastic in
boiling or heating food, and do not carelessly use plastic in the
microwave, unless the manufacturer's instructions.
5

Black Licorice (Candy)

Chewing the black color branded Red Vines Black Licorice
Twists are one candy that contains lead. Candy is withdrawn from
circulation because it contains a number of lead found in the candy.
Lead content contained in this candy is very harmful to the body.
According to the analysis, this candy contained as much as
0.33 parts per million of lead. Timbale concentrations could reach
13.2 micrograms of lead per serving. Children - children under 6
years old should not consume more than 6.0 micrograms per day
timbale of all food consumed by children - children. Excessive
consumption of lead can be toxic to the body and brain
development. And it is very dangerous for children - children
especially pregnant women.

4.10 Impact of Use of Lead (Pb)

Pollution of lead (Pb) can occur in the air, water, and soil. The
content of Lead (Pb) in the soil averaged 16 ppm, but to specific areas
in the thousands ppm (Fardiaz, 1992). Concentrations of Lead (Pb) in
air dense urban traffic can reach 5-50 times compared to the mountain
air is still preserved.
The content of Lead (Pb) in agricultural crops and plantations,
which are located adjacent to the highway is higher than agricultural
or plantation located far from the highway. It shows that the pollution
of Lead (Pb) potential derived from motor vehicles. However, in

addition to plant distance to the highway, the levels of Lead (Pb) in

plants is also affected by traffic congestion, longer exposure of the
plants, the contribution of Lead (Pb) from the ground, physiology and
morphology of plants, and wind direction.
Apart from motor vehicle exhaust fumes, pollution source Lead
(Pb) are:
- Smoke coming from industrial waste that uses materials Lead (Pb).
- Children's toys that contain Lead (Pb) such as cars, slide, etc..
- Paper food packaging and non-packaging (newspaper and
magazines) are often used to wrap food.
- Containers of food and beverage cans with solder containing Lead
(Pb).
- Scrape paints houses have long due to exposure to the sun will
cause dust containing Lead (Pb) so dangerous to health.
Impact of Exposure to Lead (Pb)-Health.
In the body, poisoning due to Lead (Pb) can cause the body's
anatomy. Preview anatomy poisoning Lead (Pb) can be seen in:
a. Blood
1. Anemia,

usually

microcytic

(small

erythrocytes),

hypochromic

(abnormally increased erythrocyte hemoglobin), associated with the

destruction of hemoglobin synthesis and increased fragility of red
blood cells.
2. Basophilic stippling (speckled image) in red blood cells.

b. Nervous system
1. Encephalopathy (degenerative brain disease) in children with brain
swelling, the possibility of demyelination (damage to the myelin
sheath of nerve) and cerebellum brain weighs upon the back of a
white, death of nerve cells.
2. Peripheral nerve inflammation to demyelination.
c. Mouth cavity
The lines lead ginggiva (gum) contained in adults with
ginggivitis (deposit colored blue / black lead sulfide).
d. Kidney
Inclusion intranuklir (merging core) acid-resistant, particularly
in the proximal tubule cells (consisting of the lead protein complexes.
e. System order
Deposition of lead radiopaque (which can not be passed so as
to form an X-ray image such as opaque white on epifise children.
Symptoms and effects of exposure to Lead (Pb) on health divided into
two, namely:
1. Exposed In Acute
Exposures Lead (Pb) in acute / early through the air are inhaled
will cause symptoms of weakness, fatigue, sleep disturbances,
headaches, muscle aches bones, constipation, abdominal pain, and
loss of appetite which can cause anemia. In some cases of acute
exposure to Lead (Pb) occur oliguria (urine pain) and acute renal failure
can develop rapidly.
2. Exposed In Chronic
The impact of chronic exposure to Lead (Pb) begins with
fatigue, lethargy, irritability, and gastrointestinal disorders.
Continuous exposure to the central nervous system show
symptoms of insomnia (trouble sleeping), confusion or anxiety,
diminished concentration and memory difficulties.

Some other symptoms caused by exposure to Lead (Pb) is

chronically include loss of libido, infertility in men, menstrual disorders
and spontaneous abortions in women. In men have proven to changes
in spermatogenesis, both in the number, movement, and shape of
sperm, everything has a value that is lower than normal standards. In
pregnant women who are exposed, Lead (Pb) cross the placenta of
pregnant women which can cause the fetus in the womb participate
exposure which can cause premature birth, low birth weight (LBW),
toxicity and even death.
Children are the most vulnerable to Lead (Pb). Adverse effect is
a decrease in intelligence, which can occur at levels of Lead (Pb) is low
in the blood. In some cases, poisoning Lead (Pb) can cause damage to
the brain tissue and death.
The impact of lead poisoning (Pb) occurring in children long
term and can not be recovered. Will be in perparah by exposure to
Lead (Pb) repeatedly and accumulation in the body.

4.11

Pb enters the body

Timbal enters into the body through digestive system,
respiration system , and sometimes through the skin. Pb which is
entering the body then starts to enter the bloodstream and its
organs. Approximately 95% of Pb in blood will be banded by
erythrocyte. (Siswanto, 1994) Beside found in bloodstream and
also ensephalon in the form of exchangeable fraction in 25 days
until a few months, Pb also found in the form of stable fraction and
teeth in 30-40 years. (Darmono, 1995) Body absorbtion towards Pb
that enters respiration system is bigger, about 30-50%. (Rusli,
2002) Pb poisoned through inhalation 10 times bigger chance to
occur than Pb poisoned through digestive system. It is because Pb
that is inhaled will be brought by bloodstream and pumped directly
to a whole body so that stimulate toxic effect. (Jacobs, 1967 at
Rusli, 2002)

4.12

Relation between Pb waste with nutrition

Heavy metals may enter the human body through the short
food chain (animals - humans) or by the length of the food chain
(plants - animals - people) called dakhil pollution
(Notohadiprawiro, 1995). Besides, through the mouth of food and
beverages, heavy metals can also enter the body through breathing
and skin. Very extensive use of heavy metals, such as for reagents
or catalysts in many industrial processes.
Along with industrial product produced, waste generated is
also useful, even in a certain amount could make danger human
life. One of the substances are heavy metals in the waste that
would go into the environment, such as rivers, lakes, soil, and air
and can undergo biological magnification in plants and animals to
be consumed by humans, thus affecting his health.
Some factor that can affect the body's susceptibility to
heavy metals, especially Pb is nutrition, pregnancy and age
(Hamid, 1991). Poor nutrition increases the levels of Pb-free in the
blood. Fergusson (1991) states that the levels of Ca and Fe is high
in food will decrease the absorption of Pb, and when the body lacks
the Ca and Fe, Pb uptake will increase. Pb can also inhibit the
enzyme that is necessary for the formation of hemoglobin.
Lead enters the body mainly through the digestive tract of
food and drinks, but can also through breathing or skin of Pb
polluted air. All foods naturally contain small concentrations of Pb
and in the process of preparing the food may lead to rise (Fardiaz,
1995). Pb contamination in the body can be determined by
measuring the levels of Pb in blood, teeth and hair. Lead in hair can
come from dust or hair paint containing lead acetate.
(source : http://jurnal.pdii.lipi.go.id/admin/jurnal/12976678.pdf)

Pb metal is a heavy metal that highly toxic and it is not

needed by humans, so if food contaminated by the metal, the body
will remove it. In the human body, metal Pb can inhibit the activity
of enzymes involved in the formation of hemoglobin (Hb) and Pb
metal fraction excreted through urine or feces as most bound by
proteins, while others accumulate in the kidneys, liver, nails, fat
tissue, and hair (Widowati, 2008). One option to overcome the

problem of contamination by metals Pb is bioremediation using

microbes (Suhendrayatna, 2001). Remediation actions necessary to
ensure land that contaminated Pb can be reused for a variety of
activities safely.
(source : www.bbpk.go.id/main/bbsfiles/JS_Vol01_No01_Juni2011/5. JS 5 HENGGAR.pdf )

CHAPTER 5
CLOSING

5.1 CONCLUSION
Pollution of lead (Pb) is one of toxic in our environment. Currently lead is
usually found in ore with zinc, silver and copper and it is extracted together with
these metals. Sometimes we used lead accidentally in daily. There are some
product or things that we used in daily which has lead in its composition like
lipstick, motor vehicle fluel (gasoline), product toys, material packer food, and
black licorice (candy). Lead can enter (drinking) water through corrosion of pipes.
This is more likely to happen when the water is slightly acidic. That is why public
water treatment systems are now required to carry out pH-adjustments in water
that will serve drinking purposes.
Pollution of lead is very dangerous for our health. There are many impacts
of use of lead (Pb). Some other symptoms caused by exposure to Lead (Pb) is
chronically include loss of libido, infertility in men, menstrual disorders and
spontaneous abortions in women. In men have proven to changes in
spermatogenesis, both in the number, movement, and shape of sperm, everything
has a value that is lower than normal standards. In pregnant women who are
exposed, Lead (Pb) cross the placenta of pregnant women which can cause the
fetus in the womb participate exposure which can cause premature birth, low birth
weight (LBW), toxicity and even death. For children it can decrease in their
intelligence, which can occur at levels of Lead (Pb) is low in the blood. In some
cases, poisoning Lead (Pb) can cause damage to the brain tissue and death.

5.2 SUGGESTION
There are some suggestion from us to avoid the affect of Pb in health.
1. If you choose or use plastic, you should choose between food packaging
with a sign in the form of a glass and fork symbol on the packaging.
Reduce the use of PVC, do not use brightly colored packaging, avoid
plastic in boiling or heating food, and do not carelessly use plastic in the
microwave, unless the manufacturer's instructions.
2. Dont give a children under 5 years old the toys like crayon or colored
pencils because in the nature of the children's curiosity is high, they will
lick, chew toys or even put it into his mouth.

REFERENCES:
www.aces.edu/pubs/docs/H/HE-0192/HE-0192.pdf
http://www.unscn.org/en/home/why-nutrition-is-important.php
World Health Organization. 1996. Guidelines for drinking water quality. Health
criteria and other supporting information. Geneva; 2ed (2): 1 9.
White R. F., Diamond R., Proctor S., Morey C., Hu H. Residual cognitive deficits 50
after lead poisoning during childhood. Br J Ind Med, 1993; 50: 613 622.

Que Hee S. S. Biological Monitoring An Introduction. Library of Congress Catalogingin-Publications Data, 1993; 423 - 424.

An article by Subbid Pemantauan Pencemaran 2009.

Houghton Mifflin, 1991, Health. Boston: Houghton Mifflin Company.
http://www.healthknowledge.org.uk/public-health-textbook/disease-causationdiagnostic/2f-environment/environmental-determinants-disease

http://download.sma1pekalongan.sch.id/umum/file/Media%20Pembelajaran/Bi
ologi/CD%20MATERI2/PDF/Hub_Ling.pdf
http://staff.uny.ac.id/sites/default/files/02%20Kesehatan%20Lingkungan.pdf