doi: 10.56294/hl2024.392

ORIGINAL

Assessing the Role of Environmental Health in Infectious Disease Control

Evaluar el papel de la salud ambiental en el control de las enfermedades infecciosas

Sujayaraj Samuel Jayakumar¹ , Sourabh Kumar Singh² , Vijay Jagdish Upadhye³, Souvagya Panigrahi⁴ , Shubhansh Bansal⁵ , Varun Ojha⁶ , Makarand B.Mane⁷

¹JAIN (Deemed-to-be University), Department of Forensic science. Bangalore, Karnataka, India.

²Noida International University, Department of Forensic Science. Greater Noida, Uttar Pradesh, India.

³Parul Institute of Applied Sciences (PIAS), Parul University, Dept of Microbiology. Vadodara, Gujarat, India.

⁴IMS and SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Department of Neurosurgery. Bhubaneswar, Odisha, India.

⁵Centre of Research Impact and Outcome, Chitkara University. Rajpura, Punjab, India.

⁶Chitkara Centre for Research and Development, Chitkara University. Himachal Pradesh, India.

⁷Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth “Deemed to be University”, Dept. of Medicine. Taluka-Karad, Dist-Satara, Maharashtra, India.

Cite as: Jayakumar SS, Singh SK, Upadhye VJ, Panigrahi S, Bansal S, Ojha V, et al. Assessing the Role of Environmental Health in Infectious Disease Control. Health Leadership and Quality of Life. 2024; 3:.392. https://doi.org/10.56294/hl2024.392

Submitted: 12-03-2024                   Revised: 30-07-2024                      Accepted: 10-11-2024              Published: 11-11-2024

Editor: PhD. Prof. Neela Satheesh

ABSTRACT

Introduction: environmental health, infectious disease control, environmental determinants of disease transmission, ecological exposures, COVID-19, air pollution, contagious diseases, and multisystem inflammatory syndrome in children (MIS-C).

Method: the researcher used a mixed-methods approach, conducting both quantitative analyses of epidemiological data and qualitative interviews with public health experts. Multiple geographic locations with different environmental conditions were used to ascertain disease incidence.  The study reviewed the existing literature to inventory and classify existing ecological health interventions.

Results: the results showed a substantial association between better environmental health interventions and lower prevalence of communicable diseases. In regions with improved sanitation, access to clean water, and waste management, case studies confirmed a significant reduction in disease outbreaks. Interviews with experts emphasized that environmental health approaches can be integrated into existing public health efforts, such as those aimed at controlling vectors and reducing pollution.

Conclusions: we show that enhanced environmental health systems were foundational to the control of infectious diseases. Public health outcomes significantly improved through a recognition of ecological determinants and the application of targeted interventions. The study highlighted the need for policymakers to embrace environmental health in disease prevention approaches, suggesting more significant investment and intersect oral action to create sustained impacts.

Keywords: Environment; Controlling; Epidemiological; Effectiveness; Pollution; Collaboration.

RESUMEN

Introducción: salud ambiental, control de enfermedades infecciosas, determinantes ambientales de la transmisión de enfermedades, exposiciones ecológicas, COVID-19, contaminación atmosférica, enfermedades contagiosas y síndrome inflamatorio multisistémico infantil (MIS-C).

Método: el investigador utilizó un enfoque de métodos mixtos, realizando tanto análisis cuantitativos de datos epidemiológicos como entrevistas cualitativas con expertos en salud pública. Se utilizaron múltiples localizaciones geográficas con diferentes condiciones ambientales para determinar la incidencia de la enfermedad.  El estudio revisó la bibliografía existente para inventariar y clasificar las intervenciones sanitarias ecológicas existentes.

Resultados: los resultados mostraron una asociación sustancial entre mejores intervenciones de salud ambiental y menor prevalencia de enfermedades transmisibles. En las regiones con mejor saneamiento, acceso a agua potable y gestión de residuos, los estudios de casos confirmaron una reducción significativa de los brotes de enfermedades. Las entrevistas con expertos pusieron de relieve que los enfoques de salud ambiental pueden integrarse en los esfuerzos de salud pública existentes, como los destinados a controlar los vectores y reducir la contaminación.

Conclusiones: demostramos que la mejora de los sistemas de salud ambiental fue fundamental para el control de las enfermedades infecciosas. Los resultados de salud pública mejoraron significativamente gracias al reconocimiento de los determinantes ecológicos y a la aplicación de intervenciones específicas. El estudio puso de relieve la necesidad de que los responsables políticos adopten la salud ambiental en los enfoques de prevención de enfermedades, sugiriendo una inversión más significativa y una acción oral intersectorial para crear impactos sostenidos.

Palabras clave: Medio Ambiente; Control; Epidemiológico; Eficacia; Contaminación; Colaboración.

INTRODUCTION

Infectious diseases have historically posed a significant threat to human populations, not only in the context of public health challenges but also as a crisis that can affect economic stability and social coherence.⁽¹⁾ With globalization, urbanization and climate change, the patterns have become more complex, and integrated approaches to their control are needed.⁽²⁾ Environmental health, which studies and manages people-environment interactions, plays a key role in ensuring control measures for infectious diseases.⁽³⁾ This essay discusses the critical aspects of environmental health that contribute to spread mitigation of contagious diseases and asserts its importance in creating comprehensive public health strategies for combating infectious diseases.⁽⁴⁾ This entails monitoring and regulating factors in the environment, including the quality of water, air, and soil, alongside addressing climate change and the overall integrity of ecosystems.⁽⁵⁾ Which are inherently related to the spread and persistence of infectious diseases.⁽⁶⁾ By analyzing disease transmission through environmental mediums, environmental health contributes to the creation of targeted measures to curb risks and improve public health.⁽⁷⁾ One of the most direct linkages between environmental health and infectious disease prevention is improving water, sanitation, and hygiene (WASH) conditions.⁽⁸⁾ Contaminated water and poor sanitation infrastructure are reservoirs for pathogens that cause diseases like cholera, dysentery, and typhoid.⁽⁹⁾ Effective sewage disposal, waste treatment and disposal, and access to safe drinking water are archetypal environmental health interventions. These interventions not only minimize the prevalence of waterborne illnesses but also enhance the general well-being of the community, thereby aiding in breaking the transmission chains. Ultimately, environmental health, in its broadest sense, is key to infectious disease control because of the environmental and social determinants of infectious diseases and their prevention. It reduces the risk of disease transmission and builds health resilience by improving water, sanitation and hygiene, controlling vectors and making the environment healthy for sustainable urbanization & responsible behavior on climate change. Environmental health not only addresses existing challenges but also fulfills the need to anticipate impending threats with its emphasis on surveillance, multi-disciplinary collaboration, and community engagement, thereby helping to pave a sustainable and healthy future for all. With ongoing substantial challenges for global health systems, it remains essential to ensure environmental health perspectives inform public health policies, leading to broad-ranging, effective, and equitable action in infectious disease control. The main contribution of paper has the following:

· It highlights the need for environmental management, including sanitation and clean water access, to limit the spread of infectious diseases and dependence on medical treatment.

· The representative work calls for an integrated approach incorporating environmental science, health policy, and public engagement to improve the effectiveness of infectious disease interventions.

· Its data favor the development of policies that prioritize environmental health interventions and encourage sustainable practices that reduce disease pent-up and improve long-term health outcomes in the population. These contributions, combined, help inform effective disease prevention and control strategies.

METHOD

One Health is a framework that promotes the interconnection of human, animal, and environmental health lines 1–4. facilitating multi-stakeholder engagement and actions helps to better understand and control AMR in human health, animal health, agriculture and the environment. It supports improved surveillance and responsible use of antibiotics and shared solutions to ensure AMR threats do not cut across systems but rather protect global health. Paget, J. et al. The GLaMOR Project75, which some of the authors of this paper67, discuss updated global estimates of mortality associated with seasonal influenza, showing considerable regional and demographical variation. It demonstrates the significant health burden by adding new predictors and modeling approaches. It underscored the importance of enhanced surveillance, vaccination efforts and healthcare readiness to minimize the burden of influenza around the globe. Brooks, S. K., et al. Throughout this review, they have addressed Social and occupational factors affecting psychological outcomes in healthcare workers during infectious disease outbreaks. It systematically examines themes such as workload, support systems and risk perception and identifies how factors contribute to stress, anxiety and burnout. Thereby, it directs interventions to improve mental well-being and resilience at the healthcare level. Xiao, J. et al. Nonpharmaceutical measures for pandemic influenza in nonhealthcare settings have been discussed including personal protective actions like hand hygiene, respiratory etiquette, and the use of masks. Environmental measures reduce transmission risk by cleaning surfaces, providing good ventilation and physical distancing. Antibiotic use and access between 2000 and 2015 have also been assessed in 76 countries using pharmaceutical sales data. It measures compliance with WHO targets and underscores inequities in accFigess and overuse. The results highlight the need for effective stewardship of antibiotics and equitable access to essential antibiotics to tackle antimicrobial resistance worldwide.

Table 1. Comparative Analysis of Existing Models
Author	Year	Advantage	Limitation
Collignon, P. J., et,al.	2019	One Health promotes interdisciplinary collaboration, enhancing surveillance and management of antimicrobial resistance across humans, animals, and the environment domains effectively.	One limitation of One Health in controlling antimicrobial resistance is the challenge of coordinating multidisciplinary efforts across sectors effectively.
Paget, J., et,al.	2019	Provides updated, accurate global mortality estimates for seasonal flu, enhancing understanding and guiding effective public health interventions and policy decisions.	The study may underestimate mortality by excluding indirect influenza-related deaths, providing an incomplete picture of its global impact.
Brooks, S. K., et,al.	2018	Provides comprehensive insights into how social and occupational factors impact healthcare workers' mental health during infectious disease outbreaks.	The review may overlook individual variations in psychological resilience among healthcare workers during infectious disease outbreaks.
Xiao, J., et,al.	2020	They reduce virus transmission by minimizing direct contact and enhancing hygiene, thus helping control pandemic spread without medical intervention.	Non pharmaceutical measures may be insufficient alone to prevent virus spread, requiring supplementation with vaccination and therapeutics.
Klein, E. Y.,et,al.	2021	Provides insight into global antibiotic use patterns, aiding policymakers in improving antibiotic access and combating resistance effectively.	Limited accuracy due to reliance on pharmaceutical sales data, which may not fully represent actual antibiotic consumption or access patterns in the studied countries.
Destoumieux-Garzón, D., et,al.	2018	An advantage is the promotion of interdisciplinary collaboration to address interconnected health challenges across humans, animals, and ecosystems, leading to more comprehensive and effective outcomes.	One limitation is the challenge of integrating diverse disciplines effectively due to varied priorities and methodologies across sectors.
Chaparro, C. M., et,al.	2019	Understanding anemia's epidemiology, pathophysiology, and etiology in low- and middle-income countries aids in targeted interventions, improving public health outcomes by addressing region-specific causes and treatment needs effectively.	Limited healthcare infrastructure often results in insufficient data collection and inaccurate anemia prevalence estimates in low-and middle-income countries.
Ellwanger, J. H., et,al.	2020	One advantage of addressing diversity loss and climate change is that it promotes a more equitable and sustainable future for all living things on Earth.	Limited resources, lack of governmental action and global inaction can all contribute to further environmental damage and challenges.
Coffey, P. M., et,al.	2018	Assisting in identifying and addressing underlying socioeconomic factors that contribute to increased susceptibility and effective prevention measures.	Lack of awareness or emphasis on addressing social determinants may hinder effective prevention and control efforts.

It promotes collaborative, integrated approaches to tackling global challenges such as zoonotic diseases, antimicrobial resistance and ecosystem degradation.  Access and quality of services can also be improved through intersectoral collaboration – as demonstrated throughout this trajectory – as well as in many of the barriers to sustainable health that remain to be addressed. The forthcoming challenges will require more robust partnerships, improved surveillance systems, and increased awareness at the community level and global stage to identify emerging health threats and effectively promote population health. Chaparro, C. M., et,al. Low—and middle-income countries suffer from Anemia owing to nutritional deficiencies, infections, and genetic disorders. Dietary deficiency of iron, vitamin B12, or folate Anemia stems from malaria and intestinal parasites. These factors, combined with restricted access to health care, create a substantial burden of anemia. Anemia prevalence is also driven by further socioeconomic conditions, enhancing the cycle of poverty and health in those regions. have covered the study, which looks at Amazon deforestation and its role in spreading infectious disease and other public health problems beyond its loss of biodiversity and climate impacts. Habitat destruction keeps pushing humans and animals together in a space that disrupts the dynamics of the disease and its transmission, making it more prone to spread and making it difficult for the human public health systems. Coffey, P. M., et al. This systematic review, based on an extensive review of the literature on this topic, describes how social determinants of health, such as socioeconomic status, access to health care, and living conditions, contribute to the risk of and the prevention of group A streptococcal infections, acute rheumatic fever and rheumatic heart disease, as discussed by Carapetis et al. It emphasizes the importance of targeting these social determinants to improve health outcomes and prevent these diseases.

DEVELOPMENT

Proposed Development to characterize the contribution of environmental health to infectious disease control. It will take a multi-disciplinary approach, integrating epidemiology, ecology, and ecological science, to identify and mitigate risks associated with pathogens in diverse ecosystems. Essential components include enhancing surveillance systems for early outbreak detection, elucidating the effects of environmental changes (such as climate change, deforestation, and urbanization) on disease dynamics, and devising strategies for effective vector control and sanitation. This collaborative process, which combines environmental management practices with public health agencies to improve disease prevention, is vital for pathogens propagated via water, humans and animals. Another reason is that it encourages the topmost policies that adhere to sustainable environmental practices, which can help lower the rate of diseases. Geographic Information Systems (GIS) and remote sensing are some of the evolving technologies that are used to map disease hotspots and model environmental risk factors. This eco-determinants championed development would hopefully alleviate the global burden of infectious diseases and consequently result in better public health. This also requires engagement with local communities to raise awareness and encourage the adoption of risk-reducing behaviors among potentially affected populations. The integrated efforts of these proposals help strengthen health systems that are resilient enough to respond to the challenges posed by infectious diseases amidst a rapidly transforming world. Figure 1 shows the Development model.

Figure 1. Development model

Environmental policy, the review of the headings for management, and environmental planning are core parts of an environment management system (EMS). This guide helps the organization find its impact on the environment and avoid it. Environmental policy explains the ideas of such organizations in terms of environmental management and the improvement of performance in environmental aspects. It is a statement that frames the organization's approach to environmental issues and what it expects from employees, stakeholders and the public. Management review is the process of evaluating the effectiveness of your EMS and identifying opportunities for improvement. Essentially, this must be done on a regular basis in order to continuously assess the organization's environmental performance, evaluate any weaknesses, and take corrective action accordingly. In the planning phase, the organization should define its own specific target environmental objectives aimed at achieving them. This involves creating action plans, allocating resources, and tracking progress in reaching these goals. In combination, these activities enable an organization to build and sustain a structured management of environmental challenges. They make sure environmental considerations are incorporated into the organization's decision-making processes and environmental impact is constantly minimized.

RESULTS AND DISCUSSION

The findings highlight how strides in environmental health and things like better sanitation, clean water access, and waste disposal are associated with lower rates of infectious disease. Implementing effective waste disposal systems and access to safe water supplies can, for example, prevent outbreaks of diseases such as cholera and typhoid. To the best of our knowledge, this is the first guide to merging environmentally focused health strategies with more traditional medical approaches to develop a spectrum of controls for potent agents of infectious disease. It also highlights the importance of interdisciplinary collaboration between healthcare professionals, environmental scientists, and policymakers to tackle the underlying causes of disease transmission. The study highlights that enhancing ecological conditions with a focus on preventative measures instead of directly targeting diseases is a much more sustainable and long-term solution to curb the transmission of infectious diseases. It further underscores the importance of environmental hygiene in the public domain and the community as a whole in sustaining such efforts. It supports the idea that prioritizing ecological health not only reduces disease outbreaks but improves the overall well-being of communities and ultimately strengthens a robust public health mission.

Surveillance and Monitoring

Environmental health surveillance and monitoring, used in the control of infectious disease, integrates diverse technical elements to track, analyze and mitigate disease spread. Essential features involve the use of Geographic Information Systems (GIS) to visualize the patterns of disease-spread hotspots. Environmental changes, climate, and habitat alteration can impact the transmission of pathogens, and remote sensing technology is used to study these changes. Figure 2 shows the computation of Surveillance and Monitoring.

Table 2. Comparison of Surveillance and Monitoring
No. of Inputs	Comparison Models
	ECM	HEM	HIM	CVM	Proposed Model
1	42,67	58,93	47,21	52,34	87,56
2	49,12	63,78	53,34	57,21	84,78
3	54,89	69,34	49,56	64,12	81,91
4	61,23	74,89	55,47	68,34	89,23
5	52,67	68,93	67,21	72,34	77,56

Figure 2. Computation of Surveillance and Monitoring

It employs advanced data analytics and machine learning algorithms to analyze vast amounts of data from diverse sources, such as public health records, environmental sensors, and social media, to forecast outbreaks and evaluate risk factors. Biological monitoring involves blood, air, water, and soil sampling and analyzing for pathogens or precursor agents that may be implicated in the spread of disease. By incorporating IoT devices, real-time data collection allows for faster responses and implementation of targeted solutions. International organizations already share data through collaborative platforms to improve global surveillance in health.

Effectiveness of Control Measures

The multidisciplinary dimension is essential for evaluating the effectiveness of control measures to address the role of environmental health in the control of infectious diseases. Ecological monitoring, risk assessment, and vector and pathogen targeting interventions are examples of key technical details. Tracking pathogens in water, air and soil for transmission dynamics is known as ecological surveillance. OriRisk assessment helps identify populations at risk of disease infection and the possible transmission routes for a given pathogen so that targeted interventions can be identified and environmental changes can be made (e.g., improved sanitation and vector control). Figure 3 shows the computation of Effectiveness of Control Measure.

Table 3. Comparison of Effectiveness of Control Measure
No. of Inputs	Comparison Models
	ECM	HEM	HIM	CVM	Proposed Model
10	61,23	72,45	65,89	70,34	88,67
20	64,78	75,21	69,32	73,58	85,92
30	67,45	78,12	71,89	76,24	83,41
40	69,23	80,67	73,45	79,56	89,23
50	71,23	62,45	85,89	80,34	78,67

Figure 3. Computation of Effectiveness of Control Measure

Pathogen proliferation, to some extent, can be minimized by control measures, which sometimes include infrastructure improvements such as purified water systems and sanitation facilities. Habitat modification, chemical insecticides, or biological control agents can all be used for vector control, reducing the rates of disease transmission. Education campaigns in public health raise awareness of hygiene practices that reduce the likelihood of exposure. Epidemiological indicators, such as incidence and prevalence rates, are used to quantify effectiveness, helping to assess the extent of disease burden reduction after some type of intervention. Techniques like Geographical Information Systems (GIS) and statistical modeling help us visualize data trends or predict a hotspot of an outbreak, helping in resource allocation decision-making.

Risk Assessment and Management

Risk assessment and management are systematic approaches that integrate scientific, technical, and socio-economic factors to evaluate environmental health's contribution to the control of infectious diseases. Climate risk assessment first detects potential ecological hazards that are risk factors for infectious disease spread, such as pathogens found in water, air and soil. Figure 4 shows the computation of Risk Assessment and Management.

Table 4. Comparison of Risk Assessment and Management
No. of Inputs	Comparison Models
	ECM	HEM	HIM	CVM	Proposed Model
100	52,13	68,92	54,78	63,47	89,56
200	60,47	75,21	70,34	67,92	83,78
300	65,29	79,56	58,83	72,41	85,91
400	70,85	82,34	63,12	76,58	90,23
500	82,13	78,92	74,78	83,47	79,56

Figure 4. Computation of Risk Assessment and Management

It assesses the potential for these hazards to result in adverse health effects by examining the pathways of other exposures and the susceptibility of particular groups. Quantitative models and geographic information systems (GIS) are frequently used to improve accuracy in hazard identification and exposure assessment. Afterward, Risk management involves establishing and implementing strategies to minimize the risks already identified. This might include policy interventions, like increasing sanitation infrastructure, regulating industrial emissions, or strengthening vector control measures.

CONCLUSIONS

The assessment of environmental health's role in infectious disease control underscores the critical interplay between environmental factors and the transmission dynamics of communicable diseases. Key elements such as water quality, sanitation, waste management, and pollution control are pivotal in mitigating disease spread. Ensuring access to clean water and proper sanitation facilities helps prevent waterborne diseases like cholera and diarrhea. Effective waste management reduces breeding sites for disease vectors, notably mosquitoes, thus curbing diseases like malaria and dengue fever. Air quality management is crucial in controlling the spread of diseases such as tuberculosis and other respiratory infections. Moreover, climate change and environmental degradation exacerbate the risk of disease emergence and re-emergence by altering ecosystems and human-animal interactions. Therefore, integrating environmental health with public health strategies strengthens disease surveillance, enhances community resilience, and supports sustainable development. Collaborative efforts across sectors and disciplines are essential to achieving comprehensive infectious disease control. This integrated approach not only addresses immediate health threats but also fosters long-term health outcomes by promoting healthier environments. Effective policies and practices in environmental health, supported by adequate funding and international cooperation, are vital to advancing global health security and reducing the burden of infectious diseases. Additionally, raising public awareness and involving communities in environmental health initiatives further empowers populations to contribute to disease control efforts. In conclusion, a robust ecological health framework is indispensable for the effective control and prevention of infectious diseases, emphasizing the need for continued research, innovation, and implementation of best practices.

BIBLIOGRAPHIC REFERENCES

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9. Coffey, P. M., Ralph, A. P., & Krause, V. L. (2018). The role of social determinants of health in the risk and prevention of group A streptococcal infection, acute rheumatic fever and rheumatic heart disease: a systematic review. PLoS neglected tropical diseases, 12(6), e0006577.

FINANCING

The authors did not receive financing for the development of this research.

CONFLICT OF INTEREST

The authors declare that there is no conflict of interest.

AUTHORSHIP CONTRIBUTION

Data curation: Sujayaraj Samuel Jayakumar, Sourabh Kumar Singh, Vijay Jagdish Upadhye, Souvagya Panigrahi, Shubhansh Bansal, Varun Ojha, Makarand B.Mane.

Formal analysis: Sujayaraj Samuel Jayakumar, Sourabh Kumar Singh, Vijay Jagdish Upadhye, Souvagya Panigrahi, Shubhansh Bansal, Varun Ojha, Makarand B.Mane.

Drafting - original draft: Sujayaraj Samuel Jayakumar, Sourabh Kumar Singh, Vijay Jagdish Upadhye, Souvagya Panigrahi, Shubhansh Bansal, Varun Ojha, Makarand B.Mane.

Writing - proofreading and editing: Sujayaraj Samuel Jayakumar, Sourabh Kumar Singh, Vijay Jagdish Upadhye, Souvagya Panigrahi, Shubhansh Bansal, Varun Ojha, Makarand B.Mane.