Environmental Health Conditions Research Articles

Seasonal ecotoxicological monitoring of freshwater zooplankton in Bir Mcherga dam (Tunisia)

Dams represent large semi-closed reservoirs of pesticides and various organic and inorganic pollutants from agricultural and human activities, and their monitoring should receive special attention. This study evaluated the environmental health status of Bir Mcherga dam using zooplankton species. The dam has a capacity of 130Mm3 and its waters are used for irrigation, water drinking supply, and fishery. Copepods and cladocerans (crustaceans) were collected in situ monthly between October and August 2012. Oxidative stress (CAT, MDA), neurotoxicity (AChE), and genotoxicity (micronucleus test) biomarkers were analyzed in two zooplankton species: Acanthocyclops robustus and Diaphanosoma mongolianum. High values of cells with a micronucleus were observed during summer. AChE activities were inhibited during early winter and summer. The high seasonal variability of CAT and MDA levels indicates that zooplankton is continuously exposed to different oxidative stresses. These results suggest that there is an obvious and continuous multi-faceted stress in Bir Mcherga reservoir and, consequently, an urgent monitoring of freshwater environments in Tunisia is needed, particularly those intended for human consumption and irrigation.

Evaluation of the safety and environmental health status in schools of Evaz county in 2017

Aims: Attention to physical, health, and safety factors in educational environments is the most effective and fundamental factor for physical and mental growth of the students and their learning. Hence, one of the most important and influential school health issues is environmental health and safety. Accordingly, this study was conducted to study the environmental health and safety of Evaz district schools. Materials and Methods: This descriptive cross-sectional study was carried out in 2017 and the conditions of environmental health and safety of 16 schools (elementary, secondary, and high schools) were studied in Evaz County. For this purpose, a checklist with 48 questions was prepared. The checklist was prepared based on the Iranian environmental health of schools standards codes and completed by means of observing and interviewing the authorities and the obtained data were analyzed using the SPSS version 16. Results: The conditions of the schools were in an unfavorable status in terms of the healthy storeroom, controlling the insects and rodents, installation electrical safety (insulating) mat under the electrical panels, and installation of handwashing guide. The results showed that there were no pool and fountain, laboratory and workshop, and balcony and terrace in some of those schools. The statistical analysis depicts the significant correlation between the school area and the places for fuel storage and teachers' rest (P = 0.03). Conclusion: Based on the results the schools of Evaz city were in a favorable status in terms of equipment safety and the building sanitary rules, while the status of individual health and building safety was lower than the standard level. So, such items should be considered for health promotion of such schools.

Sedentary behavior in the city of São Paulo, Brazil: ISA-Capital 2015.

The excessive sitting time involved in activities of low energy expenditure (sedentary behavior) can contribute to the development of chronic diseases. Assessing factors related to this behavior in a population is important to identify its most vulnerable segments. To describe sitting time distribution in the adult population of São Paulo City according to sociodemographic and environmental characteristics and health conditions. This is a cross-sectional study involving 2,512 individuals, aged 20 to 65 years, who participated in the Health Survey in the City of São Paulo (Inquérito de Saúde no Município de São Paulo - ISA-Capital) 2015. Data relating to sitting time were collected using the International Physical Activity Questionnaire (IPAQ), initially analyzed continuously, and, afterward, dichotomized by the median to analyze categorical variables. The total sitting time median in the sample was 180 min/day. The variables that, after adjustments, remained related to sedentary behavior were: schooling (prevalence ratio - PR = 1.41; 95% confidence interval - 95%CI 1.35 - 1.48); marital status (PR = 1.05; 95%CI 1.02 - 1.08); neighborhood safety (PR = 0.96; 95%CI 0.93 - 0.99); age (PR = 0.91; 95%CI 0.87 - 0.95); income (PR = 1.07; 95%CI 1.00 - 1.15); self-rated health (PR = 1.03; 95%CI 1.01 - 1.07), and gender (PR = 0.96; 95%CI 0.94 - 0.99). The most vulnerable groups to sedentary behavior in this population are: younger males, with higher schooling and income, who live in neighborhoods considered safe, unmarried, and with negative self-rated health.

Environmental Health Status of Some Aquatic Ecosystems in Badagry Division, Lagos, Nigeria

The status of Agboju, Ajegunle, Topo and Gbaji water bodies in Badagry Division of Lagos State, Nigeria was evaluated between April and November 2018 in order to determine the suitability of the ecosystem to biota and safety of the aquatic resources for human consumption. Some environmental variables such as alkalinity, temperature, biochemical oxygen demand (BOD), conductivity, total dissolved solid (TDS), carbon (iv) oxide (CO₂), total hardness, chemical oxygen demand (COD), turbidity, phosphate, dissolved oxygen (DO), pH, salinity, sulphate and nitrate, and some heavy metals (Fe, Cu, Zn, Pb, Cd and Cr) in water, sediment, aquatic plant (<i>Eichhornia crassipes</i>) and fish (<i>Ethmalosa fimbriata</i>) were measured using standard procedures. The results showed that BOD, COD, total hardness and turbidity values were above the standard permissible limits. Cd in water column of Agboju and Ajegunle, and Pb recorded from Agboju, Ajegunle and Topo, exceeded standard permissible limit. Cu (0.56±0.54), Zn (5.45±0.89), Pb (0.54±0.47) and Cr (0.455±0.375) contents in <i>E. fimbriata</i> (from Ajegunle) was slightly above permissible limits while Cd and Fe contents in the fish across the four stations were above permissible limits. Contamination factor, Index of geochemical accumulation and enrichment factor showed moderate degree of contamination of cadmium and Fe in the sediment. This preliminary study could be concluded that the biota can still survive in the ecosystems despite high contamination of the water bodies with metals. However, human consumption of several of <i>E. fimbriata</i> and water could cause health hazard. Therefore, urgent effort should be made by all users of the ecosystem to decline in discharging untreated waste into these water bodies.

Using time-lapse omics correlations to integrate toxicological pathways of a formulated fungicide in a soil invertebrate

The use of an integrative molecular approach can actively improve the evaluation of environmental health status and impact of chemicals, providing the knowledge to develop sentinel tools that can be integrated in risk assessment studies, since gene and protein expressions represent the first response barriers to anthropogenic stress.This work aimed to determine the mechanisms of toxic action of a widely applied fungicide formulation (chlorothalonil), following a time series approach and using a soil model arthropod, Folsomia candida. To link effects at different levels of biological organization, data were collected on reproduction, gene expression and protein levels, in a time series during exposure to a natural soil.Results showed a mechanistic mode of action for chlorothalonil, affecting pathways of detoxification and excretion, immune response, cellular respiration, protein metabolism and oxidative stress defense, causing irregular cell signaling (JNK and NOD ½ pathways), DNA damage and abnormal cell proliferation, leading to impairment in developmental features such as molting cycle and reproduction. The omics datasets presented highly significant positive correlations between the gene expression levels at a certain time-point and the corresponding protein products 2–3 days later. The integrated omics in this study has provided useful insights into pesticide mechanisms of toxicity, evidencing the relevance of such analyses in toxicological studies, and highlighting the importance of considering a time-series when integrating these datasets.

A systematic scoping review of environmental health conditions and hygiene behaviors in homeless shelters.

There are well-established relationships between health and homelessness, and shelters can facilitate the transmission of diseases and contribute to their prevention. Adequate environmental health conditions and hygiene behaviors in homeless shelters are fundamental to the health of their clients, a marginalized population. We report the status of environmental health conditions and hygiene behaviors in homeless shelters and associated health outcomes; interventions to improve these conditions, behaviors, and outcomes; and obstacles to improvement. PubMed, Web of Science, Scopus, and EBSCOhost were searched for peer-reviewed studies, and additional sources for grey literature. Studies were included if they reported primary data on one or more environmental health condition or hygiene behavior in homeless shelters. Twenty-eight studies were included in the review. Insufficient ventilation systems, unhygienic bedding, and overcrowding were the most documented environmental health and hygiene deficiencies in homeless shelters, and tuberculosis infections and skin diseases were the most documented associated health outcomes among clients. Studies frequently recommended or described implementation of behavioral and administrative controls, ventilation system improvements, and ultraviolet germicidal irradiation fixtures. Most studies addressed airborne transmission of tuberculosis and were conducted in high-income countries, revealing an imbalance in the literature. Insufficient resources and the transience of clients are barriers to improving hygiene behaviors and environmental conditions in homeless shelters. Further investment and research into ensuring adequate hygiene and environmental health in this setting can protect and promote the health and well-being of people experiencing homelessness.

A systematic scoping review of hygiene behaviors and environmental health conditions in institutional care settings for orphaned and abandoned children

BackgroundAdequate hygiene behaviors and environmental health conditions are fundamental to children's health, development, and well-being. They are especially important in institutional care settings for orphaned and abandoned children, a particularly vulnerable population whose basic needs are often not met. ObjectivesWe systematically reviewed the evidence about hygiene behaviors and environmental health conditions in institutional care settings for children and associated health outcomes; interventions to improve these behaviors, conditions, and outcomes; and obstacles to improvement. MethodsPubMed, Web of Science, Scopus, and EBSCOhost were searched for studies in the peer-reviewed and grey literature. Studies were included if they reported primary data on one or more environmental health condition or hygiene behavior in an institutional care setting for orphaned and abandoned children. ResultsForty-five publications reporting on over 500 institutions in 29 countries were included. The most documented concern was poor personal hygiene behaviors followed by inadequate water and sanitation infrastructure and overcrowding. Protozoan, helminthic, viral infections, and diarrheal illness among institutionalized children were the most commonly documented associated health outcomes. DiscussionMore studies documented the status of hygiene and environmental health in children's institutions than interventions to improve behaviors and conditions. Insufficient finances and expertise or involvement of caregivers are reported barriers to implementing improvements in children's institutions. The development of guidelines for essential environmental health standards in orphanages, monitoring of facility conditions, accountability for facility deficiencies, and implementation research to identify improvement opportunities would contribute to and promote the health and development of orphaned and abandoned children worldwide.

Indoor Environment Health and Safety Status in Industrial Sectors of Bangladesh: a Case Study on Industries under Kumudini Welfare Trust

This study was conducted to know the indoor environment, health and safety status towards the workers of different industries situated in Narayanganj under Kumudini Welfare Trust (KWT) of Bangladesh. The data were collected during the monthof March-April, 2016. Measurednoise level in different industries under KWT ranged from 71-90.5 dB. During the study, among all of the four industries highest level of noise was measured in Kumudini Jute Bailing and Warehouse Ltd. (90.5 dB) followed by Kumudini Garments Ltd. (78 dB). Indoor temperature in different industries under KWT ranged from 26.5°C-32°C. Highest level of temperature was measured in Kumudini Garments Ltd. (32°C) followed by Kumudini Handicraft Ltd. (30.5°C), Kumudini Pharma Ltd. (29.5°C) and Kumudini Jute Bailing and Warehouse Ltd. (26.5°C). During the observations, highest relative humidity was measured in Kumudini Garments Ltd. (19.5%) followed by Kumudini Pharma Ltd. (5.2%), Kumudini Handicraft Ltd. (2%) and Kumudini Jute Bailing and Warehouse Ltd. (1.2%). In this study, observed level of CO2 in the indoor environment of the study area ranged from - 0.2 to 0.45 %. All of the measured CO2 level is greater than standard concentration of 0.03%, except Kumudni Jute Bailing and Ware House. Based on our present clarifications there was no oxygen deficiency in the door environment of the industries under KWT.J. Environ. Sci. &amp; Natural Resources, 10(2): 65-72 2017

A Survey of Health Disparities, Social Determinants of Health, and Converging Morbidities in a County Jail: A Cultural-Ecological Assessment of Health Conditions in Jail Populations.

The environmental health status of jail populations in the United States constitutes a significant public health threat for prisoners and the general population. The ecology of jails creates a dynamic condition in relation to general population health due to the concentrated potential exposure to infectious diseases, difficult access to treatment for chronic health conditions, interruption in continuity of care for serious behavioral health conditions, as well as on-going issues for the prevention and treatment of substance abuse disorders. This paper reports on elements of a cross-sectional survey embedded in a parent project, “Health Disparities in Jail Populations.” The overall project includes a comprehensive secondary data analysis of the health status of county jail populations, along with primary data collection that includes a cross-sectional health and health care services survey of incarcerated individuals, coupled with collection of biological samples to investigate infectious disease characteristics of a county jail population. This paper reports on the primary results of the survey data collection that indicate that this is a population with complex and interacting co-morbidities, as well as significant health disparities compared to the general population.

Studying the Environmental Health Condition of the Cities in the Kermanshah Province Affected by 2017 Earthquake

Studying the Environmental Health Condition of the Cities in the Kermanshah Province Affected by 2017 Earthquake

Environmental Health and Safety Status in the Primary Schools of Garmsar City, Iran

Background: Nowadays, school administrators and designers are increasingly convinced that the quality of school buildings, spaces, and learning environments can influence students’ health and learning. It makes sense to them that, when classrooms are clean, healthy, and well-lit, students are more comfortable, less prone to illness, and more focused on their studies. The current study aimed at investigating the environmental health and safety status in primary schools of Garmsar city, Iran with the recommended standards. Methods: The statistical population of the current descriptive, cross sectional study was selected by the census method. To accomplish this, a checklist related to the school environmental health inspection provided by the Ministry of Health, was completed through direct observation. Results: Most schools had favorable conditions in terms of the medical examinations (75%), appropriate drinking fountains (69%), standard toilets (87%), window height (90%), natural lighting (65%), safety in the installation of the heater (84%), electrical and lighting (72%), fire extinguisher (68%), sewage disposal (100%), and daily waste collection (72%). However, most of the schools had no health care rooms (66%), standard first aid kit (57%), emergency exit (69%), hygienic tuck-shops (59%), standard bench and desk (53%), favorable ventilation (54%), and the appropriate distance of the board (53%). Conclusions: It was concluded that the physical status of the primary schools of Garmsar was approximately in accordance with the required standards of School Health Regulations. However, some school buildings needed repair, which should be considered in government programs. In order to guarantee the safety of schools, it is more important to evaluate the defects of the environmental health status of schools.

The impact of cookstove operation on PM2.5 and CO emissions: A comparison of laboratory and field measurements

Inefficient biomass combustion in traditional cookstoves generates high levels of household air pollution (HAP) that is associated with numerous adverse environmental and human health conditions. Many cookstoves have been evaluated using laboratory tests, but past studies revealed discrepancies between laboratory and field measurements. Fuel re-loading, a common operation in actual use but not required in the laboratory test, might be a contributing factor to this laboratory-field gap. In this study, we evaluated the pollutant emissions performance of a semi-gasifier cooking stove using both laboratory and field measurements. Emission factors and real-time properties of CO and PM2.5 were separately measured during the following 4 phases of a typical cooking event: lighting, stable combustion, fuel re-loading and post fuel re-loading. We quantified the CO and PM2.5 contributions to total cooking event emissions in each phase. We found over 70% lower PM2.5 emissions and 60% lower CO emissions during 3 no re-loading laboratory tests compared with all 16 field tests. Lighting generated 83.8% ± 15.6% of the total PM2.5 and 39.1% ± 7.8% of the total CO in laboratory tests without fuel re-loading, and 57.8% ± 33.5% and 37.9% ± 21.2% of the total PM2.5 and CO in field tests, respectively. On average, fuel re-loading led to 29.1% ± 30.8% of PM2.5 emissions and 24.9% ± 22.6% of CO emissions in 16 field tests, which also contributed to significant discrepancies between laboratory and field-based emissions. According to the ISO IWA tiered stove ratings for emissions, fuel re-loading led to at least one tier lower ranking in both laboratory and field cookstove tests. Fuel re-loading could be an important factor causing laboratory-field discrepancy of emissions, thus it could be considered in future cookstove selection and intervention projects.

Municipal solid waste generation and disposal in Robe town, Ethiopia

ABSTRACTThe amount of solid waste generated in developing countries is rising over time due to economic growth, change inconsumer behavior, and lifestyles of people. But it is hard to manage and handle the increase of solid waste with existing waste management infrastructure. Thus, the management system of solid waste is very poor and has become a serious problem. The main purpose of this study is to quantify the volume of solid waste generated and investigate factors affecting generation and disposal of wastes in the study area. The result of this study indicated that total waste generated from households was about 97.092 kg/day. Furthermore, the study reveals that the solid waste generation rate of the town is 0.261 kg/person/day. About 57.5% of solid waste is properly disposed of to a landfill site, whereas the remaining 42.5% is illegally dumped at the roadsides and open fields.Implications: Nowadays, in developing countries there is a high concentration of people in urban areas, causing the generation of an enormous concentration of municipal waste in urban areas. Therefore this study’s findings will be important for various policymakers and town planners. This may also serve as a benchmark for the municipal authorities of the town for whom the problem is still invisible and negligible and can push environmental protection authorities to reexamine the implementation of their policies and strategies with regard to the broader issues of human and environmental health conditions of town dwellers.

Community outbreak of invasive group A streptococcus infection in Ontario, Canada.

Outbreaks of invasive group A streptococcal infection (iGAS) have historically occurred in institutional settings. Increasingly, community-based outbreaks have been reported, often among marginalized populations, yet few guidelines exist for managing iGAS outbreaks in such settings. To describe the ongoing outbreak of iGAS in Middlesex-London, Ontario, and the challenges that arose while applying current guidelines to a marginalized population in a community setting. The outbreak investigation included all iGAS cases in Middlesex-London with an onset date from April 1, 2016 to February 28, 2018. Clinical specimens were submitted to provincial and federal laboratories for typing. Public health management of the outbreak involved environmental health inspections, contact tracing, chemoprophylaxis of close contacts, swabbing to determine colonization rates of Streptococcus pyogenes, and communicating with stakeholders and the public. A total of 156 confirmed cases of iGAS corresponding to 147 individuals were reported in less than two years. More than 60% of cases occurred in men (n=91) and almost half (n=71) of the total number of cases were persons who used drugs (PWUD) and/or were under-housed. Of the PWUD cases, 58 of 65 (89%) used injection drugs. Key challenges in controlling this outbreak included reaching PWUD and under-housed people; completing a case history and contact list; facilitating completion of treatment; dealing with concurrent infections such as human immunodeficiency virus (HIV) and hepatitis C virus (HCV); and optimizing environmental health conditions. Guidelines were adapted so contacts who shared drugs or injection drug equipment with a known iGAS case would be offered chemoprophylaxis regardless of the clinical severity of the case. To optimize treatment completion, a single-dose of azithromycin for individuals in close contact with PWUD and/or under-housed cases was given. Cases with macrolide-resistant strain emm9 have recently emerged. The application of institution-based guidelines for iGAS outbreaks has been ineffective in controlling this particular community outbreak. There is a need for guidelines on managing outbreaks of iGAS in the community especially when an outbreak involves marginalized populations.

Implementation of the model disability survey in people from various cultural backgrounds in a developed country; their access to work, and healthcare; Facilitators and barriers

Various studies were completed in the developing countries however this is the first one to be carried out in a developed country with a universal healthcare system. Study design: community based descriptive study. Settings: community dwelling in the greater Melbourne region, catchment area of Royal Melbourne Hospital. Participants: 100 consecutive recruited community residents has been interviewed. Procedure: After an informed consent was obtained, participants will be were required to fill and answer the standard MDS questionnaire. The Alpha version of the MDS comprises two questionnaires: –Household questionnaire (answered by the head of the household) with two modules: household roster: targeting a short description of the household and all household members and, the children module: targeting disability and health conditions in children; –Individual questionnaire (answered by a randomly-selected adult member of the household) with eight sections: socio-demographic characteristics, work history and benefits, environmental factors, functioning, health conditions and capacity, health-care utilisation, and satisfaction, personality and well-being. The WHO coding system for the individual questionnaires of the MDS will be used to quantitatively measure each participant's response. Many people with disability have less access to healthcare system, improved access to transport means and recreation facilities. Vocational opportunities are presented to individual with disabilities less than expected. Household with a person with a disability have greater difficulties and less freedom because of the caring responsibilities. Although Australia has an equitable universal healthcare system, people with disability were still disadvantaged and inferior to the persons without disability in their access to work, education and healthcare system. Household with a person with a disability have a negative impact on the other family members in their educational and vocational interest.

REVIEW OF CHALLENGES CONFRONTING THE IMPLEMENTATION AND ENFORCEMENT OF ENVIRONMENTAL POLICIES AND REGULATIONS IN SIERRA LEONE.

Environmental sustainability in a developing country like Sierra Leone is faced with numerous challenges such as shifting cultivation, mining, deforestation, land degradation, urbanization, land grabbing, wildfire outbreak, corruption, under funding, inadequate man power, pollution, and political interference. Since independence, Sierra Leone has enacted various environmental protection instruments alongside with 48 international multilateral environmental agreements though some are yet to be ratified. Environmental performance index ranking of Sierra Leone is at the bottom of the index for almost four decades. This paper examines the environmental policies, regulations, challenges, mining impacts, conflicting mandates, treaties and conventions since independence and proposed the way forward in sustaining Sierra Leone?s environment. It is concluded that the major challenges facing the current and past governments in dealing with environmental issues includes; weak policies and institutions, implementation and adoption problem; natural disasters; war; non mechanized farming, mandate overlap by ministries, corruption, poverty, illegal mining and logging, weak monitoring and absence of inter-sectorial coordination among government agencies among others. Sierra Leone needs sound environmental institutions that are equipped with environmental research facilities as well as improve the educational and expertise capacity of staff. It is recommended that sound EIA/SEA survey should be conducted annually with standard guide lines on the environment health status. The formation of the Environmental Protection Agency through the Acts of Parliament in 2008 is seen as the right step in the right direction on environmental sustainability. This review provide relevant information on the current status and challenges facing the environment and hence serve as a bench mark for designing appropriate policies and regulations for a sustainable environment in the near future.

Differential biochemical responses to metal/metalloid accumulation in organs of an edible fish (Centropomus parallelus) from Neotropical estuaries

Metal/metalloid accumulation in fish organs elicits biochemical responses indicating the overall fish and environmental health status. This study evaluated the bioaccumulation of metals and metalloid in relation to a suite of biochemical biomarkers (superoxide dismutase, catalase, glutathione-S-transferase, Na+/K+-ATPase, H+-ATPase, acetylcholinesterase activities and the levels of glutathione, metallothionein, lipid peroxidation and oxidized protein) in different organs of fish, Centropomus parallelus, in Vitória Bay and Santa Cruz estuaries (State of Espírito Santo, Brazil) with distinct contamination levels. Metal and metalloid concentrations differ in each organ and were significantly higher in winter than in summer. Chemometric evaluation performed between metal/metalloid accumulation and the biomarkers revealed a complex scenario in which the biomarker responses depend on both metal accumulation and organ/tissue sensitivity. The metal levels in gills indicate fish contamination mainly via water and the low sensitivity of this organ to most metals. Biomarker responses suggested that the metal elimination pathway is through the gills and kidney. The hepatopancreas and kidneys were the most important detoxification organs while muscle was the less reactive tissue. In general, the finding suggested that, C. parallelus is partly able to tolerate such metal contamination. However, it is emphasized that the biomarker responses imply an energetic cost and may affect the growth rate and reproduction. Given the ecological and economic importance of C. parallelus, the level of toxic metals/metalloids in juvenile fish is an important early-warning for the maintenance, conservation and commercial use of this species.

Evaluation of Public School Health and Its Accordance with School Health National Regulations: A Case Study in Kermanshah, Iran

Background: Providing a favorable health status is of high importance for educational buildings and in particular schools. The aim of this study was to evaluate the school health and its accordance with national school health regulations in Kermanshah city, Iran. Materials and Methods: This cross-sectional study, the researchers randomized 200 schools and gathered data using a checklist comprising 87 questions, 74 of them on environmental health status and 14 of them on safety status of schools. This checklist designed based on the school health guidelines (developed by the health and work environment center of the Ministry of health, treatment and medical education). In this study, the researchers used only the former and filled out the checklist through visiting schools and interviewing with their staff. The collected data were transferred to the statistics software SPSS version 16.0 and Excel version 2010 and the outputs were presented in tables. Results: Out of the 200 schools surveyed, 66.5% were old(structural dating of more than 10 years), and only 33.5% (67 schools) were new (structural dating of less than 10 years). Among these schools, 99.5% (199 schools) provide healthy tap water places, 98.5% (197 schools) healthy hand washing facilities and 100% (200 schools) healthy toilets. The average level of school buffets health was observed58.5%. The health and optimization status of the studied schools was 92-100% in accordance with article 13 of the regulation. Conclusion: According to the results of this study, there were some problems that include the health status of school buffets, classrooms and toilets, as well as the safety status of theinvestigated schools, so that attention to the health of schools should be among the priorities of the government and the authorities.

Pengaruh Kondisi Kesehatan Lingkungan Terhadap Kepuasan dan Jumlah Kunjungan Pasien di Puskesmas Kota Pekanbaru

Given the importance of environmental health at puskesmas in the environmental health care system to create a healthy environment that can provide protection for patients and puskesmas. This study aims to analyze the partial and simultaneous influence between the buildings outside, building in the building, sanitation facilities and hygiene management on environmental health condition, analyze the effect of Puskesmas environment condition to the satisfaction and number of patient visit at Pekanbaru Health Center. This study used survey methods conducted at all public health centers in Pekanbaru City from April to August 2017. The sample size was 20 Puskesmas and 400 patients visited the Puskesmas. The tools and materials used in this research are observation instruments and use checklists and questionnaire interview instruments (questionnaires). The partial simultaneous effect of outbuildings, in-building buildings, sanitation facilities and hygiene management on the health condition of the puskesmas was used multiple regression tests, with the result of correlation of the condition of outsides to 0.321 outbuildings, buildings in 0.834, sanitation facilities 0.876 and cleanliness management 0.640. The direction of positive relationships shows the greater the assessment of the four variables will increasingly make the score of environmental health assessments getting bigger as well. Influence of health condition of environment of puskesmas toward patient satisfaction using multiple linear regression test and the result is 0,669. This shows a strong influence between environment health variable of puskesmas and satisfaction of respondent who come to visit puskesmas. R Square 0,448 or coefficient of determination mean 44,8% satisfaction of respondent can be explained by environment health variable of puskesmas. The influence of health condition of puskesmas on the number of patient visit using simple linear regression test and the result is 0,628. This shows a strong correlation between environment health variables of puskesmas with respondent visit coming to visit puskesmas. R Square 0,394 or coefficient of determination mean 39,4% of respondent visit can be explained by environment health variable of puskesmas while the rest is explained by other cause. It is necessary to increase health promotion and education about the importance of environmental health of puskesmas for the community about the health condition of the environment that fulfill the health requirement and increasing the role of Dinas Kesehatan in supervision of health of puskesmas environment to be better and become the reference of accreditation of puskesmas according to standard from the Ministry of Health RI.

Economic, Energetic, and Environmental Impact Evaluation of the Water Discharge Networks from Mining Works

Sustainable development represents an optimistic scenario for the evolution of contemporary civilization. The object of this paper is to define certain evaluation criteria regarding the performances of water discharge networks from mining works, and propose a method for aggregating the specific indicators for monetary costs, energetic costs, and environmental impact-related costs. The global pollution index (GPI) represents a method for assessing environment health status or pollution levels. The GPI quantitatively expresses this status based on its index, which results from a ratio between the ideal value and the given value of certain quality indices that are considered specific for the analyzed environmental factors at certain moments. The proposed method in this paper tries to perform a synergistic aggregation of the balance sheet of harmfulness and classic balance sheets for matter and energy for an industrial process.