Conservation and environmental medicine

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Dnipropetrovs'k State Medical Academy

Foreign language chair

English scientific conference

Conservation and environmental medicine

Kolesnik Kateryna, 1st medical department, 5b

Dnipropetrovsk 2015

1. Conservation medicine

Conservation medicine is an emerging, interdisciplinary field that studies the relationship between human and animal health, and environmental conditions. Also known as ecological medicine, environmental medicine, or medical ecology. The environmental causes of health problems are complex, global, and poorly understood. Conservation medicine practitioners form multidisciplinary teams to tackle these issues. Teams may involve physicians and veterinarians working alongside researchers and clinicians from diverse disciplines, including microbiologists, pathologists, landscape analysts, marine biologists, toxicologists, epidemiologists, climate biologists, anthropologists, economists, and political scientists.

Clinical areas include HIV, Lyme disease, Severe Acute Respiratory Syndrome(SARS), avian influenza, West Nile virus, Malaria, Nipah virus, and other emerging infectious diseases.

The term conservation medicine was first used in the mid-1990s, and represents a significant development in both medicine and environmentalism. While the hands-on process in individual cases is complicated, the underlying concept is quite intuitive, namely, that all things are related. The threat of zoonotic diseases that travel to humans from animals is central. For example, burning huge areas of forest to make way for farmland may displace a wild animal species, which then infects a domesticated animal. The domesticated animal then enters the human food chain and infects people, and a new health threat emerges. Conventional approaches to the environment, animal and human health rarely examine these connections. In conservation medicine, such relationships are fundamental. Professionals from the many disciplines involved, necessarily work closely together.

2. Environmental medicine

For studying the actual effect of the environment on particular disease, conservation medicine also studies the effects of the surrounding on the human health. This is called the environmental medicine.

Current focuses of environmental medicine:

The effects of ozone depletion and the resulting increase in UV radiation on humans with regards to skin cancer.

The effects of nuclear accidents or the effects of a terrorist dirty bomb attack and the resulting effects of radioactive material and radiation on humans.

The effects of chemicals on humans, such as dioxin, especially with regards to developmental effects and cancer.

Radon gas exposure in individuals' homes.

Air and water pollution on the health of individuals.

Mercury poisoning and exposure to humans though including fish and sea life in their diet.

Lead poisoning from leaded gasoline, paint, and plumbing.

Water-borne diseases

Food poisoning

Indoor air quality

According to recent estimates about 5 to 10% of disease adjusted life years (DALY) lost are due to environmental causes. By far the most important factor is fine particulate matter pollution in urban air.

The fields of microbiology, which studies viruses, bacteria and fungi are not within the scope of environmental medicine, if the spread of infection is directly from human to human. However, infections that are water-borne (e.g. cholera and gastroenteritis caused by norovirus or campylobacteria), or food-borne, are typical concerns of environmental medicine. Its role is preventive as far as possible. Much of epidemiology, which studies patterns of disease and injury, is not within the scope of environmental medicine, but e.g. air pollution epidemiology is a highly active branch of environmental health and environmental medicine. In addition, any disease with a large genetic component usually falls outside the scope of environmental medicine, although in diseases like asthma or allergies both environmental and genetic approaches are needed.

3. Military environmental medicine

The U.S. Army has, since at least 1961, used the term "environmental medicine" in a sense different from the above. Its U.S. Army Research Institute of Environmental Medicine, at Natick, Massachusetts, conducts basic and applied research to determine how exposure to extreme heat, severe cold, high terrestrial altitude, military occupational tasks, physical training, deployment operations, and nutritional factors affect the health and performance of military personnel. Research on the effect of environmental pollutants on military personnel is not part of USARIEM's mission, but is within the purview of the U.S. Army Center for Environmental Health Research at Fort Detrick, Maryland.

4. Environmental disease

environmental medicine military pollution

In epidemiology, environmental diseases are diseases that can be directly attributed to environmental factors (as distinct from genetic factors or infection). Apart from the true monogenic genetic disorders, environmental diseases may determine the development of disease in those genetically predisposed to a particular condition. Stress, physical and mental abuse, diet, exposure to toxins, pathogens, radiation, and chemicals found in almost all personal care products and household cleaners are possible causes of a large segment of non-hereditary disease. If a disease process is concluded to be the result of a combination of genetic and environmental factor influences, its etiological origin can be referred to as having a multifactorial pattern.

There are many different types of environmental disease including:

Lifestyle disease such as cardiovascular disease, diseases caused by substance abuse such as alcoholism, and smoking-related disease

Disease caused by physical factors in the environment, such as skin cancer caused by excessive exposure to ultraviolet radiation in sunlight

Disease caused by exposure to chemicals in the environment such as toxic metals

5. Malaria as an ecological problem

It's easy to just think of malaria as a medical problem. It is caused by single-celled parasites--Plasmodium--that are spread through the bites of other parasites--mosquitoes. To beat the disease, we need to neutralize either Plasmodium or its mosquito carriers, using drugs, insecticides, nets, or even genetically-modified competitors. But malaria is also an ecological problem. Mosquitoes aren't static, unchanging targets. They move around. They mate. They breed in some areas and not in others. Their populations swell and contract throughout the year. They bite at varying times of day. We need to understand these subtle quirks of mosquito life, because they all have a huge impact on our strategies for fighting malaria. Consider the Sahel--a belt of land that stretches across Africa's waist, with the Sahara to the north and savannahs to the south. In this region, half a million people die from malaria every year--which is puzzling. Every year, between December and June, the Sahel goes through an intense dry season. Rain hardly falls. Stagnant pools and puddles, in which mosquitoes lay their eggs, evaporate. The adults ought to die before they can start a new generation. And yet, when the rains return, so do malarial mosquitoes, in huge numbers. How do they survive? Scientists have puzzled over this `dry season paradox' for more than a century. In 5-year study several significant fats have been brought out. In the transmission of the malaria 3 types of Anopheles take part in this area and all of them have different accommodation for “dry” period. The team suspects that A.coluzzi's ability to survive in a dormant state allows it to maintain cycles of malaria transmission that would otherwise break during the dry season. By peaking twice during the drought, it can continuously shuttle Plasmodium between humans at a time when the parasite should face dead-ends. Lehmann's team are now trying to break these cycles by finding A.coluzzi's dry-season hide-outs and blitzing them with insecticides. They are testing this approach in a larger number of villages. “We think we could potentially cut down transmission in those areas by 75 percent or more, and it would be very cost-effective.” His results also have implications for other malaria control strategies. For example, some scientists are trying to develop genetically modified mosquitoes that cannot harbour Plasmodium, and that would outcompete local insects. But if these GM-mozzies cannot last through the dry season, their impact would be short-lived. And if A.gambiae and A.arabiensis return in the wet season, flying in from distant parts of the Sahel, they would reintroduce a fresh pot of parasites every year. “The long-term planning of the battle against malaria cannot ignore these phenomena,” says Lehmann.

Unfortunately, that's exactly what people tend to do. Many historical attempts to control mosquitoes have failed dismally because they were built on shoddy ecological foundations.

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