Environment and Occupational Health in Bangladesh: WHO

Introduction:

WHO’s program for environment and occupational health aims at building capacity of relevant government organizations to reduce environmental health risks through research, policy advice, and awareness raising activities. Under this programme technical and policy supports are being provided to the major component of environment which are key determinants of health: Indoor Air Pollution, Occupational Health and Arsenicosis.

Country situation:

Occupational Health:

Generally, major thrust in industry sector is given on higher production and greater economic returns. Entrepreneurs often consider the regulatory compliances and related administrative costs as a deterrent to productivity. As such occupational health & safety considerations remains ignored.

Poor level understanding and even ignorance exists among the stake holders particularly among the employers and public agencies related to ensure Occupational Health and Safety.

Training and awareness programs are as such necessary focusing personnel like physicians, welfare officers, safety officers, inspectors, administrators, managers.

Arsenicosis:

Arsenic is ingested in human body mainly through drinking of contaminated ground water. High concentration of arsenic was first detected in shallow tube well of Chomogram Village of Chapainowabgonj district. Consequently 8 arsenicosis patients were identified by the fact findings group of the department of OEH, NIPSOM in 1994.

A comprehensive medical case definition has been agreed for arsenicosis that enables accurate detection of patients. Health personnel have been trained to better handle illness caused by arsenic. Considerable research has been undertaken to better understand the health impact of arsenic exposure and to try to develop an effective treatment protocol. Knowledge and understanding of arsenic health risk improved from applied research studies in Bangladesh. For long term knowledge development and impact it is felt that arsenic should be incorporated in medical curriculum. Forty percent (40%) of 20 million affected people have gained access to safe water source. Rural people are aware of complications resulted from Arsenicosis

Indoor Air Pollution:

Almost 92% of Bangladeshi population use biomass fuel for cooking. Women and children are exposed to high levels of IAP and contribute substantially to under-five mortality due to Acute Lower Respiratory Infection and Chronic Obstructive Pulmonary Disease death in women. Recent WHO estimates indicate that more than 32,000 ALRI deaths in children under-five and nearly 14,000 COPD deaths are attributable to solid fuel use. In Bangladesh total disease burden due to IAP is estimated to be 3.6%

Switching from smoke producing solid fuel to cleaner energy source should be ideal. This may not be possible in the context of present economic condition of majority of households. However, well designed improved stoves can be promoted which are able to reduce pollution between 50-90% increased level of combustion. Further, use of improved stoves can reduce the time spent by women for collecting fuel that is associated to alleviating drudgery and reducing vulnerability of achieving to MDG3. In fact addressing IAP can make a positive contribution to achieving most of the Millenniums Development Goals (MDG).

WHO Contribution:

Ø      WHO has provided technical support for developing a TOT manual along with simplified Bangla version on Indoor Air Pollution (IAP). A pool of trainers has been developed to build capacity of community towards reducing the harmful effect of IAP.

Ø      National framework on health impact of IAP was developed and supported research on health effect of biomass fuel combustion on women and children.

Ø      A national strategy for health and safety has been developed in English and Bangla.

Ø      Draft profile of construction sectors on safety and health was produced. A base data on prevalence of occupational injuries in the country has been developed.

Ø      A considerable number of health personnel have been trained to better handle illness caused by arsenic.

WHO Current collaboration:

The WHO Bangladesh provided technical assistance for developing a compendium of recent research studies on occupational health in Bangladesh. It also supported studies on workplace injuries at two tertiary level hospitals and a pilot epidemiological study on prevalence of occupational injury in Bangladesh. There are provision in the current biennium workplan to provide necessary support for developing education and training materials for health professional, and workers.

WHO has identified a few areas to research on Arsenic epidemiology; Multi-center multi-drug trial; Arsenic in food stuffs.  Follow up of the first identified arsenicosis cases as undertaken in the current work plan might yield valuable information regarding present status of those patients. Assessment of drinking water source and health status of the people of that village might be also informative for researcher.

Source: WHO – Country Office for Bangladesh. 7 September 2010

http://www.whoban.org/en/Section3/Section40/Section60.htm