Concepts of Environmental Health

This article discusses the concepts of environmental health in the context of mass gatherings. It explores the principles of prevention, precaution, participation, sustainability, equity, proportionate regulation, partnership, and population focus. It also highlights the importance of mass gatherings in enhancing public health systems. The article further discusses environmental health issues such as food poisoning, Legionella, environmental risks, and vaccine-preventable diseases, and provides strategies to curb them. Additionally, it emphasizes the role of stakeholders and risk management in ensuring the success of mass gatherings.

Running Head: CONCEPTS OF ENVIRONMENTAL HEALTH 1
Concepts of Environmental Health
Student’s Name
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CONCEPTS OF ENVIRONMENTAL HEALTH 2
Introduction
A mass gathering is defined as a function at a specified place with a minimum of one thousand
people or more. This brings about the pressure to the response resources and planning of the
event to the hosting nation, state or local community. Mass gathering functions such as events
scheduled at sports air shows, outdoor celebrations, facilities, dignitary visits and rock concerts
are distinct in their demands and technicalities (Memish, et al., 2019). The complexity not only
lie with the provision of medical services but also plans for emergencies for any kinds of
probable environmental health and weather hazards. This paper outlines the important
observations acquired by the Health Protection Agency in the United Kingdom in providing and
planning for public health aids in 2012 for London (Todkill, et al., 2016). This paper integrates
the mass gathering during the 2012 Olympics and also describes the necessary processes that led
to the effective management of the systems. Better surveillance systems were used to make sure
that the stakeholders concerned with the public health were aware of everything that occurred
during the 2012 summer (Kenyon & Bodet, 2018).
Environmental Health Principles
The following are some of the principles:
 Prevention principle: administrative actions and decisions were made after putting into
consideration the ways in which risks to public health were to be avoided and prevented.
 Precautionary principle: this principle required the regulators to promote safety and
not to be sorry.

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 Participation principle: communities and persons were encouraged to be responsible for
their own health. The public was called upon to engage in decisions that promoted and
protected public health and individual health.
 Principle of sustainability: environmental, health, economic, social and public health
aspects were put into consideration before making decisions with the aim of enhancing
and maintaining the well-being of the public (Kromidha, Spence, Anastasiadis, & Dore,
2019). The interests of generations to come were also considered.
 Principle of equity: actions and decisions made were practicable and reasonable. They
were not unfair or unduly as to oppress the public and individuals.
 Principle of proportionate regulation: measures were put into consideration to a degree
that was appropriate in order to reduce huge effects on the members of the public and on
business.
 Partnership principle: the promotion and protection of the community health demanded
collaboration and joint responsibility across numerous levels and sectors of the public and
government.
 Principle of population focus: administrative responsibilities and decisions focused on
the population's health and required actions of enhancing and promoting the public
health. By putting this into consideration, public health was promoted and protected.
Importance of mass gatherings
Every system of national public health and every mass gatherings were individual and distinct.
The sustainability and health legacy of the public concerns were put into account as the first
priority in every planning aspects. There are long-term gains in the country and the public health
systems can benefit from the mass gatherings (Kenyon & Bodet, 2018).

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Working closely with various stakeholders during the processes of planning contributed to the
increase in the understanding and profile of public health, more specifically, government sectors.
This promoted strong collaborations and coordination with partner entities all over the health
sector. Legacy was achieved through the created and enhanced correlations. For instance, in the
year 2012 in London, groups were created incorporating all major stakeholders that improved the
forecast of the quality of air. The groups also created smartphone applications that offered long-
lasting legacy and enhanced access to air quality data by the public (Bretherton, Piggin, & Bodet,
2016).
Mass gatherings were suitable drivers in enhancing processes and systems. A number of
processes and systems that were improved established for the purposes of Games in 2012 were
further developed and maintained. Today, the United Kingdom enjoys maximum resilience
through enhanced analysis systems, reporting, processes and information. The United Kingdom
also enjoys the capability to quickly move to daily reporting from weekly reporting in case of an
important occurrence. Additionally, there exist wider cadres of experienced employees to
manage responses in case of an event as well as the broader body of trained staffs to handle
emergency responses (Bistaraki, McKeown, & Kyratsis, 2019).
Environmental Health Issues associated with the topic
1. Food poisoning
Water and food-borne illnesses occurred during the mass gathering due to their regular
occurrence in all nations regardless of hosting functions as observed by the World Health
Organization in 2015. The first priority of public health is to minimize the risks of water and
foodborne diseases through preventive mechanisms during mass gatherings (Yezli, et al., 2018).

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Curbing Food Poisoning
Most mass gatherings are supposed to be having surveillance systems that are made to sniff out
infectious diseases, for example, foodborne illnesses. These surveillance systems will include;
laboratory reporting and clinical reporting. Additionally, mass gathering s could use the
syndromic surveillance in press reports, social media and self-reporting (Bistaraki, McKeown, &
Kyratsis, 2019).
Mass gatherings should set up ranges of outbreak plans for responding. They can employ the
daily used outbreak response strategies. In this point of view, the response planning structure in
mass gatherings will involve using well tested and tried systems as well as plans as opposed to
inventing new plans targeting the events. On the other hand, there has to be validation against the
required additions as seemed fit to the gatherings. In particular, the expected response speed as
well as the extra challenges in media relations and communications (Nsoesie, et al., 2015).
2. Legionella
Legionnaires’ disease has sporadic cases that routinely occur in numerous areas in the world.
Similar to illnesses that spread via food, there is a possibility that such cases will present
themselves in mass gatherings as observed and stated in 2015 WHO report.
Curbing Legionella
Standard systems used in surveillance should detect potential cases or outbreaks of this disease.
On the other hand, coordination existing between the concerned individuals and the public health
involved in sampling and monitoring supplies of water in mass gatherings should be flagging
cases. Contamination incidences of Legionella that can trigger disastrous incidences should be
flagged (Fleischauer & Gaines, 2017).

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Standard response plans for in outbreaks for legionnaires cases need to be in places even before
the mass gathering. Any case that arises with a possible link to mass gathering events has to be
added to investigation fast. Also, the case should be maintained at a lower threshold if not
normal. Getting arrangements in place for possible instances of escalating investigations as
possible health cases. These formations of escalations make it possible for laboratory testing and
epidemiological information to be coordinated and obtained rapidly (Santomier, Hogan, & Kunz,
2016).
3. Environmental risks and Air Quality
Extreme or unusual conditions in the environment, for example, cold or hot weather, poor quality
of air or flooding can have impacts on how mass gatherings are run as well as the participants in
the health sector. Looking at the hosted 2012 Olympic Games, poor quality of air is able to have
an effect on the performances of athletes. Ozone events in the atmosphere are other factors to
consider since it has been linked with asthmatic attacks on performing athletes. Therefore, health
responders should be looking into possible means of assessing or identifying any such attacks as
stated in the WHO conference in 2018.
Curbing Environmental Risks and Air Quality
In mass gatherings, the planning window should be used by the organizing committee as well as
public health assistants to consider the possible ways of accessing information used in
monitoring, plume modelling and meteorological information for instances that air might be
polluted. Additionally, the central coordinating centre needs to be able to reach for information
present in the national and local meteorological sites. The local public teams concerned with

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health should be monitoring the health impacts from the events harsh weather (Boggia, Massei,
Paolotti, Rocchi, & Schiavi, 2018).
There has to be an analysis that is working on the possible effects of any adverse weather
conditions. Data can be gotten from other experienced countries which could be ready to provide
access. Experienced countries already have pre-prepared ideas for dealing with relevant cases in
mass gatherings (Boggia, Massei, Paolotti, Rocchi, & Schiavi, 2018). They also can device
dissemination routes regarding large gatherings.
4. Vaccine Prevented Diseases
There are risks of infection of individuals who come inform numerous countries to disease best
prevented by diseases. However, the susceptibility varies hugely as seen in the 2015 WHO
report. This can be used in developing possibilities that international travelling for mass
gatherings may lead to exportation or importation of diseases preventable through vaccines.
Curbing Vaccine Prevented Diseases
There can be a reduction in risk through the provision of vaccination before the beginning of
travels for mass gatherings. Generally, the countries having their citizens travel or the host
country has to update their vaccination program to be useful for the event (Bistaraki, McKeown,
& Kyratsis, 2019).
Host countries in need to identify whether there is VPS prevalence in the event or in the
countries that are taking part in the gathering. This aims to look for instances or windows that
could lead to a spread of diseases.
Relevant professionals and environmental health roles

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1. Working and planning with stakeholders and partners
The duration and intensity of international mass gatherings such as the Paralympic and the
Olympic Games that tag along with issues regarding public health mean that there is importance
in having coordinated strategic approaches in delivery and planning. Those running and hosting
mass gatherings are forced to work with and involve numerous stakeholders as described in the
2007 National Health Security Act. The public health is required in this coordination right from
the beginning of planning to help in understanding and recognizing the preparedness need as
well as develop effective responding moves to occurred incidences (Santomier, Hogan, & Kunz,
2016). The coordination of these bodies should begin right from the initial bid and goes on to the
operations, planning, and evaluation, and lastly the development of legacies through mass
gatherings. Historically, public health members have not been involved in the top table seats
during mass gatherings’ planning (Parnell, Cope, Bailey, & Widdop, 2017). On the other hand,
the 2012 Paralympics and Olympics managed to involve the public health body, recognizing it
and integrating it into the process early in the stages (Kim, Jun, Walker, & Drane, 2015).

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The figure above shows the various bodies that can work together in mass gatherings
(Fleischauer & Gaines, 2017).
When various organizations are set to work together, for example, the World Health
Organization, it is crucial that there is an established link with other organizations. The WHO
organisation could link with the Federation Internationale de Football Association or the
International Olympic Committee. These actions ensure there is a raised known main
importance, the public's health, other than the organisations bidding to be well known across the
world for their organization's strategies (Grabher & Thiel, 2015). Health planning, therefore,
becomes a complex process with every inclusion of organisations since all the organisations are
supposed to provide suggestions regarding the public’s medical and safety measures.
2. Risk management
There is a target, to manage risk, through assessment and its identification before responding to
every risk. The assessment of risk has to be done for a likelihood combined instances for various

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things to occur and their impacts that arise if any risk is identified. The planning process should
first begin with the identification of important risks to the public’s health during events as well as
any concerns or gaps related before going into their assessments (Kromidha, Spence,
Anastasiadis, & Dore, 2019). The 2007 National Health Act identifies that every mass gathering
could be different whereas every gathering imposes risks required to be addressed. The
gatherings’ locations, nature of events, in-country and visitor demographics and external factors
make every gathering unique. Also, the importance lies in the review of previous experiences in
case hosted gatherings are similar. Additionally, public risks in health can be changed by mass
gatherings (Brown, Essex, Assaker, & Smith, 2017).
The processes in risk management are supposed to be planned in the early stages and go on being
monitored in every on-going process development. This provides frameworks good for facility
and resource allocating, emergency planning responses, the take of preventive actions as well as
legacy planning (Kim, Jun, Walker, & Drane, 2015). Looking at the previous health assessments
done in regards to the 2012 Games, the findings in this event were used as driving points for
three running years to be able to address the risks and gaps. This risk assessment performed in
the event was made up of the following four questions:
 What are the various risks in health that may be absorbed into the host country during the
gatherings?
 What were the possible risks in health that the host country would take in?
 What might be the exported health risks from the country hosting the event to other
involved countries?
 Does terrorism instances include in the risk possibilities?

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Risks could be made of associated vectors and imported infections, vaccination levels against
diseases and weather conditions. Every factor on risk should be considered during the planning
stage to reduce impacts. For example, visitors may be advised on vaccination importance, there
may be an increased level of reporting and surveillance and there is a consideration of the
existing cold or hot weather plans.
3. Prioritizing Risk
Successful risk identification encourages prioritisation by planners picking from risk assessment.
In doing this, the different identified risks may be treated as functions in their likelihood of
occurrence together with their impacts that arise once either of the risks occurs (Smith, et al.,
2016). The 2011 South Australian Public Health Act, Sec 6 well expresses this prioritization
technique as seen below:
 Assessment of impacts is bets based on the public health’s state in host countries,
experience, surveillance data, expert judgment and literature.
 Risk likelihood occurrence is determined by the mass gathering’s context whereby the
venues, immunities of attendees and environmental risks are included.
All the processes mentioned above could be achieved through risk categorisation. He used
categories are medium, high and low-risk possibilities in accordance with the every risks
sufficiency and minimum levels of categorizing the risks (Kenyon & Bodet, 2018). Hence, a 3 by
3 matrix is used.
All the public health risk assessments should be used in covering public’s health together with
other systems which could be affecting the conductance of events. The Olympic Games’ initial
assessment was working in tandem with different work streams other than being linked with

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various organizers, partners, governments, intelligent services and security. As important as
predicting risks, another importance lies with planners’ ability to ensure there are strong health
systems that are capable of coping with risks previously not anticipated. The 2008 Public Health
and Wellbeing Act identifies the need for such systems (Zaidi & Pelling, 2015).
During an event, developing a system that works with a risk assessment through cases improves
categorical analyses whenever potential health factors are detected. In the 2012 Games, this
technique was used in identifying possible risks to Games with occurring incidences (Zaidi &
Pelling, 2015). None, of the significant risk, occurred. For example, chicken pox in ship Games
drivers was taken to be below public health risks.
4. Control, communication and command
One challenging aspect in mass gathering planning is the importance of having a unified control,
communication and command between the involved stakeholders in delivering the events. It is a
complex procedure since there often are overlapping responsibilities for the various subnational
and national government levels who may not be opting to work together. The bodies also may be
new to the running of such events and inexperienced. An effective mechanism use of C3
provides insurance that every involved stakeholder understands the allocated objectives the
arrangement should be put in place to provide good information by agreeing to avail reports and
manage arising situations (Yezli, et al., 2018).
5. Ensuring resilience.
One big benefit that planned mass gathering brings is the ability to manage gatherings as events
rather than as emergencies. Looking at the 2012 games, a series of games were developed across
the agencies and planned to give an entertaining event. Though the number of games was huge,

CONCEPTS OF ENVIRONMENTAL HEALTH 13
the organizations seamlessly arranged them. Therefore, mass gathering as seen in the 2012
Olympic games should be taken or conducted as emergencies. Whether the gathering relates to
games or not, the methods of escalating or invoking safety remain the same (Boggia, Massei,
Paolotti, Rocchi, & Schiavi, 2018).
One more importance lies in the existence of the capacity and resilience in responding to major
or emergency public health incidences in mass gatherings. What this entails is the provision of
enough resources for continuing to deliver steady running mass gatherings (Bretherton, Piggin,
& Bodet, 2016). The response to an incident in such mass gatherings is mentioned under the
2008 Public health and Wellbeing Act.
In the occurrence of a big incident relating to mass gatherings, stakeholders who are most
familiar with such incidences should lead since they would have already developed their working
relationship, established trust and gathered enough knowledge to run emergencies. Therefore,
another team should be present to run the crucial matters as seen in the 2012 Olympic Games
where senior staff ensure resilient management of the 2012 games to the end (Kromidha, Spence,
Anastasiadis, & Dore, 2019).
6. Establishing a Concept of Operation
Concepts of Operations are important documents for panning C3 arrangements for both
stakeholders and internally situated partners.

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The figure above shows the 2012 Olympic ConOps (Fleischauer & Gaines, 2017).
These service delivery models as the one shown above are able to define and ensure agreement
by stakeholders on the required service for running public health services in events. The
components in the ConOps should be able to link with one another in the process of working
with stakeholder organizations who are important to running mass gatherings. The stakeholders
and partners are bound in this working document as they meet their deadlines and operational
commitments (Brown, Essex, Assaker, & Smith, 2017).
7. Choosing an Operations centre
Developing one major centre for conducting operations in mass gatherings is invaluable. The
staffing and logistics put in one place increased speed, effectiveness and efficiency in handling

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issues. Additionally, the central facility can be run 24/7 through establishing shift rotations
management strategy. Hence, mass gathering can be monitored continuously for any developing
case. The 2012 Games used modern technology such as smartphones, tablets and computers with
cloud storage to ensure flexibility and robustness in its staffing operations (Boggia, Massei,
Paolotti, Rocchi, & Schiavi, 2018).
Conclusion
Extensive work with stakeholders and background provision of information in the state of a mass
gathering is important just as it was in the 2012 Olympic Games. Building normal practice for
running mass gatherings rather than running similar gatherings as emergency ensures resilience
and increases the host country's level of confidence. Therefore, ass gatherings could be business
as usual due to planned roles, exercises and responsibilities for the partners and stakeholders
involved (Santomier, Hogan, & Kunz, 2016).
Looking at the 2012 London Paralympic and Olympic games, health impacts in similar extreme
gatherings should first be envisioned before undertaking the following procedures for successful
operation:
 Evaluation and testing of used systems.
 Developing surveillance plans.
 Conducting risk assessments for pritisation purposes.
 Determining resources available and those required.
 Identifying and training stakeholders.

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