Introduction toEnvironmental Public Health Tracking
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Running head: ENVIRONMENTAL HEALTH PROBLEMS
ENVIRONMENTAL HEALTH PROBLEMS
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ENVIRONMENTAL HEALTH PROBLEMS
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1ENVIRONMENTAL HEALTH PROBLEMS
Introduction
Meeting present-day needs without undermining the capacity of future generations to
fulfill their own is described as Sustainability. It has three principal pillars: fiscal, ecological
and social. Sustainable development is essential because it saves national budgets, preserves
natural resources, helps fulfills people's needs, helps to coordinate natural resources with
people and for future generations it preserves natural resources (Holden, Linnerud, &
Banister, 2014). Environmental sustainability refers to the work inside the natural resources.
Introduction of pollutants which cause adverse changes in the natural environment is
regarded as pollution. ”. The environmental factors that affect health can be through air,
water, soil and food exposure to dangerous substances, natural disasters as well as technical
ones, change in climate, hazards to the workforce, built climate (Yadav et al., 2015). Noise,
heat or light, may take the form of chemical substances or electricity and can be considered
as pollution. Pollutants or the emission elements, may either be considered as foreign
substances / energies, or pollutants that arise naturally. The World Health Organization, as it
relates to health, describes the environment, as “all the physical, chemical, and biological
factors external to a person, and all the related behaviours”. One out of nine deaths occur due
to air pollution world widely. “WHO estimates that around 7 million people die every year
from exposure to fine particles in polluted air that penetrate deep into the lungs and
cardiovascular system, causing diseases including stroke, heart disease, lung cancer, chronic
obstructive pulmonary diseases and respiratory infections, including pneumonia.” Air
pollution is a combination of airborne small particles and gases. Car pollutants, industrial
chemicals, dust, pollen, and mold spores can be stored as particulate matter. Each year
approximately due to exposure to air pollution, 5000 Australians die. Thousands of people
experience health problems including heart disease, stroke and asthma. Coal-fired power
stations are a significant contributor to Australian air pollution and are the country's main
Introduction
Meeting present-day needs without undermining the capacity of future generations to
fulfill their own is described as Sustainability. It has three principal pillars: fiscal, ecological
and social. Sustainable development is essential because it saves national budgets, preserves
natural resources, helps fulfills people's needs, helps to coordinate natural resources with
people and for future generations it preserves natural resources (Holden, Linnerud, &
Banister, 2014). Environmental sustainability refers to the work inside the natural resources.
Introduction of pollutants which cause adverse changes in the natural environment is
regarded as pollution. ”. The environmental factors that affect health can be through air,
water, soil and food exposure to dangerous substances, natural disasters as well as technical
ones, change in climate, hazards to the workforce, built climate (Yadav et al., 2015). Noise,
heat or light, may take the form of chemical substances or electricity and can be considered
as pollution. Pollutants or the emission elements, may either be considered as foreign
substances / energies, or pollutants that arise naturally. The World Health Organization, as it
relates to health, describes the environment, as “all the physical, chemical, and biological
factors external to a person, and all the related behaviours”. One out of nine deaths occur due
to air pollution world widely. “WHO estimates that around 7 million people die every year
from exposure to fine particles in polluted air that penetrate deep into the lungs and
cardiovascular system, causing diseases including stroke, heart disease, lung cancer, chronic
obstructive pulmonary diseases and respiratory infections, including pneumonia.” Air
pollution is a combination of airborne small particles and gases. Car pollutants, industrial
chemicals, dust, pollen, and mold spores can be stored as particulate matter. Each year
approximately due to exposure to air pollution, 5000 Australians die. Thousands of people
experience health problems including heart disease, stroke and asthma. Coal-fired power
stations are a significant contributor to Australian air pollution and are the country's main
2ENVIRONMENTAL HEALTH PROBLEMS
source of nitrogen oxides (NOx) and sulfur dioxide (SO2)( Chen, Li & Yao, 2018). Canberra,
frequently referred to as Australia's "bush capital," holds the distinction of having the world's
worst air quality (Brown, 2014).
Driving forces- Factors that motivate and move the involved environmental cycle. Urban
and regional air pollution originates from a number of point sources and dispersed sources
(Gentry-Shields & Bartram, 2014). Different sources include pollution from motor vehicles,
home wood heaters, burns for danger mitigation, forest burns, and bushfires. Point sources
include some commercial and manufacturing operations, such as coal-fired power plants,
metal mining, and coal mines. Canberra has remained on the path of smoke coming from
major bushfires on the South Coast for much of the past month. Though westerly winds
appeared to carry cleaner air throughout the day, shore winds prevailed in the evenings,
blowing smoke from the coastal firegrounds west to and over Canberra. Urbanisation with
74% of Australians expected to live in Australia capital cities by 2061.
Electricity generation from coal-fired power plants- The National Pollutant Inventory states
that fine particulate matter, nitrogen oxides, and sulfur dioxide are the primary source of
electricity production. The power industry is the main source of mercury in the atmosphere,
too. Coalfired power plants also release a number of other contaminants including carbon
monoxide, gross particulate matter and volatile organic compounds (Chan et al., 2017).
Motor vehicle emissions- Second-largest national source of nitrogen oxides and carbon
monoxide.
Metal ore and coal mining- These are the top most sources of coarse particulate pollution and
fine particulate matter.
Reducing threat burns and bushfires- The National Pollutant Database lists threat mitigation
burns, farm burn-offs and bushfires as the primary source of carbon monoxide globally and
as the third highest source of nitrogen oxides (Voulgarakis & Field, 2015).
source of nitrogen oxides (NOx) and sulfur dioxide (SO2)( Chen, Li & Yao, 2018). Canberra,
frequently referred to as Australia's "bush capital," holds the distinction of having the world's
worst air quality (Brown, 2014).
Driving forces- Factors that motivate and move the involved environmental cycle. Urban
and regional air pollution originates from a number of point sources and dispersed sources
(Gentry-Shields & Bartram, 2014). Different sources include pollution from motor vehicles,
home wood heaters, burns for danger mitigation, forest burns, and bushfires. Point sources
include some commercial and manufacturing operations, such as coal-fired power plants,
metal mining, and coal mines. Canberra has remained on the path of smoke coming from
major bushfires on the South Coast for much of the past month. Though westerly winds
appeared to carry cleaner air throughout the day, shore winds prevailed in the evenings,
blowing smoke from the coastal firegrounds west to and over Canberra. Urbanisation with
74% of Australians expected to live in Australia capital cities by 2061.
Electricity generation from coal-fired power plants- The National Pollutant Inventory states
that fine particulate matter, nitrogen oxides, and sulfur dioxide are the primary source of
electricity production. The power industry is the main source of mercury in the atmosphere,
too. Coalfired power plants also release a number of other contaminants including carbon
monoxide, gross particulate matter and volatile organic compounds (Chan et al., 2017).
Motor vehicle emissions- Second-largest national source of nitrogen oxides and carbon
monoxide.
Metal ore and coal mining- These are the top most sources of coarse particulate pollution and
fine particulate matter.
Reducing threat burns and bushfires- The National Pollutant Database lists threat mitigation
burns, farm burn-offs and bushfires as the primary source of carbon monoxide globally and
as the third highest source of nitrogen oxides (Voulgarakis & Field, 2015).
3ENVIRONMENTAL HEALTH PROBLEMS
Pressures- Pressures resulting from causes which are normal and human. The residual
impacts of past-intensive pressures such as water diversion and large-scale land clearing are
also being discussed. Increasing population, non-regulated diesel engines, including rail and
non-road transport commercial and other domestic sources, prescribed burning and bushfires
contributes to pressure affecting ambient air quality.
State changes- The environmental condition (quality) can be influenced by the various
pressures exerted. State's indicators: air • Contaminant concentrations (e.g., sulfur dioxide,
nitrogen oxides, particulate matter, ozone, lead) in urban air • In urban air, carbon monoxide
and volatile organic compounds concentration• Amount of hours / days each year when
contaminants surpass requirements • Total suspended particulate matter, PM10/PM2.5/black
smoke exceeding criteria or regulations Presence of substances which deplete ozone in air •
Global greenhouse gas concentrations • Air pollution levels of indoor• Annual number of
serious pollution incidents
Exposures - And if the environmental situation is unreasonably impacted, health and well-
being of individuals may only be affected if they are actually exposed (Boylan et al., 2018).
'Exposure' indicators: Air
• Population living in the vicinity of air pollution sources (traffic, industrial activities) •
Population with increased personal exposure to air contaminants such as particulate matter
having diameter which is less than 10 micrometers • Population proportion subjected to
elevated rates of micro environmental pollutants and time estimates in microenvironments.
Effects – On being exposed to an environmental hazard, the person’s health effects that may
differ in type, intensity and magnitude based on the degree of exposure, the type of danger
and other factors can manifest (Navi, 2018). The adverse effects of environmental exposures
can be acute, arising relatively soon after exposure or may be chronic, resulting from
cumulative exposures over time. Environmental health issue can be listed as:
Pressures- Pressures resulting from causes which are normal and human. The residual
impacts of past-intensive pressures such as water diversion and large-scale land clearing are
also being discussed. Increasing population, non-regulated diesel engines, including rail and
non-road transport commercial and other domestic sources, prescribed burning and bushfires
contributes to pressure affecting ambient air quality.
State changes- The environmental condition (quality) can be influenced by the various
pressures exerted. State's indicators: air • Contaminant concentrations (e.g., sulfur dioxide,
nitrogen oxides, particulate matter, ozone, lead) in urban air • In urban air, carbon monoxide
and volatile organic compounds concentration• Amount of hours / days each year when
contaminants surpass requirements • Total suspended particulate matter, PM10/PM2.5/black
smoke exceeding criteria or regulations Presence of substances which deplete ozone in air •
Global greenhouse gas concentrations • Air pollution levels of indoor• Annual number of
serious pollution incidents
Exposures - And if the environmental situation is unreasonably impacted, health and well-
being of individuals may only be affected if they are actually exposed (Boylan et al., 2018).
'Exposure' indicators: Air
• Population living in the vicinity of air pollution sources (traffic, industrial activities) •
Population with increased personal exposure to air contaminants such as particulate matter
having diameter which is less than 10 micrometers • Population proportion subjected to
elevated rates of micro environmental pollutants and time estimates in microenvironments.
Effects – On being exposed to an environmental hazard, the person’s health effects that may
differ in type, intensity and magnitude based on the degree of exposure, the type of danger
and other factors can manifest (Navi, 2018). The adverse effects of environmental exposures
can be acute, arising relatively soon after exposure or may be chronic, resulting from
cumulative exposures over time. Environmental health issue can be listed as:
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4ENVIRONMENTAL HEALTH PROBLEMS
Amount of foodborne disease outbreaks (e.g., E. coli, listeria, Salmonella) and
waterborne disease (e.g., cholera, giardia, typhoid, shigella)
Work-related mortality and morbidity (e.g. mesothelioma, asbestosis, silicosis, heavy
metal poisoning, fatal and non-fatal injury)
Morbidity and mortality associated with malaria, typhoid, polio, hepatitis A , cholera
and other infectious / parasitic diseases
In young children morbidity and mortality associated with diarrhoea
Morbidity and mortality which is linked with acute respiratory infections / pneumonia
in young children
Asthma-related morbidity and mortality
Mortality and morbidity from chronic respiratory disease
Mortality and morbidity due to:
Allergic diseases, hypersensitivity disorders
Dermatitis, dermatoses
Birth defects
Reproductive consequences
Childhood leukaemia
Malignant melanomas
Developmental defects
Cognitive weaknesses, neurotoxicity
Psychiatric disorders
Action- Specific steps may be taken depending on public health determinants of the health
care. It involves a regulatory reform, improvements in the standardization of environmental
healthcare, assessment of technological controls and extension of health education
Amount of foodborne disease outbreaks (e.g., E. coli, listeria, Salmonella) and
waterborne disease (e.g., cholera, giardia, typhoid, shigella)
Work-related mortality and morbidity (e.g. mesothelioma, asbestosis, silicosis, heavy
metal poisoning, fatal and non-fatal injury)
Morbidity and mortality associated with malaria, typhoid, polio, hepatitis A , cholera
and other infectious / parasitic diseases
In young children morbidity and mortality associated with diarrhoea
Morbidity and mortality which is linked with acute respiratory infections / pneumonia
in young children
Asthma-related morbidity and mortality
Mortality and morbidity from chronic respiratory disease
Mortality and morbidity due to:
Allergic diseases, hypersensitivity disorders
Dermatitis, dermatoses
Birth defects
Reproductive consequences
Childhood leukaemia
Malignant melanomas
Developmental defects
Cognitive weaknesses, neurotoxicity
Psychiatric disorders
Action- Specific steps may be taken depending on public health determinants of the health
care. It involves a regulatory reform, improvements in the standardization of environmental
healthcare, assessment of technological controls and extension of health education
5ENVIRONMENTAL HEALTH PROBLEMS
The conceptual framework for DPSEEA could link adverse effects on human health with
environmental exposure to action, enabling interventions to address either environmental
exposure and adverse health effects or both and their determinants in the cause-effect chain.
Individual monitoring programs and encourage new indicators and programmes and policies
that can be linked with conceptual framework. It is considered in the sense of social
determinants of health (SDH) where the natural environment resides, arguing that widely
used constructs misrepresent their position as an outcome created by the same social
determinants of health. The role of social determinants within the framework centered on
environmental change and the functioning of the ecosystem, noting that widespread use of
frameworks gives causal primacy to these determinants which includes primary health.
Frameworks are widely used to provide simple conceptual representations of dynamic
processes in policy-facing research; like the concepts they embody, they are used to promote
cooperation across disciplinary and policy boundaries.
Dr. Tedros Adhanom Ghebreyesus, General Director of the WHO, during the first WHO
Global Conference on Air Pollution and Health in 2018, called air pollution a "silent public
health emergency" and "the new tobacco". At source air pollution management technologies
have been developed and implemented in all industries and power plants. Strengthening
education, training, public knowledge and public engagement has been identified as related
steps to increase opportunities for achieving the priorities and objectives on the critical
problem of environmental pollution. At this level, international cooperation is crucial for
effective control of pollution in terms of science, production, administration policy,
monitoring and politics. Air pollution law needs to be balanced and revised, and policy
makers should consider developing a powerful environmental and health protection tool
(Epstein & Buhovac, 2014). Resources that can aid in determining health hazards and
environmental impacts associated with exposure to pollutant requirements and even harmful
The conceptual framework for DPSEEA could link adverse effects on human health with
environmental exposure to action, enabling interventions to address either environmental
exposure and adverse health effects or both and their determinants in the cause-effect chain.
Individual monitoring programs and encourage new indicators and programmes and policies
that can be linked with conceptual framework. It is considered in the sense of social
determinants of health (SDH) where the natural environment resides, arguing that widely
used constructs misrepresent their position as an outcome created by the same social
determinants of health. The role of social determinants within the framework centered on
environmental change and the functioning of the ecosystem, noting that widespread use of
frameworks gives causal primacy to these determinants which includes primary health.
Frameworks are widely used to provide simple conceptual representations of dynamic
processes in policy-facing research; like the concepts they embody, they are used to promote
cooperation across disciplinary and policy boundaries.
Dr. Tedros Adhanom Ghebreyesus, General Director of the WHO, during the first WHO
Global Conference on Air Pollution and Health in 2018, called air pollution a "silent public
health emergency" and "the new tobacco". At source air pollution management technologies
have been developed and implemented in all industries and power plants. Strengthening
education, training, public knowledge and public engagement has been identified as related
steps to increase opportunities for achieving the priorities and objectives on the critical
problem of environmental pollution. At this level, international cooperation is crucial for
effective control of pollution in terms of science, production, administration policy,
monitoring and politics. Air pollution law needs to be balanced and revised, and policy
makers should consider developing a powerful environmental and health protection tool
(Epstein & Buhovac, 2014). Resources that can aid in determining health hazards and
environmental impacts associated with exposure to pollutant requirements and even harmful
6ENVIRONMENTAL HEALTH PROBLEMS
air contaminants can be found on the EPA website those are The Environmental Benefits
Mapping and Analysis Software (BenMAP) is a method for calculating health effects and the
economic costs associated with improvements in urban air pollution (Sacks et al., 2018) and
Guidelines for Preparing Economic Analysis provide a sound scientific foundation for
performing economic analysis of regulations and policies on the environment.
Governments at all levels (federal, state and local) have a particular obligation to seek
to establish the conditions under which people can be as safe as possible. To order for
governments to play their position within the public health system, policy makers must
provide the required political and financial resources for strong and efficient public health
agencies to government. The public health mission was described as "accomplishing the
interest of society in ensuring conditions under which people can be safe" (Walter et al.,
2018). The role of government in fulfilling this task was defined in terms of three core
functions of public health practice: health status assessment and health needs assessment,
policy development, and ensuring that essential services are given.
Reduce air pollution by strengthening regulations- The first concern with Australia's air
pollution control systems stems from the lack of implementation of the requirements and
targets outlined in the AAQ NEPM. These requirements are not enforcement criteria but
report expectations and recommendations without penalty if states do not comply with them.
The action that’s needs to be taken are:
Create a National Act to Prevent Air Pollution
Develop a national air pollution exposure reduction framework
Legislation sets mandatory national emission limits
Deploy best practice technologies for reducing emissions at coal-fired power plants
Create a national charge-based licensing scheme with fees entirely accountable for air
pollution externalities
air contaminants can be found on the EPA website those are The Environmental Benefits
Mapping and Analysis Software (BenMAP) is a method for calculating health effects and the
economic costs associated with improvements in urban air pollution (Sacks et al., 2018) and
Guidelines for Preparing Economic Analysis provide a sound scientific foundation for
performing economic analysis of regulations and policies on the environment.
Governments at all levels (federal, state and local) have a particular obligation to seek
to establish the conditions under which people can be as safe as possible. To order for
governments to play their position within the public health system, policy makers must
provide the required political and financial resources for strong and efficient public health
agencies to government. The public health mission was described as "accomplishing the
interest of society in ensuring conditions under which people can be safe" (Walter et al.,
2018). The role of government in fulfilling this task was defined in terms of three core
functions of public health practice: health status assessment and health needs assessment,
policy development, and ensuring that essential services are given.
Reduce air pollution by strengthening regulations- The first concern with Australia's air
pollution control systems stems from the lack of implementation of the requirements and
targets outlined in the AAQ NEPM. These requirements are not enforcement criteria but
report expectations and recommendations without penalty if states do not comply with them.
The action that’s needs to be taken are:
Create a National Act to Prevent Air Pollution
Develop a national air pollution exposure reduction framework
Legislation sets mandatory national emission limits
Deploy best practice technologies for reducing emissions at coal-fired power plants
Create a national charge-based licensing scheme with fees entirely accountable for air
pollution externalities
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7ENVIRONMENTAL HEALTH PROBLEMS
Expand state inspections of industries and raise fines for industries that violate their
conditions of license
Conclusion
This study pays particular attention to DPSEEA framework and facilitate protection from
ecologically based diseases and foster a safe environment. Users of these methods need to
understand the issue and intervention contextual and motivating variables, and re-examine the
reasoning model as new evidence emerges. Together these mechanisms have the ability to
add to our understanding of environmental health issue recognition, validation and
management. The role of the key stakeholders have been established. As Canberra is
identified as the most polluted city there needs to resolve the problem of air pollution and
improve the air quality to prevent chronic disease with the help of government initiative nd
public support.
Expand state inspections of industries and raise fines for industries that violate their
conditions of license
Conclusion
This study pays particular attention to DPSEEA framework and facilitate protection from
ecologically based diseases and foster a safe environment. Users of these methods need to
understand the issue and intervention contextual and motivating variables, and re-examine the
reasoning model as new evidence emerges. Together these mechanisms have the ability to
add to our understanding of environmental health issue recognition, validation and
management. The role of the key stakeholders have been established. As Canberra is
identified as the most polluted city there needs to resolve the problem of air pollution and
improve the air quality to prevent chronic disease with the help of government initiative nd
public support.
8ENVIRONMENTAL HEALTH PROBLEMS
References
Boylan, S., Beyer, K., Schlosberg, D., Mortimer, A., Hime, N., Scalley, B., ... & Capon, A.
(2018). A conceptual framework for climate change, health and wellbeing in NSW,
Australia. Public Health Res Pract, 28(4), e2841826.
Brown, N. (2014). Never Lost for Words: Canberra’s Archives. Public History Review, 21,
81-101. Economic Review, 49, 68-83.
Chan, H. R., Fell, H., Lange, I., & Li, S. (2017). Efficiency and environmental impacts of
electricity restructuring on coal-fired power plants. Journal of Environmental
Economics and Management, 81, 1-18.
Chen, S., Li, Y., & Yao, Q. (2018). The health costs of the industrial leap forward in China:
Evidence from the sulfur dioxide emissions of coal-fired power stations. China
Epstein, M. J., & Buhovac, A. R. (2014). Making sustainability work: Best practices in
managing and measuring corporate social, environmental, and economic impacts.
Berrett-Koehler Publishers.
Gentry-Shields, J., & Bartram, J. (2014). Human health and the water environment: Using the
DPSEEA framework to identify the driving forces of disease. Science of the Total
Environment, 468, 306-314.
Holden, E., Linnerud, K., & Banister, D. (2014). Sustainable development: our common
future revisited. Global environmental change, 26, 130-139.
Navi, M. (2018). Developing health-related climate indicators: a case study of South
Australia (Doctoral dissertation).
Sacks, J. D., Lloyd, J. M., Zhu, Y., Anderton, J., Jang, C. J., Hubbell, B., & Fann, N. (2018).
The Environmental Benefits Mapping and Analysis Program–Community Edition
(BenMAP–CE): A tool to estimate the health and economic benefits of reducing air
pollution. Environmental Modelling & Software, 104, 118-129.
References
Boylan, S., Beyer, K., Schlosberg, D., Mortimer, A., Hime, N., Scalley, B., ... & Capon, A.
(2018). A conceptual framework for climate change, health and wellbeing in NSW,
Australia. Public Health Res Pract, 28(4), e2841826.
Brown, N. (2014). Never Lost for Words: Canberra’s Archives. Public History Review, 21,
81-101. Economic Review, 49, 68-83.
Chan, H. R., Fell, H., Lange, I., & Li, S. (2017). Efficiency and environmental impacts of
electricity restructuring on coal-fired power plants. Journal of Environmental
Economics and Management, 81, 1-18.
Chen, S., Li, Y., & Yao, Q. (2018). The health costs of the industrial leap forward in China:
Evidence from the sulfur dioxide emissions of coal-fired power stations. China
Epstein, M. J., & Buhovac, A. R. (2014). Making sustainability work: Best practices in
managing and measuring corporate social, environmental, and economic impacts.
Berrett-Koehler Publishers.
Gentry-Shields, J., & Bartram, J. (2014). Human health and the water environment: Using the
DPSEEA framework to identify the driving forces of disease. Science of the Total
Environment, 468, 306-314.
Holden, E., Linnerud, K., & Banister, D. (2014). Sustainable development: our common
future revisited. Global environmental change, 26, 130-139.
Navi, M. (2018). Developing health-related climate indicators: a case study of South
Australia (Doctoral dissertation).
Sacks, J. D., Lloyd, J. M., Zhu, Y., Anderton, J., Jang, C. J., Hubbell, B., & Fann, N. (2018).
The Environmental Benefits Mapping and Analysis Program–Community Edition
(BenMAP–CE): A tool to estimate the health and economic benefits of reducing air
pollution. Environmental Modelling & Software, 104, 118-129.
9ENVIRONMENTAL HEALTH PROBLEMS
Voulgarakis, A., & Field, R. D. (2015). Fire influences on atmospheric composition, air
quality and climate. Current Pollution Reports, 1(2), 70-81.
Walter, T., Stevens, P., Verhoeven, A., & Boxall, A. M. (2014). title Impacts of climate
change on public health in Australia: Recommendations for new policies and
practices for adaptation within the public health sector.
Yadav, I. C., Devi, N. L., Syed, J. H., Cheng, Z., Li, J., Zhang, G., & Jones, K. C. (2015).
Current status of persistent organic pesticides residues in air, water, and soil, and their
possible effect on neighboring countries: A comprehensive review of India. Science of
the Total Environment, 511, 123-137.
Voulgarakis, A., & Field, R. D. (2015). Fire influences on atmospheric composition, air
quality and climate. Current Pollution Reports, 1(2), 70-81.
Walter, T., Stevens, P., Verhoeven, A., & Boxall, A. M. (2014). title Impacts of climate
change on public health in Australia: Recommendations for new policies and
practices for adaptation within the public health sector.
Yadav, I. C., Devi, N. L., Syed, J. H., Cheng, Z., Li, J., Zhang, G., & Jones, K. C. (2015).
Current status of persistent organic pesticides residues in air, water, and soil, and their
possible effect on neighboring countries: A comprehensive review of India. Science of
the Total Environment, 511, 123-137.
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