Environmental Epidemiology: Health Risk Assessment of Indian Slums

This report examines environmental epidemiology, specifically focusing on the health risks faced by women and children residing in Indian slums. It investigates the detrimental effects of slum conditions, including water and air pollution, on residents' health, highlighting diseases like cholera, diarrhoea, and respiratory issues. The study employs a health risk assessment methodology, encompassing issue identification, hazard identification, dose-response assessment, exposure assessment, risk characterization, and risk communication strategies. It analyzes pollution sources, identifies vulnerable populations, and proposes interventions, such as improved sanitation and waste management, to mitigate health risks and improve living standards. The report emphasizes the need for collaborative efforts, particularly with governmental agencies like the Gujarat Pollution Control Board, to address environmental hazards and enhance public health outcomes within slum communities.

Running head: ENVIRONMENTAL EPIDEMIOLOGY 1
Environmental Epidemiology
Student’s Name
Institutional Affiliation

ENVIRONMENTAL EPIDEMIOLOGY 2
Introduction
Human beings live in various environments, which also contains a range of living and
non-living organisms. Most of the social problems like diseases, injuries and other issues
arise as a result of interaction between them and other occupants of different ecosystems.
Therefore, to know the extent of harm done to human beings, it is better to undertake
environmental epidemiology. Epidemiology is a line of study which is responsible for the
analysis of the distributions of various health determinants and other conditions leading to
diseases in multiple populations (Mberu, Haregu, Kyobutungi & Ezeh, 2016). The
environmental epidemiology, on the other hand, is a portion of the general epidemiology
whose primary role is to study the impact of environmental exposures on human health.
There exist a range of environmental exposures which affect the health and wellbeing of
human beings, and they include but not limited to pollution, drought and famine, earthquakes
and deforestation.
Research Question
The slum residence in India is a severe issue which has contributed a range of health
issues on both children and women. These women and children are often prone to various
diseases such as cholera which strike as a result of poor hygienic conditions and improper
waste disposal methods and for this reason, their mortality rates are high compared to their
counterparts who live in suitable environments. Various groups, including the Indian
government, have come out to advocate for the improvement of the slum conditions which
would consequently help improve the living standards of the slum residents and avoid cases
of developing more slums. For example, the launching of the Urban Low-Cost Sanitation
whose primary aim was to improve the conditions of latrines and toilets and to provide water
could be of much help to the residents. How then does the Indian slum conditions affect

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women and children compared to those living in decent conditions and what interventions
could be used to improve the requirements of the slum residents to achieve better living
standards?
Background Information
A slum can be described as a primitive or informal settlement in a town or a city
which is characterised by poor housing, substandard waste disposal and lack of sufficient
water supply among other issues that make the lives of the residence uncomfortable. Most of
the slums are found in third world countries whose concentrations are in continental Africa.
Other countries which are not among the third world countries but have slums residence
include India and Nepal, among others. This study relies on the effects of slums conditions on
the populations of Indian women and children. Slums in India are situated in such cities like
Delhi, Mumbai, West Bengal, Tripura, Goa and Punjab among other cities (Lumagbas et al.
2018). The residents of such places experience various health conditions arising from the
filthy nature of a slum.
The research work done by Maharana, Paul, Garg, Dasgupta, Bandyopadhyay (2018)
provides that the health conditions in slums are mostly caused by the range of pollutions in
the slum setting in India. They surveyed the Kolkata Slums of India and came up with
comprehensive data regarding the populations of women and girls who are affected every
year. Some of the form of pollution outlined include indoor air pollution, water pollution and
the general environmental pollution as a result of poor waste disposal. Below are some of the
kinds of pollution and their relationships with the diseases that they cause to the residents.
Water Pollution
Water pollution is the contamination of fresh water. In the slum setting, water is the
element that is mostly polluted. A large number of slum residents use plastics and other items

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whenever they buy stuff. However, due to poor or no methods of disposing of the waste
products, they often opt to dump the used items on both the still and the running waters
(Matawle et al. 2017). The act makes it impossible to get clean and healthy water within their
residence. Other materials dropped in the waters include various chemicals, trash and human
wastes due to lack of sufficient latrines and toilets. With the poor disposal of wastes and the
stagnation of waters, the areas are usually infested by flies and mosquitoes among other
diseases causing organisms. The conditions associated with water pollution in the slums
include cholera, diarrhoea, lead poisoning, dysentery and hepatitis A, among other diseases.
Air Pollution
The activities that contaminate the air including but not limited to the chemicals
which are also known as the volatile organic compounds from food cooked. Garbage is
another element that contributes to air pollution (Arora, Rasania, Bachani, Gandhi &
Chhabra, 2018). They give rise to a bad smell, which causes discomfort in the breathing
systems of the slum residents. At different occasions, there is the release of particulate matter.
The most dangerous problem caused by air pollution is a deteriorated breathing system. Most
of the slum residents suffer from such diseases like asthma, pneumonia and other related
disorders. In other occasions, the pollution leads to the acidification of air that may cause
other critical conditions and which may lead to large percentages of deaths (Verma et al.
2019). Children are mostly helpless and rely on nature and their parents to survive. Therefore,
in the presence of polluted air, they become vulnerable to critical infections as their immunity
are not yet actively developed.
The State of Health Problems in the Indian Slums
Slum life is often characterised by poverty, and in such conditions, the children are
affected more. Due to poverty, most children in India become street children and roam

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around garbage collection daily. The option is a matter of risking life, and thus, they are
affected by diseases arising from poor sanitation. Nijman, (2015) Provide that the highest
fatalities in the Indian slums are caused by air pollution with a population of up to 527 000
people, including men, women and children perishing every year. The researchers calculated
the number and estimated to be six times increment within the last ten years. The statistics
extracted from Van de Vijver et al. (2015) show that up to 1 billion litres of raw sewage are
poorly disposed in the Ganges and it forms part of the reasons which makes India one of the
countries which are highly environmentally polluted.
Due to the poor sewage management in the slum sector, the infection through water-
borne disease has been on the rise and is approximated to affect 5-10 million people every
year (Haque & Singh, 2017). The general slum statistics provides that up to 250 million
people who live in the slum setting have no proper dumping sites for garbage and thus dump
them on the floor. The act has the prevalence of diarrhoea among children, which is
understood to stand at 150, 00 deaths of children per annum. India thus forms the highest
number of children dying under the age of five in the whole world as their statistic stands at
approximately 2 million deaths per year (Naz, Page & Agho, 2016). The figures thus show
the need for research whose aim is to highlight the possible improvements on the status of
slums and the overall living conditions in the slums.
The significance of conducting this Environmental Health Risk Assessment is to
identify the state of pollution effects on the lives of slum residence and give a
recommendation on the relevant organisations that could help improve the living standards of
such people.
Methods of Conducting the Health Risk Assessment
Issue Identification

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Issue identification was the first step, and its primary motive was to come up with
clear information on the drivers of the health risks in the Indian slums. One of the ways used
to gather the data was a physical visit to the slum sites to have a glance at what happens in
such an environment. There were observable features of a slum including the water
deficiency, poor housing and inadequate garbage disposal among other features (Sun, Zhang,
Ma, Chen, & Ju, 2017). People in the setting set up their small business like hotels and
groceries in filthy environments but had a continual flow of customers. The parameters of
businesses, especially those selling foodstuff in polluted environments providing a foundation
for the persistence of the health conditions. However, evidence of Urban Low Cost Sanitation
structures could be seen at intervals to support the fact that the issue is already addressed.
Hazard Identification
Hazard identification looked at the severity and possible reversibility of the health
issues associated with the significant problem identified. The primary concern is the slum
setting, and its characteristics make it difficult for people to survive in right living conditions.
The filthy conditions due to the dumping of both human and environmental wastes into water
bodies, poor garbage disposal and the several forms of pollution all form examples of the
hazards in the slum setting. Some of the dangers have immediate effects like diarrhoea
arising from the consumption of contaminated food and breathing problems and allergies
from unsafe air.
Dose-Response Assessment
Some causative factors get into the residents in high quantities (doses), which makes
them uneasy about containing. Other elements, for example, the chemicals, may be
carcinogenic and once they get into the body, they may cause adverse effects (Buchanan,
Gorris, Hayman, Jackson & Whiting, 2017). The body systems of the residents can be said to

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have improved immunity leading to resistance because they have interacted with various
doses of the causative agents which have made them develop relevant disease fighters.
Therefore, if the treatment is of low quantity, then it will be destroyed by the body system
during high amounts of the dose call for the intervention of hospitals and relevant
government departments.
Exposure Assessment for the Relevant Population
Exposure usually looks at the duration, timing, frequency and the consistency of the
causative agents of health deterioration in the slum setting as highlighted by Wu et al. (2016).
The agents of diseases that the residents are exposed to include Particulate Matter (PM) and
chemicals (which may be carcinogenic) arising from contaminated air. They are also exposed
to bacteria and virus from the contaminated water and inadequate garbage disposal. The
agents of diseases will continue to exist as long as better initiatives to improve slum
conditions are not put in place. Some of the exposure routes within the residential include
inhalation of contaminated air, consumption of filthy food and possible dermal way,
primarily when bacteria infested water is used for bathing and gets open scars.
Risk Characterisation
After analysis, there was a realisation that both water and air pollution are the most
significant causative agents of the health conditions in the Indian slums. The contributing
factors to the two aspects include but not limited to the careless exposure of chemicals,
release of particulate matter into the air and dumping of garbage and other waste products,
including human wastes into both still and running waters (Pauwels et al. 2015). With the
knowledge of ranks of causative factors and the contributing elements of poor health

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conditions in slums, it would be easy to identify and recommend the best ways to deal with
each factor as a single entity until the better conditions are restored.
Risk Communication Strategy
The strategies to use while communicating the risk would be based on three
significant steps of defining the communication challenge, understanding their needs, and
finally connecting with them to showcase the action plan to reduce the risk. Establishing the
communication challenge would help me come up with the most viable audience of the issue
(Tong, Raynor, Blalock & Aslani, 2015). For this case, the Gujarat Pollution Control Board
would be the most preferred agency at the national level. The agency deals with
environmental pollution issues and can help address them to the government to win support
that would ensure the slum conditions in most of the cities are improved. Improving the lives
of the people in a slum setting and transforming the features of a slum remains to be a
significant issue that needs to be discussed with a series of stakeholders from the board
above. However, an unwavering trust must be developed on who would be genuine to spark
the deal (Gupta & Guin, 2015). After all the plans have been made, the public shall be
addressed through the media to get information on how the improvements should be made.
The communication would help them plan themselves in case there is a need for evacuation.
Conclusion
Financial status is known to be the determinant of residential places. Those who are
considered to be inferior always occupy the primitive conditions where they encounter
adverse conditions of health. Poor people in the cities of India including Mumbai, Kerala and
Punjab among others are found at the slum settings. They are exposed to various health
problems arising from the pollution of water, air and the general environment, and this has
increased the mortality rates in such places. Women and children are the most affected as

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they mostly remain indoors as the men go out in search of livelihood. Based on the findings
of this study, I would recommend that the government and other related organisations, both
national and international, to team up together and allocate some funds which could be used
to improve housing and sanitation in the slum areas. The move would help reduce the
prevalence of water and air-borne diseases, thus increasing the life expectancy in such areas.
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