RF_E_12_SUDHA.pdf
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Dear Mahalakshmi,
This has reference to the discussions I had with you requiring your
help in organizing a meeting on Airpollution and asthama. Enclosed is
a draft received from Sagar Dhara. Pl take action to send notice to
invite people for a preliminary meeting on the 26th. You can either
develop a letter head using the logos sent by Sagara. Ensure that the
letter includes KSPCB.
Any question you can call Sagar.
Thanks
Sharatchandra
Begin forwarded message:
22 Oct 2007
Dear...
1 wish to invite you or a representative from your organization for a meeting at 3 pm on Friday, 26th
Oct at
to discuss and plan for a forthcoming workshop on air pollution and environmental
health—children’s asthma. The workshop will be held on 22-23rd Jan 2008 in Bangalooru with 100125 invited participants. The draft announcement of the workshop is attached.
The workshop will be different from other workshops as it will not only explore the subject through
presentations made by people with experience in the fields of air pollution management, health care
and community interventions, but will provide more than half the workshop time for breakout
sessions which will allow the workshop participants to work out intervention plans to mitigate air
pollution, improve health care for air pollution related health effects and do community interventions
to help communities to mitigate they risk they face.
The meeting agenda will be:
1.
2.
3.
4.
5.
6.
7.
8.
Workshop dates
Workshop venue
Workshop flyer
Steering Committee formation
Workshop methodology
Workshop agenda (draft)
Workshop speakers (suggestions)
Workshop participants (suggestions)
As previous experience in running such workshops exists, many of the agenda items can be covered
quite quickly. The Mumbai workshop report and other material will be distributed at the meeting.
Thanks in advance for your time.
Sincerely,
Workshop on air pollution and environmental health—children’s asthma
Bangalooru, 22-23 January 2008
Air pollution and its related impacts on human health has become visibly severe. Over 300 million people
suffer from asthma worldwide (WHO), and the number is rising. The human and economic burden associated
with asthma surpasses that of HIV/AIDS and tuberculosis combined. In India, air pollution is estimated to
cause, at the very minimum, 100,000 excess deaths and 25 million excesses illnesses per year.
To mitigate this impact quickly, air pollution control and health care interventions must be supplemented with
an effective community-based intervention programme aimed at involving risk bearers participating in
solving their problems. This workshop will allow its participants to make air pollution control, health care
and community intervention plans for Bangalore; and encourage government, professional and civil society
organizations, and individuals to commit to taking specific responsibility to implement the intervention plans.
It is hoped that a committee will be formed to iollowup on the workshop’s recommendations. Childhood
asthma is a good indicator of the prevailing problem, hence has been chosen as the focal theme. The first
workshop of this kind was conducted successfully with 80 Indian and foreign participants in Mumbai in June
2005. More such workshops are planned for other cities later.
The workshop will discuss:
•
•
•
•
A ir pollution and health effects and estimation of air pollution-related injury
Air pollution management interventions to reduce air pollution exposures
Health care interventions to mitigate asthma
Community interventions to help people mitigate air pollution-related health risks
The workshop will attempt to produce an action plan to:
•
•
•
•
•
•
•
Improve understanding of asthma and its relationship to air pollution
Train asthma patients and communities to recognize air pollution related health effects and
improve asthma management
Improve management of air pollution and its related health effects
Develop approaches to help minimize exposure to air pollution
Encourage coalition building between affected communities and those working on issues
related to air pollution control and its health effects
Create partnerships between government agencies and community-based organizations
Encourage participants and other agencies to commit to taking specific responsibilities to
implement the workshop's recommendations
Participants: Asthma patients and networks, community health workers, professionals—
government and non-government—working in the fields of air pollution control, environmental
health, and communicators
Organizer: Cerana Foundation, D-101 I lighrise Apts, Lower Tank Bund Rd, Hyderabad 500
080. Telefax: 40 2753 6128. Email: eranafdn@rediffmaiLcom
Sponsors: UNEP, Karnataka State Pollution Control Board,
Registration request form
Instructions for registration request: This workshop requires no registration fee. If you are interested in
participating in the workshop, please fill the form below and email to ceranafdn@rediffmail.com (give the
attachment file your last name, eg, if your last name is Gupta, your registration request form sent as an
attachment file should be given the name gupta.doc or gupta.txt), or mail a hardcopy to Cerana Foundation,
D-101 Highrise Apts, Lower Tank Bund Rd, Hyderabad AP 500 080. Please send your form early, but no
later than to reach us by 15 Dec 2007. Only registered participants may attend the workshop. If your
arrival and departure information is not known now, please send it to us immediately after receiving our
acceptance of your registration request, which we will do by 10 Jan 2008.
Name: Mr/Ms/Dr*
Organization:
Mailing address:
Tel No:
Fax No:
Email:
Discipline: Environmental science/engineering/ Health/Law/ Community organizer/ Media/ Other*
(please specify)
Specialization (eg, air pollution monitoring, pulmonologist, environmental law, etc):
Are you interested in joining a tour of “high pollution & asthma prevalence” areas on 24th
Jan? Y/N*
If you are not a Bangalooru resident, please provide information regarding your arrival and
departure
Arrival mode: Air/ Train/ Bus*. Arr dl:
June. Expected arr time:
Arriving from:
FIt/Train name & #:
Arriving airport/ station/ bus stand:
Departure mode: Air/ Train/ Bus*. Dep dt:
Departing to:
June.
Expected dep time:
Fl (/Train name & #:
Departing airport/ station/ bus stand:
Will you participate on both days or one day only*. If for one day, will it be 22nd or 23rd*.
Do you have any special diet restrictions?
* Please strike off what is not relevant
/^< 3
Annexure : 1
1st List of Participants for the workshop.
Possible participants are listed below.
Please do add on more names, insert suggestions, remarks for them.
Any additional information, like people whom you know personally who can be included esp
the steering committee are welcome.
Medical Fraternity:
• Community Health Cell (CHC) , Bangalore, Contact
Thelma
:9341257911/080-25533(!6 | (Res)
Society For Community Health Awareness, Research and Action,
(SOCHARA)/ Communii. 1 lealth Cell,
367, Srinivasa Nilaya, Jakkasandra, 1st main, 1st Block, Koramangala,
Bangalore. Telephone- 91-80-255315, Email: sochara@vsnl.com
Website: www.sochara.oro
UNION’s:/ASSOCIATIONS
• Government Workers Union : Contact: Mohan Mani
• Trade union’s Bangalore 1 Used
• Auto Rickshaw Union’s
• Petrol Bunk workers’ union, organisation
• Indian Medical Association: Bangalore Chapter
• Karnataka Association for Community Health: Dr Girish
• National Institute for O cupational Health (NIOH) : Bangalore regional
office: Dr Rajmohan
• Stone crushers /Quarry \\ ( >rkers union
IAP
.
NGO’s
• Public Affairs Centre shecF
• CHC: Society For ( uni in unity Health Awareness, Research and
Action, (SOCHARA)
Community Health Cell,
367, Srinivasa Nilaya, Jal.'.usandra, lsl main, 1st Block, Koramangala,
Bangalore. Telephone- 91 '0-255315 Email: sochara@vsnl.com
Website: www.sochara.oi
Civic (Vinay Baindnur) /. mil ra
FEDINA No. 154, An icya Temple Street Domlur Village,
Bangalore 560 071 In. ... Contact: Duarte Barreto
Quarry Workers
Rural Integrated Development Society (
Nr. 63. Little Rose Villa, K.S.F.C. Layout,
Q.W.R.I.D.S.)
Road,
St.Thomas
Town
Post,
Oil
Mill
Bangalore - 56008 !.
•
MYRADA, No 2, Service Road, Domlur Layout, Bangalore - 560
071 Email: myradj vsnl.com Ph: 91-80-25353166
•
•
•
•
•
Maya
Saathi
Jana Sahayog Rajendran: water pollution study
Rajiv Gandhi
Indira Gandhi Institute f< ■: Child Health : Dr Asha Benakappa,
•
•
•
•
•
Child Right’s Trust
Alternative Law Forum
Jana Jagriti Samiti, Nandikur
7)
Cooligarige Nivarane Sa r ha :Contact: madhusudan/kknns/ pakriswamy
NGO’s like QWRIDS, w king with quarry workers and their welfare
CMC A : Children’s M( •n.jnt for Civic Awareness (CMCA) joint
\ eminent organizations (NGOs) - Public
initiative of the two non
Affairs Centre (PAC) & . wabhimana. CMCA is a commitment to nurture
and foster active citizen^ p in children. Launched in 14 schools of
Bangalore as a small ini live in the year 2000, to foster civic and
environmental consciou jss among children, CMC A has instituted Civic
Clubs in over 180 schoi m Bangalore, Hubli Dharwad, Mumbai and
i . \ M ain, Koramangala 4th block, Bangalore Bidar. #346, 3rd Cross.
..5
S4; Telefax: +91 -80-41105161
560 034. Ph: +91-80-25
Email cmcaexpressionsG ■ihoo.co.in
Copyright © Children's ' vemcnt for Civic Awareness
•
Janagraha : 198, Nancf
Bangalore - 5600
janaagraha@vsnl.com
g Load (near the AIRTEL Office), Jayamahal,
Piione:
3330668, 3542381/82.
E-mail:
•
Traffic police Welfare G i
ps.
Social Scientists :
scientist/bhoomi egovci
I
in st of information
Government
•
Arvind Jahnu Secretary, Do!
•
•
Corporation
BBMP
R.iinataka
tech
:
v
balaji social
0 77^
•
•
Planning organisation
Traffic Department
Delhi Based/All India
• Indian Association for Air Pollution ControL, Delhi, (Sagar will initiate the
invite)
• MoEF
• CPCB, Sengupta in Delhi will be informed, Shukla from Bangalore office to
be invited, Balaji in Bang.d . c office is interested in joining the workshop.
Hospitals:
• Manipal Group of Hospital
Department of Respiratory Med'
spirometry and other facilities f
Contacts: Dr Isaac Mathew/Dr .
more information:
Ruchi Vishwanath / Bhuvaneslr.
Good Relations India Pvt Ltd.
nc at Manipal Hospital is equipped with
the diagnosis and management of asthma.
Ima Sundaramm
tri Krishnamoorthi
Mob: 99804 22440 / 99808 101 ’
•
•
•
•
•
•
•
Bangalore Children’s Hospii .
Narayana Hrudayala
Hosmat
Dr Prema
Dr Omprakash
Dr Parameshwar : Mob:9845
St John’s : George jj’souza/
26S9
Press:
Magazines:
Sahana charan hindu:
ROHC:Dr Rajmohan Air Pollution 11 lie
NIAS: sociologist/
gen raghunath dorabji tata institute- r rrobiologist/Max Martin (India Today)
CSE,
Papers: Deccan Herald, The times of idia, Asian Age,
Kannada: Kannada Prabha, Prajavai
\ cningers,
Ammu Joseph
Sideshows :
Vinod Eshwar : Trees poster presentation
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Page 1 of2
Community Health cell
From:
Sagar Dhara [sagdhara@gmail.com]
Sent:
Sunday, November 11, 2007 9:21 PM
To:
Thelma Narain; Thelma Narain; Ravi Marian; Premdas
Cc:
Mahalakshmi Parthasarathy
Subject: Fwd: Asthma workshop meeting, 19th Nov
12 Nov 2007
Dear Thelma and Ravi, CHC:
I wish to invite you or a representative from your organization for a meeting at 3 pm on Monday, 12 th Nov at
the Karnataka State Pollution Control Board, Conference Room, 5th Floor, Parisara Bhavan, 49 Church Street
(parallel to MG Road), Bangalooru 560 001 (Tel: 80-25581383, 25589112, 25586520) to discuss and plan for a
forthcoming workshop on air pollution and environmental health—children's asthma. The workshop will be
held on 22-23rd Jan 2008 in Bangalooru with 100-125 invited participants. The draft announcement of the
workshop is attached.
fhe workshop will be different from other workshops as it will not only discuss the subject through
presentations made by people with experience in the fields of air pollution management, asthma management
and community interventions, but will provide about half the workshop time for breakout sessions which will
allow the workshop participants to work out intervention plans to mitigate air pollution, improve health care for
air pollution related health effects and do community interventions to help communities to mitigate the risk they
face, and to take specific responsibility for implementing these intervention plans.
The meeting agenda will be:
1.
2.
3.
4.
5.
6.
7.
Workshop venue
Workshop flyer
Steering Committee formation
Workshop methodology
Workshop agenda (draft)
Workshop speakers (suggestions)
Workshop participants (suggestions)
as previous experience in running such workshops exists, many of the agenda items can be covered quite
quickly. The Mumbai workshop report and other background material will be distributed at the meeting.
For any further information prior to the meeting, please feel free to contact me (40 2753 6128, 94404 01421) or
Mahalaxmi (80 2678 9637, 98455 75665).
I look forward to seeing you at the meeting.
Sincerely,
Sagar Dhara
Ps: please copy all emails to me and Mahalaxmi.
Workshop on air pollution and environmental health—children’s asthma
12-Nov-07
Page 2 of 2
Bangalooru, 22-23 January 2008
Air pollution and its related impacts on human health has become visibly severe. Over 300 million people suffer from
asthma worldwide (WHO), and the number is rising. The human and economic burden associated with asthma surpasses
that of HIV/AIDS and tuberculosis combined. In India, air pollution is estimated to cause, at the very minimum, 100,000
excess deaths and 25 million excesses illnesses per year.
To mitigate this impact quickly, air pollution control and health care interventions must be supplemented with an effective
community-based intervention programme aimed at involving risk bearers participating in solving their problems. This
workshop will allow its participants to make air pollution control, health care and community intervention plans for
Bangalore; and encourage government, professional and civil society organizations, and individuals to commit to taking
specific responsibility to implement the intervention plans. It is hoped that a committee will be formed to followup on the
workshop's recommendations. Childhood asthma is a good indicator of the prevailing problem, hence has been chosen as
the focal theme. The first workshop of this kind was conducted successfully with 80 Indian and foreign participants in
Mumbai in June 2005. More such workshops are planned for other cities later.
The workshop will discuss:
Air pollution and health effects and estimation of air pollution-related injury
Air pollution management interventions to reduce air pollution exposures
Health care interventions to mitigate asthma
Community interventions to help people mitigate air pollution-related health risks
The workshop will attempt to produce an action plan to:
Improve understanding of asthma and its relationship to air pollution
Train asthma patients and communities to recognize air pollution related health effects and improve
asthma management
Improve management of air pollution and its related health effects
Develop approaches to help minimize exposure to air pollution
Encourage coalition building between affected communities and those working on issues related to air
pollution control and its health effects
Create partnerships between government agencies and community-based organizations
Encourage participants and other agencies to commit to taking specific responsibilities to implement
the workshop^ recommendations
Participants: Asthma patients and networks, community health workers, professionals—government
and non-govemment—working in the fields of air pollution control, environmental health, and communicators
OrganizCF: Cerana Foundation, D-101 Highrise Apts, Lower Tank Bund Rd, Hyderabad 500 080.
Telefax: 40 2753 6128. Email: cran^fthi^i^diffmmLcoin
Sponsors: UNEP, Karnataka State Pollution Control Board,
**************************************************************
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12-Nov-07
Minutes of 19th Nov 2007 meeting
Participants:
1) Mohan Mani: workersblr@yahoo.co.in
2) Dr R.Sukanya, CHC: sukan r@rediffmail.com
3) QWARIDS: J. Manoharan: qwarids@vsnl.net
4) Bangalore Medical College and Research Institute: Dr Premalatha: premalatha53@hotmail.com
5) B.Venkatesh, Member Secretary, KSPCB; kspcb@kar.nic.in
6) Mr Syed Khaja, Regional Officer KSPCB, Hindustani@hotmail.com,
7) Mahalakshmi. Parthasarathy
8) Sagar Dhara
The meeting agenda discussed:
1.
Workshop venue: The in house KSPCB auditorium was visited by the participants and generally
agreed that it was appropriate for the workshop, which intends to have a number of breakout sessions.
2.
Workshop flyer
The name for the workshop was discussed and “Workshop on Environmental Health - Asthma “
Bangalore was preferred over specifically drawing attention to “Children’s Asthma”, since we are
targeting the adults in the high risk categories like traffic constables etc. This was to be agreed
upon during the 24th Nov meeting after considering other opinions.
3.
Steering Committee formation
People who were present for the meeting were to be included and the list to be finalised on the 24th
meeting.
4.
Workshop methodology
Workshop was conceived to provide the action plans to participants and concerned citizens to
improve air quality in the city of Bangalore. The breakout sessions will provide ample space for
participants to interact and put forth their views on the subject of air pollution management,
asthma management and the necessary community intervention. The individual plans will be then
synthesized to present a larger picture.
5.
Workshop agenda (draft)
The sessions were listed by Sagar (need to be added), we need to fit in sessions to focus on case
studies and to formulate action plans targeting certain sections of people e.g. garment
workers/traffic police etc who are at a higher risk. We feel that it will be good if we get more views
and clarity on this subject hence the need for 24th Nov 2007, Saturday meeting.
6.
Workshop speakers (suggestions)
It was decided that the speakers can speak in the language of their choice. The speakers in one
session can include a person who can highlight the issue and the others can throw better light on
the possible interventions. This was thought to be effective esp. if the workshop plans to focus on
various “high risk” groups and prepare relevant action plans tailor made for their situation.
7.
Workshop participants (suggestions)
More suggestions are welcome.
Minutes of 24th Nov 2007 meeting
Participants:
Pangalore Medical College and Research Institute: Dr Premalatha:
premalatha53@,hotmail. com
Msl^akshmi. B Janasahayog— 080-22128565
10)
Malathi Saroj: Voluntary Health Association ofKarnataka
11)
vhakCfbgL vsnl net, in!prajnamah(fyahoo, com. Ph: 9343537458/9448489411
Dr NagabhushanaProfessor ofPediatrics, Dr B.RAmbedkar Medical College Vice
12)
President Respiratory Chapter, Indian Academy ofPediatrics, Karnataka State Branch.P
nagabhushana s@, rediffmail. com/ respicon2005&yahoo. co. in
Dr B. R^avichandran Research Officer, Regional Occupational Health Centre, Bangalore
Medical College Campus, 9448015382, ravichandran65(cpyahoo.co,
Mahalakshmi. Parthasarathy
Fhe meeting agenda discussed:
1. Workshop flyer
“Workshop on Environmental Health - Asthma” Bangalore was preferred over specifically
drawing attention to “Children’s Asthma”. It was felt that there could be a session in the case
studies which focuses on children.
Flyer can have information pertaining to Asthma from Dr Parmesh’s study. Further it was
suggested that the points to be discussed in die flyer needs to include community based
intervention plans in India specifically Karnataka. The last point about partner city approach was
thought to be unrelated with regards to this workshop.
2. Steering Committee formation
People who were present for the meeting were to be included.
Workshop methodology’
•
Some suggestions of case studies for which action plans need to be prepared include: Traffic
Police, Women and Children who stay indoors, School Children, Pourkarmikas of BMP as they
deal with Garbage segregation, Garment Workers as they work in difficult conditions, Auto
drivers unions (as ROHC and Samarthan trust (one of the invitees) are involved with them for
studies and awareness generation in a different context)
3.
•
It was suggested that Indian Association for Occupational Health also has to be involved in
getting more clarity.
•
On Indoor air pollution : Cigarette smoking, emissions in software tech park offices (TERI
study) and cooking fuel emissions needs to be addressed. In this context research done on smoke
free chulhas by Shell foundation were mentioned.
•
A reinforcement session for “training community interventionists” for recognition of the
asthma symptoms and better air pollution management was perceived to be important.
4..
Workshop agenda (draft)
Dr Nagabhushana has short length videos of Asthmatics talking about living with it, he offered to
play them at the workshop. The group thought that these can be a good starting point for the
workshops.
There are other videos on Indoor air pollution one of it shows a “Model of a Asthma free house”
which can be used for training sessions eventually.
5.
Workshop speakers (suggestions)
ROHC can present the findings from its Study of air quality in bangalore under the
National Environmental Helath Profile study.
Dr Parmesh clinical study on asthma in school going children.
Air pollution management by better traffic management: somebody from the traffic dept.
6. Workshop participants (suggestions)
Some suggestions include: Dept of Labour, ESI hospitals (two tier system: Hospital and
Dispensaries), Medical colleges in Bangalore (6 -7 in number), St John’s dept of community
medicine.
Dr P. A Mahesh from JSS institute (Suggested by Dr Ravichandran: is doing a
study on causative agents of Indoor air pollution)
8.
Workshop Dates:
Regarding the workshop dates: As there is a national meet of Indian Academy of Pediatrics
in Bhubaneshwar many doctors who have agreed to take part in the workshop will be out
of station till the 22nnd morning. So they were wondering whether there is a possibility of
rescheduling it by a day or two ?
9.
Co-sponsors:
Dr Nagabhushana has agreed to Talk to Indian Medical Association, Indian Academy of
Pediatrics (Karnataka Branch), Indian Academy of Pediatrics Respiratory Chapter. I need
to officially write to them requesting for the same.
Dr Premalatha has said that she will talk to Dr Premaleela from Directorate of Health and
family welfare.
CHC needs to officially communicate it to us in writing but they have been sounded on it.
VHAK representative has said that she will too discuss and get back officially.
Janasahayog who work in 80 slums in Bangalore have said that they will officially agree
after discussing it with other people in their organization.
•
•
•
•
•
Minutes of 8th Dec 2007 meeting
Participants:
Sowbhaghya E.G. / Christopher: Garment Workers \Jnion — Karnataka ®
15)
No 324, Sri Krishna Nilaya, Mayura Nagara, 10,h cross, Andrahalli Main road, Peenya — 2ul stage,
Bangalore - 91, Ph: 28367354/9845950390
Email: garment_workers@yahoo. com
Thomas Thanapaul: ConsultantQWBJDS
Sagar Dhara
Mahalakshmi. Parthasarathy
16)
15)
18)
The following decisions were reached:
1. Workshop flyer
• The title will be “Workshop on Environmental Health --Intervention programmes for
mitigating air pollution related health risks, Bengalooru.
• Flyer will retain the first para from the Bombay workshop and the 2nd para will be data
specific to Bangalore and the 3rd para will have a mention about high risk groups.
•
The final version will be produced by Sagar after incorporating the Bangalore specific data
in the 2nd and the 3rd para.
•
1000 copies of the English version will be printed at Hyderabad and 2000 copies of the
translated Kannada version will be printed at Bangalore.
2. Workshop methodology
•
fhe focus was breakout sessions: It was decided that the breakout sessions will broadly be
divided into those affected by; Vehicular Pollution, Indoor air pollution and at workplaces.
•
The vehicular pollution will cover the general populace the traffic police, and the auto
rickshaw drivers
•
The workplaces include: 1) garment workers 2) Quarry workers 3) IT /BPO sector
•
The indoor air-pollution can include the women who are exposed to smoke. CHC suggested
that cigarette smoking and anti tobacco campaign can also be explored.
•
Suggestions for chairpersons for the plenaries are required to be sent by me.
•
Sagar felt that the human perception to risk is a factor which needs to be emphasized and
understood in order to get effective results.
Suggestions of Names of speakers/Topics
Workshop on environmental health:
Intervention programmes for mitigating air pollution-related health risks
Bengalooru, 22-23 January 2008
22 Jan
Workshop day 1, Auditorium, 5th Fir, Karnataka State Pollution Control Board, Parisara
Bhavan, 49 Church Street, Bengalooru 560 001
^30-9.30
Registration & networking
- Io
9.30-10.30 Plenary Session 1: Inaugural session
His Excellency, The Governor, Karnataka State will inaugurate the workshop
Presiding H C Sharatchandra
Welcome Address Sagar Dhara, Director, Cerana Foundation Welcome Address
Keynote address: Surendra Shrestha, Director, Asia-Pacific Region, UNEP
Mem Secy Venkatesh KSPCB, Vote of thanks
10.45-12.45 Plenary session 2: Air pollution-related health risks
Chair:
.
Speaker 1: The air pollution problem in Bengalooru
Speaker 2: Air pollution-related health impacts in Bengalooru
Speaker 3: Community health programmes in Bengalooru
Speaker 4: Experiences from other cities
(2^
.
.
i
J'yipvi
(g)
S'
Discussion - uo
(g)
■
c
13.30-15.30 Plenary session 3: Responses to air pollution-related health risks
___ Se/k
Chair:
Po H
H
Speaker 1: Air quality management programme in Bengalooru
k £ Pc S
%Z1)C
Speaker 2: Asthma surveillance and management programme in Bengalooru t>)
Speaker 3: Experiences from other cities
Speaker 4:
Discussion
15.45-16.00 Briefing on how breakout sessions are to be conducted and their deliverables
Pp-k
^1(1 T'
16.00-17.30 Breakout session 1: Review of existing risk mitigation plans and preparing
additional plans that can be implemented by workshop participants
(X^y-A/
Qo/Y at
l)
Facilitators for the three breakout sessions
1
—
-
,
23 Jan
Workshop day 2, Auditorium, 5th Fir, Karnataka State Pollution Control Board,
Parisara Bhavan, 49 Church Street, Bengalooru 560 001
9.00-11.00 Plenary session 4: Learning from other experiences
Chair:
&
Speaker 1:
Speaker 2:
Speaker 3:
Speaker 4:
11.15-12.45 Breakout session 2: Phasing and costing the plans
Facilitators
13.30-15.00 Breakout session 3: Taking responsibility
Facilitators
15.00-15.30 Tea break and group representatives of each breakout group to synthesize the 3 plans
15.30-16.30 Plenary session 5: Presentation of plans, general discussion and forming ad hoc
coordination committee
Chair: Mr R Rajamani
16.30-17.00 Closing session: Conclusions
Chair: Mr R Rajamani
2
Page 1 of 1
community health cell
From:
Asthma Workshop [asthmaworkshop@gmail.com]
Sent:
Wednesday, December 19, 2007 5:06 PM
Subject: lnvite:Workshop on environmental health, 22-23 January 2008
Dear friend,
On behalf of Karnataka State Pollution Control Board, I have the pleasure of inviting you for the
Workshop on environmental health—Intervention programmes for mitigating air pollution-related health
risks, to be held in Bengalooru on 22-23 January 2008. The workshop is being organized by Cerana
Foundation is association with KSPCB as co-organizer.
I he workshop will bring together various stakeholders—air pollution sufferers and their networks,
community health workers, regulators, town planners, health care professionals, the media and others to:
a) Formulate an action plan, in addition to those that exist, to tackle the issue of air pollution-related
health risks, and to take individual and organizational responsibility to implement the plan, and
b) Encourage coalitions and partnerships and form a network to help implement this plan.
[f you are interested in attending the workshop, please fill and return die attached registration form by 31st
I )ec 2007. The addresses and contacts are given in the form.
11 you require assistance for travel and stay in Bengalooru, please let us know immediately.
With warm
wishes,
Sincerely,
Mahalakshmi
Parthasarathy
(KSPCB - Workshop — Secretariat
12/20/2007
Workshop on Environmental Health:
Intervention programmes for mitigating air pollution related health risks
22-23 January 2008
Auditorium, Karnataka State Pollution Control Board, 3rd Floor, Parisara Bhavan, 49 Church Street,
Bengalooru 560 001
The concept
This workshop is part of an environmental health workshop series initiated two years ago with a view to make
risk bearers the key players in mitigating air pollution related health risks. In India, air pollution is estimated
to cause, at the very minimum, 100,000 excess deaths and 25 million excesses illnesses every year. To
effectively mitigate health risks of air pollution, air quality management and asthma (and other air pollutionrelated diseases) management programme must be supplemented with an effective community intervention
programme.
Why Bengalooru
Bengalooru has the dubious distinction of being the asthma capital of India. Studies estimate that
10% of Bengalooru’s 60 lakh population and over 50% of its children below 18 years suffer from air
pollution related ailments. Environmental changes consequent to unplanned growth of the city
through industrial development, increasing population and vehicular pollution are responsible for
this. Nearly 1,500 new vehicles are registered in the city every day.
The workshop will focus on formulating specific action plans for high-risk groups that are
susceptible to pollution by vehicular exhaust and through exposure to pollutants at home and at their
workplaces. Other than children, these include traffic police, women, old people, quarry workers,
industrial workers, long - distance commuters and just about everybody with significant exposure to
air pollution.
Participants
Asthma and other air pollution affected persons, government and non-government and professional
organizations, and individuals working in the fields of: air quality management, chest diseases, environmental
health, community health, public health awareness programmes, and concerned citizens.
Organizers
Cerana Foundation, D 101 Highrise Apts, Lower Tank Bund Rd, Hyderabad 500 080. Telefax: 91
40 2753 6128 in association with Karnataka State Pollution Control Board, Attn: Mahalakshmi
Parthasarathy, 302, 33/34/35, Amara Canopy Apts, 6th Cross, BTM 2nd Stage, Bengalooru 560 076.
Tel: 91 80 2678 9637, 0 98455 75665 Email for workshop correspondence:
asthmaworkshop@gmai 1 .com
Sponsors
United Nations Environment Programme
A complete list of co-sponsors will be available at the workshop
Workshop format
•
Plenary Sessions: To understand (through presentations) issues related to air pollution and its health risks
in Bengalooru, and the current efforts being made to tackle them
•
Breakout Sessions: To enable workshop participants to review existing air quality-related risk mitigation
plans, and formulate additional plans (in small-group discussions) that they can commit to implementing
as individuals or organizations
•
Informal Interactions: To encourage the formation of coalitions and partnerships amongst workshop
participants to execute implementation of formulated plans
Plan premise
Plans prepared by the participants must
•
•
•
•
Pertain to specific indoor conditions, workspaces, and ambient environments of their choice
Lay emphasis on high-risk groups
Consist of three components; interventions with risk bearers, health effects management and air quality
management
Focus on children’s asthma where relevant
Expected outcome
The workshop will:
•
•
•
•
Encourage the creation of a voluntary multidisciplinary taskforce of various stakeholders
Provide information on low-cost interventions
Raise public awareness ofair pollution-related health risks
Help in influencing public policy in air pollution related health risks
Registration Request Form
The workshop requires no registration fee but only registered participants may attend the workshop. If you
are interested in participating in the workshop, kindly note the following requirements:
Please fill the form below and email to asthmaworkshop@gmail.com
The attachment file containing your registration request must give your last name, eg, if your last name is
Gupta, the attachment file must be titled gupta.doc or gupta.txt.
In case you wish to register through post, please mail a hardcopy of the filled form to
Cerana Foundation, D-101 Highrise Apts, Lower Tank Bund Rd, Hyderabad, AP, 500 080.
OR
Mahalakshmi Parthasarathy, KSPCB Workshop Secretariat, 33/34/35, Amara Canopy Apartment, Apt
No 302, 6th Cross, BTM 2nd Stage, Bengalooru 560 076
Your forms must reach us no later than 31st Dec 2007. The workshop secretariat will confirm your
registration by 10th January 2008. If you are unable to provide information regarding your arrival and
departure at this point, please do so immediately on receipt of our confirmation.
Name: Mr/Ms/Dr*
Organization:
Mailing address:
Tel No:
Fax No:
Email:
Discipline: Environmental science/Engineering/ Health/Law/ Community organizer/ Media/ Environmental
activism/ Other* (please specify)
Specialization (eg, air pollution monitoring, pulmonologist, environmental law, etc):
If you are not a Bengalooru resident, please provide information regarding your arrival and departure
Arrival mode: Air/ Train/ Bus*. Arr dt:
Arriving from:
Expected arr time:
Flt/Train name & #:
Arriving airport/ station/ bus stand:
Departure mode: Air/ Train/ Bus*. Dep dt:
Departing to:
Expected dep time:
Flt/Train name & #:
Departing airport/ station/ bus stand:
Will you participate on both days*
If for one day, will it be 22nd or 23rd*
Do you have any special diet restrictions?
* Please strike off what is not applicable
Draft
-Can local air pollution be mitigated without controlling global warming and moving
without equity in consumption and emissions? S Dhara, Cerana Foundation (I will only
speak if we are short of speakers in this session) decide on 27th
- Learning from South-east Asian initiatives in tackling air pollution related health risks;
Mylvakanam lyngararasan, UNEP.../long range transportation of pollutants...
Discussion
23 Jan
9.00-9.30
Briefing on how breakout sessions are to be conducted and their deliverables
9.30-11.00
Breakout session 1: Review of existing risk mitigation plans and preparing
additional plans that can be implemented by workshop participants
Facilitators for the three breakout sessions
11.00-11.15
Tea
11.15-13.15
Breakout session 2: Phasing and costing the plans
Facilitators
13.15-14.00
Lunch
14.00-15.00
Plenary session 4: Panel discussion: What do we need to do to win the war against
air pollution in Bengaluru?
Moderator: Dunu Roy/suggestions....
Suggested names for the panel: Paritosh Tyagi, S K Gupta, Mohan Mani, Combater, Leo
Sultana, Vidya Dinker, Industry Association Representative, Sanjay Biswas, Nandan
Nilekini or Narayana Murthy, Balakrishna Shetty, Ram Guha, Sharad Lele, M V
Ramana, Yelappa Reddy
(max 6 persons, preferably with different views and
experiences so that the discussion is lively and the panel can arrive at some consensus for
some minimum set of recommendations)
Or
Panel discussion....
1 person from the traffic department + 1 from the KSPCB+ + 1 FROM BBMP+1 from
industrial associations like NASSCOM /CII+ I from the IT industry itself (Nilekani if he
has already agreed to be a part of it)+ 1 from the media Zassociation+2 from NGO’s
working on Civic/Environmental issues CMCA/Janagraha- Ramesh Ramanathan/Samuel
Paul PAC?) to discuss about the commitments relevant from their sector in combating air
pollution...
14.00-15.00
Synthesizing the various plans by breakout session group leaders
15.00-15.15
Tea
15.15-16.15
Plenary session 5: Presentation of plans, general discussion and forming ad hoc
coordination committee
3
Draft
Chair: Mr R Rajamani
16.15-16.45
Closing session: Conclusions
Chair: Mr R Rajamani
Comments on the workshop and how this process should be taken forward:
A participant
Member of ad hoc committee formed in the workshop
Representatives of each breakout session
BBMP
Arvind Janu
Sharatchandra or someone from KSPCB
Comments: Mylvakanam lyngararasan, UNEP
Vote of thanks: T Vijayendra, Cerana Foundation
Notes on breakout sessions: The ideal group size for each breakout session is 10-15 persons. So,
we can have about 6-7 groups. Keeping in mind the workshop’s objectives, the Steering
Committee wishes to have the participants prepare implementable plans for high risk groups in
spaces that they are active in, ie, indoor spaces, workspaces (office and factory) and ambient
spaces (on roads—traffic policemen, autorickshaw drivers, children commuting to school). We
have 4 spaces—ambient (vehicular pollution exposure), indoor, factories and offices. Three
plans should be made for each space—air quality management, asthma management, community
intervention. However, asthma management is the same (more or less) for all spaces, so we need
only one beakout group to discuss that issue. All the spaces then require breakout groups for air
quality management and community management. However, air quality in ambient spaces is
regulated by the PCBs, factory spaces by the Factories Inspectorate and indoor and office spaces
are unregulated. Factories and offices have unions, whereas ambient and indoor spaces do not.
Considering these factors, I suggest the following breakout sessions:
Breakout session 1—Asthma management for all spaces
Breakout session 2—Ambient air quality management
Breakout session 3—Factory air quality management
Breakout session 4—Air quality management in unregulated spaces (indoors and office)
Breakout session 5—Community intervention for factories and offices
Breakout session 6—Community intervention for ambient and indoor spaces
If we had only 60 participants on the 2nd day, that would make 10 persons per group. Anything
more than that number would increase the average number in each breakout group.
4
Page 1 of 1
community health cell
From:
Asthma Workshop [asthmaworkshop@gmail.com]
Sent:
Wednesday, December 19, 2007 5:30 PM
To:
chc@sochara.org ; cmcaexpressions@yahoo.co.in ; qwarids@vsnl.net ; premalata53@hotmail.com;
pramodkulkarni@vsnl.net ; prajnamali@yahoo.com; prabhu@samarthan.in;
sukan_r@rediffmail.com; janasahayog@gmail.com ; vhak@bgl.vsnl.net.in;
garment_workers@yahoo.com; girishnrao@yahoo.com; vadesha@gmail.com; dhenuka@teri.res.in
Subject: Request for co-sponsorship for the air pollution and Environmental Health workshop....
Dear
!■
As we discussed on the phone, please send a letter on thez letterhead of your organisation
addressed to ’’Cerana Foundation D-101 High rise Apartments, Lower Tank Bund Road,
Hyderabad -500080”, stating that your organization will co-sponsor the Bangalore w/shop.
You can mention that as a co-sponsor one does not bear any financial or organizational
liabilities for this workshop. Please do include your logo if you have one.
You can send a hard copy of the letter to me at; Mahalakshmi Parthasarathy, Workshop
Secretariat, Amara Canopy Apartment, 33/34/35, Apt 302, 6 111 cross,
- 2nd stage,
cross, BTM
BTM Bangalore -560076.
W arm Regards
Mahalakshmi
12/20/2007
Draft
Workshop on environmental health:
Intervention programmes for mitigating air pollution-related health risks
Bengaluru, 22-23 January 2008
KSPCB Auditorium, S^Flr, Karnataka State Pollution Control Board, Parisara Bhavan, 49, Church
Street, Bengaluru 560 001
Day 1
9.00-10.15
Registration & networking
10.30-11.15
Inaugural session
His Excellency, The Governor, Karnataka State, will inaugurate the workshop by
lighting a lamp
R Rajamani, Facilitator
Sagar Dhara, Director, Cerana Foundation, Welcome address
H C Sharatchandra, Chairman, KSPCB
Surendra Shrestha, Director, Asia-Pacific Region, UNEP, Keynote address
Venkatesh, KSPCB, Vote of thanks
Note: IfSengupta and Meena Gupta come, they will have to be accommodated in the
inaugural session. We also have to decide when the Governor will speak
11.15-11.30
Tea
Note: Each plenary session may hpve a maximum of 5 speakers @15 min each, with a
30 min discussion at the end. A list ofspeakers and their topics has been suggested and
a final selection has to be made from the list. We had earlier agreed that Bengaluru
will contribute 3 speakers to sessions 2 & 3, and the remaining speakers in these
sessions will be from outside. For session 1, the speakers may largely be from outside
Bengaluru, though I would strongly recommend that someonefrom Bengaluru who has
used yoga be included in this session. These are only guidelines and should not
become sticking issues, as this is one point on a long road, and everyone will get a
chance to make her/his point. Suggestions for speakers and their topics are given
below.
11.30-13.15
Plenary session 1: Air pollution-related health risks
Chair:
^15 2.
The air pollution in Bengalooru: Simba*
Air pollution-related illnesses in Bengalooru: Parmesh*
Community health intervention programmes in Bengalooru: Ravi Narain*, CHC
^-Air pollution and morbidity in Bengaluru, Uma, Ernzen
_ CHave the setting of air standards helped in mitigation air pollution related health risks?
<-H K Parwana*, Punjab PCB
AmpoRufien-and^ardiovascular riskrU>evi-Shetty7Narayana-Hfudaya4aya
x
4*1°^
Draft
Air Pollution and eye injury, A S Venkatachalam, Hyderabad
Discussion
13.15-14.00
Lunch
14.00-15.45
Plenary session 3: Responses to air^llution-related health risks
Chair:
iK
Air quality monitoring and regulation in Bengaluru: Current and future programmes,
Sharat*
Planning for good air quality in Bengaluru, NeeijarKurhari
Traffic management in Bengaluru, M N Sreehari
Asthma surveillance and management programme in Bengaluru: George D’Souza*
The plight of a silicosis-affected quarry worker and why the system has failed him:
Thomas, QARRIDS
Why has curative medicine taken precedence, over preventive medicine in air pollutionrelated health effects: Thelma Narain, CHC
How good is the correlation between air pollution and asthma? Frank Murray
Experience of using yoga/ holistic medicine for managing repiratory illnesses,
Discussion
15.45-16.00
Tea
16.00-17.45
Plenary session 3: Learning from other experiences
Chair:
The Bangladesh air pollution related health risk mitigation experience: Hashmi*,
Ministry of Environment, Bangladesh
The bucket brigade: Nityanand,
Can town planning be done differently to minimize air pollution related health risks? S
K Gupta, Envirotech or someone else
Can local air pollution be mitigated without controlling global warming and without
equity in consumption and emissions? S Dhara, Cerana Foundation (I will only speak
if we are short of speakers in this session)
Learning from South-east Asian initiatives in tackling air pollution related health risks;
Mylvakanam lyngararasan*, UNEP
23 Jan
9.00-9.30
Briefing on how breakout sessions are to be conducted and their deliverables
9.30-11.00
Breakout session 1: Review of existing risk mitigation plans and preparing
additional plans that can be implemented by workshop participants: Gap analysis,
identifying critical elements that if put into place can help reduce air pollution related
health risks, what is required to put these elements into place in light of the
impediments for putting them into place.
2
Draft
Facilitators for the three breakout sessions
11.00-11.15
Tea
11.15-13.15
Breakout session 2: Phasing and costing the plans: Prioritising the elements
required to be put into place, who will put them into place, what cooperation is required
from other agencies, timelines and costs for putting these elements into place, action
plan.
Facilitators
13.15-14.00
Lunch
14.00-15.00
Plenary session 4: Panel discussion: What do we need to do to win the war against
air pollution in Bengaluru?
Moderator: Dunu Roy
Suggested names for the panel: KSPCB, Bengaluru Planning Dept, P K Mohanty,
Jamasahyog, Dominic Misquith, Moham Mani or some NGO (max 6 persons,
preferably with different views and experiences so that the discussion is lively and the
panel can arrive at some consensus for some minimum set of recommendations)
14.00-15.00
Synthesizing the various plans by breakout session group representatives
15.00-15.15
Tea
15.15-16.15
Plenary session 5: Presentation of plans, general discussion and forming ad hoc
coordination committee
Chair: Mr R Rajamani
16.15-16.45
Closing session: Conclusions
Chair: Mr R Rajamani
Comments on the workshop and how this process should be taken forward:
A participant
Member of ad hoc committee fonned in the workshop
Representatives of each breakout session
BMMP
Arvind Janu
Sharatchandra or someone from KSPCB
Comments: Mylvakanam lyngararasan, UNEP
Vote of thanks: T Vijayendra, Cerana Foundation
3
Draft
Notes on breakout sessions: The ideal group size for each breakout session is 10-15 persons.
So, we can have about 6-7 groups. Keeping in mind the workshop’s objectives, the Steering
Committee wishes to have the participants prepare implementable plans for high risk groups in
spaces that they are active in, ie, indoor spaces, workspaces (office and factory) and ambient
spaces (on roads—traffic policemen, autorickshaw drivers, children commuting to school).
We have 4 spaces—ambient (vehicular pollution exposure), indoor, factories and offices.
Three plans should be made for each space—air quality management, asthma management,
community intervention. However, asthma management is the same (more or less) for all
spaces, so we need only one beakout group to discuss that issue. All the spaces then require
breakout groups for air quality management and community management. However, air
quality in ambient spaces is regulated by the PCBs, factory spaces by the Factories Inspectorate
and indoor and office spaces are unregulated. Factories and offices have unions, whereas
ambient and indoor spaces do not. Considering these factors, I suggest the following breakout
sessions:
Breakout session 1—Asthma management for all spaces
Breakout session 2—Ambient air quality management
Breakout session 3—Factory air quality management
Breakout session 4—Air quality management in unregulated spaces (indoors and office)
Breakout session 5—Community intervention for factories and offices
Breakout session 6—Community intervention for ambient and indoor spaces
If we had only 60 participants on the 2nd day, that would make 10 persons per group. Anything
more than that number would increase the average number in each breakout group.
4
Agenda for the Workshop on environmental health: Intervention
programmes for mitigating air pollution-related health risks
Bengalooru, 22-23 January 2008
KSPCB Auditorium, S'11 Fir, Karnataka State Pollution Control Board, Parisara Bhavan, 49, Church Street,
Bengalooru 560 001
Day 1
9.00-10.00
Registration & networking
10.00-10.45
Inaugural session
Mr Sagar Dhara, Cerana Foundation, Welcome address
Dr H C Sharatchandra, KSPCB, Presidential remarks
Mr Surendra Shrestha, UNEP, Keynote address
Mr R Rajamani, Retired civil servant, MoEF, Facilitator’s remarks
Mr B Venkatesh, KSPCB, Vote of thanks
10.45-11.00
Tea
11.00-13.00
Plenary session 1: Air pollution-related health risks
Chair: Dr Jayaram G K, ILID
Mr Mylvakanam lyngararasan, UNEP, Learning from South-east Asian experiences in tackling
air pollution related health risks
Dr H Parmesh, Lakeside Hospital, Air pollution-related illnesses in Bengalooru
Dr Sukanya Rangamani, CHC, Communities Health and air pollution—Community action to
mitigate environmental health risks
Dr B Nagappa, KSPCB, Ambient air pollution in Bengalooru
Ms Dhenuka Srinivasan, TERI, Indoor air pollution
Discussion
13.00-13.45
Lunch
13.45-15.45
Plenary session 2: Current responses and challenges to air pollution-related health risks
Chair: Dr Mahesh Babu R, Consulting physician
Mr Anand Rao, BMTC, Traffic planning for better air quality in Bengaluru
Mr M D N Simha, KSPCB, Air quality monitoring and regulation in Bengaluru: Current and
future programmes
Dr George D’Souza, St John’s Hospital, Surveillance of asthma and other lung diseases
Testimonies of affected persons: Quarry worker, Garbage worker. Garment worker,
Ms Jayashree, QWRIDS, Has the system been able to respond to the plight of “aam admi ” who
is affected by air pollution?
Discussion
15.45-16.00
Tea
1
16.00-1730
Plenary session 3: Other experiences and broader issues
Chair: Mr Paritosh Tyagi, Retired civil servant, CPCB
Dr A Venkatachalam, Consulting ophthalmic surgeon. Air pollution and ocular complications
Prof S Shivkumar, M S Ramaiah Institute of Technology Planning towns to minimize air
pollution related health risks
Dr Rajendra Prasad, Indian Association of Air Pollution Control, Have air quality standards
helped in mitigating air pollution related health risks?
Mr Sagar Dhara, Cerana Foundation, Local & global air pollution—2 sides of the same coin
that can only be tackled only together and only through equity in carbon emissions
Discussion
23 Jan
9.00-9.30
Briefing on how breakout sessions deliverables and methodology
930-11.15
Breakout session 1: Review of existing risk mitigation plans (if relevant), preparing
additional plans that can be implemented by workshop participants: Gap analysis,
identifying critical elements that if put into place can help reduce air pollution related health
risks, what is required to put these elements into place in light of the impediments for putting
them into place.
Breakout session 1—Asthma management for all spaces. Facilitators: Dr Athar Qureshi,
Physician and community health worker
Breakout session 2—Ambient air quality management. Facilitator: Mr Paritosh Tyagi, Retired
civil servant, CPCB, Dr Vinay Vishwanath, CHC
Breakout session 3—Factory air quality management. Facilitators: Mr S K Gupta, Indian
Association ofAir Pollution Control
Breakout session 4—Air quality management in unregulated spaces (indoors & office):
Facilitators: Dr Vinay Kumar, Software consultant, environmentalist and organic farmer, Mr S
J Chander, Institute of Public Health
Breakout session 5—Community intervention for factories and offices. Facilitators: Mr Cyril
Fernandes, Worker, trade unionist and environmental activist. Dr Sukanya Rangamani, CHC
Breakout session 6—Community intervention for ambient and indoor spaces. Facilitators: Ms
Priya Patel, Community health specialist. Dr E Premdas, CHC
The correct breakout sessions, their members, facilitators and each session’s mandate will be
circulated on the 23rd morning.
11.15-11.30
Tea
11.30-13.15
Breakout session 2: Phasing and costing the plans: Prioritising the elements required to be
put into place, who will put them into place, what cooperation is required from other agencies,
timelines and costs for putting these elements into place, action plan.
Breakout session 1—Asthma management for all spaces. Facilitators: Dr Athar Qureshi,
Physician and community health worker
Breakout session 2—Ambient air quality management. Facilitator: Mr Paritosh Tyagi, Retired
civil servant, CPCB, Dr Vinay Vishwanath, CHC
Breakout session 3—Factory air quality management, Facilitators: Mr S K Gupta, Indian
Association ofAir Pollution Control
2
Notes for breakout sessions
Deliverables: Formulation of specific intervention programmes by each breakout session
The programme can be as diverse as lobbying with government to get specific things done, eg,
banning private transport in the inner city during certain hours, improving public transport; workshop
participants doing public awareness programmes, setting up community self-help groups for
identification and management of asthma, tree planting, doing continuing medical education amongst
health workers on asthma management, setting up partnerships, etc.
The single most important criteria is that the programmes formulated in the breakout sessions must be
implementable by workshop participants, and the workshop participants should take responsibility to
implement them.
F ormulating the intervention programmes
The first day of the workshop provides inputs for the participants to prepare their intervention
programmes. All breakout sessions are scheduled for the second day. The breakout sessions initially
suggested were:
Breakout session 1—Asthma management for all spaces. Facilitators: Athar Qureshi, Physician and community
health worker
Breakout session 2—Ambient air quality management. Facilitator: Paritosh Tyagi, Retired civil servant, CPCB
Breakout session 3—Factory air quality management. Facilitators: S K Gupta, Indian Association of Air
Pollution Control
Breakout session 4- -Air quality management in unregulated spaces (indoors & office): Facilitators: Vinay
Kumar, Software consultant, environmentalist and organic farmer
Breakout session 5—Community intervention for factories and offices. Facilitators: Cyril Fernandes, Worker,
trade unionist and environmental activist
Breakout session 6—Community intervention for ambient and indoor spaces, Facilitators: Priya Patel,
Community health specialist
This will be reviewed on the 22nd evening and the final plan for the number of breakout sessions and
the topic for each break session and their facilitators, and who would be in which breakout session will
be announced on the 23rd morning. The groups in each breakout will be mixed. Health workers will
be put not just in Breakout session 1, but in all other breakout sessions as these sessions require their
inputs. This will hold for people from other backgrounds as well. You may however, indicate in
writing to the organizers which breakout session you would prefer to join.
Step 1: Review of existing air pollution related health risk programmes
Air pollution related health risk mitigation programmes include programmes such as: a) Reduce
pollution emissions, eg, engineering controls, eg, use of unleaded gasoline, low sulphur diesel, greater
use of public transport and lesser use of private transport, b) Facilitating better dispersion of pollutants,
eg, redesigning habitats, better traffic control, c) Reduce human exposure to pollutants, eg. Use of
respiratory protection devices by workers working in dusty areas, d) Increasing public awareness
1
In the next step, is to spell out the present status of each issue for which a future vision has been listed.
The intervention programme prepared in the Mumbai workshop, provided to you at the time of
registration, will give you some idea of how this is done.
Step 2.3 Desired action
In this step, the action required to go from the present status to the vision should be detailed out to the
extent possible. This may, for example, include the action steps required to make the leap from the
present status to the visioned state, the phases and timeline for them, who amongst the partners would
take the responsibility for implementing the action steps, who would they choose as their partners,
who would be the target groups of the action.
Tiw (i*'&
ktsp
You may add to these sub-heads. But please remember, if the ad hoc committee is formed (as we
desire), you will have more time to work out greater details later. Right now, what is important to do
is to produce a credible plan that the workshop participants take ownership off and take responsibility
for implementing.
may be a good idea if the action plan elements are kept simple and do-able by the workshop
Ti /rT Itparticipants.
Step 3 Prioritizing the action plan by multi-voting
In the last step, ideas from Step 1 and 2 are ranked by a process of multi-voting, where participants
vote for one or more vision idea. The number of votes that each idea gets will determine its priority.
Step 4: Integrating and harmonizing the plans
Each breakout session should elect a representative who can integrate and harmonize the output of
his/her breakout session and with those of other breakout sessions in a discussion with other breakout
session representatives. This exercise can be done during lunch and when the panel discussion takes
place post-lunch on 23rd January.
The output of each breakout session will then be presented by its representative in Plenary session 5.
Step 5: Forming an ad hoc committee and a convener to do followup work on the workshop
deliverables
In Plenary session 5, the intervention programmes formulated in the breakout sessions will be
presented and discussed. To followup on the implementation of the deliverables, the participants may
form an ad hoc committee from amongst themselves. Alternatively, select a convener and fix a
meeting date for a followup meeting, when a committee may be formed.
3
about recognizing asthma, e) Setting up asthma help centres, e) Community health outreach
programmes for asthma, etc.
Various government and non-govemment organizations have plans to mitigate air pollution related
health risks. If any such plans for Bengalooru, eg, the Task Force on Air Quality Management for
Bengalooru is available to you, you may choose to review it. However, any review that you do and
conclusions that you arrive at must be implementable by you. For example, if you wish to offer
critical comments on the town development plans, you must have the commitment and the
wherewithal to reach your comments to policy makers and the town planners, and be taken seriously.
You review may make you add to existing plans, eg, how to improve or increase health care outreach
programmes presently being undertaken by certain hospitals, or linking such programmes being
undertaken by several organizations. Again, you suggestions should be such that you, collectively, are
willing to take responsibility for the intervention plans you suggest.
If you do not have access to existing plans, please do not spend time trying to review plans from
cursory knowledge of such plans gleaned from newspapers. Please remember that an attempt will be
made in this workshop to form an ad hoc committee to take the programmes formulated forward.
Such reviews can always be done by that committee later, after studying existing plans.
Step 2: Suggest supplemental programmes to reduce air pollution related health risks
The supplemental plans for air pollution related health risk mitigation must be in addition to those that
already exist. For example, as far as our knowledge goes, there are no community health outreach
programmes for asthmatics. Such programmes may include training community health workers to
identify asthmatics, particularly in low income and high risk groups, training asthmatics to recognize
their triggers, setting up systems to handle asthma emergencies, developing an asthma network
consisting of all stakeholders in Bengalooru city, using FM radio stations to do interactive
programmes with parents of asthmatic children, working with school children using diffusive samplers
to monitor pollution levels in community neighbourhoods, training commumties to minimize indoor
and outdoor air pollution, training workers on the law pertaining to shopfloor toxins, etc.
The programmes must be practical and implementable by the workshop participants. The way to
arrive to arrive at these ideas are suggested below:
Step 2.1 Visioning
Individuals in each breakout session may spell out their vision of the specific improvements they wis
made in future for the issue they were dealing with. All ideas will be written on slips and posted on a
board, without too much comment from other members of the breakout session. Ideas will then be
clubbed by major heads, eg, public participation, technology shifts, asthma surveillance systems,
advocacy, etc. Ideas that did not fall into any major head may be temporarily put into a “temporary
parking lot”, to be dealt with later. Vision ideas may also classified as—short-term, medium-term and
long-term. Only such ideas that the participants expect that they can implement should be worked
upon further; these will be primarily short and medium term plans.
Step 2.2 Present status
2
Agenda for the Workshop on environmental health: Intervention
programmesfor mitigating air pollution-related health risks
Bengalooru, 22-23 January 2008
KSPCB Auditorium, S4 Fir, Karnataka State Pollution Control Board, Parisara Bhavan, 49, Church Street,
Bengalooru 560 001
Day 1
9.00-10.00
Registration & networking
10.00-10.45
Inaugural session
Mr Sagar Dhara, Cerana Foundation, Welcome address
Dr H C Sharatchandra, KSPCB, Presidential remarks
Mr Surendra Shrestha, UNEP, Keynote address
Mr R Rajamani, Retired civil servant, MoEF, Facilitator’s remarks
Mr B Venkatesh, KSPCB, Vote of thanks
10.45-11.00
Tea
11.00-13.00
Plenary session 1: Air pollution-related health risks
Chair: Dr Jayaram G K, ILID
Mr Mylvakanam lyngararasan, UNEP, Learning from South-east Asian experiences in tackling
air pollution related health risks
Dr H Parmesh, Lakeside Hospital, Air pollution-related illnesses in Bengalooru
Dr Sukanya Rangamani, CHC, Communities Health and air pollution—Community action to
mitigate environmental health risks
Dr B Nagappa, KSPCB, Ambient air pollution in Bengalooru
Ms Dhenuka Srinivasan, TERI, Indoor air pollution
Discussion
13.00-13=45
Lunch
13.45-15.45
Plenary session 2: Current responses and challenges to air pollution-related health risks
Chair: Dr Mahesh Babu R, Consulting physician
Mr Anand Rao, BMTC, Traffic planning for better air quality in Bengaluru
Mr M D N Simha, KSPCB, Air quality monitoring and regulation in Bengaluru: Current and
future programmes
Dr George D’Souza, St John’s Hospital, Surveillance of asthma and other lung diseases
Testimonies of affected persons: Quarry worker, Garbage worker. Garment worker,
Ms Jayashree, QWRIDS, Has the system been able to respond to the plight of “aam admi ” who
is affected by air pollution?
Discussion
15.45-16.00
Tea
1
16.00-1730
Plenary session 3: Other experiences and broader issues
Chair: Mr Paritosh Tyagi, Retired civil servant, CPCB
Dr A Venkatachalam, Consulting ophthalmic surgeon. Air pollution and ocular complications
Prof S Shivkumar, M S Ramaiah Institute of Technology Planning towns to minimize air
pollution related health risks
Dr Rajendra Prasad, Indian Association of Air Pollution Control, Have air quality standards
helped in mitigating air pollution related health risks?
Mr Sagar Dhara, Cerana Foundation, Local & global air pollution—2 sides of the same coin
that can only be tackled only together and only through equity in carbon emissions
Discussion
23 Jan
9.00-9.30
Briefing on how breakout sessions deliverables and methodology
9.30-11.15
Breakout session 1: Review of existing risk mitigation plans (if relevant), preparing
additional plans that can be implemented by workshop participants: Gap analysis,
identifying critical elements that if put into place can help reduce air pollution related health
risks, what is required to put these elements into place in light of the impediments for putting
them into place.
Breakout session 1—Asthma management for all spaces. Facilitators: Dr Athar Qureshi,
Physician and community health worker
Breakout session 2—Ambient air quality management. Facilitator: Mr Paritosh Tyagi, Retired
civil servant, CPCB, Dr Vinay Vishwanath, CHC
Breakout session 3—Factory air quality management. Facilitators: Mr S K Gupta, Indian
Association ofAir Pollution Control
Breakout session 4—Air quality management in unregulated spaces (indoors & office):
Facilitators: Dr Vinay Kumar, Software consultant, environmentalist and organic farmer, Mr S
J Chander, Institute of Public Health
Breakout session 5—Community intervention for factories and offices. Facilitators: Mr Cyril
Fernandes, Worker, trade unionist and environmental activist. Dr Sukanya Rangamani, CHC
Breakout session 6—Community intervention for ambient and indoor spaces. Facilitators: Ms
Priya Patel, Community health specialist. Dr E Premdas, CHC
The correct breakout sessions, their members, facilitators and each session’s mandate will be
circulated on the 23rd morning.
11.15-1130
Tea
11.30-13.15
Breakout session 2: Phasing and costing the plans: Prioritising the elements required to be
put into place, who will put them into place, what cooperation is required from other agencies,
timelines and costs for putting these elements into place, action plan.
Breakout session 1—Asthma management for all spaces. Facilitators: Dr Athar Qureshi,
Physician and community health worker
Breakout session 2—Ambient air quality management. Facilitator: Mr Paritosh Tyagi, Retired
civil servant, CPCB, Dr Vinay Vishwanath, CHC
Breakout session 3—Factory air quality management. Facilitators: Mr S K Gupta, Indian
Association ofAir Pollution Control
2
Breakout session 4—Air quality management in unregulated spaces (indoors & office):
Facilitators: Dr Vinay Kumar, Software consultant, environmentalist and organicfarmer, Mr S
J Chander, Institute ofPublic Health
Breakout session 5—Community intervention for factories and offices. Facilitators: Mr Cyril
Fernandes, Worker, trade unionist and environmental activist. Dr Sukanya Rangamani, CHC
Breakout session 6—Community intervention for ambient and indoor spaces, Facilitators: Ms
Priya Patel, Community health specialist. Dr E Premdas, CHC
13.15-14.00
Lunch
14.00-15.00
Plenary session 4: Panel discussion: What do we need to do to win the war against air
pollution in Bengaluru?
Moderator: Mr S K Gupta, Indian Association ofAir Pollution Control
Panel: Mr H Srinivasiah, Factories Inspectorate, Government ofKarnataka
Mr Arvind Jannu, Department ofEnvironment and Ecology, Government ofKarnataka
Mr P H Rane, Traffic Department, Bengalooru Police
Mr Govinda Raj, Bruhat Bangalooru Mahanagara Palike
Dr Jagdish Chinappa, Indian Association ofPediatrics
Mr V N Subba Rao, Karnataka Media Academy
13.15-15.00
Synthesizing the various plans by breakout session group representatives (who may sit
separately through a working lunch and during the panel discussion time)
15.00-15.15
Tea
15.15-16.15
Plenary session 5: Presentation of plans, general discussion and forming ad hoc
coordination committee to continue work in Bengaluru
Chair: Mr R Rajamani, Retired civil servant, MoEF
Brief presentations by representatives from each breakout sessions
Discussion
16.15-16.45
Closing session: Conclusions
Chair: Mr R Rajamani, Retired civil servant, MoEF
Comments on the workshop and how this process should be taken forward:
Convener, Ad hoc committeeformed in the workshop
Dr Neeija Rajkumar, Air Quality Management Task Force for Bengalooru, Government of
Karnataka
Mr Mylvakanam lyngararasan, UNEP
Dr H C Sharatchandra, KSPCB
Mr T Vijayendra, Cerana Foundation^ Vote of thanks.
3
13 Nov 2007
Dear
I wish to invite you or a representative from your organization on behalf of Karnataka State
Pollution Control Board for a meeting at 3 pm on Monday, 19th Nov 2007 at the
Karnataka State Pollution Control Board, Conference Room, 5th Floor, Parisara Bhavan, 49
Church Street (parallel to MG Road), Bengalooru - 560 001 (Tel: 80-25581383, 25589112,
25586520) to discuss and plan for a forthcoming workshop on air pollution and
environmental health—children's asthma. The workshop is to be held on 22-23rd Jan 2008
in Bengalooru with 100-125 invited participants. The draft announcement of the workshop
is attached.
The workshop will be distinctive from other workshops as it will not only discuss the
subject through presentations made by people with experience in the Helds of air pollution
management, asthma management and community interventions, but will provide about
half the workshop time for breakout sessions which will allow the workshop participants to
work out intervention plans to mitigate air pollution, improve health care for air pollution
related health effects and do community interventions to help communities to mitigate the
risk they face, and to take specific responsibility for implementing these intervention plans.
It is envisaged that the workshop will help in congeal a core group at Bangalore from the
areas mentioned above to carry forward the interventions that are essential to mitigate air
pollution.
The meeting agenda will be:
1.
2.
3.
4.
5.
6.
7.
Workshop venue
Workshop flyer
Steering Committee formation
Workshop methodology
Workshop agenda (draft)
Workshop speakers (suggestions)
Workshop participants (suggestions)
'
many of the agenda items can be
As previous experience in running such workshops exists,
covered quite quickly. The Mumbai workshop report and other background material will
be distributed at the meeting.
For any further information prior to the meeting, please feel free to contact me at:
Mahalakshmi - Mob: 98455 75665/ 080-26789637.
I look forward to seeing you at the meeting.
Sincerely,
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Mahalakshmi Parthasarathy
Ps: please copy all emails to me and Sagar Dhara
Workshop on air pollution and environmental
health—children's asthma
B^ngalooru, 22-23 January 2008
Air pollution and its related impacts on human health has become visibly severe. Over 300
million people suffer from asthma worldwide (WHO), and the number is rising. The
human and economic burden associated with asthma surpasses that of HIV/AIDS and
tuberculosis combined. In India, air pollution is estimated to cause, at the very minimum,
100,000 excess deaths and 25 million excesses illnesses per year.
To mitigate this impact quickly, air pollution control and health care interventions must be
supplemented with an effective community-based intervention programme aimed at
Involving risk bearers participating in solving their problems. This workshop will allow its
participants to make air pollution control, health care and community intervention plans
for Bangalore; and encourage government, professional and civil society organizations, and
individuals to commit to taking specific responsibility to implement the intervention plans.
It is hoped that a committee will be formed to followup on the workshop's
recommendations. Childhood asthma is a good indicator of the prevailing problem, hence
has been chosen as the focal theme. The first workshop of this kind was conducted
successfully with 80 Indian and foreign participants in Mumbai in June 2005. More such
workshops are planned for other cities later.
The workshop will discuss:
to
• Air pollution and health effects and estimation of air pollution-related injury
• Air pollution management interventions to reduce air pollution exposures /
• Health care interventions to mitigate asthma
y
• Community interventions to help people mitigate air pollution-related health/
risks
The workshop will attempt to produce an action plan to:
•
•
•
Improve understanding of asthma and its relationship to air pollution
Train asthma patients and communities to recognize air pollution related health
effects and improve asthma management
Improve management of air pollution and its related health effects
•
•
•
•
Develop approaches to help minimize exposure to air pollution
Encourage coalition building between affected communities and those working
on issues related to air pollution control and its health effects
Create partnerships between government agencies and community-based
organizations
Encourage participants and other agencies to commit to taking specific
responsibilities to implement the workshop^ recommendations
Participants: Asthma patients and networks, community health workers, professionals—
government and non-government—working in the fields of air pollution control,
environmental health, and communicators
Organizer: Cerana Foundation, D-101 Highrise Apts, Lower Tank Bund Rd, Hyderabad
500 080. Telefax: 40 2753 6128. Email: cranafdn@rediffmail.com
Sponsors: UNEP,
Control Board.
Karnataka
State
Pollution
Name: Mr/Ms/Dr* Dr.Vinay Viswanatha, Mr.E.Premdas,Dr.R.Sukanya,Ms Jayasree
Organization: Community Health Cell
Mailing address: 359 (Old No. 367), Srinivasa Nilaya,
Jakkasandra, I Main, I Block, Koramangala, Bangalore- 560034
Tel No:
Fax No: 25525372
91 -80 -25531518
Email: chc@sochara.org
Discipline: Environmental science/Engineering/ Health/Law/ Community organizer/ Media/ Environmental
activism/ Other* (please specify)
Specialization (eg, air pollution monitoring, pulmonologist, environmental law, etc):
If you are not a Bengalooru resident, please provide information regarding your arrival and departure
Expected arr time:
Arrival mode: Air/ Train/ Bus*. Arr dt:
Flt/Train name & #:
Arriving from:
Arriving airport/ station/ bus stand:
Expected dep time:
Departure mode: Air/ Train/ Bus*. Dep dt:
Departing to:
Flt/Train name & #:
Departing airport/ station/ bus stand:
Will you participate on both days*
persons
If for one day, will it be 22nd or 23rd* : Both days - 2 ; 23rd - 2 or 3
Do you have any special diet restrictions?
* Please strike off what is not applicable
Notes ok the breakout sessions from the Mumbai workshop
Breakout session 1
Air quality management interventions: Gap analysis, identifying critical elements that, if put into
place, can help reduce asthma incidence, what is required to put these elements into place and what are
the impediments for putting them into place.
Asthma management interventions: Gap analysis, identifying critical elements that if put into place
can help reduce asthma incidence, what is required to put these elements into place and what are the
impediments for putting them into place, who will put them into place, what cooperation is required
from other agencies, timelines and costs for putting these elements into place.
Community interventions: Gap analysis, identifying critical elements that if put into place can help
reduce asthma incidence, what is required to put these elements into place and what are the
impediments for putting them into place, who will put them into place, what cooperation is required
from other agencies, timelines and costs for putting these elements into place.
Breakout session 2
Air quality* management interventions: Prioritising the elements required to be put into place, who
will put them into place, what cooperation is required from other agencies, timelines and costs for
putting these elements into place, action plan.
Asthma management interventions: Prioritising the elements required to be put into place, who will
put them into place, what cooperation is required from other agencies, timelines and costs for putting
these elements into place, action plan.
Community interventions: Prioritising the elements required to be put into place, who will put them
into place, what cooperation is required from other agencies, timelines and costs for putting these
elements into place, action plan.
Breakout session methodology
fhe sequential steps followed in preparing the action plan are given below:
Visioning: Individuals spelt out their vision of the specific improvements they wish made in future
for the issue they were dealing with. Vision ideas were clubbed by major heads. Ideas that did not fall
into any major head were temporarily put into a “parking lot”, to be dealt with later. Vision ideas were
also classified as—short-term, medium-term and long-term.
Present status: In the next step, each group spelt out the present status of each issue.
Desired action: In the third step, each group worked out the action that is required to go from the
present status to the vision they had spelt out.
Multi-voting: In the last step, vision ideas were ranked by a process of multi-voting.
Groups
Workshop participants were divided into three groups to prepare action plans. Trained persons
facilitated the discussion in each group. Ground rules were followed for smooth functioning of the
groups. The members of each group are listed below.
Action plan 1: Air quality management
Action plan for the air quality management suggested interventions in the following areas: Planning air quality management, public participation, emission
control, transport sector and technology shifts.
Air quality management: Planning of air quality management
____ Present status____ __________ Action required___________
•
•
•
«
Many pristine environments not
identified, therefore unprotected
Areas of high risk associated
with poor air quality
inadequately identified
Lack of integration between
development planning and
environmental protection
Over-dependence on command
and control methods via the
regulatory mechanisms
__________ Vision
•
Identify ecologically sensitive areas (ESAs), and notify them
•
•
Identify areas with high risk associated with poor air quality,
do air quality monitoring, and establishing baseline datums
Assess risk posed by air quality in different areas
Action plan to reduce emissions and improve air quality .
include elements such
o Re-zoning of areas to using GIS to reduce risk associated
with poor air quality
o Set up new licensing standards
o Prohibit indiscriminate biomass burning
o Establish new infrastructure for the transport sector
o Move towards more eco-friendly transport systems and
technologies, eg, bicycles and bicycle tracks
o Carrying capacity of air sheds should be established
before siting air polluting industries and sources
o Provide financial help for cleaner technologies and fuels
Fix appropriate management strategies for each area
Monitor effectiveness of action plan
______
Link project funding to environmental sustainability
Rely less on foreign funding
Use Indian funding for environmentally sustainable projects
Prepare & circulate paper on air pollution and health impacts
Draw action plan to make all air pollution policies and plans
in consultation with public
•
•
•
•
•
•
•
•
•
•
2
•
•
•
ESAs, eg, Western Ghats, identified and
notified; pristine environments protccted_
Reduced risk in areas that previously had
high risk associated with poor air quality
Greater emphasis put on preventing asthma
than curing it
Urban planning and environmental
protection are integrated
Strategic environmental planning
emphasized over regulatory control
Air quality management: Public participation
Present status
Limited awareness about
environmental issues
_____________ Action required___________ __ ___________ Vision______
•
•
•
•
•
Public has limited rights to
environmental information
•
•
•
•
•
•
Limited people’s participation
in environmental decision
making
•
•
•
•
•
•
•
Include environmental education as part of school syllabus
from lower classes
Have more field trips/workshops in environmental education
Create environmental awareness among adults through cultural
programmes, workshops, banners, etc
Hold more drawing, painting, quiz competitions on
environmental topics for kids
Do more “public rights-based” awareness programmes
Do follow-up programmes after doing awareness programmes
Increase number of air quality monitoring stations and
publicize data from these stations
Public information cells must be created in pollution control
boards and environmental ministries
Information on air pollution and its impacts should be given to
gram panchayats (local self governments)_________________
Citizen’s groups to be formed, trained, and given government
recognition to monitor air quality
Public participation in public hearing processes should be
encouraged and strengthened
Community should be encouraged to participate along with
government in efforts to reduce air pollution
Communities should be given control over natural resources
Communities should be encouraged to use their traditional
knowledge systems in managing natural resources
Recommendations made in public hearings for facilities
requiring environmental clearances should be mandatorily
incorporated into the environmental clearance process
Popularize scientific awareness
3
•
Increased public (adults and children)
awareness on environmental issues
Better public awareness of health
implications of indoor and outdoor air
pollution
•
Increased public participation in
environmental management—as a right, and
not as a favour
0
Greater public participation in
environmental monitoring and management
leading to better regulatory compliance and
improve public access to information, eg.
EIAs being in public domain
People are empowered to monitor air
quality, eg, the use of the bucket method,
and ensure compliance of environmental
laws
Good public participation in public hearings
help avoid dirty and hazardous projects
Local communities have total control over
environmental regulatory decisions over
industries and polluting sources in their
areas, including refusal of permissions
Air quality management: Emission control
Present status_____
Violators of environmental laws
and regulations get away scotfree. or very lightly
Regulators remain largely
unaccountable for present state
• Old high-emission technologies
in use
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Universal yardstick to measure
progress made in emission
control unavailable
High ground level emissions
Roadside soil gets re-entrained
________Vision
___________ Action required__________ _
•
•
•
•
•
Amend Indian Penal Code (IPC) and environmental laws to
bring regulators and violators of environmental laws and
regulations under the ambit of IPC
Provide for stiff penalties for polluting and fuel adulteration
0
•
IPC used for non-compliance of
environmental laws and regulations
Regulators become accountable to public
Assess technologies of proposed projects for emissions
• Cleaner technologies and fuels used to
reduce emissions
Determine best available technology for all uses
Mandate that only best available technology is to be used
Continuous review of technologies for future application
Government-industry partnership provides assistance to high
air polluting small-scale industry to help them comply with
standards
Set quotas for air pollution emissions, including for individuals
Industrial licensing should prescribe strict time limits for plant
and machinery, so that outdated technologies are phased out
Introduce strict licensing policies for backyard smelters and
other small-scale polluting industries
Policy changes brought about to see shift from the use of
polluting fuels—petrol, diesel, to cleaner fuels, eg, gas, bio-gas
Encourage the use of low-cost bio-diesel that has low NOx
emissions (low O3) as a carbon-neutral alternative to CNG
Reduce subsidy diesel and diesel-driven vehicles
Improve kitchen ventilation; where possible use exhaust fans
Develop dose-response equations to air pollutants
Public health used as a tool for emission
control
Monitor health of workers exposed to pollutants and maintain
their health records_________________________________
Green the city
• Biotic control methods for pollution control
effectively used
4
Air quality management: Transport sector
Present status_____ ___________ Action required_____________
City roads congested and bad at
places
High pollution levels caused by
vehicular emissions
Inadequate public transport
Long lines for CNG acts as a
deterrent to switch over from
petrol/diesel
•
•
•
®
Improve public transport, including mass transport systems,
eg, railways, and encourage their use
• Reduce the number of 2-wheelers
• Provide segregated bicycle lanes and better footpaths
• Do not build malls at crowded junctions
• Educate vehicle owners on benefits of timely vehicle servicing
• Encourage entry of fuel cell powered vehicles
• Admix 10% ethanol in petrol
• Make ultra-low sulphur diesel available to trucks and buses
• Use of private vehicles may be restricted by law
• Make financing of private vehicles difficult
• Make toll amounts for single-occupancy cars higher
•
_________ Vision
•
•
_
Reduction in traffic congestion
Lowering of vehicular emissions
Air quality management: Technology shifts
____ Present status____ _____________ Action required____________ ___________ Vision________
•
e
High emissions and high energy
costs due to use of older
technologies
•
Supply-side management of
dirty fuels causing a lot of
pollution
•
•
•
Dirty environments
•
•
•
•
! •
•
Educate industry and transport owners on new low-emission
• Lower emissions and fuel saving through
technologies and their power-saving benefits
technology shifts
Provide clean air technologies to small-scale industries,
particularly to lead and zinc recyclers__________________
Provide financial assistance for making fuel shifts
• Shift in energy consumption patterns
Encourage use of renewable energy and cleaner cookstoves
Emphasize demand-side management through public
awareness campaigns__________________________________
Encourage the use of eco-friendly products
Cleaner environments
Encourage the slogan—Reduce, reuse, recycle
Make eco-labelling of products mandatory
Make doing life-cycle analysis compulsory
Mandate branding products with energy & air pollution burden
5
Multi-voting: In the multi-voting, the various sectoral interventions received the following votes, indicating their rank order of importance.
Public participation
52
Planning of air quality management 49
Emission control
38
Technology interventions
21
Transport sector
7
Action plan 2: Asthma management
The action plan for asthma management suggested interventions in the following areas: Resource bank, networking, asthma surveillance, education
and management, advocacy, education through media and research
Asthma management: Resource bank of health care providers, patients, NGOs, government and experts
Present status _______________________ Action required
______ Vision __
•
No patient
counselling
centres
• Each asthma unit to be provided with a counsellor
Target
Partners
Action steps
• Asthma
patients &
families
•
No community7
volunteers
working
specifically for
asthma
•
Timeline
• Hospital
managements
• Counsellors
Implementers
1-3 yrs
• Contact asthma care
units
• Create required
infrastructure
• Involve and train community workers to work for asthma
• Government
• Hospital
managements
• Private health sector
Target
• Asthma
patients &
families
Implementers
• Government
• NGOs
j_________________
Partners
• NGOs
• Government
• Communities
Action steps
• Train volunteers
• Organize meetings
• Monitor progress
6
Timeline
1 yr
Asthma counselling
centres established,
including in schools and
colleges
One asthma worker for
every thousand population
Asthma management: Resource bank of health care providers, patients, NGOs, government and experts (contd)
____ Vision
Action required
Present status
No known
specialized
asthma care units
»
No networking
among health
service providers
•
No support
group for
patients
• Set up specialized asthma care unit in each tertiary care hospital
______ Action steps_____ Timeline
Partners
Target
1 -3 yrs
• Put forth proposal for
• Government
• Asthma
setting up unit
patients
• NGOs
•
Arrange
funds (private
• Medical
& public)
practitioners
• Arrange health care
• Medical
staff for unit
colleges
• Publicise unit_______
• Set up a platform for health service providers to interact
Action steps
• Initiate contact with
professionals
• Arrange monthly
meets
• Start an asthma
journal__________
Set up a support group for patients
Target
® Health care
providers
• Research
personnel
• Experts
e
Target
• Patients &
families
Partners
• Health care
providers
• NGOs
Partners
• NGOs
• Patients &
families
• Health care
professionals
Action steps
• Contact patients &
families
• Form support groups
• Publicize
7
Timeline
6 mths1 yr
Implementers
• Government
• Hospital
managements
• Private health sector
Implementers
• NGOs
Each hospital to have a
special asthma unit with
specialized counselling unit
as have been set up for
HIV/AIDS
Existence of networks of
health care providers,
hospitals and laboratories
tracking each childhood
asthma case till treated
successfully
Patient network in existence
Timeline
6 mths1 yr
Implementers
• NGOs
• Community
volunteers
J
Asthma management: Partnering and networking—Asthma coalition/consortium
Present status
____________________ Action required____________________
• Take steps to form an asthma coalition
No asthma
coalition exists in
Partners
_____ Action steps
Target
Mumbai
• Patients & • Local officials • Take the aid of
• Exposure
existing partners to
families
• Donors
measurement
form a committee
• NGOs
• Media
infrastructure
• Identify key partners
• Hospitals
• Associations
weak
• Organize local meets
• Community
• Public health
• Set up communication
volunteers
programmes
between patients &
& workers
poorly funded
workers
• Programmes for
• Discuss preventive
preventing asthma
measures
lacking
• Hold regional (dist,
state-level) & national
meeting
Timeline
Implementers
1 yr: local • Cerana Foundation
meeting
may take the
2 yrs:
initiative, others will
regional
follow
meeting
3 yrs:
forming
national
coalition
5 yrs:
committees
function
properly
Asthma management: Surveillance system
_____ ______________ Action required__________________
Present status
•
No systematic
Develop a comprehensive surveillance system that provides information on incidence and
surveillance
prevalence of asthma in Mumbai__________________ ___________ _______________
currently in place.
Timeline
Target
Partners
Action steps
Implementers
Some
• Health Dept
• Identify coordinating 1-3 yrs
• Mumbai Municipal
• Patients
surveillance may ® Policy
Corporation
agency
• Municipal
exist in pockets
Corporation
• Record data
makers
• Hospitals
• Coordinating agency
e Health care
to collect, analyze,
providers
• Paramedics
distribute data
• Communities • Medical
•
Set up website
colleges
8
______Vision
_
International networking
among NGOs
• National committee to
address asthma at national
level by the end of the fifth
year
• More government funds and
aid are allocated for asthma
control
• Day care centres are created
for all strata of society
• Youth are involved with the
issue
•
•
4
____ Vision______
Better surveillance of asthma
Decreased incidence of
asthma amongst children
Increased awareness about
asthma
Asthma management: Education and management
Present status _______________________ Action required_______________________ _______ Vision
•
Preliminary steps
being taken by
physicians to
educate patients
and their families
Holding regular workshops for general practitioners (physicians) for early diagnosis of asthma
Holding workshops for patients for them to understand their disease
Teaching about asthma in community medicine courses
Holistic approach developed towards asthma
Holding regular classes for parents of asthmatic children on recognizing asthma and its links to
the environment
Target
Partners
Action steps
Time-line
Implementers
1-3 yrs
• Doing continuing
• Patients
• Specialists
• Medical associations
medical education
• Associations
• Families
• Health Department
(CME) for physicians
• Communities • Media
• Publishing and
• Schools
• Community
distributing literature
groups
in hospitals, schools
• Clubs
•
Developing a website
• Institutes—
yoga, ayurved
•
•
•
•
•
•
•
•
High public awareness about
asthma
Asthma management experts
would have reached interior
parts of the country
Develop an understanding of
cultural differences between
communities
Asthma management: Advocacy
_______Present status__________
•
®
•
Government not yet focussed on asthma, hence no
pro-active government policy
Not all stakeholders are yet involved with this issue
Though air quality has improved, more needs to be
done to improve it
Action required
•
Public campaigns are
conducted to achieve
desired end-goals
9
__________________ Vision_______________
• Government focuses attention on asthma and commits funds
• Government becomes pro-active in developing policies,
legislation, regulation for a cleaner and pollution-free indoor and
outdoor environments
• There is an increased involvement of all stakeholders in this issue
Asthma management: Education through media
_
Present status
_____ Action required_____
_____________________ Vision_______
•
Asthma related issues has
no exposure in media
• Use media for educating public about
asthma and reach deprived groups
•
•
High public awareness about asthma
Asthma management experts would have reached interior parts of the
country
Asthma management: Research
•
Present status
______ Action required
_____________________ Vision
Limited research and
studies being done
•
•
•
•
Encourage studies on asthma and
provide the wherewithal for this
Nutritional aspects of asthma management are better understood
Research on the genetic basis of asthma being done
Preventive measures for asthma attacks are better developed
Multi-voting: In the multi-voting, the various sectoral interventions received the following votes, indicating their rank order of importance.
Education and management 29
Networking
21
Asthma surveillance
19
Resource bank
16
Research
16
Education through media
9
Advocacy
7
10
Action plan 3: Community intervention
The action plan for the community suggested interventions in the following areas: Education and awareness, collective action/community empowerment,
government accountability and changing value systems (enlightenment).
Community intervention: Education and awareness
__________ Present status_________
_________ Action required_________
•
•
•
•
•
•
•
•
•
•
Lack of community educators for asthma
Myths, misconceptions, ignorance about asthma
abound
Environmental education not part of school
education
Access to asthma management centres poor
Asthma triggers in the workplace accepted as
holding job is more important
Low awareness of asthma issues
Awareness of asthma lower amongst the poor as
their education levels are low
Information on impact of pollutants inaccessible
Environment has been included in NCERT books,
but not all children use these books
Some cultural factors are impediments for
asthmatics to discuss their problem
Observe communities at risk and their.environments,
including cause-effect relationships between asthma
and air pollution
• Take stock of existing knowledge and expertise,
educational and medical resources
• Develop relationship with communities
• Eco-clubs, self-help, youth and women’s groups •
should be used as mediums for education on asthma
• Use existing science &, environmental awareness
programmes to spread awareness about asthma
protection
• Develop educational material and plans for its
dissemination
• Introduce yoga classes in communities
• Prepare workbooks to help asthmatics understand
the risk they face and take steps to protect
themselves
• Intervention areas—Govandi slums, Chembur,
Western and Eastern highways
• Assess/evaluate progress & modify it as required
•
ii
________ Vision
•
•
•
•
•
•
Current community workers
trained to work as asthma workers
Increased asthma awareness in
community, including slums and
rural areas, through campaigns
Cause-effect relationship between
asthma and air pollution >s well
understood by public
Yoga used in asthma management
Workbooks available to help
asthmatics understand the risk they
face and take steps to protect
themselves
Improved data collection and
dissemination
Community intervention—Government accountability
________ Present status__________ _________ Action required_________ _________ Vision__
<»
9
•
•
•
•
Carbon users are not paying for the pollution they
cause
Government departments function in isolation and in
an uncoordinated manner
Government departments pass-the-buck, indulge in
blame-games, have high inertia
Government policy is currently against community
interests
Communities do not have the space to participate in
policy formulation
Local communities are not taking adequate
responsibility to make government accountable
Individuals in India and the US are not accountable
for their daily actions—actions that add up and
immensely contribute to environmental
degradation—energy consumption, solid waste
generation, toxic chemicals release, aerosol
propellants, tobacco smoke, etc
• In line with the “polluters pays” principle, policy
changes should be brought about to make carbon
users (conspicuous consumers) compensate carbon
victims (air pollution sufferers)
• Regulators should be made to implement what they
say in public
• Local administrators should be appointed to
decentralize government functioning
• Local communities should be empowered to draw up
local environmental management plans
• As sense of ownership of action plan increases,
communities should be encouraged to demand that
government become more accountable
Community intervention—Changing value systems
________ Present status_______
_________Action required_______
©
o
People lack concern for others
People keep their homes clean but do not mind
polluting neighbourhood
Gap between allopathy and alternate holistic
treatment
• Changing value systems is very difficult, but must be
done through example and gentle persuasion
® Attempts are made to have “Right to life”, enshrined in
the Indian Constitution as a fundamental right, re
interpreted to mean “Right to know risks being faced”
12
•
•
•
Government becomes more
accountable for its actions and
sensitive to the needs of
communities
Government departments work in
coordination
Polluters become accountable for
the pollution they cause
________ Vision_______
•
Global outlook starts shifting from
“gain maximization for a few” to
“risk minimization for all"
Community intervention—Collective action/community empowerment
Present status______ ___
_________ Action required
S
<s>
a
Inadequate networking amongst NGOs for taking up
community intervention programmes for asthma
mitigation
Communities are not empowered to act on this issue
Geographical areas where communities at risk reside
makes their empowerment difficult
The politicization of issues in communities poses a
barrier for taking up this issue
Asthma patients are not empowered to deal with
issue—they do not know their options
• Take steps to make risk-bearers the centre of risk
mitigation programme and involve them in
investigation programmes
• Networking amongst stakeholders to be improved
• Create local action groups, self-help groups
• Set up a peer counselling system
• Discuss environmental issues, including hazards and
their solutions in such groups, eg, regarding vehicular
emissions, public transport, indoor air quality,
ventilation, etc
• Public policy issues arising as demands from
community discussions need to be articulated to
authorities, eg, improvement in public transport
system, etc
• Local communities should be empowered to
participate in making environmental management
plans
• Government should be asked to take up programmes
for asthma mitigation on an emergency basis
<> Popularize car sharing
______ Vision______
a
G
ffi
©
Risk bearer become the centre of
risk mitigation programmes
Sufferers, community-based
groups, women’s groups, form
community-level planning and
implementing bodies and are
involved in decision making
Every ward has a community
based group to report on industry
and vehicular emissions
Clubs involved in doing
community-based work, including
doing surveys, checkups
Multi-voting: In the multi-voting, the various sectoral interventions received the following votes, indicating their rank order of importance.
Education and awareness
Collective action
Government accountability
Changing value systems
37.5
24.5
24.5
8.5
13
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Details of invitees for the 19th Nov 2007 meeting
NAMES.
OF,
INVITEES
3.1. Glv <^ ^7
NGO’s_______ _______
1) Society7 For
Community Health .
Awareness,. Research arid.
Action,
■(SOCHXKA)i^^irity
ADRESS
g
n‘
<
Public Affairs Centre
A
' .. l.
' "‘f "7
;•
Jana sahayog
Work extensively on
communi ty health
Confirmed; will be
attending
Envisage core
group to be an
important
outcome to
carry forward
the good work
in the area.
Civic issues
Would not be able to
attend as has an
internal meeting on
the same day
Work with people in
urban slums also have
done a water pollution
Confirmed, Mr.
Narasimhamurthy
and
Need to be
involved as they
have been
working
intensively on
civic awareness.
Latest campaign
for electoral
process :vote
Bengaluru
Can help in
better
understanding
7 Tlielxna :Wi25791 V08025533064 (Res)
■nXyr-y ■
W7.V7CS?
7O 111
•
;
REMARKS
■
367; Srinivasa Nilaya,
Jakkasahdraj-1st main, 1st Block,
Koramangala, Bangalore.
Telephone-91-80-255315,
Email: socHara@,vs nl.com
Website: vww.sochara.org
»7
...
CONFIRMATION
FOR
19th
MEETING
.
-
OF
:
Dt Sukanva /Dr
.
Vinay/Dr ’
*
■ ThelrrigMJ^remdfe. <•
.
in
■■
CommunityHealth Cell'
(CHQ
AREA
INTEREST
.
.
nji
...
.J,,'
•'
-
'
>
■
,
Poornima
Janardhan D G
Pr6gfam me Consultan tPublic Affairs Centre,- Bangalore.
98'457.-62757
’ '- y’
poornimaj ana rd ha n(te vah oo.com
‘.......
JANASAHAYOG
40,;8tl?Cross, 5th Main,
Sampangirama nagar. Bangalore-
1
-560027
Phone & Fax + 91-80-22128565
janasahayog@gmail.com
Child Rights Trust
study
Mr Vasudevan. Sharma
o
-f-:- 7'vadesha@gmail.-com -
944847251.3
/
■
''
Concerned person .
-MV
NO
? Service Road,
Road Domlur
T
No 2,
Layout, Bangalore—’—-560 071
Mr Selva will attend
the impact of air
pollution with
the
prevailing
social
inequalities and
also take the
message to the
areas they work.
has been informed Part of the.child
and'had said he will welfare
revert back.
committee,
works ostly on
policy advocacy
. fslated to child
. ^rights.
~ Have . sent imdte
. /spoken to* Arul /yet
to revert back
■
Si
:
;
..
,
mvrada@vsril.com Ph: 91-80V .O 25353166CMCA : Children’s
#346, 3rd Cross, 8th A Main,
/Movement for Civic^
Koramangala . .4th s block.
Awareness
C..;-yr Bangalore - '560 034. Ph
V- :25538584Z41105161
.'V■>„ --cfflea6kpfessions@.yah6b.coan '
? A :t'?-' ■
AG '
.•C':. - -i' • "■
(CMCA) joint initiative
of the two non
government
organizations (NGOs) '
- Public Affairs Centre
(PAC) & Swabhimana.
with a commitment to
nurture and foster
active citizenship in
children with regards
to civic and
environmental
Have sent invite and
spoken to them over
phone/they will try
sending someone but
they
have
their
monthly
volunteer
meeting on 19th Nov
2007
Need to be
involved as a
synergy
can
bring about the
required results
to push for a
higher
environmental
I civic
consciousness
amongst
the
youngsters.
2
consciousness. Has
over 180 schools in
Bangalore, Hubli
Dharwad, Mumbai
and Bidar.
Quarry Workers &
Rural Integrated
. _
No.- 63; Little Rose Villa,
K.S.F.C Layout,
'
_.........................
Banr
1
560084
■="-
Manoharan
988630367
Confirmed/will
attend
;
•
7 . :
Work on health
issues of Quarry
workers and
. their children
-
• XQQ'.
.
.........
1
Government__________
11.............
ioaktilkarmfevsnl.net ■
456767
___ '
'
_______________
Pramod Kulkarni
(Karnataka) State '
'Hdaltfr^dTamil
welfare Deparm
______ ,
•
~
.. ..........................
•
o
-___________ ■
.
—
5«™VD«E°E
■■
confirmed
___ i. •
- r 'Dir
Dir
: ' i Contirmed —DrPfemaleela
™
--------------------Church street Bangalore
Chr
Chairperson/Memeber Confirmed
. . - .__________________________________ J ^.nanperson/m
difhfw(S)vsril
net
'•
■
'__________________
...................... .... ftermtsrv
Doctors
Dr Girish , Asst Prof Secretary KACH,
Nimhans
girishnrao@\ah()o.com
I 9341226277'
Work with
Runaway
children
'4.
__
:
°
andPEhwo^enC
edrift
. -
Have Dr’s who have
done studies on air
pollution in the city
.
.
Confirmed to send
Dr ‘ who are familiar
with the area.
I'
I
.
.
Their network
can be useful.
3
Dr Prithvish
Dr.S.Pruthvish
Professor of Community
Medicine and Director - Health
Care waste Management Cell,
MS Ramaiah Medical College,
Bangalore, India
Mobile: 9901042731
(o) 23600968 ® 23410005
psreekantaiah@yahoo.com
Dr Omprakash
5/A, Kumarakrupa Road, High
Grounds, Bangalore - 560001
Ph no. 2267428
prasadom@hotmail.com
Victoria Hospital
Premalatha53@hotm.ail.com
/______
Dr Prema Sharathchndra
Co-ordination
Has worked with auto
driver unions
Cannot attend
will be traveling,
he
Has given some
relevant
contacts will be
in contact for
further
information.
No confirmation
Confirmed will
attend
Paedaetrics/has
given number of
relevant
contacts
.
A
'
-
aHH
ST'
'
n o A'
<2O7z_.
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4
2- 2-2-
1) Presenter: Dr.R.Sukanya, Research and Training Associate, Community Health
Cell,Bangalore
2) Title: Community health and air pollution- community action to reduce health
risks
3) Abstract: This presentation will highlight how communities' health is
affected by air pollution and explain why a community approach to reduce health
risks is urgently required. Community groups like children, women and persons at
workplace are most vulnerable and have varied disease burdens. The factors
that increase or decrease such The talk will focus on why and what can public
do about strategies to tackle environmental health risks and the role of the
public in such intervention strategies will be also be explained. Some examples
of community intervention programmes in Bangalore will be showcased.
4) Resume- br.R.Sukanya is a team member from Community Health Cell,
Bangalore. CHC is part of the global, national and regional people's health
movement. CHC supports community health action and advocacy, conducts
training in community health for various groups working on health issues and
facilitates networking of partner organizations in the campaign for right to
health for all.
Air pollution and health impact
CMommity h.aia> ■»'»«' P°''»'1,>";
----- '
♦Clem A® “ ta“fo'°»oiS™”SiUwl>ei”S! I
environmental Health risks
^DiseaseTamburden
riaronic
♦Respiratory infect^Xfase?reartive airway
January 22-23,Bangalore
I
cancers
Dr.RSukanya
Community Health Cell
Bangalore
W0MEN AND CfflLDREN-MOST VULNERABLE
Community health impact
>^S=3B”
^Tobacco smoke
g
DISEASE
disproportionate burdenofdis^_
What have we done?
KS^'0'"4"
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1
Consortium for tobacco free
Karnataka
4 CFTFK is a network of organizations working
towards tobacco control in the state,initiated
byCHC
4 Children, office goers,health professionals,
patients and their relatives,general public
4 Create awareness about ill effects of tobacco,
socioeconomic political aspects of tobacco
cultivation and the industry
4 Policy work on ban of tobacco
4 Networking with community groups
Challenges - Community
Action
4 Human perception of risk determines
response to health risk
4 Communities become risk bearers
4 Polluting Technology- Has to be eliminated
4 Convergence of different communities
4 Framework of Equity
What do we need to do ?
4 Complex factors - multiple level of
interventions
4 Interventions have to be equitable
4 Public participation for Community Action
4 Access to information
4 Community health - economic productivity,
social well being- educational attainment
Advantages Community action
4 Preventing Disease -
Health care costs
Disease burden
4 Long term impact on Health
4 Most equitable option - benefits across broad
groups or populations
2
Why do we need community
health monitoring?
Health monitoring in
environmental pollution impacted
communities
• Only a small percentage of all known chemicals have been
New Delhi, 17th February 2008
R.Sukanya
Community Health Cell,Bangalore
problem is “proof of absence” - WRONG ASSUMPTION
Exposure - Is it the cause for my
health problem?
• Acute events Fire/Flare in a Factory - Breathing difficulties
Effluent discharge contaminating water - Loose stools
Pesticide poisoning of children in a school near
sprayed field- fainting
• More than the usual number of people are affected
• Exposure occurs first, followed by health effects
• Specific chemical - health effect
• Evidence - Physical proof of fire/blackish water;
Documentary proof of medical certificates
CAUSE —'
Genotype
Nutrition
Immunity
Behaviour
/
VECTOR
fully studied for their human health impact.
• “Absence of proof’ of exposure to toxin and health
• Exposure to toxins and Health problems - identified
late,identified at a severe stage,and cannot be cured.
Exposure- Is it the cause for my
health problem?
• Past exposure - Current health problem
(Endosulfan - Children developmental delay)
• Current exposure- Long term health problems
(Air pollution - Asthma)
• Current exposure- Future health problems
(VOC's - Cancer)
• Multiple Chemicals - Health Problems ?
• Pollution is common - Problems are also common
Biologic, Chemical,
Physical (injury, trauma)
Social / Psvcholoaical
\
Sanitation
Weather
Pollution
Socio-Cultural
Political
PERSON Z--------------------------------A ENVIRONMENT
Interaction of Host, Causative Factor and Environment through
Time governs disease occurrence.
CAUSE —’ I
Genotype
Nutrition
I
Immunity j
Behaviour
Malarial parasite
/
\
/ MOSQUITO \
\
'
PERSON ----------------------------------
Climate
change
Pollution
Socio-Cultural
Political
I
ENVIRONMENT
| INCREASE IN MALARIA EPIDEMICS"]
1
Causative Factors in Disease
Giologic
genetic
Describe ....
• Person who has directly experienced the illness or adverse
event narrates what happened.
• Explains the Sequence of events
sodo-cultural
i
GOOD
HEALTH
(idianouraf
em-ironmeutaf
Time
nutrition,if
• Questions directed to understand what the person perceives
as the reason behind the illness.
DISEASE
1,4
! entered the factory and we couldfeel a strong smell. Women said
it is the smell ofpesticide sprayed. They sometimes spray during the
weekend.Afler halfan hour of work,!felt nauseous and vomitted.
1 was then unconscious and woke up to find myselfin the Hospital.
The doctor asked me whether 1 had eaten in the morning. I usually do
not. Many of us women do not eat in the morning But the smell was
too much. '
(itaflftstn-icc
iwfiuuoiofjiraf
By time...
Describe
Time dimension is an important component of Monitoring.
Time trends (long-term & seasonal) are important to study
since Disease rates change overtime.
/ keep six honest serving men, (they taught me all I knew).
Study of long-term trend:
Their names are what, why, and when and
how and where and who.
- Rudyard Kipling
• Helps in the prediction of future occurrence of a disease.
• They can be used in Health Policy making.
• They can also be used in evolving Hypothesis on Etiology
of disease as in the case of smoking and lung cancer.
• Study of seasonal variations can be helpful in understanding
patterns of disease and even increase in risk due to
behavioural factors.
By Person
• Age, Sex, Race - who are the affected people and why are
they more susceptible.
• Marital status. Immune status are subject to change
• Behavioural characteristics like use of tobacco, alcohol,
etc.- Interaction of these factors influence general health
status
• Conditions of living like socio-economic status. Housing,
Access to Health & Medical care, Urban/Rural, etc.
By Place
Gives insight into the geographical extent of the problem
Geographic consistency refers to the congruence of the observed illness
episodes and the exposure area. ('.ategories could be:
•
Place of Residence
•
Place of Employment
The choice would depend on the nature of the problem.
Data on place is better presented pictorially in Maps rather than Tables.
A Spot Map of people affected is very useful. It will be useful to
make a map of the exposure area (including possible run-off areas
and spray drift areas) and mark the households where acute illness
episodes and chronic hr,;ilth problems are rcnnrtpd
2
Collect Evidence
Describe
• Extent of the health problem in the population.
• Detailed description ofthe health problem by population
composition, geographic spread and occurrence along the
time-dimension.
• Identification of High Risk groups in the population.
• Clues to the causes of disease which can help in
Exposure
People’s description
Photos/Newspaper reports
Reports from Corporate
Companies
Village meetings
Estimate of Environmental
contamination - factory
records / Modelling
Health Problem
People’s description ( notes
and tapes)
Photos / Newspaper reports
Medical records / Lab Tests
Technical papers/reports
Grama Sabha meeting report
Research study findings
Doctors’ / Health system
testimonies
developing appropriate hypothesis for testing.
X..
Collect Evidence
• Must be able to recognize what will constitute evidence in
a certain case. This recognition is developed by
j ......... - -*
researching, learning, and experience.
i
• Testimonies—Documentary—Laboratory
• Clinical records - definitive diagnosis
• Report Cards - ongoing monitoring
Questionnaire surveys-Cross
sectional Surveys
• What are the health problems among children in villages of
Cuddalore Sipcot area?
• What are the factors that lead to women having abortions
in a mining area ?
• How many men workers are having asthma in the refinery?
• What work process predisposes men to leave their job in a
chlorine factory?
—
..
......fiWUBt.------ i
§
4
■ ~ M
...
• Questionnaire survey - frequency of a problem
• Body mapping - exploring the type of problems
. Sissw
fj-a
1 JS-i
q >
;
■
*
—I
M 'Se i
Patterns....
• Every Monday morning - women in the cashew
processing factory complained of Giddiness,nausea
and vomiting. (As spraying occurred in the weekend)
• People living along the stream with pesticide run-off, have
more episodes of illnesses, more children from these
houses have epilepsy and congenital defects
• Persons working in chlorine cells have reported complaints
of tremors.
3
Patterns
Comparison
.
Comparison
• Frequency of health problem - wheeze in workers / non
workers; men/ women ; children/ adults
• Frequency of problem - affected community vs. Control
community ( less exposed)
• Frequency of problem (death )-affected community or
workers group vs district population of similar age and
No. of susceptible
sex
Total population
Causation
Comparison
• Exposure
• Nil / Different exposure
Who are the people ?
Age,sex,work
Who are the people ?
Age,sex,work
What is the health problem?
What is the health problem?
How many ? 6/30 women are
sick
How many ? 1/5
women are sick
• Exposure -> Disease : Temporality
• Dose - response :
Severe exposure -Severe Disease also
Lesser exposure / No exposure - No disease
• Strength of association
50 % of exposed are sick /10 % of unexposed are sick
• Biologic plausibility : Mercury — Tremor
Pesticide — Respiratory paralysis
Dust-silica- Breathing difficulty
Skills required
Long term Monitoring
• To document
• Describe the Health status of populations
• To mobilize community
• Determine the “causes” of health problems
• To understand community health
• Predict the occurrence of health problems in
• To network
• To respond to a situation
• To be able to seek truth - learn about toxin,learn
about disease
populations
• Control the occurrence of health problems in the
population through prevention / therapy
4
Limitations of science
Limitations of Science
Clinical effects mimic common illnesses Therefore burden of illnesses
has never been quantified. Eg. Headache , Nausea, Breathlessness
Failure to establish the threshold levels of exposure for
common outcomes. ( we have only LD 50 levels)
Follow-up studies among communities are rare.
Experimental trials - Manipulating exposure of potential toxins among
human population is unethical.
Sample size and statistical significance as a criteria for
scientific plausibility.
Toxicity studies in animal models are 5-6 years but in human
beings, diseases occur after 20 years, trans generationally.
Single chemical -effect models - In reality, multiple chemical
interactions
Timing of exposure is inaccurate,Surrogates of exposure are used.
Expert systems of knowledge - will explore gene interactions, cancer
etc. As Compared to Wise systems- community knowledge of
illhealth.
—
5
Towards a System - Preparatory Phase
TOWARDS A SYSTEM OF COMMUNITY
HEALTH MONITORING
. Sensitivity to presence of possible toxin /
pollutant.
. Gathering information.
. Identifying partners.
. Identifying key players.
Dr. Rakhal Gaitonde
Community Health Cell & People's Health Movement
Towards a System - Monitoring Phase
. Planning a strategy.
. Collecting local information.
. Putting information together, making sense of
information.
. Putting information together
Towards a System - Post Monitoring Phase
. Dissemination.
. Follow up activity / using the information.
1
Sensitivity to presence of possible toxin
Sensitivity to presence of possible toxin
Contd....
. Cluster of cases - mainly non- infectious.
- Cancers, asthma, skin conditions, birth defects, abortions.
. Clusters of unusual symptoms
- Attacks of breathlessness, itchy patches on the skin,
episodes of eyes burning and watering, fainting / feeling
faint, irregular menstrual periods etc.
. Presence of industry / industrial complex
nearby.
. Effects on plants.
. Effects on animals - sudden fish kills, deaths,
abnormal births.
. Doctors advising people to leave the area to get
relief from recurrent illnesses.
. Visible effluents, gas leaks, sever odours.
Gathering information
. Possible causes of symptoms / diseases /
problems in animals.
- From doctors; Local Vets; Local colleges; Internet;
Other environmental groups; Journalists.
. Possible sources of such chemicals.
- From doctors; Local Vets; Local colleges; Internet;
Other environmental groups; Journalists.
. Details about various industries nearby (and
upstream where appropriate)
Gathering information contd...
. Details about laws, rules and norms.
- Good manufacturing practices, effluent treatment,
government monitoring bodies, threshold levels that
are relevant to local courts.
. Similar problems in communities in other areas
living near similar industry.
. Environment groups, health groups, internet,
journalists
2
Identifying partners
. Doctor / para-medical professional.
. Environmental group / activist.
. Local academic institution.
. Local medical college hospital.
. Legal cell.
. Media partners.
Identifying key players
. Local self-government structure / representatives.
. District authorities.
. Pollution control authorities.
. Public health care system.
. Industry representatives.
. Workers unions.
. Representatives of groups in local communities.
. Environmental / Chemical labs.
Putting information together
. Are there symptoms / diseases that are likely to be
caused by toxins / pollutants?
. Are these toxins products / by-products of a nearby
(or upstream) industry?
. What are the legal guidelines for effluent / emission
treatment and composition?
. Where and how can these be tested - what
samples need to be collected? How?
Planning a strategy
. Defining overall goals of campaign.
. Identifying partners - roles and responsibilities.
. Evolving funding strategy.
. Evolving knowledge strategy.
. Evolving advocacy strategy.
. Evolving a communication strategy (media).
. Define the various components.
. Any confirmatory tests?
. Other communities affected? Visit / information.
3
Collecting local information
Collecting local information
. Environmental sampling.
. Biological sampling.
. Health impacts - survey / surveillance.
. Identify substance / substances that can cause
harm. Produced in a factory nearby (plausible)
. List known side effects / health impacts of the
substances.
. Make sure to include ALL symptoms
*
Collecting local information
. The symptoms need to be chosen carefully.
. They need to be typical of the toxin.
. Do NOT neglect unusual symptoms.
. Simple questions to rule out other common
diseases that can cause similar symptoms.
. Symptoms that are more 'objective' and more
'exclusive' for a given toxin.
. Subtle signs.
Collecting local information
. Other questions:
- Documenting exposure.
- Documenting symptoms.
. Logistical:
- On whom to do the questionnaire.
- Age group / circumstances.
- How often.
Collecting local information
. After deciding on the exact symptoms to
document.
- The words to be used in the questionnaire.
- The meaning and definition of a symptom.
- The tool - training of the field worker /
standardization.
Putting information together
. Making sense of the information collected.
. Using multiple perspectives and paradigms to
put this together.
Follow up activity
Dissemination
. Within community.
. General media.
. Mitigation / compensation.
. To local self government.
. Prevention
. To district authorities.
. Research
. To Pollution control board / Health department
. Rehabilitation
. To industry.
. To larger environment and health movement.
. Policy
. To academic community.
5
Concepts of Health
Concepts of Health
. Health depends upon much more than merely
the presence or absence of genes, germs br
toxins.
BIO-PHYSICAL
BIOLOGICAL/BEHAVIORAL ---- - HEALTH
SOCIO-ECONOMIC
. Theoretically one can discuss three levels of
causation.
- Immediate.
- Intermediate.
- Basic.
. No isolated intervention can have a holistic or
sustainable effect.
Concept of Community health
Concepts of Health
. Not just presence of ill people but the proportion
of ill people.
- Presence of illness.
- Outcome - cure; disability; death.
. Community defined not only geographically.
. Environment and occupational health struggles
need to be seen in this overall view as one of
many struggles.
. Modified by factors affecting people at
community level - simply due to reason of
belonging to that 'community'.
. A common structure causing the various ills and
injustices.
. Need to build networks with / lend solidarity to /
learn from other struggles.
. Access; Determinants; livelihoods; power &
control of resources.
Concepts of Disease
. Disease - break down of normal functioning of the
body / organs eg. Asthma
Functioning of Organs in the body
. Symptoms - a problem / discomfort that the person
complains of eg. Breathlessness
. The numerous organs work to maintain the
normal function of the human body eg.
Respiratory system - 02; Renal to filter wastes.
. Sign - something elicited by the trained health
worker eg. Wheeze on auscultation
. Thus proper functioning is critical to overall
health.
. Syndrome - Collection of symptoms eg. Mad
Hatter syndrome
. Functioning includes:
. Disease - collection of symptoms, signs, biological
modifications eg. Renal Failure
- Physical component.
- Chemical component.
1
Natural History of Disease
Inflammatory reaction
Progression of disease through successive stages to
recovery, disability or death in the absence of intervention.
ONSETTOP
rows
SYMPTC
. Heat
. Redness
. Swelling
EXPOSURE.
\
. Pain
. Loss of functioning
Susceptibility |
USUAL TIME OF
DIAGNOSIS
PATHOLOGIC
CHANGES
—r
Sub-Clinical
Disease
Often Bulk of Iceberg
—
|
Clinical
I Recovery Disability
Disease
Often merely
Tip of Iceberg
Eg. Respiratory system
Respiratory system and toxins
. Nose / Lipper airways / lower airways / lungs
. Huge area for gas exchange - therefore entry
of gases - Hydrogen Sulphide; Mercury vapour.
. Protective component - in addition to usual
response - constriction of the airways.
. Physical component - muscles / rib cage /
diaphragm.
. Chemical component - air exchange
- CO2
. Toxins can initiate inflammatory process along
surfaces - Kerosene, gasoline fumes Chemical pneumonitis.
. Some toxins can cause the protective
mechanisms to hyper-react - eg. Chlorine
causing Hyper-reactive airway syndrome.
> 02
Organs and disease
Organs and disease an example
. The body will successfully adapt to minor
changes.
. Problems will arise either if the challenge is too
large or the protective mechanism goes out of
control.
. Break down of normal functioning of organs
leads to disease - when this crosses a certain
threshold it MAY result in symptoms.
. Kidneys.
. Filters the blood its waste products.
. Mercury can damage the cells that filter the blood.
. Leads to increased leakiness - may or may not be
associated with disease.
2
Community He*
mmunity Health Learning programme (CHLP) - P.Sr... Page 2 of 2
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Organs and disease an example
Organs and disease
. Extensive destruction of cells leads to improper
functioning and cessation of filtering leading to
renal failure and the accumulation of toxins in the
blood.
. Symptoms such as itching, puffiness of face.
. Signs such as - raised urea, creatinine, high BP.
. Thus for a symptom to show itself quite a bit of
damage has already occurred, an inflammatory
reaction has been kicked of.
. Conversely even if there is damage - it may not
show up as bodily symptoms.
. Some times symptoms may be very late
manifestations, - eg. In cancers
Organs, disease and symptoms
Organs, disease and symptoms
Respiratory system:
. Many processes can lead to the same
symptoms.
. Inflammation.
. Organ dysfunction to symptom path common
regardless of reason for initial insult.
Organs, disease and symptoms
Pneumonitis
bacteria
Organs, disease and symptoms
Peripheral nerves
Kidney
Diabetes
Toxic chemicals
‘Renal Failure
Diabetes
mercury vapor / gasoline vapor
Vitamin B12 Deficiency
- Nerve damage
Mercury
3
Organs, disease and symptoms
How to differentiate causes ?
. Individually - may be difficult.
Respiratory system
. One needs to describe patterns in communities.
Dust allergy
Episodic breathlessness
Viral infections
. Example
- Seasonal breathlessness vs. breathlessness year
round
Chlorine gas
Soot and other particulate pollutants
Individual variation
How to differentiate causes?
. One needs to see context; other symptoms;
other signs; biological tests.
. Example - numbness of hands and legs nerves destroyed.
. The sensitivity / threshold / immune system.
. Thus two or more people exposed to the same
toxin may react quite differently.
. Eg. Pollen allergy; dust allergy.
. Diabetes - Increased sugar in blood.
. Nutrition
. Vit B12 - Anemia, Vitamin level in the blood.
. Mental status
. Mercury - exposure history, mercury in blood.
. Underlying illness
. Note both diabetes and Vit B12 deficiency can
occur in people with exposure to mercury.
. Children
Individual variability
. Thus one needs to look for and recognize
patterns.
. One needs to control / take note of individual
variability while building up a case.
Toxins
. A substance that disrupts the normal
functioning of the organs / cells.
- Naturally occurring substances found in body.
- Naturally occurring substances not usually found in
the body.
- Artificial substances.
4
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i n v e n t
Routes of entry
. Oral - most dramatic.
. Respiratory
. Skin - not usually thought off but sometimes
most crucial.
Effect of the toxin depends on..
. Dose
. Potency
. Mode of entry
. Individual hypersensitivity
. Underlying factors like nutrition etc.
How do toxins act?
. Chemical reactions of the body affected.
. Break up of genetic material.
. Physical irritation / destruction.
. Endocrine / immune disruption.
What does the body do to the toxin?
. Bio- modification
. Makes it more excretable.
. Less toxic
More toxic.
. Storage and accumulation
Conclusions
. Importance to understand the fully natural
history of the diseases being caused by the
toxin.
. Important to rule out other common causes that
can cause same symptom.
. Importance of individual variability.
. Importance of looking at community distribution.
THANK YOU
1
Gmail - Revised agenda for the Conference - pl ignore the previous ones!
http://mail.google.com/mail/?ui=2&ik=f799cc59fe&view=pt&cat-ca ...
Sukanya Rangamani <sukanr@gmail.com>
BETA
Revised agenda for the Conference - pl ignore the
previous ones!
Shweta Narayan <nopvcever@gmail.com >
Thu, Feb 7, 2008 at 4:42 PM
To: Arul Selvam Kumar <arulcem@yahoo.co.in>, Advocate Barathi <metturpollution@gmail.com>,
Lakshmi Premkumar <lakshmepremkumar@gmail.com>, nityanand jayaraman <nity68@gmail.com>,
Madhumita <madhu.dutta@gmail.com>, theshramik@yahoo.com, piyush sethia <jungleclub@gmail.com>,
rakhal & subha <subharakhal@gmail.com>, Sukanya Rangamani <sukanr@gmail.com>, samataindia
<samataindia@gmail.com>, vidyadinker@gmail.com, debjeet2002@gmail.com, maheshpandya@sify.com,
prabjit_barn@yahoo.ca, aio@gmx.ch, janhitfoundation@gmail.com, "ecofriends. org"
<rakesh@ecofriends.org>, SASANKA DEV <fordisha@cal2.vsnl.net.in>, umendradutt@gmail.com,
parimalkumar@yahoo.com , info@mlpc.in, Phoenix <phoenix@mail.primorye.ru>, Natalia Lisitsyna
<sakhalinwatch@yandex.ru>, Lauren Allan-Vail <LAIIan-Vail@pacificenvironment.org>, Denny Larson
<denny@gcmonitor.org>, axabellard@argos-sci.com, dsgamiles@argos-sci.com, Siziwe
<siziwe@groundwork.org.za>, Anastasia Otieno <otienoa@reconcile-ea.org >, Moo Mooksuwan
<moo_ksuwan@yahoo.com>, arpa wangkiat <arpawangkiat@yahoo.com>, Ruth Breech
<ruthbreech@gmail.com>
Dear All,
Here is the final agenda for the conference. We had to make some changes in the program due to the
unavailability of some resource persons on some days.
Please feel free to get back to me in case of any clarifications.
regards
Shweta Narayan
International Bucket Brigade & Community Environmental and Health Monitoring
Conference
16-19 February 2008
Agenda:
Day 1:16 February 2008
10.00 am to 10.30 am - Key Note speech - Sandeep Pandey (to confirm)
10.30 am to 11.30 am - General Self introduction of the delegates
11.30 am to 11.45 am - TEA BREAK
11.45 am to 1.45 pm - Presentations from delegates (10 min each)
1.45 pm to 2.45 pm - LUNCH BREAK
2.45 pm to 4.45 pm - Presentations from delegates (10 min each)
1 of 4
2/12/2008 12:35 PM
Page 2 of 3
n a I i n i kesha v@ red iff m ail.com
+91 9840974404
Ms. Anuradha Vidyasankar
anul4chennai@yahoo.co.in
+91 9940687625
Dr. K. M. Parivelan
parivelan@yahoo.co.uk
+91 9840957622
Mr. Suresh Mariaselvam
suresh.masel@gmail.com
+ 91 9940047556
Ms. Thamizhselvi
sthamizh_selvi@yahoo.com
+91 9840957624
TNTRC team takes this opportunity
to thank all the stakeholders in
Tsunami Recovery for their
excellent cooperation and great
support and look forward to
enjoying the same with new entity
which will be formalized soon.
Thanks and regards,
Nalini Keshavraj
Manager
http://maiLgoogle.com/a/sochara.org/?ui=l&ik=66a626d4bd&view=cv&search=inbox&th=... 2/7/2008
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_
Gmail - Revised agenda for the Conference - pl ignore the previous ones!
http://mail.google.com/mail/?ui=2&ik=f799cc59fe&view=pt&cat=ca...
5.30 pm to 5.45 pm - Discussion
5.45 pm to 6.15 pm - Group 3 & 4 Feedback
6.15 pm to 6.30 pm - Discussion
6.30 pm to 6.45 pm - Wrap up for the day.
7.45 pm - Dinner and film screening
Day 3: 18 February 2008
7.30 am to 8.30 am - Breakfast
9.00 am to 10.30 am - Demonstration of the Real Time Monitor for the delegates
10.30 am to 1.30 pm - Visit to ITO traffic junction in Delhi, along with media persons for the Real Time
Air Monitoring.
1.30 pm to 2.30 pm - LUNCH BREAK
2.30 pm to 3.30 pm - Low Cost Environmental monitoring - Case studies. (Cuddalore, Mettur, SA,
Thailand, Russia*, US)
3.30 pm to 3.45 pm - Wrap Up of the session
3.45 pm to 4.45 pm - Bucket Building and Environmental Monitoring - (DENNY LARSON)
4.45 pm - 5.00 pm - TEA BREAK
5.00 pm to 5.30 pm - Discussion on the previous session
7.45 pm - Dinner/ Film Screening
Day 4: 19 February 2008
9.00 am to 9.30 am - Presentation from CSE - What to Sample? (CHANDRA BHUSHAN)
9.30 am to 10.00 am - Presentation from CSE - How to Sample - (LAB EXPERT - CSE)
What to look for, What you need to know, What information you need to provide.
10.00 to 10.30 - Converting sampling data into campaigns, case studies from CSE - (CHANDRA
BHUSHAN)
10.30 am to 11.00 am -Q&A and Discussion
11.00to 11.15 am-TEA BREAK
11.15 am - 12.15 pm - Sub group exercise of monitoring questions for different environmental
scenarios/ case studies - Chemical industries, refineries, Mining, Non Point Source.
12.15 pm to 12.45 pm - Group 1 & 2 Feedback
12.45 pm to 1.00 pm - Discussion
1.00 pm to 1.30 pm - Group 3 & 4 Feedback
1.30 pm to 1.45 pm - Discussion
3 of 4
2/12/2008 12:35 PM
Dear friends
Greetings from JAA-K
The Right to Health Care campaign is being carried out by many people’s
organizations and voluntary organisations in various districts since 6th April 2006. As
decided in the previous meeting held on 25th June 2006 in Bangalore, the next
meeting to discus the following agenda is fixed for
Date : 25th August 2006 at
Venue: Christian Medical Association of India (CMAI)
21 HVS Court, III floor
Cunnigham Road
Bangalore- 560 001
Phone: 22205464
(CMAI is the first building on the right as you enter from Cunnigham road, Entrance is from Queens
Road.)
Time: 10 am -4 pm
Agenda
1. Summarization of the discussion so far happened 6th April. (Short list emerging
issues of concern)
2. Progress of the campaign so far
a) Report of district meeting
b) Address data base
c) Core group meeting on Wednesdays
d) Budget preparation (for human resource and campaign material)
e) Right to information Act to be use as a tool for the campaign
f) Background information prepared so far and translated.
3. District workshop design
4. Detailed discussion on strategies for taking the campaign forward
5. Any other.
With regards
Chander
For JAA-K
Gmail - Reyised agenda for the Conference - pl ignore the previous ones!
http://mail.google.com/mail/?ui-2&ik f799cc59fe&view~pt&cat ca.
1.45 pm to 2.45 pm - LUNCH BREAK
2.45 pm to 4.45 pm - Emergency Response: Taking samples; Advocacy for better emergency
response (fire, health etc); legal recourses for compensation and criminal/regulatory action.
(NITYANAND JAYARAMAN)
4.45 pm - WRAP UP/ GOOD BYE
8.00 pm - Leave for Bhopal
4 of 4
2/12/2008 12:35 PM
Page 1 of 3
Sub: New office location
intimation, staff mail-ids and
mobile nos. (for time being).
Greetings from TNTRC!
We are pleased to inform you
that today (6-02-08) we are
successfully moving into the
new premises located at
Ground Floor "Ezhilagam",
Chepauk, Chennai 600 005
(the office of Mr.C.V.Sankar ,OSD
was located earlier) from our
current office at 54/1 Josier street,
Nungambakkam, Chennai - 600
034
We would like to inform that the
telephone and fax lines and TNTRC
proxy server and website would
remain disconnected temporarily
for a fortnight and we hope to
restore them at the earliest.
TNTRC staff will be available by
mobile or email (personal listed
below)
until
the
regular
communication is restored.
Please make necessary changes to
your records and notify your staff
about the new location of TNTRC
office and the contact details of the
staff.
The mobile numbers and mail-ids
for TNTRC staff are as follows:
Dr. Nalini Keshavaraj
http://mail.google.coiWa/sochara.org/?ui=l&ik=66a626d4bd&view=cv&search=inbox&th= ... 2/7/2008
Gmail - Invitation - Int'l Environmental and Health Monitoring Confe...
http://mail.google.com/mail/?ui=2&ik=f799cc59fe&view=pt&cat=ca
33 i I
Sukanya Rangamani <sukanr@gmail.com>
BETA.
Invitation - Int'l Environmental and Health Monitoring
Conference - Delhi, India
Shweta Narayan <nopvcever@gmail.com>
To: Shweta Narayan <nopvcever@gmail.com>
Tue, Jan 8, 2008 at 12:00 PM
Dear All,
Community Environmental Monitoring (India) a project of New Delhi based The Other Media, and
Global Community Monitor (US) is organising an International Bucket Brigade and Environmental and
Health Monitoring Conference in India from February 16 th to 19th, 2008. This meeting will bring
together on a common platform the community activists from all over the world including different
pollution impacted communities of India. The meeting is primarily to share one's experiences, learn from
the successes and failures and pool in resources with people and groups fighting environmental
pollution and corporate greed. We will also have a team of experts and scientists to provide us with the
basics of the community monitoring tools and knowledge that will enable us tackle problems
The conference will be held at Jamia Hamdard, Delhi, located in the South Eastern suburbs of New
Delhi. Arrangements for accommodation and food have been made from 15 th to the 19th at Jamia
Hamdard campus itself.
We would like to invite you or maximum two members from your organisation/ community who would be
interested to the conference. We would request that you arrive at Jamia latest by 16 th morning as the
first day of the conference is one of the most important days and would involve sharing of our
experiences in our respective areas and would also set the trend for the next three days of discussion.
After the conference we are planning an trip to Bhopal to extend our support and solidarity to the
struggle of the survivors of the world's worst industrial disaster. This trip is optional for the participants.
We would be leaving for Bhopal on a night train on 19th and be reaching there on 20th morning. It will be
about 9 hour journey. The stay in Bhopal would be for a day or two depending on your further travel/
return plans. Please email us your plans for the Bhopal trip and if you wish to join us for the trip please
email your name and age to us so that we can book your tickets to Bhopal. Please keep the trip in mind
while booking for your return tickets so that the place from where the ticket is booked is factored in. We
would be happy to reimburse second class train fare for all participants.
Please find a draft agenda for the events for your review and comments. We would also request you to
please let us know if there is any health or environmental monitoring experiences or case studies that
you would like to share with the members at the conference so that we can allot time to your
presentations.
Please send in your confirmations as soon as possible.
Regards
Shweta Narayan
India Community Environmental Monitoring
+91 94440 24315
nopvcever@gmail.com
1 of3
1/31/2008 11:20 A?
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www.sipcotcuddalore.com
Schedule of conference:
15 - Arrive in Delhi - Rest day
16 - Delhi Conf Day - Experience Sharing Day
17 - Day 2 Conference
18 - Day 3 Conference
19 - Delhi Demos - Media demo at traffic junction for benzene levels, Hound demo for media and
communities, roundtable with the government and the NGOs working on Air Pollution
OPTIONAL: Group Leaves for Bhopal PM
20 - Toxic Tour in Bhopal
21 - Bhopal/ Delhi
AGENDA:
Day 1 -16 February - Introduction to the delegates and the background of their communities
9:00 am to 9:30 am - Key Note speech on Air Pollution - Sunita Naraian - CSE
9:30 am to11:15 am - Self introductions and background of the place they come from (10 mins per
person)
11:15 am to 11:30 am - Tea Break
11:30 am to 1:30 pm - Self introductions and background of the place they come from (10 mins per
person)
1:30 pm to 2:30 pm - Lunch Break
2:30 pm to 4:00 pm - Self introductions and background of the place they come from (10 mins per
person)
4:00 pm to 4:15 pm - Tea Break
4:15 pm to 6:30 pm - Self introductions and background of the place they come from (10 mins per
person)
6:30 pm to 7:30 pm - Rest
7:30 pm - Dinner
9:00 pm - Film screening from one of the communities (optional for the participants)
DAY 2 - 17 February - Environmental Monitoring - basics, methods, importance, experience from
communities
7:30 am to 8:30 am - Breakfast
9 a.m. to 10.30 am - Basics of environment and health - Nity/Rakhal
10:30 am to 10:45 am - Wrap up on importance of monitoring. Four pillars of community monitoring.
ENVIRONMENTAL MONITORING
10:45 am to 11:45 am - Low cost environmental monitoring - Case studies.
11:45 am to 12 noon - Tea Break
12 noon to 12:45 pm - Sub group exercise of monitoring questions for different environmental
scenarios/ case studies - Chemical industries, refineries, garbage dump yard, hazardous waste
landfills, dust pollution - sponge iron units, mining, stone crushing units, stone quarries.
12:45 pm to 1:45 pm - Discussion on the monitoring questions with the larger group and feedback
session.
1:45 pm to 2:30 pm - Lunch Break
2:30 pm to 3:30 pm - Bucket Brigade - Building, using for sampling, interpreting the results, using the
results
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Gmail - Invitation - Int'l Environmental and Health Monitoring Confe...
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3:30 pm to 4:00 pm: Discussion
4:00 pm to 4:15 pm - Tea Break
4:15 pm to 6:00 pm - EIA and Generating Baseline Environmental data.
7:30 pm to 8:30 pm - Dinner
9:00 pm - Film Screening (optional)
DAY 3-18 February - Health Monitoring - basics, methods, importance, experience from communities
7:30 am to 8:30 am - Breakfast
9:30 am to 10:30 am - Basics of health monitoring - Rakhal
Understanding symptoms, define health of community, assessment, studies and long-term monitoring.
Limitations of science
10:30 am to 11:30 am - Low cost health monitoring Case studies: Bhopal , Mettur, Kodi, Punjab, Eloor,
Kasargode, International - if any
11:30am to 11:45 am - Tea Break
11:45 am to 12:45 pm - Low cost health monitoring Case studies - Continued
12:45 pm to 1:00 pm: Health as organizing tool - Labour experience
1:00 pm to 1:30 pm - Sub group exercise of monitoring questions for different health scenarios/ case
studies - Chemical industries, refineries, garbage dump yard, hazardous waste landfills, mining and
quarry areas
1:30 pm to 2:30 pm - Lunch Break
2:30 pm to 3:00 pm - Discussion on the monitoring questions with the larger group and feedback
session.
3:00 to 5:00 pm: Emergency Response: Taking samples; Advocacy for better emergency response (fire,
health etc); legal recourses for compensation and criminal/regulatory action.
7:30 pm to 8:30 pm - Dinner
9:00 pm - Film Screening (optional)
DAY 4: 19 February - Visit at traffic junction and a coal fired power plant in Delhi for Hound, Press
Conference and visit to industrial estate
7:30 am to 8:30 am - Breakfast
9:00 am to 10:30 am - Demonstration of the Real Time Monitor for the delegates
10:30 am - Visit to ITO traffic junction and Indraprasth Power Plant in Delhi, along with media persons
for the Real Time Air Monitoring.
1:30 pm to 2:30 pm - Lunch Break
2:30 pm - Roundtable: Center for Science and Environment, Ministry of Environment and Forests,
Health Department and Delegates of the conference.
Evening leave for Bhopal
3 of 3
l/31/2008 11:20 Ab
International Bucket Brigade & Community Environmental and Health
Monitoring Conference
16-19 February 2008
Agenda:
Day 1:16 February 2008
Time
Program
10.00 am to 10.30 am
Key Note speech - Nandlal Master (Anti Coke Campaigner)
10.30 am to 11.30 am
General Self introduction of the delegates
11.30 am to 11.45 am
TEA BREAK
11.45 am to 1.45 pm
Presentations from delegates (10 min each)
1.45 pm to 2.45 pm
LUNCH BREAK
2.45 pm to 4.45 pm
Presentations from delegates (10 min each)
4.45 pm to 5.00 pm
TEA BREAK
5.00 pm to 6.00 pm
Presentations from delegates (10 min each)
REST
7.45 pm - Dinner get together
Day 2: 17 February 2008
Time
Program
7.30 am to 8.30 am
Breakfast
9.00 am to 10.00 am
Basics of Environment and Health - (NITYANAND JAYARAMAN)
10.00 am to 10.15 am
Discussion
10.15 am to 11.15 am
Understanding EIA and Generating Baseline Environmental data,
Post Project Monitoring - (LEO SALDHANA)
11.15 am to 11.30 am
TEA BREAK
11.30 am to 12.15 am
Concepts of health - the causation, and the broader determinants
of health. Define health of community; Concepts of body function /
dysfunction / disease / how this is reflected in symptoms and signs /
natural history / diagnosis of disease / community based tools for
the same. Understanding symptoms; Toxins / types / routes of
exposure / what does the body do to the toxin / what does the toxin |
do to the body - assessment (DR. RAKHAL GAITHONDE)
12.15 pm to 12.30 pm
Discussion
■
Organised by:
Community Environmental Monitoring - A project of The Other Media, Community Health
Cell & Global Community Monitor
International Bucket Brigade & Community Environmental and Health
Monitoring Conference
_ _ 16-19 February 2008______________________
12.30 pm to 1.00 pm
Establishing causation - describing / establishing patterns /
comparison - PQRST - to^L - body mapping / Risk mapping /
hound, studies and long-term monitoring. Limitations of science (the
need for long term monitoring/studies and limitations in science
would be emphasized during the D/E/C - Pqrst explanation. (DR.
SUKANYA)
1.00 to 2.00 pm
LUNCH BREAK
2.00 pm to 3.00 pm
Low cost health monitoring Case studies: Bhopal, Punjab, South
Africa, Rajan Patil
3.00 pm to 3.15 pm
Wrap up of the previous session - (DR. SUKANYA/ DR. RAKHAL)
3.15 pm to 4.15 pm
Case studies - Group exercise (Scenarios - Stone Crushing units,
Refinery, Garbage dumpyards, Chemical industrial areas)
Questions:
1. Information requirements & how will you obtain information about
the types of pollutants and the prevalent health problems.
2. What do you want to study and why?
3. How will you study?
4.15 pm to 4.30 pm
TEA BREAK
4.30 pm to 5.00 pm
Group 1 & 2 Feedback
5.00 pm to 5.15 pm
Discussion
5.15 pm to 5.45 pm
Group 3 & 4 Feedback
5.45 pm to 6.00 pm
Discussion
6.00 pm to 6.15 pm
Wrap up for the day.
7.45 pm - Dinner and film screening
Day 3: 18 February 2008
Time
Program
7.30 am to 8.30 am
Breakfast
9.00 am to 10.30 am
Demonstration of the Real Time Monitor for the delegates
10.30 am to 1.30 pm
Visit to ITO traffic junction in Delhi, along with media persons for the
Real Time Air Monitoring.
1.30 pm to 2.30 pm
LUNCH BREAK
2.30 pm to 3.30 pm
Low Cost Environmental monitoring - Case studies. (Cuddalore,
Mettur, SA, Thailand, Russia*, US)
Organised by:
Community Environmental Monitoring - A project of The Other Media, Community Health
Cell & Global Community Monitor
Internationa! Bucket Brigade & Community Environmental and Health
Monitoring Conference
16-19 February 2008
_________________
3.30 pm to 3.45 pm
Wrap Up of the session
3.45 pm to 4.45 pm
Bucket Building and Environmental Monitoring - (DENNY
LARSON)
4.45 pm - 5.00 pm
TEA BREAK
5.00 pm to 5.30 pm
Discussion on the previous session
7.45 pm - Dinner/ Film Screening
Day 4: 19 February 2008
Time
Program
9.00 am to 9.30 am
Presentation from CSE - What to Sample? (CHANDRA BHUSHAN)
9.30 am to 10.00 am
Presentation from CSE - How to Sample - (LAB EXPERT - CSE)
What to look for, What you need to know, What information you
need to provide.
10.00 am to 10.30 am
Converting sampling data into campaigns, case studies from CSE
(CHANDRA BHUSHAN)
10.30 am to 11.00 am
Q&A and Discussion
11.00 to 11.15 am
TEA BREAK
11.15 am - 12.15 pm
Sub group exercise of monitoring questions for different
environmental scenarios/ case studies - Chemical industries,
refineries, Mining, Non Point Source.
12.15 pm to 12.45 pm
Group 1 & 2 Feedback
12.45 pm to 1.00 pm
Discussion
1.00 pm to 1.30 pm
Group 3 & 4 Feedback
1.30 pm to 1.45 pm
Discussion
1.45 pm to 2.45 pm
LUNCH BREAK
2.45 pm to 4.45 pm
Emergency Response: Taking samples: Advocacy for better
emergency response (fire, health etc); legal recourses for
compensation and criminal/regulatory action. (NITYANAND
JAYARAMAN)
4.45 pm
WRAP UP/ GOOD BYE
8.00 pm - Leave for Bhopal
Organised by:
Community Environmental Monitoring - A project of The Other Media, Community Health
Cell & Global Community Monitor
ODOR PERCEP HON THRESHOLDS VERSUS DANGER LEVELS
OF AIRBORNE GASES AND PARTICULATE MATTER
R. E. Ruthenberg 9/18/02
Humans are programmed or trained to believe that their senses will protect them from potentially
dangerous things. In particular, we tend to believe that “if I can’t smell it, it’s not bad for me.” hi
fact, this is not true and can lead to erroneous perceptions of air pollution levels in our environment.
A number of substances are commonly emitted by combustion sources, particularly aircraft.
Concentrations of aircraft emissions at airports results in substantial levels of pollutants that are
carried to neighboring communities, where residents tend to draw conclusions based on their senses
of sight and smell. There is often no technical corroboration of these tentative sense-based
conclusions if there are no pollutant level monitors, such as employed by the EPA, located in the
area. The objective of this report is to quantitatively demonstrate that our noses are insensitive to
air pollutant levels that are dangerous to our health and well-being.
We do this by comparing the odor threshold concentrations (the level at which they can be smelled)
to the danger level of several substances. Pollution “danger” can be generally defined as ‘acute” or
“chronic” exposure level related, where acute means a short-term high level while chronic relates to
a longer term average exposure that is typically lower than the acute level. In this context, the
danger level for the considered substances varies from 1, 8 or 24 hours (acute) to 1-70 years of
lifetime average exposure (chronic). [70 years is normally associated with carcinogens (cancer
causing).]
On a technical note, both odor thresholds and danger level concentrations for any given substance
might be found in the literature or guidelines/regulations (USEPA and the Hazardous Chemical
Database, h_ttp.://ull.chemistiv.uakron.edu/erd/index.html used here) in terms of parts-per-million by
volume (PPMv) or micrograms per cubic meter of air (pg/rnS). The conversion factors between
these two are given in Appendix 1.
The actual levels are not so important here, as the focus is on the substance concentration ratio of
(Odor Threshold)/(Danger Level) or O/D. That is, if the O/D ratio is exactly 1.0, then we luckily
will smell the danger just as it is becoming dangerous. If the O/D ratio is substantially less than 1.0,
then we will sense impending danger well before the substance concentrations reach potentially
dangerous levels. On the other hand, if the O/D ratio is substantially greater than 1.0, our noses will
not inform us of the danger until we are already in the dangerous condition; the greater the ratio the
poorer job our sense of smell protects us.
An MSNBC report quote is a relevant stage-setter for the data: “In our town, you can smell jet fuel
in the air,” said Wietecka (sic), who years ago helped customers and moved jetways as an intern for
TWA. “We wake up to the smell of benzene and formaldehyde-based chemicals.” [Ref Appendix
2]
Let’s look at those two substances first. From Appendix 1, it is seen that the O/D ratio for benzene
is 38,281 while that for formaldehyde is 11,400! This tells us that the fact that the residents seem to
be detecting these odors often (as compared to, say, a few hours in a year) means that the situation
1
is rather chronic and that the EPA danger levels for both of these carcinogenic substances is
exceeded by factors greater than 10,000:1!
Another appropriate example is carbon monoxide. Most educated adults know that this is a
dangerous substance that causes many deaths each year, primarily due to defective heating systems.
Quite relevantly in this case, the O/D ratio is infinitely large because CO is a totally odorless
substance i.e. don’t count on your nose as a detector. CO poisoning can be either acute (death
potential) or chronic (neurological problems, etc.), both resulting from elimination of the oxygen
carrying capability of our blood. Table 1 summarizes this information for additional substances.
Note that in all cases the O/D ratio greater than 10 tol!
Table 1
SUBSTANCE
Carbon Monoxide
Ozone_________
Benzene________
Formaldehyde
Acetaldehyde
Nitrogen Dioxide
1,3-Butadiene
Sulphur Dioxide
ODOR
THRESHOLD
<None>_____
<3888_______
4900________
912_________
375_________
2000________
4000________
1220
DANGER
THRESHOLD
10.000
0.08________
0.128
0.08________
0.5_________
100
01__________
80
0/D RATIO
Infinite
48,600
38,281
11.400
750
20____
18.5
15.25
Conclusions
Our nose is a poor detector for ALL of these dangerous pollution substances and should not be
counted on as a guide to whether conditions are safe. [In the case of carbon monoxide, the nose is
not a detector at all.] Serious chronic (longer term) health problems such as cancer, respiratory
illness and heart disease can result if high but non-detectable chemical concentrations persist and
corrective steps arc not taken.
Conversely, if the odors of any of these substances ARE being detected, it’s a sure sign that the
levels are probably high enough to cause acute (immediate) health problems e.g. asthmatic or
cardiac attacks for at least some of the population and that corrective measures need to be taken
immediately.
Officially calibrated pollution monitors should be installed in any suspect area to confirm the exact
substance (what wc think we smell might actually be something else) and the short/long term
concentration levels.
Appendix 1
Derived conversion factor:
1 PPMv
40.49*formula mass
(].lg/mJ)
*CO: lPPMv=40.49*28.01=l 134 y g/n?
3
3
Odor Threshold: <None> flg/m Danger level: 10,000 |.lg/m O/D Ratio: Infinite
[Danger: 8-hour average]
9
*Ozone (03): lPPMv=40.49*48=1944 |lg/m3
3
3
Odor Threshold: <2ppm=3888 Jlg/n? Danger level: 0.08 |l g/m 0/D Ratio: 48,600
[Danger: 8-hour average]
♦Benzene: lPPMv=40.49*78.11=3163 gg/in
Odor Threshold: 1.55ppm=4900 J-lg/n? Danger level: 0.128 ).lg/m O/D Ratio: 38,281
[Danger: Carcinogenic, IE-6 in 70 years average]
* Formaldehyde lPPMv=40.49*30.03=1216 flg/m3
Odor Threshold: 0.75ppm=912 flg/m3 Danger level: 0.08 (.ig/m
O/D Ratio: 11.400
[Danger: Carcinogenic, IE-6 in 70 years average.]
* Acetaldehyde lPPMv=40.49*44.05=1784 gg/m3
3
3
Odor Threshold: 0.21ppm=375 |lg/m Danger level: 0.5 flg/m O/D Ratio: 750
[Danger: Carcinogenic, H>6 in 70 years average.]
*NO2: lPPMv-40.49*46.01=1863 pg/n?
Odor Threshold: 1.074ppm=2000 pg/nf Danger level: 100 pg/nT
[Danger: annual arithmetic mean]
1,3-Butadiene:
lPPMv=40.49*54.09=2168 j-lg/n?
*
O/D Ratio: 20
Odor.Threshold: 1.85ppm=4000 pg/m3 Danger level: 0.1 p g/nf
O/D Ratio: 18.5
EDanger: Carcinogenic. IE-6 in 70 years average.]
*SO2: lPPMv=40.49*64.1=2595 pg/n?
3
3
Odor Threshold: 0.47ppm=1220 pg/nf Danger level: 80 pg/nf O/D Ratio: 15.25
[Danger: annual arithmetic mean]
Gas physics reference (here for conversion factors).
http://www.civiljntu.edu/~reh/courses/ce251/25 l_notes_dir/rode4.html#SECT10N()004130000000
0000000
Appendix 2
MSNBC report July 2000.
“They weren’t smokers, and there was no apparent other cause for their illnesses — except that Park
Ridge lies just three miles from O’Hare Airport, one of the busiest air travel hubs on Earth.
Their puzzling condition set Wietecka on a crusade against what he calls the “nasty soup” of
chemicals that drifts out from O'Hare — nitrogen oxides, sulfur oxides and hydrocarbons from jets,
along with carbon monoxide from ground vehicles.
Wietecka's crusade is a somewhat lonely task: U.S. authorities do not have hard standards for
the amount of pollution jets are allowed to spew into the air. And there’s no ongoing enforcement
system for the standards that do exist. However, the issue is on the agenda as the United Nations'
talks on global pollution resume this week in Bonn.
In the meantime, to many residents in quiet Park Ridge, pop. 37,000 and the hometown of
Hillary Clinton and Harrison Ford, their bustling neighbor to the west is a major nuisance. “In our
town, you can smell jet fuel in the air,” said Wietecka, who years ago helped customers and moved
jetways as an intern for TWA, “We wake up to the smell of benzene and formaldehyde-based
chemicals.”” •
4
Ak Polh/tion Manual
International Bucket Brigade & Community
Environmental and Health Monitoring Conference,
Feb 16-19, 2008
New Delhi
Organised by:
Community Environmental Monitoring, a project of The Other
Media,
Community Health Cell,
Global Community Monitor
Sources & Pollutants
Pure air is made of nitrogen, oxygen, water vapour, and some other trace elements. Unpolluted
air contains dust and other chemicals such as sulphur and phosphorous from natural weathering
and chemical and biological processes. Air is considered to be polluted when any chemical,
biological or physical contaminant that ’’normally" would not be there enters the air. Air pollution
can cause respiratory and other health problems, limit visibility and damage buildings and public
property through corrosion.
There are many sources of air pollutants in the indoor and outdoor environments. Automobiles
are a significant mobile source of air pollution. In addition there are many stationary sources of air
pollution -- such as oil refineries, chemical plants, power plants, waste dumps, waste water
facilities, medical and municipal waste incinerators, construction and demolition sites, auto body
shops, dry cleaners.
Air Pollutants fall into one of two groups - Particulate Matter (PM) and Gases.
1. Particulate Matter: PM 10, dust, heavy metals, lead, soot, other solids
The term particulate matter covers a wide range of finely divided solids that may be dispersed
into the air from combustion process, industrial activities or natural sources. PM can come from
incinerator stacks, power plants, road traffic, construction etc. It is usually referred to by the
largest particle’s diameter (a micron = 10 -6 m = 1 millionth of a meter). So, PM 10 would refer to
PM whose largest particle size does not exceed 10 microns. Mechanically generated dust
particles are generally larger and do not stay in the air for too long. Particulates are important in
relation to health not only because they persist in atmosphere longer than larger particles, but
also they are small enough to be inhaled and to penetrate deep into the respiratory tract.
Currently there are National standards for Suspended Particulate Matter (SPM) and Respirable
Particulate Matter (RPM).
PM toxicity: articulate pollution generally consists of a mixture of particles of dust, pollen, ash,
soot, metals, and various other solid and liquid chemicals found in the atmosphere. The
proportions of these components vary widely depending on the source. In and around chemical
industries and petrochemical industrial locations, it is generally found that SPM comprises
carbon, tray material (hydrocarbons, soluble in organic solvents such as benzene), water-soluble
material (such as ammonium sulphate) and insoluble ash (containing small amounts of iron, lead
and other wide variety of elements).
So, in addition to the problems caused by physically invading the respiratory system, PM that is
loaded with toxic chemicals may also exert a variety of toxic effects defined by the resident
chemicals.
2. Gases
Ammonia, chlorine, ozone (smog), NOX, Carbon monoxide, sulphur gases, and volatile organic
compounds (VOC) such as benzene, toluene are examples of toxic gases. VOCs are volatile
compounds containing carbon and, often, hydrogen. Toxic gases exert a variety of health effects.
The terrible tragedy at the Union Carbide factory in Bhopal in 1984 was caused by the release of
methyl isocyanate and hydrogen cyanide gases.
National Ambient Air Quality Standards
Particulars
i Sulphur
Dioxide
Industrial
Air
Residential,
Rural and
other areas
Sensitive
Areas
Implications
I 80 ug/m3
60 ug/m3
80 ug/m3
15 ug/m3
30 ug/m3
Exposure to Sulphur Dioxide primarily
affects the mucous glands and the lungs.
| 120
| ug/m3
T
r
“
I Average
: exposure are wheezing and breathing i
probit- s. Long-term exposure could result
in Asthma and Bronchitis.
1 24 hrs.
i Oxides
j Nitrogen
of
80 ug/m3
120
ug/m3
i (NO2)
I Annual
i Average
l 24 hrs.
60 ug/m3
80 ug/m3
15 ug/m3
30 ug/m3
1
I Suspended
1 Particulate
■ Matter
| (SPM)
360
ug/m3
500
ug/m3
| Annual
Average
i 24 hrs.
140 ug/m3
200 ug/m3
70 ug/m3
100
! ug/m3
J ——-r
Respirable
L
Particulate
Matter
j (RPM)
: 120
ug/m3
150
ug/m3
Annual
Average
24 hrs.
Lead (Pb)
Annual
Average
24 hrs.
Ammonia
(NH3)
1 Annual
I Average
24 hrs.
1.0 ug/m3
1.5 ug/m3
0.1
i mg/m3
i 0.4
: mg/m3
I
Exposure to Nitrogen Dioxide can cause
respiratory ailments, asthma, and it also
increases the susceptibility of lungs to
infections
SPM contains soot, smoke, products of
incomplete combustion of organic matter
and dust. Such particles are generally
larger than 10 microns in diameter and thus
are too large to be inhaled beyond the nasal
passage. Children are primarily affected by
SPM as they are in the habit of breathing
through their mouths thus SPM enters their
lungs bypassing the nasal clearance
mechanism. It causes breathing troubles,
wheezing, asthma and bronchitis.
Particulate matter less than 10 microns in
diameter are respirable particulate matter.
These can easily enter the lungs of both |
adults and children and is known to cause I
breathing problems and lung disorders.
i 60 ug/m3
100 ug/m3
50 ug/m3
75 ug/m3
0.75 ug/m3
1.0 ug/m3
0.5
ug/m3
0.75
ug/m3
Lead is a heavy metal found in paints and
industrial facilities involved in battery
recycling. Lead can enter the human body '
by inhalation or through lead-contaminated
drinking water.
Lead interferes with the Central Nervous
System and the kidneys. Exposure to even
small amounts can cause neurological
damages and renal failure in adults. ’
Exposure to lead can affect the thyroid |
forming ability among the children. Children '
are
particularly
susceptible
to
lead
poisoning and health effects due to lead i
exposure. Lead exposure among children is '
linked to reduced Intelligence Quotients (IQ) j
and behavioural abnormalities.
0.1 mg/m3
0.4 mg/m3
0.1
mg/m3
0.4
mg/m3
Ammonia is one of the most common gases ■
used for industrial purposes. Ammonia i
causes severe irritation to the eyes, nose, !
lungs and throat. Symptoms include burning '
sensation, headache, dizziness, wheezing, j
!
I
i
exposure could lead to damage in the ■
central
nervous
system
resulting in
unconsciousness and convulsions. Intense
ammonia exposure can also cause death.
I
-
j Carbon
Monoxide
i (CO)
i 8 hrs.
' 1 hour
: 5.0
mg/m3
10.0
2.0 mg/m3
| 4.0 mg/m3
i! mg/m3
1-°
I 2.0
■ mg/m3
mg/m3
Carbon
Monoxide
is
a
colourless,
odourless, tasteless toxic gas, which is a
product of incomplete carbon combustion. :
CO reduces the oxygen carrying capacity of
the blood thus creating a deficiency of
oxygen in the organs and tissues.
Symptoms of exposure could vary from - ;
: headache, weakness, dizziness, nausea
and vomiting to coma and death (in case of
prolonged and intense exposure). Children
i and pregnant women are most susceptible
to CO toxicity.
^Sensitive areas are locations like hospitals, schools etc.
Other common air pollutants:
Heavy Metals: Heavy metals like lead; cadmium and chromium etc. are the most common
contaminants of the air. The most important sources of heavy metals emissions are combustion
of fossil fuels and waste.
Lead: See table above
Chromium and Cadmium: They are used
used in
in metal
metal alloys
alloys and
and pigments
pigments for
for paints,
paints, cement,
cement
paper, rubber, and other materials. Low level exposure to these metals can irritate the skin and
cause ulceration while long term exposure could cause kidney and liver damage, bone
deformation and high blood pressure.
Dioxins and Furans: Dioxins and furans are inevitable byproducts of combustion involving
chlorinated material. They are persistent, bioaccumulative and are capable
.,____ of exerting
..... .....
transgenerational effects. They are known human carcinogens, and their effects target virtually
every system in the human body. However, contaminated food rather than inhalation of polluted
air is the most significant route of exposure to dioxins and furans.
Sulphur compounds: The primary source of sulphur dioxide is from burning coal; thus major
emitters of sulphur dioxide include coal-fired power plants, smelters, and pulp and paper mills.
Sulphuric acid aerosol is formed in the atmosphere from oxidation of sulphur dioxide in the
presence of moisture. Industries that either use or manufacture the acid can also emit sulphuric
acid. Hydrogen sulfide (gas with a characteristic rotten egg odour) is emitted from a variety of
industrial processes, including oil refining, wood pulp production and wastewater treatment.
Exposure to sulphur dioxide could lead to lung dysfunction, wheezing and breathing problems,
asthma and bronchitis; Hydrogen sulphide can cause, irritation of eyes and respiratory system^
coma, convulsion, conjunctivitis, eye pain, lacrimation (tears to eyes), photophobia, dizziness,’
headache, weakness and exhaustion, irritation, insomnia, gastrointestinal disturbances.
Sources of air pollution within the industries:
Stack or vent emissions are often identified as the most significant sources of emissions in a
factory. In reality, however, fugitive emissions from storage tanks, cooling tanks, pipe connectors,
valves, equipment leaks, flanges, pumps, compressors, pressure release devices etc are capable
of violating the ambient air quality standards and even exceeding the stack emissions.
Documenting Air pollution
Most commonly, air pollution is noticed through a change in the smell of the air one breathes. If it
smells different, in all likelihood, the air is not "normal." Although, the nose cannot identify each
chemical individually, it is the cheapest tool for monitoring air pollution. Community monitoring of
air pollution should, therefore, include chemical odour incident monitoring using the nose as a
tool.
Chemical Odour Incident Monitoring:
The sense of smell, hearing, sight and feeling can form the basis for documenting air pollution.
International agencies, including the US EPA, and several community groups in South Africa,
U.S.A, and the Philippines use chemical odour incident monitoring to document air pollution.
Daily Chemical Odour Monitoring is really quite simple.
•
Organise a village meeting, or a meeting of youth or women in the pollution-impacted
community;
• Ask them to describe the odours they experience, and list them.
•
Ask them to describe some of the immediate health effects or symptoms experienced by
them as a result of the odours, and list them.
•
Ask them to maintain records of the most intense odours throughout the day, using the
questionnaire provided in Annexure 1 below.
•
In the event of major incidents - serious emissions or soot deposit from plants etc - a
letter may be written to the regulatory authorities enclosing the incident monitoring form.
How to rate the smell: The intensity of the smell can be rated as "high," "low" or "No smell." To
get a degree of standardization among the monitors, a simple rule of thumb can be followed. If
the odour is overpowering, easily perceptible and/or induces noticeable symptoms, the odour can
be rated "high intensity." If the odour is perceptible or just barely so, rate the odour "low intensity."
It helps to do a group rating of different smells at different locations in an industrial estate to
check the standardization.
The power of the chemical odour incident monitoring, when conducted systematically, lies in its
ability to yield trend data to answer questions such as these:
1. Are chemical odours present day-long?
2. Does their intensity vary with the time of day?
3. What kinds of smells are common? Which sources are they associated with?
4. What kinds of immediate health symptoms are associated with each smell?
5. What is the geographical spread of the odours?
What incidents need to be closely monitored?
Any incident of intense smell, which may or may not have resulted in immediate
health effects.
Any visible sign of air pollution - black smoke, coloured smoke, dust
Any gas leak or explosion inside the factory or around it, including chemical
tanker.lorry incidents
«
Any unusual hissing sound in the factory, indicating a gas leak
Any situation of perceptible physical reaction in the absence of smell, noise or
any other visible pollution
Laboratory analysis of air toxics:
High Volume Sampling:
A high volume sampler has an air suction machine that pulls the air through a special filter paper.
While the sample air is being pulled through, the flow rate can be adjusted and the sample can be
taken over a specific period of time. This determines the volume of the sample taken. Any
material deposited on the filter paper and is analysed further. High volume sampling gives a
quantitative analysis of the pollutants presents in the air.
Buckets Samplers:
Community activists in the United States have developed a well-tested tool called the "bucket" to
allow communities to sample the air they breathe. The sampler is a plastic bucket with a
detachable bag inside it. To sample the air, the valve on the nozzle of the bucket is opened. This
operates a pump that sucks in the air and fills up the bag. Once filled, the bag can be detached
and couriered to the analytical laboratory.
Several community groups in North America, South Africa and the Philippines are currently
successfully using the bucket. The analytical protocols are standardized and allow communities
to choose from one or more of several analytical categories that test for different air pollutants
with known toxicological profiles.
The advantage of the bucket is that it is a low-cost, but physically and scientifically robust tool,
that can be deployed by the community as and when they sense intense air pollution. More
importantly, it builds capacity within the community, particularly among the youth, engages them
in a meaningful way in the struggle against pollution and strengthens their struggle.
What’s the worth of buckets?
The buckets can be used to measure the everyday pollution levels or to respond to accidental
releases at the chemical factory in your area. The Buckets take "grab" samples at nose-level and
can give you a snapshot of what you are breathing. Buckets have proven to be a valuable tool to
keep polluters in line and challenge their baseless claims that emissions are within permissible
limits.
The government agencies too are more likely to begin monitoring and publish the results once
they know that communities are taking regular samples and monitoring the state of the
environment.
Data generated by the bucket gives information about the levels of several gases, some of them
with known toxicological properties. The analytical data thus generated combined with regularly
maintained chemical odour incident records provides a fair picture of air quality in an area. It
would also alert us to the need, if any, for precautionary action to protect health.
Are the results credible?
Grab Sampling is a well-established technique in the environmental monitoring industry. The
bucket employs the same principles and techniques as the US Environmental Protection Agency
and other industries do to take samples. Indeed, the Bucket was co-developed as a community
tool by the US EPA. Bucket samples that were analysed alongside samples taken simultaneously
by well-established techniques yielded similar results. Quality assurance and quality control
measures provide additional scientific information and increase the credibility of the bucket
samples. Currently, Columbia Analytical Services, a US EPA-certified laboratory in California
performs the sample analyses. The laboratory is placed among the top 10 laboratories in the U.S.
Are the buckets difficult to use?
The bucket design is well suited for community use. Sturdy and easy to use, the buckets provide
a less expensive way of obtaining the comprehensive information relating to toxic gases in the air.
This information can help you ask informed questions and express legitimate documented
concerns. The buckets represent sound science, and can [provide the data-backing
L
required to
corroborate community concerns about pollution and related health effects.
How does the bucket take an air sample?
The plastic bucket serves as a rugged enclosure for a standard "Tedlar" sampling bag and for the
equipment needed to fill the bag with outside air. A small vacuum sucks air out of the bucket
When you open the valve attached to the sampling bag, air rushes in to fill the bag. After taking a
sample, a trained person, like the bucket coordinator, removes the sampling bag and sends it for
analysis. The bucket coordinator puts a new bag and then you are ready to take another sample.
What buckets Do and Do-not Do?
The laboratory can only analyze the bucket sample for gases.
•
Buckets cannot measure for PM, including heavy metals, soot, dust, and other solids.
•
Buckets cannot measure for toxins that normally attach themselves to particles such as
dioxins.
•
Buckets cannot measure for acid rain or radiation.
What pollutants can be tested for using bucket samples?
For testing around chemical plants and oil refineries, two common analytical procedures are
requested for, they are - a) VOC’s (Volatile Organic compounds) and inorganic gases and b)
sulphur compounds.
•
'
Volatile Organic Compounds
With bucket samples, the lab can ('
‘ ' many of these compounds at parts per billion (ppb)
detect
levels. Some of the measured VOCs include
i.. Benzene Toluene, 3 types of Xylenes, Methylene
Chloride, Tetrachloroethane, Acetone etc.
Sulphur Compounds
Sulphur compounds can also be detected at levels below 1 ppb. Some of the sulphur compounds
are - Hydrogen Sulphide, Carbonyl Sulphide, Carbon Disulphide, 7 types of Mercaptans and 5
types of Thiophenes.
Bucket samples are currently being sent to a USEPA-certified laboratory in the US for analyses
because labs in India don’t have one essential component required for the analyses.
How are the results interpreted?
Laboratories report the amount of chemicals in the air as a "concentration." Our air is made up of
many different gases all mixed together. Nitrogen gas constitutes 70% of air. Other chemicals are
present in very small amounts. A concentration describes how much of a certain chemical exists
in a given amount of air. Concentration can be expressed as PPM or PPB (parts per million or
billion) and mg/m3 or ug/m3 (rnilli- or micro-grams per meter cubed)
Parts Per Billion:
A chemical present in air at Ippb concentration represents one molecule of contaminant in 1
billion molecules of air.
uq/m3 Micrograms Per Meter Cubed:
This defines how much a chemical weighs per volume of air. If a chemical contaminant is present
at 2 ug/m3, that means that the total weight of that contaminant in a cubic meter or air totals 2 ua
or 2 millionth of a gram.
y
What do all these numbers mean?
The bucket results tell how much of a certain chemical was present at the time of sampling.
However, these numbers are meaningless without a reference or benchmark.
Background concentration:
"Background concentration" of a chemical is the normal concentration of the chemical in
unpolluted air or normal air. See the National Ambient Air Quality Standards for more informal,
i.
Health effects: For unpolluted air, chemical contaminants should not be in excess of background
levels. These chemicals can exert varying toxic effects on the health of people depending upon
the toxicity of chemical contaminants and their concentration in excess of background levels.
Very large deviations above background concentration should be closely studied because these
chemicals could adversely affect public health. While standards exist for some of the toxic gases
measured by the Bucket, it is always preferable to keep all contaminants within background levels
of concentration. That is because the toxicity and method of action of many of these poisons is
not known. Emerging evidence also indicates that the effects of chemical poisons may magnify if
the victim is exposed to a cocktail of poisons.
Some Common VOCs and Their Toxic Effects
Symptoms and Target Organs
Name
; Usage
1,1,1-
j Used as a dry cleaning Symptoms: irritation of eyes, skin, weakness and
vapour i exhaustion, restlessness, irregular respiration,
agent,
a
degreasing agent and as i muscle fatigue: in animals: liver changes
Target organs: eyes, skin, CNS, liver
a propellant
Trichloroethane
Used as an air deodorant
and as insecticide
Symptoms: irritation of eyes, skin, nose, throat,
respiratory
system,
bronchitis,
hypochromic
anemia, headache, drowsiness, weakness and
exhaustion,
dizziness,
nausea,
incoherence,
vomiting, confusion, chemical pneumonia
Target organs: eyes, skin, respiratory system, CNS,
blood
2 - Butanone
Used as a solvent and in
the
surface
coating
industry, in manufacturing
synthetic resin
Symptoms Irritation eyes, skin, nose; headache;
dizziness; vomiting; dermatitis
Target Organs Eyes, skin, respiratory system,
central nervous system
Acetone
Used as a solvent, in the
production of lubricating
an
oils
and
as
in
intermediate
and
pharmaceuticals
pesticides.
Symptoms Irritation eyes, nose, throat; headache,
dizziness, central nervous system depression;
dermatitis
Target Organs Eyes, skin, respiratory system,
central nervous system
Benzene
Constituent in motor fuels, Symptoms Irritation eyes, skin, nose, respiratory
solvent for fats, inks, oils, system; dizziness; headache, nausea, staggered
paints,
plastics
and gait; anorexia, lassitude (weakness, exhaustion);
rubber. Also use din dermatitis; bone marrow depression; [potential
of occupational carcinogen]
manufacturing
j Target Organs Eyes, skin, respiratory system,
detergents,
blood, central nervous system, bone marrow
pharmaceutical,
Cancer Site [leukemia]
explosives and dyestuff.
Chlorobenzene
: Used in the manufacture
; of
dyestuffs
and
i pesticides
1,4
Dichlorobenzene
Symptoms Irritation eyes, skin, nose; drowsiness,
incoordination; central nervous system depression;
in animals: liver, lung, kidney injury
Target Organs Eyes, skin,
central nervous system, liver
Chloroform
respiratory system,
Used as a solvent - Symptoms Irritation eyes, skin; dizziness, mental j
widely
distributed
in i dullness, nausea, confusion; headache, lassitude ;
atmosphere and water
I (weakness, exhaustion); anesthesia: enlarged liver; i
[potential occupational carcinogen]
Target Organs Liver, kidneys, heart, eyes, skin, |
central nervous system
Ethylbenzene
! Used as a solvent and in | Symptoms Irritation eyes, nose, respiratory system;
| the
manufacture
of : headache,
lassitude (weakness,
exhaustion),
' styrene related
products
’ ‘
'>
dizziness, confusion, malaise (vague feeling of
discomfort), drowsiness, unsteady gait; narcosis;
1 defatting
dermatitis:
possible
liver
injury;
i reproductive effects
Target Organs Eyes, skin, respiratory system,
central nervous system, liver, reproductive system
Formaldehyde
Use din particle board,
insulation
Symptoms Irritation eyes, nose, throat, respiratory
system; lacrimation (discharge of tears); cough;
wheezing; [potential occupational carcinogen]
Target
Organs
Eyes,
respiratory
system
Cancer Site [nasal cancer]
m-/p-Xylene and o- Used as a solvent, as
Xylene
! constituents
of
paint,
lacquers, varnishes, inks,
dyes, adhesive, cement,
and aviation fluid. Also
used in manufacture of
perfumes, insect repellent,
pharmaceuticals and the
leather industry.
Symptoms Irritation eyes. skin, nose, throat;
dizziness, excitement, drowsiness, incoordination,
staggering gait: corneal vacuolization; anorexia,
nausea, vomiting, abdominal pain: dermatitis
Target Organs Eyes, skin, respiratory system,
central nervous system, gastrointestinal tract,
blood, liver, kidneys
Perchloroethylene
Symptoms Irritation eyes, skin, nose, throat,
respiratory system: nausea; flush face, neck;
dizziness, incoordination; headache, drowsiness:
skin erythema (skin redness); liver damage;
[potential occupational carcinogen
Target Organs Eyes, skin, respiratory system, liver,
kidneys,
central
nervous
system
Cancer Site [in animals: liver tumors]
Styrene
Tetrachloroethylene
Used in dry cleaning
high
At
temperature Symptoms Irritation eyes, nose, respiratory system;
becomes a plastic; used , headache,
lassitude (weakness,
exhaustion),
: in manufacture of resins, • dizziness,
uizznuuuiusion,
maiaise (vague feeling
reeling of
or
confusion, malaise
polyesters, insulators, and discomfort), drowsiness, unsteady gait; narcosis;
I in drug manufacturing
defatting
dermatitis;
possible
liver
injury;
reproductive effects
j Target Organs Eyes, skin, respiratory system,
| central nervous system, liver, reproductive system
;
■!
degreasing
cleaning
I
Toluene
Trichloroethylene
and
dry
respiratory system: nausea; flush face, neck; |
dizziness, incoordination; headache, drowsiness; j
skin erythema (skin redness); liver damage;
[potential occupational carcinogen
i Target Organs Eyes, skin, respiratory system, liver,
kidneys,
central
nervous
system (
Cancer Site [in animals: liver tumors]
Irritation
eyes,
nose;
lassitude
i Used in manufacture of Symptoms
euphoria,
exhaustion), confusion,
Benzene, as a solvent for (weakness,
paints and coatings or as dizziness, headache; dilated pupils, lacrimation
* ' * ii
muscle
fatigue, ,■
a component of car and ; (discharge of tears); anxiety, ...
—
paresthesia;
dermatitis;
liver, kidney 1
aviation fuels.
| insomnia; p
----- ---------------------i
i damage
respiratory system, !
Target Organs Eyes, skin, f
central nervous system, liver, kidneys
Irritation eyes, skin; headache, visual
! , .
Used as a solvent in Symptoms
vapour degreasing. Used ‘ disturbance,, lassitude (weakness, exhaustion), !
as an intermediate iin dizziness, tremor, drowsiness, nausea, vomiting; !
production in pesticides, dermatitis; cardiac arrhythmias, paresthesia; liver
waxes, gums, resins, tars, j injury; [potential occupational carcinogen]
and paints.
Target Organs Eyes, skin, respiratory system,
heart, liver, kidneys, central nervous system i
Cancer Site [in animals: liver & kidney cancer]
[Volatile Organic Compounds: Exposure to VOCs primarily occurs through inhalation, affecting
the mucous membranes of eyes, nose, throat and respiratory tract. Prolonged exposures to
VOCs are known for causing various types of cancer. These chemicals are also known as
endocrine disrupters as they imitate or disrupt the action of naturally occurring hormones in the
human body. Whatever little we know about the toxics effects of VOCs. indicates that these
chemicals are serious concerns to human health]
Annexure 1
AIR EMISSIONS MONITORING/ REPORTING SHEET
Name of the monitor:
Date of the incident
Address:
Time of the incident
Location of the source of the emission:
Name of the unit
(Please specify if the emissions/ leak was from any particular point of the unit)
Describe the wind flow during the leak:
From the plant - gusty, steady, strong, light, none
What was the usual direction of the wind for the area at that time -
Identify the smell
Rotten eggs
Sour
Acid like
Gasoline/ kerosene/ oil
Ammonia
Nail paint/ paint
Any other
What is the immediate health effect of the leak
makes feel nauseous
gives a headache
eyes burning
throat closing
difficulty in breathing
any other
How does the emission look like:
Smoke
vapour clouds
fire
Explosion
Was there any flare? If yes then what was the colour of the smoke from the flare?
•Answer the additional questions in case of Accidents
Has the incident been reported to the local authorities?
By whom?
What was the response of the local authorities (visit by officials, action taken against polluter,
compensation paid, samples taken etc)
Was there any human injury as a result of the leak/ emissions? If yes, please answer the
following:
How many people were affected?
How did they came in contact with the air/ gas?
Was complaint filed with police, PCB? If yes, provide copy of complaint. If not, file complaint with
copies to local group and relevant Panchayat.
Please fill out their persona! d tails:
Name
Age
Sex
Occupation
Address
Type of injury
Extent of injury
Date/time of injury
Any medical treatment taken? Describe'with name of doctor, doctor’s report/prescription etc
Any loss of workdays. If yes, how many?
Has there been any death due to the exposure?
Name
Sex
Age
Address of the deceased.
Describe incident leading to death Where was the victim at the time of exposure?
What was the victim doing at the time of exposure?
Was death immediate?
What symptoms?
Cattle Animal Injury/Death
Number of animals affected? Kind of animal
Describe injury, cause of injury.
Was a veterinarian consulted? If yes please attach details of diagnosis, prescription, tests
performed?
Was complaint filed with police, PCB? If yes, provide copy of complaint. If not, file complaint with
copies to local group and relevant Panchayat.
FACT SHEET ON CHLORINE
Chlorine is a poisonous, greenish-yellow gas with a . ury irritating smell. It is a very ir. Stating, and
dangerous chemical. Usually combined with other chemicals, it is used to disinfect water, and in
many other chemical industrial processes
Chlorine gas is not usually found in the environment. If chlorine is spilled into water or onto soil or
if it is released from a tank into the air, the chlorine will evaporate very quickly forming a greenishyellow cloud that is heavier than air and can be carried by the wind several miles from the source,
maintaining dangerous concentration of chlorine.
Exposure to chlorine can occur following an accident, such as a leak or spill from a chlorine tank.
Most of the chlorine that enters lakes, streams, or soil evaporates into the air or combines with
other chemicals into more stable compounds. Chlorine-containing chemicals that seep through
soil down into groundwater can remain unchanged for many years.
HOW ARE PEOPLE EXPOSED TO CHLORINE?
Exposures to chlorine gas are usually due to industrial processes or accidental spills. When
chlorine combines with lake or river water, a number of chemicals including chloroform (a
carcinogen) can be formed.
Breathing: Most high-level exposure occurs in workplaces where chlorine is used. Breathing in
the gas is the most common way for it to enter the body.
Drinking/Eating: Low level exposure can occur when water containing chlorine is used for
drinking or for food preparation.
Touching: Small amounts can pass through the skin when people are exposed to chlorine gas,
chlorine bleach, etc.
HEALTH EFFECTS
immediate Effects - The toxic effects of chlorine are primarily due to its corrosive properties.
Chlorine causes damage to tissues and destroys cells in the body.
* Chlorine gas is irritating and corrosive to the eyes, skin, and respiratory tract.
® Exposure to chlorine may cause burning of the eyes, nose, and throat; cough as well as
constriction and swelling of the lining cells of the airways and lungs can occur.
Respiratory - Inhalation of high concentrations of chlorine gas can rapidly lead to breathing
difficulty with airway constriction and accumulation of fluid in the lungs (pulmonary edema).
Patients may have immediate onset of rapid breathing, blue discoloration of the skin, or
wheezing. Damage to the respiratory system may progress over several hours. Exposure to
chlorine can lead to reactive airways dysfunction syndrome (RADS - a respiratory disorder), a
chemical irritant-induced type of asthma over the long run.
Children may be more vulnerable to corrosive agents than adults because of the smaller diameter
of their airways.
Cardiovascular- After severe exposure, cardiovascular collapse may occur because of the lack of
oxygen due to toxic effects in the respiratory system.
Dermal - Chlorine irritates the skin and can cause burning pain, inflammation, and blisters.
Exposure to liquefied chlorine can result in frostbite injury.
Ocular - Low concentrations in air can cause burning discomfort, spasmodic blinking or
involuntary closing of the eyelids, redness, conjunctivitis, and tearing. Corneal burns may occur at
high concentrations.
Chronic Exposure
•zavy*-
Chronic exposure to chlorine, usually in the workplace, may cause corrosion of the teeth. Multiple
exposures to chlorine have produced flu-like symptoms and a high risk of developing reactive
airways dysfunction syndrome (RADS • chemical irritant induced asthma).
Symptoms
Exposure
1-3 ppm
Mild nose (mucous membrane) irritation
5 ppm
Eye irritation
5-15 ppm
Throat irritation, moderate irritation of upper respiratory tract
30 ppm
430 ppm (for 30 minutes)
Immediate chest pain, vomiting, changes in breathing rate, and
cough___________________________________________________
lung injury (toxic pneumonitis) and pulmonary oedema (fluid in
the lungs)_____________________________________ __________
Death
1000 ppm
Death within a few minutes
40-60 ppm
The concentrations listed above are approximate; the effects will depend also on exposure
duration. In general, people who suffer from respiratory conditions such as allergies, or who are
heavy smokers, tend to experience more severe effects than healthy subjects or nonsmokers.
FIRST-AID
•
Remove the patient immediately from the scene of the accident.
•
If there is irritation of the eyes, gently irrigate with water.
«
If there is breathing difficulty - go immediately to the hospital - the doctor will give
oxygen and a nebulizer with medicines to relieve the breathing difficulty.
•
If there is collapse - rush urgently to hospital - the doctor will give oxygen and other
medicines to resuscitate the patient.
•
There is no specific antidote for chlorine poisoning. Treatment noted above is supportive.
•
If symptoms persist please see a doctor.
QUESTIONS AND ANSWERS ON CHEMICALS AND HEALTH
- by Dr. Rakhal Gaithonde, Community Health Cell
1.
Why do I need to know about chemicals?
Changing lifestyles and a rapid increase of industries using synthetic materials has led to the use of
thousands of chemicals in the manufacturing process. If not handled or disposed properly these
chemicals can reach our surroundings and enter our bodies in different ways.
Many of these chemicals can have adverse effects on the health of humans, animals as well as the
environment.
While ALL humans are invariably exposed to chemicals, those living near industries, waste-dump sites
and along water bodies draining these industries are especially at risk. This is especially so in the
context of rampant corruption, weak regulatory systems and industries who have a callous attitude
towards the health of the poor.
2.
How do chemicals reach the environment?
Chemicals can be of two types - some occur naturally in the environment and others are manufactured.
Industrial processes can concentrate naturally occurring chemicals - leading to very high levels of these
chemicals that can cause adverse effects on health. Examples include mercury, asbestos etc. Industrial
processes can also lead to the formation of new / synthetic chemicals - both as products of the process
as well as by-products or waste products.
Both these types chemicals reach the environment and cause adverse health impact as a result of their
release by industry into the environment. Some chemicals like pesticides are also poisonous and reach
the environment due to human activity.
3.
How do chemicals reach my body?
Chemicals can reach our bodies in many ways. Some chemicals in the air can enter thorough the air we
breathe. Chemicals in the soil can enter the water we drink or can contaminate the food we eat. Many of
the food products contain varying amounts of chemicals that were applied as pesticides. Many animals
eat contaminated plants or drink contaminated water. Chemicals are concentrated in the animal's bodies
and can enter ours when we eat them eg. Fish, goats and chicken, milk etc.
Most chemical contaminants are present in very small quantities and may not be easily identified in food
and water without special tests. However many a time even these small quantities are enough to cause
harm.
4.
How does my body respond to these chemicals?
The human body is well adapted to digest and convert food into energy. The human body can also
detoxify / neutralize / excrete naturally occurring amounts of natural chemicals. The human body
however is not very good at excreting or de-toxifying very high concentrations or synthetic chemicals.
These chemicals when not properly detoxified usually interfere with the normal functioning of the body,
leading to adverse health effects.
Some chemicals are also stored in the body and can thus effect the health many years after it first
entered the body.
5.
What are the effects of chemicals on my body?
The effects on the body can be - immediate, long-term or they may affect future generations. Another
way of looking at effects are those that start immediately on the body coming in cotact with the chemical,
and those that start many years after the chemicals enter the body. Some of the symptoms may be very
obvious and severe, while some may be very subtle - however all symptoms and diseases due to
chemicals are totally avoidable.
Symptoms that start immediately on coming in contact with chemicals include episodic breathlessness
and noisy breathing (especially in young children), irritation of the eyes and skin, feeling faint or giddy
etc. Symptoms that are long term include neurological problems, cancers, immuno-deficiency, menstrual
problems. Those that represent inter-generational effects of chemicals include abortions, abnormal
fetuses etc.
6.
How do I recognize the effects of chemicals on my body?
Most of the symptoms / health effects of chemicals may resemble symptoms that may occur due to
natural causes.
However you can suspect chemicals as a cause if you are in a situation where you are at a high risk for
exposure. These would include living near an industry, working in factories that use these dangerous
chemicals, living down stream - near water bodies into which effluents from these factories are let out.
In addition one should suspect chemicals when there is an unusually high rate of a particular illness in a
community. This can only be recognized when one collects information from the whole village or near by
villages and compares it with populations not at similar risk.
7.
What is the responsibility of the industry?
The industry as the producer of these chemicals as it makes profit out of these is primarily responsible
for the responsible use, proper detoxification and disposal of all chemicals. It is also thus primarily
responsible for any health effects that arise out of these chemicals in the communities around the factory
or in workers within the factory. These will occur only when the factory ignores the safety rules are
regulations and the rules for proper treatment of chemicals during and as by products of the
manufacturing process.
The factory also has the moral and legal responsibility to inform the communities around the factories
and the workers working within the factory of the possible dangers of the various chemicals being used
or let out as effluents.
8.
What is the role of the government?
The government through its various agencies is responsible for the regulation and monitoring of the
factories. These agencies are mandated to check regularly whether the factories are complying with the
norms. These agencies are also supposed to act on complaints from citizens regarding irregularities.
The government also ensures that the factories compensate communities adequately if there is any
damage, and makes sure that adequate preventive steps are taken to prevent any harmful effects of
toxic chemicals.
9.
What does the doctor recommend?
It is important for all communities to assess the risk for effects due to toxic chemicals.
If there are any industries near by - make sure you are aware of all the processes and
chemicals used.
Make sure to find out if the local doctors and the government nurse are aware of the various
safety procedures in case of accidents or any illness that can be due to the chemicals used in
the factories.
If they are unaware - please request them to find out so that they can help you.
Raise the issue of any possible suspicious occurrences, illnesses in the gram sabha and with
panchayat members - the panchayat is primarily responsible for the development of the area.
Raise the issue of any possible suspicious occurrences, illnesses with the district and block level
officials.
Despite the presence of various norms and regulation and laws and agencies to do this work unless communities get to together and demand justice these laws and rules are meaningless.
*
MERCURY AND HEALTH
By Dr. Rakhal Gaithonde, Community Health Cell
Mercury is probably best known as the silver liquid in thermometers. However, it has over 3000 industrial uses.
Mercury and its compounds are widely distributed in the environment as a result of both natural and man-made
activities. The utility, and the toxicity, of mercury have been known for centuries. New evidence demonstrates
that even low levels of mercury exposure may be hazardous.
WHAT IS MERCURY? WHAT ARE ITS PHYSICAL CHARACTERISTICS?
Mercury is a metal. It is liquid at room temperature. If left in the open it will evaporate into fumes. This
happens especially in warm climate.
WHERE IS MERCURY FOUND?
Mercury is usually found in combination with other chemicals. While it may be naturally present in some
places most of the harmful mercury reaches the environment usually because of industrial processes,
these processes include production of thermometers, during the production of PVC, during the
production of chlor-alkali etc.. Once in-the environment it can be further changed into different products.
HOW DOES MERCURY ENTER MY BODY?
Mercury can enter your body either through direct ingestion (by eating it or substances contaminated
by it) or by breathing it in (by breathing in fumes of mercury).
WHAT ARE THE EFFECTS OF MERCURY ON MY HEALTH?
The effects of mercury on health can be divided into immediate and long term effects.
When a person in exposed to large amounts of mercury fumes or the metal itself she ! he immediately
has the following:
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Fatigue, fever and chills.
Respiratory symptoms such as cough, shortness of breath, tightness and burning pain in the
chest and inflammation of the lungs.
There may be symptoms in the neurological system like shaking of hands / tremors,
sleeplessness, memory loss, headaches and emotional instability.
There may also be gastrointestinal symptoms like nausea, vomiting and diarrhea. There will be
an associated metallic taste.
When a person is exposed to small amounts of mercury over longer periods of time she / he may
develop the following symptoms.
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The commonest system to be affected is the nervous system - symptoms include unsteadiness,
clumsiness, tremor, behavior changes , mood changes, abnormal sensations (unarchi)
The kidneys can be damaged.
An increase in the blood pressure and the heart rate. There have been some studies linking
exposure to mercury to increased risk of heart attacks.
The effect of mercury on the reproductive system as well as on abortions is not clear - while it
has not been proved to be conclusively harmful - it has not been proven to be completely safe
either.
Some studies have shown that the developing fetus' brain may be damaged if the pregnant
mother is exposed to mercury.
There has been no clear link between mercury and cancer.
HOW DO I DETECT / SUSPECT MERCURY'S EFFECTS?
When you develop any of the above symptoms - especially if you know of factories using mercury near
your place of residence it is wise to check with your doctor. Mercury can be detected in your blood and
urine - but these tests are not widely found and may be accessible only in large medical centers. It is
important thus to prevent all possible exposure to mercury.
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WHAT DOES THE DOCTOR RECOMMEND?
It is :mportant to be aware of any sources of mercury nearby. Please find out the chemicals
factories near by are using and see if there is any use of mercury.
Make sure not to handle any liquid that is silvery shiny - it may be mercury.
If you notice any symptoms like tremors, teeth problems in many people in the community and
you know you have been exposed to mercury, or you suspect to have been exposed to mercury
please check it out.
It is important to find out because the effects of some forms of mercury may be treatable by
giving chemicals that will wash the mercury out of the body. But some varieties of mercury may
cause permanent damage in the body. However it is much easier to prevent mercury from
entering your body than treating mercury induced harmful effects.
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