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Problem Identification: Existing Evidence
The key environment-related human diseases are associated with poor quality air, water, noise pollution, and exposure to electromagnetic and ultraviolet radiation. The results of plenty of studies indicate the existence of the relation between the contamination of water by hazardous chemicals and the development of respiratory and cardiovascular diseases, cancer, asthma, allergies, as well as reproductive and central nervous system disorders (Rozell & Reaven, 2012; Villanueva et al., 2014). According to the official information provided by the World Health Organization (WHO), the availability of pure water is a necessary condition for the existence of human beings, while water suitable for consumption accounts for only three percent of its total capacity (“Diseases and risks,” 2017). A quick deterioration in the quality of drinking water has occurred as a result of contamination by chemical and radioactive substances, pesticides, synthetic fertilizers, and sewage sludge, making it a global environmental health concern.
Human activity negatively affects the state of water basins, which entails the deterioration of human health and disturbance in the balance of ecosystems. The main causes of discharges and deteriorating water quality are industrial production, intensive agricultural activities, and population growth. For example, Rozell and Reaven (2012) claim that the extraction of shale gas leads to significant contamination of groundwater with toluene, benzene, dimethylbenzene, ethylbenzene, arsenic, etc. At present, the damage to the ecology of the shale basin in Pennsylvania is extremely negative (Rozell & Reaven, 2012).
It is the environmental problem along with the use of a large amount of water for hydraulic fracturing, which is the most critical for the development of shale mining in densely populated areas. Even though hydraulic fractures are much lower than the level of groundwater, toxic substances contaminate the soil layer, groundwater, and air. Elaborating on the topic of groundwater pollution associated with gas, Vengosh, Jackson, Warner, Darrah, and Kondash (2014) discovered that natural gas found in water near several shale gas wells was present even before the start of production, which means that it is not connected with hydraulic fracturing of the formation. At the same time, the traditional development of gas fields possesses even greater risk for groundwater than hydraulic fracturing, but it is conducted away from residential areas. Both Rozell and Reaven (2012) and Vengosh et al. (2014) consider that this topic needs to be studied further to come up with relevant solutions on how to resolve the problem.
The problem of water pollution is a concern for healthcare policymakers for more than 50 years. During this time, much has been done to improve the quality of water. Some national initiatives and recommendations were adopted and implemented. For example, the International Maritime Conventions and the U.S. Environmental Protection Agency (EPA) standards on the Protection and Use of Transboundary Waters and International Lakes led to the improvement of the water situation in the European and Western regions. Nevertheless, there is still much to do in the field of water protection. In their recent study, Villanueva et al. (2014) argue that up to 756 kinds of harmful substances are contained in drinking water, of which 20 species are confirmed to be carcinogens, 18 are promoters of cancer, 24 are considered to be carcinogenic substances, and 47 substances may cause gene mutations. Also, all these organic substances are rather difficult to eliminate by traditional cleaning technologies.
Data from the study by Zhang, Zhuang, Ma, and Jiang (2014) shows that 80 percent of all diseases in the world are caused by contaminated drinking water, and 50 percent of the world’s infant mortality occurs due to polluted water. At this point, 1,2 billion people worldwide suffer from various diseases associated with the use of such water, while 25 million children die annually from the associated diseases (Hanna-Attisha, LaChance, Sadler, & Champney Schnepp, 2016). The number of people dying annually from cholera, dysentery, malaria, and other infectious diseases caused by water pollution exceeds five million people (“Diseases and risks,” 2017). Among the main diseases caused by water pollution, there are cancer, heart-related diseases, fluorosis, and disease of the digestive system.
Currently, one of the indispensable stages of water disinfection is chlorination. However, excessive sanitation can lead to the formation of by-products, one of which is a carcinogen-chloroform recognized by the medical community (Zhang et al., 2014). The prolonged use of untreated water leads to the fact that pollutants settle on the walls of blood vessels. This accelerates the onset of sclerosis of the vessels of the heart and brain. The long-term use of drinking water with a high content of fluoride can lead to poisoning of the body. In particular, the penetration of excess fluoride into the bone system causes a substitution of this microelement of calcium contained in the skeleton, which leads to weakening and softening of the bones of the human body. Also, contaminated water contains a significant number of pathogens that can cause various diseases (Zhang et al., 2014). For example, gastritis and enteritis, diarrhea, infection of the genitourinary system, cholecystitis, and other diseases may occur. Salmonella can cause typhus, paratyphoid fever, and other ailments.
In addition to health risks, water pollution increases costs associated with the corresponding diseases. Collier et al. (2012) discuss the direct healthcare costs of diseases transmitted by water. More than 40 thousand hospitalizations for primary water pollution-related diseases in the US cost $ 970 million annually. Moreover, another 50 thousand hospitalizations caused by the diseases of the digestive system are estimated at $ 860 million per year (Collier et al., 2012). This shows that despite the efforts initiated by healthcare, including sanitation advancements, the situations remain critical in the US and worldwide.
Gaps, Inconsistencies, and Limitations
Speaking of gaps in the contemporary literature regarding water pollution and associated health risks, it is possible to point out that little attention is given to public health response. Even though some regulations, protocols, and acts determine this reaction, the literature lacks a clear understanding of how to address this challenge. As noted by Hanna-Attisha et al. (2016), the number of people and especially children suffering from elevated blood lead levels grow, while healthcare lacks the informed response prioritization.
The literature review revealed inconsistency regarding the threat of natural gas to water contamination. While Vengosh et al. (2014) discovered that it cannot pollute groundwater significantly, Rozell and Reaven (2012), on the contrary, believe that there is a need to adjust the technology to make it safer, thus increasing drinking water quality. The mentioned inconsistency leads to the fact that it is necessary to explore the topic in an in-depth manner. As for limitations, many studies focus on one region or country that makes it difficult to generalize ideas expressed by authors. Currently, one may gather such data only from WHO statistics or some local agencies like the Centers for Disease Control and Prevention (CDC). Therefore, it seems to be better if some studies would provide global data in an attempt to save lives and make people healthier.
Future Research Needs to Resolve the Problem
The traditional methods used to solve the problem of water pollution associated diseases refer to sanitation. Improvement of the quality of water by eliminating the causes of pollution is not effective enough to restore the purity of water in rivers and lakes (Villanueva et al., 2014). There is a need for the implementation of sound water management, which should not only lead to improved water quality but also ensure the protection and restoration of aquatic habitats and their biological communities.
How can healthcare contribute to addressing water pollution? The studies emphasize the need to further enhance the technology of shale gas production to control methane emissions, soil, and groundwater pollution caused by the current high level of uncertainty in the estimates (Vengosh et al., 2014). It should be stressed that prospects for large-scale shale gas production are currently available only in sparsely populated areas and in countries, which agree to reduce environmental safety. As for the rest of the global population, it still needs some relevant solutions and advancements. In their turn, Collier et al. (2012) declare the need for further examination of ways to reduce healthcare costs for hospitalization and treatment of patients diagnosed with water transmitted diseases. To sum it up, it is of great importance to conduct further research in the field of water pollution and associated health risks, focusing on costs, causes, policies, practices, and prevention.
Collier, S. A., Stockman, L. J., Hicks, L. A., Garrison, L. E., Zhou, F. J., & Beach, M. J. (2012). Direct healthcare costs of selected diseases primarily or partially transmitted by water. Epidemiology & Infection, 140(11), 2003-2013.
Diseases and risks. (2017). Web.
Hanna-Attisha, M., LaChance, J., Sadler, R. C., & Champney Schnepp, A. (2016). Elevated blood lead levels in children associated with the Flint drinking water crisis: A spatial analysis of risk and public health response. American Journal of Public Health, 106(2), 283-290.
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Rozell, D. J., & Reaven, S. J. (2012). Water pollution risk associated with natural gas extraction from the Marcellus Shale. Risk Analysis, 32(8), 1382-1393.
Vengosh, A., Jackson, R. B., Warner, N., Darrah, T. H., & Kondash, A. (2014). A critical review of the risks to water resources from unconventional shale gas development and hydraulic fracturing in the United States. Environmental Science & Technology, 48(15), 8334-8348.
Villanueva, C. M., Kogevinas, M., Cordier, S., Templeton, M. R., Vermeulen, R., Nuckols, J. R.,… Levallois, P. (2014). Assessing exposure and health consequences of chemicals in drinking water: Current state of knowledge and research needs. Environmental Health Perspectives, 122(3), 213-221.
Zhang, X., Zhuang, D., Ma, X., & Jiang, D. (2014). Esophageal cancer spatial and correlation analyses: Water pollution, mortality rates, and safe buffer distances in China. Journal of Geographical Sciences, 24(1), 46-58.