**1. Introduction**

160 Health Management – Different Approaches and Solutions

Wincent, A.; Liden, Y. & Arner, S. (2003). Pain questionnaires in the analysis of long lasting

311-321, ISSN: 1090-3801.

(chronic) pain conditions. *European Journal of Pain*, Vol. 7, No. 4 (August 2003), pp.

In many metropolitan cities, environmental pollution has a substantial impact on social and cultural well being. Statistically provable direct heath effects may require further studies to establish the influence on the community and the public healthcare system. The combined effects of fossil fuel burning and economic growth have negative impacts on health and financial costs in many areas. The main research objective aims at exploring the links between environmental pollution and health related problems. The inherently slow and reactive response over generations has repeatedly made corrective actions after an incident but not before and sometimes becomes too late. Also, health and safety precautions are often not properly exercised in a pre-emptive manner. Any proactive measure through proper early warning and environmental control methodologies would certainly yield a reduction in preventable illnesses as well as health degradation that result from improper care and environmental pollution.

Pollution is not only a problem in the community as a whole. Even at home, indoor air pollution causes a wide range of health-related issues (Bruce, 2000). The impacts of pollution on human health must therefore be assessed both for indoor and the broader outdoor environment. Since the industrial revolution of the 19th century, health hazards related to discharge of toxic chemicals and heavy metals from manufacturing plants has also become a more serious health issue. Air pollutants can travel hundreds of miles causing respiratory problems and chronic diseases. Heavy metal and toxic chemical deposits enter the food chain through the food chain and water supply (Nasreddinea, 2002). As health of the general population degrades, more people require medical attention that will eventually stretch healthcare resources to their limits.

Work on reducing health problems directly or indirectly caused by environmental pollution is urgently needed because demand on public health services is expected to grow substantially over the next two decades as a direct consequence of population aging in most developed countries (Christensen, 2009). In many cases, chronic disease is avoidable if appropriate actions are taken especially among senior citizens given access to the appropriate assistive technologies.

The environment has a substantial impact on both chronic and infectious disease (Hall-Stoodley, 2004). Take, for example, water contamination that was caused by massive

Environmental Pollution and Chronic Disease Management – A Prognostics Approach 163

Prognostics is an engineering discipline focused on predicting the time at which a component will no longer perform a particular function. Lack of performance is most often component failure. The predicted time becomes then the remaining useful life (RUL). The science of prognostics is based on the analysis of failure modes, detection of early signs of wear and aging, and fault conditions. These signs are then correlated with a damage propagation model. Potential uses for prognostics is in condition-based maintenance. The discipline that links studies of failure mechanisms to system lifecycle management is often referred to as prognostics and health management (PHM), sometimes also system health management (SHM) or - in transportation applications - vehicle health management (VHM). Technical approaches to building models in prognostics can be categorized broadly into

From this definition, prognostics and health management (PHM) methodology has been used in the electronics industry to predict the system's *health* degradation thereby determining a product's remaining useful life. The word *health* here refers to a product's operational state, very similar in the context of a person's health and well-being. Putting these into the context of a human body as a *system*, which consists of sub-systems such as immune system and digestive system. Under certain circumstances, the health of a subsystem can degrade. Think of the case where predominant bacteria is accumulated in the stomach resulting in the reduction of nitrate and nitrite (Sobkoa, 2005), the bacteria will continue to grow while the environmental conditions remain unchanged and before they run out of space or nutrients. In this particular example, PHM can be used to model the growth of bacteria inside the stomach and how digestion is affected such that a number of corrective actions can be taken before the situation worsens. Put it quite simply, PHM as implemented in electronics, can also be applied to healthcare management in very much the same way. One of the key focus of this chapter is to discuss how PHM can assist with health management for environmental health and chronic disease. We shall look at the relationship between environmental pollution and chronic disease by exploring a number of different

attributes. We shall commence by taking a look at the broader scope of public health.

This section addresses the link between culture and environment that causes health concerns. For example, numerous mishaps have been reported in various developing countries as a direct result of excessive coal mining over the past decade. Business decision makers have put the sale of coal above the safety of miners and environmental damage. Such sentiment may ultimately lead to irreversible health consequences which far exceed that of the momentary financial gains. This is best demonstrated by the consequential healthcare costs and potential legal compensations that result from these incidents. In many

In response to these social and cultural factors that will almost certainly affect the health and well-being of millions of people, this section will concentrate on exploring how proper

The link between health and general education, personal hygiene and habits has been comprehensively studied at the turn of the millennium (Lorig, 1996). (Kickbusch, 2001) suggests that there is a significant gap between developing countries and industrialized

**2. Cultural and environmental impacts on public health** 

health management can provide a remedy and improve public health.

**2.1 Perception, general health awareness and education** 

cases, the remedy cost far exceeds that of prevention.

data-driven approaches, model-based approaches, and hybrid approaches.

flooding in Queensland, Australia, during summer 2011. The sewer system was overwhelmed by a sudden influx of water within a relatively short period of time that led to contamination of the region's water supply system. A soaring number of cases of ascariasis and giardia were reported soon after the floods. Pathogens such as bacteria, parasites and viruses responsible for spreading a range of infectious waterborne diseases across vast distances, can affect both drinking and recreational water (Colford, 2007). While a clear relationship exists between water contamination and infectious disease, the impacts on chronic diseases may not be obvious although the long-term health hazards are thought to be even more serious with a higher risk of fatality as a direct result of bladder cancer and chronic ingestion of arsenic in drinking water (Cantor, 1997).

Industrial processes such as mining, manufacturing and petroleum distillation discharge a vast amount of toxic chemicals. Even a small amount of highly toxic organic compounds can cause genetic disorders that lead to cancers and birth defects. The problem associated with an imbalance of aquatic ecosystems due to environmental pollution must therefore be thoroughly addressed. The process of managing industrial waste and pollution relates to both direct impact on human health and a broader scope of food contamination as animals along the food chain accumulate toxins in their fat and flesh from their food. The extent of contamination in the food chain increases as the toxin accumulates while propagating further up the food chain (Pereira, 2004). In an example of paralytic shellfish toxins, where the toxins first enter the food chain through waste discharged from a factory into the water eco-system. The chemicals are soaked up by shellfish that in turn becomes food of other animals that are ultimately consumed by humans. A range of other hazardous problems are also observed during this process, for example, some chemicals can cause genetic mutation that leads to cancer (Landrigan, 2002). The impacts of both microbiological and chemical contamination across the food chain must therefore be closely examined.

Water contamination is only one of the many examples of pollution-induced chronic disease contributor. Another classic example is the close relationship between second hand cigarette smoking and lung cancer (Arden Pope III, 2002). Essentially everything that we take, from the air we inhale to the water we drink and the food we eat, can potentially pose serious health risk. The primary objective of this chapter is to thoroughly investigate the relationship between environmental pollution and chronic disease in the perspective of health management and prevention by first taking a look at why health management is more difficult to address in some countries than others. Although this is generally a more serious problem in developing countries with inadequate sanitation infrastructures and policies, it may not necessarily be true that industrialized nations are less prone to pollution-induced health risks.

All these entail the collection and subsequent analysis of data from different sources; these include environmental pollution, disease prevalence, demographic variables, climatology and historical weather data analysis. To analyze such data for health management and planning, an efficient system such as prognostics and health management (PHM) is needed. PHM is a methodology widely used in different sectors of electronics for accurate prediction and computation modelling of system health degradation and maintenance (Lau, 2011). The term 'prognostics' simply means prediction of what is likely going to happen, as in medical science where prognostics has been used in the forecast of global pandemics (Wong, 2006). To understand how this puts into the context of health management for environmental health and chronic disease, we first take a look at the definition of PHM in engineering from *wiki*:

flooding in Queensland, Australia, during summer 2011. The sewer system was overwhelmed by a sudden influx of water within a relatively short period of time that led to contamination of the region's water supply system. A soaring number of cases of ascariasis and giardia were reported soon after the floods. Pathogens such as bacteria, parasites and viruses responsible for spreading a range of infectious waterborne diseases across vast distances, can affect both drinking and recreational water (Colford, 2007). While a clear relationship exists between water contamination and infectious disease, the impacts on chronic diseases may not be obvious although the long-term health hazards are thought to be even more serious with a higher risk of fatality as a direct result of bladder cancer and

Industrial processes such as mining, manufacturing and petroleum distillation discharge a vast amount of toxic chemicals. Even a small amount of highly toxic organic compounds can cause genetic disorders that lead to cancers and birth defects. The problem associated with an imbalance of aquatic ecosystems due to environmental pollution must therefore be thoroughly addressed. The process of managing industrial waste and pollution relates to both direct impact on human health and a broader scope of food contamination as animals along the food chain accumulate toxins in their fat and flesh from their food. The extent of contamination in the food chain increases as the toxin accumulates while propagating further up the food chain (Pereira, 2004). In an example of paralytic shellfish toxins, where the toxins first enter the food chain through waste discharged from a factory into the water eco-system. The chemicals are soaked up by shellfish that in turn becomes food of other animals that are ultimately consumed by humans. A range of other hazardous problems are also observed during this process, for example, some chemicals can cause genetic mutation that leads to cancer (Landrigan, 2002). The impacts of both microbiological and chemical

Water contamination is only one of the many examples of pollution-induced chronic disease contributor. Another classic example is the close relationship between second hand cigarette smoking and lung cancer (Arden Pope III, 2002). Essentially everything that we take, from the air we inhale to the water we drink and the food we eat, can potentially pose serious health risk. The primary objective of this chapter is to thoroughly investigate the relationship between environmental pollution and chronic disease in the perspective of health management and prevention by first taking a look at why health management is more difficult to address in some countries than others. Although this is generally a more serious problem in developing countries with inadequate sanitation infrastructures and policies, it may not necessarily be true

All these entail the collection and subsequent analysis of data from different sources; these include environmental pollution, disease prevalence, demographic variables, climatology and historical weather data analysis. To analyze such data for health management and planning, an efficient system such as prognostics and health management (PHM) is needed. PHM is a methodology widely used in different sectors of electronics for accurate prediction and computation modelling of system health degradation and maintenance (Lau, 2011). The term 'prognostics' simply means prediction of what is likely going to happen, as in medical science where prognostics has been used in the forecast of global pandemics (Wong, 2006). To understand how this puts into the context of health management for environmental health and chronic disease, we first take a look at the definition of PHM in engineering from

chronic ingestion of arsenic in drinking water (Cantor, 1997).

contamination across the food chain must therefore be closely examined.

that industrialized nations are less prone to pollution-induced health risks.

*wiki*:

Prognostics is an engineering discipline focused on predicting the time at which a component will no longer perform a particular function. Lack of performance is most often component failure. The predicted time becomes then the remaining useful life (RUL). The science of prognostics is based on the analysis of failure modes, detection of early signs of wear and aging, and fault conditions. These signs are then correlated with a damage propagation model. Potential uses for prognostics is in condition-based maintenance. The discipline that links studies of failure mechanisms to system lifecycle management is often referred to as prognostics and health management (PHM), sometimes also system health management (SHM) or - in transportation applications - vehicle health management (VHM). Technical approaches to building models in prognostics can be categorized broadly into data-driven approaches, model-based approaches, and hybrid approaches.

From this definition, prognostics and health management (PHM) methodology has been used in the electronics industry to predict the system's *health* degradation thereby determining a product's remaining useful life. The word *health* here refers to a product's operational state, very similar in the context of a person's health and well-being. Putting these into the context of a human body as a *system*, which consists of sub-systems such as immune system and digestive system. Under certain circumstances, the health of a subsystem can degrade. Think of the case where predominant bacteria is accumulated in the stomach resulting in the reduction of nitrate and nitrite (Sobkoa, 2005), the bacteria will continue to grow while the environmental conditions remain unchanged and before they run out of space or nutrients. In this particular example, PHM can be used to model the growth of bacteria inside the stomach and how digestion is affected such that a number of corrective actions can be taken before the situation worsens. Put it quite simply, PHM as implemented in electronics, can also be applied to healthcare management in very much the same way. One of the key focus of this chapter is to discuss how PHM can assist with health management for environmental health and chronic disease. We shall look at the relationship between environmental pollution and chronic disease by exploring a number of different attributes. We shall commence by taking a look at the broader scope of public health.
