**2. Cultural and environmental impacts on 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 cases, the remedy cost far exceeds that of prevention.

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 health management can provide a remedy and improve public health.

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

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

Environmental Pollution and Chronic Disease Management – A Prognostics Approach 165

included in the regression models. By applying fuzzy ontology for assessment (Tho, 2006), ventilation control can be activated by using prospective estimation for the modeling of pollutant flow within the mine shaft. Known information is used to estimate the VOC

Fig. 1. A prognostics and health management system for air quality monitoring

consequently leads to contamination of surrounding water sources.

these diseass and compensation can be staggering.

Coal dust can also affect local residents surrounding a mining site. While we discuss issues related to indoor air quality and health in the next section in more detail, it is important to address the link between health management and those living nearby. Policies related to safe mining is therefore an important issue to look at. For example, the decision between opencast and underground mine development would, among various economic and practicality factors, have an implication on compromising between the hazards to miners working in the mine and the extent of environmental pollution to the surrounding areas. In adition to coal dust, opencast mining also produces a large amount of toxic gases such as methane and sulphur dioxide which can cause acid rain (Heinberg, 2009). Further, soot emission is also known to cause climate change (Karl, 2003). Coal pollution dust can also enter the food chain in areas where argricultral activities exist and toxic waste water can be discharged into rivers and underground without undergoing proper treatment. The discharged water combined with runoff from mine tailings can cause pollution to surface water and groundwater in mine areas resulting in soil contamination. Excessive discharge of water can also cause land to subsidence, such risk is even more prominant around coastal mines since water being pumped out from the mines can be combined with sea water that

The health risks posed to miners and their associated costs also need to be addressed. Among a long list of complications that can be developed including hearing impairment, neuromuscular disorders, rheumatism, chronic obstructive pulmonary disease (COPD) and acute respiratory infection (ARI) (Hnizdo, 2003); pneumonia caused by coal dust inhalation is perhaps the most serious fatal occupational diseases to hit coal miners. The cost of treating

Different energy sources may be responsible for different kinds of environmental pollution with varying degree of negative impacts on human health and how far the effects can be felt. Even so-called clean energy may not be totally free from causing pollution. For example, wind energy may be widely regarded as a clean energy source. Rotating wind turbines causes pollution in the form of noise although most of them may be installed far away from residential zones (Pedersen, 2004). Elevated level of noise produced from a wind

spread and the change in concentration over time.

nations of which literacy is becoming increasingly important for social, economic and health development. Perception and awareness plays a vital role in disease control. In the case of infectious disease spread, pathogens can easily be spread from one person to another without any precautions. As a person coughs, air-borne disease spread by droplet infection can reach surrounding human traffic such that anyone who walks past can be caught off guard. Common sense may tell us that there are certain precautionary measures that can be taken to minimize the risk of disease spread. However, the threat must first be realized for an action to be taken, like a person will cover the mouth before coughing only with the knowledge that communicable diseases such as influenza can be spread through dispersion of air-borne transmission by droplets (Roy, 2004). The person should also understand the need of disposing of the tissue properly after use. This simple example reminds us the importance of general health awareness for disease prevention.

The issue of disease prevention, particularly for chronic diseases where some symptoms may not exhibit themselves for months or even years, delayed diagnosis may lead to premature mortality. Health degradation is sometimes gradual without any pain or discomfort until a series of other complications are developed. Although regular medical check-ups can detect or prevent illnesses and diseases, this also requires general awareness and the perception of needs. To elaborate on the details of chronic disease problems related to health education, the next section will look at a case study of coal mining and the nearby inhabitants.

#### **2.2 Environmental health and energy supply**

Soaring energy costs put tremendous pressure on the coal mining industry as coal is widely used for power generation as well as conversion into liquid biofuel. The impact of coal mining on health can affect both miners and nearby inhabitants. Health management policies are required to address different environmental circumstances for everyone concerned.

The primary health concern is air pollution. The air quality of an underground coal mine is usually regulated by a gas drainage line where toxic gases are pumped out and neutralized. Exposure to volatile organic compounds (VOCs) is one of the major toxic chemical risks on the human respiratory system (Manuel, 1999). It is estimated that as much as 4.23 g of methane is released per 1 kg of underground-mined coal (Spath, 1999). The idea of utilizing prognostics for the investigation into cumulative coal-mine-dust exposure of coal miners was proposed in (Bourgkard, 1998) such that a PHM system such as that illustrated in Fig. 1 can collect air samples from various parts of the mine shaft and to regulate the air quality as well as triggering an alarm when toxic gas concentration reaches a predetermined threshold specific to the gas measured.

This monitoring system consists of three key components, namely gas sampling sensor network for data acquisition, prognostics module for system monitoring with data analysis module for statistical modelling. The analyzed data is used to regulate the mine shaft ventilation and to trigger an alarm should an evacuation due to dangerous level of gas become necessary. Gas sampling is accomplished by analysis of solid particles and chemicals for the presence of a range of VOCs.

Gas concentration surveillance methods can be classified into three regression classes, namely linear regression, Poisson regression and regression with ARIMA (Autoregressive Integrated Moving Average) error structures (Jiang, 2007). Covariates such as miners' work shift indicators, seasonal trends with harmonic terms, and coal export indicators are often

nations of which literacy is becoming increasingly important for social, economic and health development. Perception and awareness plays a vital role in disease control. In the case of infectious disease spread, pathogens can easily be spread from one person to another without any precautions. As a person coughs, air-borne disease spread by droplet infection can reach surrounding human traffic such that anyone who walks past can be caught off guard. Common sense may tell us that there are certain precautionary measures that can be taken to minimize the risk of disease spread. However, the threat must first be realized for an action to be taken, like a person will cover the mouth before coughing only with the knowledge that communicable diseases such as influenza can be spread through dispersion of air-borne transmission by droplets (Roy, 2004). The person should also understand the need of disposing of the tissue properly after use. This simple example reminds us the

The issue of disease prevention, particularly for chronic diseases where some symptoms may not exhibit themselves for months or even years, delayed diagnosis may lead to premature mortality. Health degradation is sometimes gradual without any pain or discomfort until a series of other complications are developed. Although regular medical check-ups can detect or prevent illnesses and diseases, this also requires general awareness and the perception of needs. To elaborate on the details of chronic disease problems related to health education, the next section will look at a case study of coal mining and the nearby

Soaring energy costs put tremendous pressure on the coal mining industry as coal is widely used for power generation as well as conversion into liquid biofuel. The impact of coal mining on health can affect both miners and nearby inhabitants. Health management policies are required to address different environmental circumstances for everyone

The primary health concern is air pollution. The air quality of an underground coal mine is usually regulated by a gas drainage line where toxic gases are pumped out and neutralized. Exposure to volatile organic compounds (VOCs) is one of the major toxic chemical risks on the human respiratory system (Manuel, 1999). It is estimated that as much as 4.23 g of methane is released per 1 kg of underground-mined coal (Spath, 1999). The idea of utilizing prognostics for the investigation into cumulative coal-mine-dust exposure of coal miners was proposed in (Bourgkard, 1998) such that a PHM system such as that illustrated in Fig. 1 can collect air samples from various parts of the mine shaft and to regulate the air quality as well as triggering an alarm when toxic gas concentration reaches a predetermined threshold

This monitoring system consists of three key components, namely gas sampling sensor network for data acquisition, prognostics module for system monitoring with data analysis module for statistical modelling. The analyzed data is used to regulate the mine shaft ventilation and to trigger an alarm should an evacuation due to dangerous level of gas become necessary. Gas sampling is accomplished by analysis of solid particles and

Gas concentration surveillance methods can be classified into three regression classes, namely linear regression, Poisson regression and regression with ARIMA (Autoregressive Integrated Moving Average) error structures (Jiang, 2007). Covariates such as miners' work shift indicators, seasonal trends with harmonic terms, and coal export indicators are often

importance of general health awareness for disease prevention.

**2.2 Environmental health and energy supply** 

inhabitants.

concerned.

specific to the gas measured.

chemicals for the presence of a range of VOCs.

included in the regression models. By applying fuzzy ontology for assessment (Tho, 2006), ventilation control can be activated by using prospective estimation for the modeling of pollutant flow within the mine shaft. Known information is used to estimate the VOC spread and the change in concentration over time.

Fig. 1. A prognostics and health management system for air quality monitoring

Coal dust can also affect local residents surrounding a mining site. While we discuss issues related to indoor air quality and health in the next section in more detail, it is important to address the link between health management and those living nearby. Policies related to safe mining is therefore an important issue to look at. For example, the decision between opencast and underground mine development would, among various economic and practicality factors, have an implication on compromising between the hazards to miners working in the mine and the extent of environmental pollution to the surrounding areas. In adition to coal dust, opencast mining also produces a large amount of toxic gases such as methane and sulphur dioxide which can cause acid rain (Heinberg, 2009). Further, soot emission is also known to cause climate change (Karl, 2003). Coal pollution dust can also enter the food chain in areas where argricultral activities exist and toxic waste water can be discharged into rivers and underground without undergoing proper treatment. The discharged water combined with runoff from mine tailings can cause pollution to surface water and groundwater in mine areas resulting in soil contamination. Excessive discharge of water can also cause land to subsidence, such risk is even more prominant around coastal mines since water being pumped out from the mines can be combined with sea water that consequently leads to contamination of surrounding water sources.

The health risks posed to miners and their associated costs also need to be addressed. Among a long list of complications that can be developed including hearing impairment, neuromuscular disorders, rheumatism, chronic obstructive pulmonary disease (COPD) and acute respiratory infection (ARI) (Hnizdo, 2003); pneumonia caused by coal dust inhalation is perhaps the most serious fatal occupational diseases to hit coal miners. The cost of treating these diseass and compensation can be staggering.

Different energy sources may be responsible for different kinds of environmental pollution with varying degree of negative impacts on human health and how far the effects can be felt. Even so-called clean energy may not be totally free from causing pollution. For example, wind energy may be widely regarded as a clean energy source. Rotating wind turbines causes pollution in the form of noise although most of them may be installed far away from residential zones (Pedersen, 2004). Elevated level of noise produced from a wind

Environmental Pollution and Chronic Disease Management – A Prognostics Approach 167

Whether people are willing to learn from past experience is another issue that health management needs to addressed. By recalling the SARS (Severe Acute Respiratory Syndrome) epidemic was initially erupted in China's Guangdong province in 2003, rumours claimed vinegar could be used as a disinfectant and kill the SARS virus (Rosling, 2003). Like stockpiling table salt in 2011, people responded in exactly the same way when they stocked

These examples, showing how people react to rumours, provide an insight into the importance of carefully planned policies in anticipation of public reactions. Certain clues may be made available to policy makers for prediction of how general perception will be

To assist with health management for prevention and control of environmentally related diseases, a general understanding of methodologies in monitoring environmental pollutions that cause a range of chronic diseases and premature death is vitally important. Environmental monitoring relies heavily on sensors and wireless networks that connect the sensors together. Wireless sensor networks provide a range of solutions for monitoring different sources of pollutions from the air we breathe to the water we drink. Different

A wide range of sensors are deployed in different locations to monitor different parameters.

A sensor is defined by (Carstens, 1992) as a device that provides a usable output signal in response to a specified measurement parameter, for example, methane gas concentration, or

up excessive quantities of vinegar some eight years earlier.

**3. Environmental monitoring technology** 

sensors exist for different applications.

Fig. 2. Environmental health monitoring system

**3.1 Sensors** 

These cover both human health and the surround environment

driven.

turbine is often resulted from deficiency linked to lubrication and component wear (Gray, 2010), pollution control through noise control can be accomplished using the following prognostics approach: A prognostics system typically consists of a variety of onboard sensors, data acquisition systems, and signal processing and analysis algorithm. Application of prognostics based maintenance technology to wind turbine has the potential to significantly reduce induced noise and increase turbine reliability by enabling conditionbased maintenance (CBM) thus enabling advance detection of dry lubricants as well as component tear and wear. Detection of faults in their early stages provides an opportunity to carry out necessary maintenance work prior to a turbine degradation that may generate excessive noise.

Among various energy sources commonly used over the past decade or more, nuclear energy is perhaps the deadiest that can kill many people over a long period of time spanning across decades due to radioactive pollution as a direct cause of many acute and chronic conditions (Andia, 1998). Although excessive discharge of radioactive pollutants does not occur often, once it happens the situation can be critical as radiation is released into the environment that can travel for thousands of miles across the world. Well-known accidents include the 1986 Chernobyl reactor meltdown in the former Soviet Union, Three Mile Island incident in the USA and more recently Fukushima nuclear plant in Japan overheated after an earthquake triggered tsunami damaged the plant's power supply to the cooling system. Note that the word 'meltdown' is appropriately used in a nuclear reactor disaster to describe the blast. This is because commercial nuclear reactor fuel is not enriched to the radioactive materials used in nuclear weapons intended to cause massive explosions. In the case of a meltdown, the core temperature inside the nuclear fuel rods casues the solid rod to melt, turning in liquid. As the happens the molten radioactive materials of the fuel rods would react with ground water (Caldicott, 2006). The wide range of fatal health problems will be seen for the decades to come as there is currently no known cure to radioactive poisoning as the damage to human tissue is irreversible.

#### **2.3 Health management, policies and public reactions**

Earlier in the section we have discussed the health management issues related to perception and general awareness. The role of health management and policies can differ significantly from country to country. While this chapter will not touch on politics, there are a number of issues that should be addressed. Take the table salt snatching example in March 2011 following the Fukushima nuclear incident in Japan, rumours triggered panic buying of table salt around the Greater China region (Pierson, 2011). Fear was sparked by internet rumours that salt consumption can ward off radiation exposure. Further panic was also driven by the theory that salt in future may be produced from radiation-contaminated sea water. Without citing any references, it should be obvious to readers that common table salt as a remedy and that production of salt by radioactive-pollution affected sea water cannot possibly be true.

Sometimes rumours are not totally unfounded. There are perhaps some related facts, such as in this particular example, iodine salt can yield a lower absorption of certain radioactive exposure (Mettler Jr., 2002). People with no knowledge on how radiation may affect human health can be driven to respond to rumours in an inappropriate way. Further, no effort has been made on finding out whether table salt sold on the market is iodized and they lack the knowledge of understanding the difference between iodine tablets and iodized salt. This is a classic example of an overreaction by people to rumours.

Whether people are willing to learn from past experience is another issue that health management needs to addressed. By recalling the SARS (Severe Acute Respiratory Syndrome) epidemic was initially erupted in China's Guangdong province in 2003, rumours claimed vinegar could be used as a disinfectant and kill the SARS virus (Rosling, 2003). Like stockpiling table salt in 2011, people responded in exactly the same way when they stocked up excessive quantities of vinegar some eight years earlier.

These examples, showing how people react to rumours, provide an insight into the importance of carefully planned policies in anticipation of public reactions. Certain clues may be made available to policy makers for prediction of how general perception will be driven.
