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Dr Wilfried Kreisel Director, WHO Centre for Health Development
Niigata City, 29 March 2005
Water and Health
The 75th Annual Meeting of the Japanese Society for Hygiene
2
Selected Topics at previous meetings of the Japanese Society for Hygiene
• 1929: Hygiene related to sunlight and ventilation • 1934: The role of temperature, humidity and ventilation • in architecture• 1942: Studies on changing impact of industrial pollutants. • 1950: The status of school hygiene under the new • educational system • 1970: Hygienic aspects of air pollution • 1980: Environmental carcinogens and expectations of
public health
3
Broad Outline of Presentation
1. Water and health in Japan: a brief historical analysis
2. The global situation: WHO perspective on emerging challenges and water borne health risks
3. How to meet future challenges in water and health?
4
Water and health in Japan: a brief historical analysis
Dondo dam, Hyogo Prefecture
A. 1868-1900
B. 1901-1945
C. 1946-2004
5
Water and health in Japan1868-1900
Characteristics of water supply system at that time:A. Pre-modern: continuation of the method from
the Edo period B. Utilization of wooden pipesC. Usage of water from riversD. Hygiene and health as great
concerns
Kande Shrine, Hyogo Prefecture
6[Source: “A comparison of the development of public water supplies in England and Wales and in Japan”, Yamamura, Takafusa, 1983]
13710
7967
162637
105786
51678
33776
138247152
155574
110086
46019
1079211142
3382
55144
14990
13362
4136
103716264
4967
3114
0
20000
40000
60000
80000
100000
120000
140000
160000
180000
Num
ber
of
patients
/de
ceas
ed
1877 1879 1882 1885 1886 1890 1891 1895 1902 1916 1920
Year
Number o f pat ien ts and mortal i ty in major cho le raoutbreaks in Japan
Number of recorded patients Number of recorded cases of mortality
Number of patients and mortality in major cholera outbreaks in Japan
7
[Source: “A comparison of the development of public water supplies in England and Wales and in Japan”, Yamamura, Takafusa, 1983]
Nu m be r o f r e c o r de d pa t i e n t s i n m a jo r dys e n t e r yo u t br e ak s i n J apan
167000155000
108000
0
20000
40000
60000
80000
100000
120000
140000
160000
180000
1893 1894 1899
Year
Num
ber
of
patients
Number of recorded patients
Number of recorded patients in major dysentery outbreaks in Japan
8
Water and Health in Japan1868-1900
1. Drinking Water Caution Act was implemented in 1878.2. First sewerage system was established in Tokyo in 1884.3. In 1887, Mr Henry S. Palmer designed the first modern
water distribution system (with iron pipes, sand filtering, pumps, and the process of disinfecting) for Yokohama City. Other cities followed, e.g. Nagasaki (1891), Osaka (1895), Hiroshima (1898), Tokyo (1898) and Kobe (1900).
4. Waterworks Clauses Act was established in 1890.5. First major water pollution occurred at Ashio Copper Mine
in Tochigi Prefecture, in 1891.6. The Sewerage Law was introduced in 1900.
9[Source: Statistical Survey Department, Statistics Bureau, Ministry of Public Management, Home Affairs, Posts, and Telecommunication, Japan]
Popu lat ion c h an ge in Japan (1 901-1945 )
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
1901
1904
1907
1910
1913
1916
1919
1922
1925
1928
1931
1934
1937
1940
1943
Year
Popu
lation (
in t
housa
nd)
Population growth in Japan (1901-1945)
10
Water and health in Japan 1900 – 1945
1. Infectious diseases were still a major concern: e.g., cholera outbreaks in 1902, 1912, 1916, and 1920.
2. More cities established modern water supply system: Okayama City in 1905, Shimonoseki City in 1906, and Akita City in 1911.
3. Introduction of wastewater treatment tanks, i.e., septic tanks4. First patient of Itai-itai disease was identified in 1912. 5. Damage from the war was great: in 1945, for instance, about
80 percent of water pipes in the City of Kobe were leaking water.6. Water consumption for industrial purposes increased.
11[Source: Ministry of Health, Labour, and Welfare, Japan]
Percentage of people with access to water supply(1950-2000)
0
20
40
60
80
100
120
1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000
Year
Peopl
e w
ith a
ccess
to w
ater
supp
ly (
Percentage of people with access to water supply (1950-2000)%
)Pe
ople
with
acc
ess
to w
ater
sup
ply
(%)
12
Population of Japan (1946-2000)
0
20000
40000
60000
80000
100000
120000
140000
1945
1950
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
Year
Popu
lation (in thousa
nd
[Source: Statistical Survey Department, Statistics Bureau, Ministry of Public Management, Home Affairs, Posts, and Telecommunication, Japan]
Population increase in Japan (1946-2000)Po
pula
tion
(in th
ousa
nd)
13
Water and Health in Japan 1946 – 2004
1. Change in chlorination method: from periodic chlorination to regular chlorination
2. Waterworks Law was implemented in 1957.
3. Rapid decrease in the mortality from water-borneinfections,particularly in the period between 1950 and 1970.
Futami, Hyogo Prefecture
14
Incidence and mortality from cholera in Japan(1946-1998)
0
200
400
600
800
1000
1200
1400
1946
1950
1954
1958
1962
1966
1970
1974
1978
1982
1986
1990
1994
1998
Year
Num
ber of cas
es
Incidence of cholera Mortality from cholera
Cholera
[Source: Ministry of Health, Labour, and Welfare, Japan]
Incidence and mortality from cholera in Japan (1946-1998)
Num
ber o
f cas
es
Incidence of cholera Mortality from cholera
15
Inc idence a nd mor ta l i t y from ty pho id fev e r in J a pa n(1946-1998 )
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
1946
1949
1952
1955
1958
1961
1964
1967
1970
1973
1976
1979
1982
1985
1988
1991
1994
1997
Year
Num
ber
of
patients
/m
ort
ality
Incidence of typhoid fever Mortality from typhoid fever
Typhoid fever
[Source: Ministry of Health, Labour, and Welfare, Japan]
Incidence and mortality from typhoid feverin Japan (1946-1998)
Num
ber o
f pa t
ient
s/m
orta
lity
16
Access to water supply by Prefecture
96.8 %All PrefecturesAverage of all prefectures
100 %TokyoHighest
83.9 %KumamotoLowest
Access to water supply by Prefecture
PrefectureAccess to water supply based on prefectures (2004)
[Source: Ministry of Health, Labour, and Welfare, Japan]
17
1910 1930 1950 1970 1990 2010
0
20000
40000
60000
80000
100000
120000
Popu
latio
n ( 1
000)
Year
Total population
sanitary treatment
Unsanitary treatment
public water supply
public sewerage system
75%
Development of water supply and sanitation- summary -
Source: Prof. Y. Magara, Hokkaido University
18
0
20000
40000
60000
80000
100000
1960 1965 1970 19750
1000
2000
3000
4000
5000
6000
Poliomyelitis
Shigellosis
Typhoid
Paratyphoid Cas
e of
Shi
gello
sis/
year
Cas
e of
pol
io e
tc./y
ear
Year
Control of feces-oral route related diseases in 1960-1975
Source: Prof. Y. Magara, Hokkaido University
19
Specific Chemical Pollution Related Diseases
1. Minamata disease (due to methylmercury contamination): the first patient identified in 1953; Based on the so-called Compensation Law of 1974, by March 2001, 2955 persons have been certified as Minamata Disease patients.
2. Itai-itai disease (as a result of cadmium contamination):the first patient was found in 1912; 184 patients were identified during the period 1967 - 2000.
20Note: Rates of non-conformity for health-related pollutants (based on old environmental quality standards) (Non-conformity rate for alkyl-mercury has been 0% since 1971)
Rates of non-conformity to water environmental quality standards for protecting human health
Source: Ministry of the Environment
Pb
CN
Cd
As
PCB
Organic
phosphorus
Total mercury
Cr
21
Rates of conformity to water environmental quality standards (BOD or COD, according to water area)
Source: Ministry of the Environment
All water areas Rivers Lakes and Reservoirs Sea areas
Conformity rate (%)
fiscal year
22
Source: Ministry of the Environment
Integrated Water Resources Management
Sea areas
Farmland
Urban areas
Lakes and Reservoirs
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