Estimating burden of disease due to environmental factors with an emphasis on inadequate water, sanitation and hygiene

Wolf, Jennyfer (2019) Estimating burden of disease due to environmental factors with an emphasis on inadequate water, sanitation and hygiene. Doctoral thesis, University of East Anglia.

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Environmental risks, including inadequate water, sanitation and hygiene (WASH), are major determinants of health and are responsible for much of the world’s disease and deaths. Risk factor-attributable burden of disease assessments are important for prioritizing diseases and risk factors in policies and interventions. Risk factor exposure data and exposure-response information describing the association between the risk factor and the health outcome are used to calculate the population attributable fraction (PAF). The PAF signifies the proportion of ill health or deaths that could have potentially been prevented by removing the risk factor or by reducing it to an alternative level. It is used to calculate risk factor-attributable disease burden estimates.

The research presented and summarized here focuses on disease burden estimation attributable to environmental risk factors, especially to inadequate WASH. It includes research that improved availability of population-level data on relevant exposures, extended previous exposure classifications, generated and updated exposure-response relationships and estimated disease burden attributable to a range of environmental risk factors and for various adverse health outcomes. Research evaluating environmental health interventions as well as research examining factors associated with heterogeneous effectiveness of WASH interventions complements this work.

The presented work showed the great importance on health of environmental risk factors, provided important inputs for the monitoring of the Sustainable Development Goals (SDGs) and alternative methods and estimates to the Global Burden of Disease studies. It further highlighted the need for WASH interventions that lead to more radical WASH transitions, that target and reach whole communities and that consider response bias due to lack of blinding in subjectively assessed health outcomes. It further showed scarce evidence on the impacts on health of many environmental risk factors.

Item Type: Thesis (Doctoral)
Uncontrolled Keywords: Publication
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Jennifer Whitaker
Date Deposited: 10 Mar 2020 14:20
Last Modified: 10 Mar 2020 14:20


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