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5.16 Surgery
Injuries or disorders of the body are treated by incision or manipulation with the
help of instruments. Life cycle assessment in the United States revealed that production of single-use surgical devices and disposable materials, energy used for heating, ventilation, and air conditionings, as well as anesthetic gases have been major
sources of environmental emissions (Thiel et al. 2015). Poor solid waste management and housekeeping may cause spread of infection within the hospital to outside
the hospital.
Nosocomial is a primary cause of mortality and morbidity in the United States
(McFee 2009) and many other countries. Surgery demands high sterile and clean
environment as the patient who undergoes surgery may contact nosocomial infection if the equipments and operation theatre are not sterilized and clean. The
COVID-19 pandemic forced a radical decline in surgical activity to protect uninfected patients from nosocomial infection. Based on observation made in France,
between March 1, 2020 and April 5, 2020, out of 305 patients admitted to digestive
surgery departments, 4.9% developed nosocomial infection with SARS-Cov-2
(Luong-Nguyen et al. 2020).
5.17 Pulmonology
Pulmonology is a branch of medical science that is concerned with ailments involving the respiratory tract. A variety of microorganisms can cause infection of upper
respiratory tract that includes the common cold, acute bronchitis, SARS, COVID-19,
influenza, and respiratory distress syndromes. Excessive air pollution from natural
(Box 5.6) and artificial (5.6) sources can lead to respiratory illnesses. Over half of
Box 5.5 Pesticide in Modern Agriculture and Health
The application of endosulfan by aerial spraying over the cashew plantations
in Kasaragod district of Kerala state, India from 1978 (NIOH 2001) was the
cause of series of health issues.  The cashew nut trees are primarily in the
higher portions while the village houses are located in the valleys. Streams
flow with lots of small ponds and tributaries which drain into a nearby river.
Households get their water from open wells or “surangas” (tunnel). The use of
endosulfan resulted in mass deaths of fishes, bees, birds, frogs, and cows. The
endosulfan application also affected large number of diseases related to the
central nervous system affecting about 8000–9000 people in Kasaragod district (Joe 2010).
In Karnataka state, India application of endosulfan between 1980 and 2000
on 850 ha in Dakshin Kannada affected population in nearly 20 villages of the
state (Down to Earth 2017).
5.17 Pulmonology
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