Environmental health

Environmental health is the branch of public health concerned with all aspects of the natural and built environment affecting human health. Environmental health is focused on the natural and built environments for the benefit of human health. The major subdisciplines of environmental health are: environmental science; environmental and occupational medicine, toxicology and epidemiology.

Other terms referring to or concerning environmental health are environmental public health, and public health protection/ environmental health protection.

FEMA - 16491 - Photograph by John Fleck taken on 09-30-2005 in Mississippi
FEMA/EPA Hazardous Materials Team removing hazards left in the wake of Hurricane Katrina, 2005.

Definitions

Environmental health has been defined in a 1999 document by the World Health Organization (WHO) as:

Those aspects of the human health and disease that are determined by factors in the environment. It also refers to the theory and practice of assessing and controlling factors in the environment that can potentially affect health.
Environmental health as used by the WHO Regional Office for Europe, includes both the direct pathological effects of chemicals, radiation and some biological agents, and the effects (often indirect) on health and well being of the broad physical, psychological, social and cultural environment, which includes housing, urban development, land use and transport.[1]

As of 2016 the WHO website on environmental health states "Environmental health addresses all the physical, chemical, and biological factors external to a person, and all the related factors impacting behaviours. It encompasses the assessment and control of those environmental factors that can potentially affect health. It is targeted towards preventing disease and creating health-supportive environments. This definition excludes behaviour not related to environment, as well as behaviour related to the social and cultural environment, as well as genetics."[2]

The WHO has also defined environmental health services as "those services which implement environmental health policies through monitoring and control activities. They also carry out that role by promoting the improvement of environmental parameters and by encouraging the use of environmentally friendly and healthy technologies and behaviors. They also have a leading role in developing and suggesting new policy areas."

The term environmental medicine may be seen as a medical specialty, or branch of the broader field of environmental health. Terminology is not fully established, and in many European countries they are used interchangeably.

Disciplines

Five basic disciplines generally contribute to the field of environmental health: environmental epidemiology, toxicology, exposure science, environmental engineering, and environmental law. Each of these disciplines contributes different information to describe problems and solutions in environmental health, but there is some overlap among them.

  • Environmental epidemiology studies the relationship between environmental exposures (including exposure to chemicals, radiation, microbiological agents, etc.) and human health. Observational studies, which simply observe exposures that people have already experienced, are common in environmental epidemiology because humans cannot ethically be exposed to agents that are known or suspected to cause disease. While the inability to use experimental study designs is a limitation of environmental epidemiology, this discipline directly observes effects on human health rather than estimating effects from animal studies.
  • Toxicology studies how environmental exposures lead to specific health outcomes, generally in animals, as a means to understand possible health outcomes in humans. Toxicology has the advantage of being able to conduct randomized controlled trials and other experimental studies because they can use animal subjects. However there are many differences in animal and human biology, and there can be a lot of uncertainty when interpreting the results of animal studies for their implications for human health.
  • Exposure science studies human exposure to environmental contaminants by both identifying and quantifying exposures. Exposure science can be used to support environmental epidemiology by better describing environmental exposures that may lead to a particular health outcome,identify common exposures whose health outcomes may be better understood through a toxicology study, or can be used in a risk assessment to determine whether current levels of exposure might exceed recommended levels. Exposure science has the advantage of being able to very accurately quantify exposures to specific chemicals, but it does not generate any information about health outcomes like environmental epidemiology or toxicology.
  • Environmental engineering applies scientific and engineering principles for protection of human populations from the effects of adverse environmental factors; protection of environments from potentially deleterious effects of natural and human activities; and general improvement of environmental quality.
  • Environmental law includes the network of treaties, statutes, regulations, common and customary laws addressing the effects of human activity on the natural environment.

Information from epidemiology, toxicology, and exposure science can be combined to conduct a risk assessment for specific chemicals, mixtures of chemicals or other risk factors to determine whether an exposure poses significant risk to human health (exposure would likely result in the development of pollution-related diseases). This can in turn be used to develop and implement environmental health policy that, for example, regulates chemical emissions, or imposes standards for proper sanitation.[3] Actions of engineering and law can be combined to provide risk management to minimize, monitor, and otherwise manage the impact of exposure to protect human health to achieve the objectives of environmental health policy.

Concerns

Environmental health addresses all human-health-related aspects of the natural environment and the built environment. Environmental health concerns include:

According to recent estimates, about 5 to 10% of Disability-adjusted life years (DALYs) lost are due to environmental causes in Europe. By far the most important factor is fine particulate matter pollution in urban air.[4] Similarly, environmental exposures have been estimated to contribute to 4.9 million (8.7%) deaths and 86 million (5.7%) DALYs globally.[5] In the United States, Superfund sites created by various companies have been found to be hazardous to human and environmental health in nearby communities. It was this perceived threat, raising the specter of miscarriages, mutations, birth defects, and cancers that most frightened the public.[6]

Information

The Toxicology and Environmental Health Information Program (TEHIP)[7] is a comprehensive toxicology and environmental health web site, that includes open access to resources produced by US government agencies and organizations, and is maintained under the umbrella of the Specialized Information Service at the United States National Library of Medicine. TEHIP includes links to technical databases, bibliographies, tutorials, and consumer-oriented resources. TEHIP is responsible for the Toxicology Data Network (TOXNET),[8] an integrated system of toxicology and environmental health databases including the Hazardous Substances Data Bank, that are open access, i.e. available free of charge.

Mapping

There are many environmental health mapping tools. TOXMAP is a geographic information system (GIS) from the Division of Specialized Information Services[9] of the United States National Library of Medicine (NLM) that uses maps of the United States to help users visually explore data from the United States Environmental Protection Agency's (EPA) Toxics Release Inventory and Superfund Basic Research Programs. TOXMAP is a resource funded by the US federal government. TOXMAP's chemical and environmental health information is taken from the NLM's Toxicology Data Network (TOXNET)[10] and PubMed, and from other authoritative sources.

Environmental health profession

Environmental health professionals may be known as environmental health officers, public health inspectors, environmental health specialists, environmental health practitioners, or sanitarians. Researchers and policy-makers also play important roles in how environmental health is practiced in the field. In many European countries, physicians and veterinarians are involved in environmental health. In the United Kingdom, practitioners must have a graduate degree in environmental health and be certified and registered with the Chartered Institute of Environmental Health or the Royal Environmental Health Institute of Scotland.[11] In Canada, practitioners in environmental health are required to obtain an approved bachelor's degree in environmental health along with the national professional certificate, the Certificate in Public Health Inspection (Canada) CPHI(C).[12] Many states in the United States also require that individuals have a bachelor's degree and professional licenses in order to practice environmental health. California state law defines the scope of practice of environmental health as follows:[13]

"Scope of practice in environmental health" means the practice of environmental health by registered environmental health specialists in the public and private sector within the meaning of this article and includes, but is not limited to, organization, management, education, enforcement, consultation, and emergency response for the purpose of prevention of environmental health hazards and the promotion and protection of the public health and the environment in the following areas: food protection; housing; institutional environmental health; land use; community noise control; recreational swimming areas and waters; electromagnetic radiation control; solid, liquid, and hazardous materials management; underground storage tank control; onsite septic systems; vector control; drinking water quality; water sanitation; emergency preparedness; and milk and dairy sanitation pursuant to Section 33113 of the Food and Agricultural Code.

The environmental health profession had its modern-day roots in the sanitary and public health movement of the United Kingdom. This was epitomized by Sir Edwin Chadwick, who was instrumental in the repeal of the poor laws, and in 1884 was the founding president of the Association of Public Sanitary Inspectors, now called the Chartered Institute of Environmental Health.

See also

Journals:

(For additional related journals, see List of environmental health journals)

Organisations:

References

  1. ^ Novice, Robert (editor) (1999-03-29). "Overview of the environment and health in Europe in the 1990s" (PDF). World Health Organization.CS1 maint: Extra text: authors list (link)
  2. ^ WHO (n.d.). "Health topics: Environmental health". Retrieved 10 January 2015.
  3. ^ Environmental Health: from Global to Local (2 Editor= Howard Frumkin ed.). San Francisco: John Wiley & Sons. 2010.
  4. ^ National and regional story (Netherlands) - Environmental burden of disease in Europe: the Abode project. EEA.
  5. ^ Knows and unknowns on burden of disease due to chemicals: a systematic review. Press-Ustinov, A., et al. 2011. Environmental Health 10:9.
  6. ^ Schleicher, D. (1995). Superfund’s Abandoned Hazardous Waste Sites. In A. Wildavsky (Ed.), But Is it True?: A Citizen’s Guide to Environmental Health and Safety Issues (153-184) . Cambridge, MA: Harvard University Press
  7. ^ "TEHIP". United States National Library of Medicine.
  8. ^ "TOXNET". United States National Library of Medicine.
  9. ^ sis.nlm.nih.gov
  10. ^ toxnet.nlm.nih.gov
  11. ^ "Job Profiles: Environmental health officer". National Careers Service (UK). Retrieved 17 August 2014.
  12. ^ "Canadian Institute of Public Health Inspectors". Retrieved 4 February 2015.
  13. ^ California Health and Safety Code, section 106615(e)

Further reading

Air pollution

Air pollution occurs when harmful or excessive quantities of substances including gases, particles, and biological molecules are introduced into Earth's atmosphere. It may cause diseases, allergies and even death to humans; it may also cause harm to other living organisms such as animals and food crops, and may damage the natural or built environment. Both human activity and natural processes can generate air pollution.

Indoor air pollution and poor urban air quality are listed as two of the world's worst toxic pollution problems in the 2008 Blacksmith Institute World's Worst Polluted Places report. According to the 2014 World Health Organization report, air pollution in 2012 caused the deaths of around 7 million people worldwide, an estimate roughly echoed by one from the International Energy Agency.

California Office of Environmental Health Hazard Assessment

The Office of Environmental Health Hazard Assessment, commonly referred to as OEHHA (pronounced oh-EEE-ha), is a specialized department within the cabinet-level California Environmental Protection Agency (CalEPA) with responsibility for evaluating health risks from environmental chemical contaminants.

OEHHA is the scientific adviser within CalEPA and provides the health effects assessments that assist regulatory decision makers within CalEPA, the California Department of Public Health, and other agencies and non-governmental organizations (see below). This includes assessing health and environmental risks from:

Carcinogens

Reproductive toxins

Air pollutants

Pesticides

Chemical contaminants in food and water

Chemical exposures in the workplace

Climate change in California

Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention (CDC) is the leading national public health institute of the United States. The CDC is a United States federal agency under the Department of Health and Human Services and is headquartered in Atlanta, Georgia.Its main goal is to protect public health and safety through the control and prevention of disease, injury, and disability in the US and internationally. The CDC focuses national attention on developing and applying disease control and prevention. It especially focuses its attention on infectious disease, food borne pathogens, environmental health, occupational safety and health, health promotion, injury prevention and educational activities designed to improve the health of United States citizens. In addition, the CDC researches and provides information on non-infectious diseases such as obesity and diabetes and is a founding member of the International Association of National Public Health Institutes.

Chartered Institute of Environmental Health

The Chartered Institute of Environmental Health (CIEH) is a professional membership body concerned with environmental health and promoting standards in the training and education of environmental health professionals.

Edwin Chadwick

Sir Edwin Chadwick KCB (24 January 1800 – 6 July 1890) was an English social reformer who is noted for his leadership in reforming the Poor Laws in England and instituting major reforms in urban sanitation and public health. A disciple of Utilitarian philosopher Jeremy Bentham, he was most active between 1832 and 1854; after that he held minor positions, and his views were largely ignored. Chadwick pioneered the use of scientific surveys to identify all phases of a complex social problem, and pioneered the use of systematic long-term inspection programmes to make sure the reforms operated as planned.

Environment, health and safety

Environment, health and safety (EHS) is a discipline and specialty that studies and implements practical aspects of environmental protection and safety at work. In simple terms it is what organizations must do to make sure that their activities do not cause harm to anyone.

Regulatory requirements play an important role in EHS discipline and EHS managers must identify and understand relevant EHS regulations, the implications of which must be communicated to executive management so the company can implement suitable measures. Organisations based in the United States are subject to EHS regulations in the Code of Federal Regulations, particularly CFR 29, 40, and 49. Still, EHS management is not limited to legal compliance and companies should be encouraged to do more than is required by law, if appropriate.From a health & safety standpoint, it involves creating organized efforts and procedures for identifying workplace hazards and reducing accidents and exposure to harmful situations and substances. It also includes training of personnel in accident prevention, accident response, emergency preparedness, and use of protective clothing and equipment.

From an environmental standpoint, it involves creating a systematic approach to complying with environmental regulations, such as managing waste or air emissions all the way to helping site's reduce the company's carbon footprint.

Successful HSE programs also include measures to address ergonomics, air quality, and other aspects of workplace safety that could affect the health and well-being of employees and the overall community.

Environmental Health (journal)

Environmental Health is a peer-reviewed medical journal established in 2002 and published by BioMed Central. It covers research in all areas of environmental and occupational medicine. The editors-in-chief are Philippe Grandjean (University of Southern Denmark) and David Ozonoff (Boston University School of Public Health). According to the Journal Citation Reports, the journal has a 2015 impact factor of 3.453.

Environmental Health Perspectives

Environmental Health Perspectives (EHP) is a peer-reviewed open access journal published monthly with support from the U.S. National Institute of Environmental Health Sciences (NIEHS). The primary purposes of EHP are to communicate recent scientific findings and trends in the environmental health sciences; to improve the environmental health knowledge base among researchers, administrators, and policy makers; and to inform the public about important topics in environmental health. As of 2015 EHP has an impact factor of 8.44.It is indexed in PubMed.

Environmental Protection Administration, Executive Yuan

The Environmental Protection Administration, Executive Yuan (EPA, Chinese: 行政院環境保護署; Pe̍h-ōe-jī: Hêng-chèng Īⁿ Khoân-kéng Pó-hō͘ Sú) is a cabinet-level executive agency responsible for protecting and conserving the environment in the Republic of China. This also includes, air quality, noise control, monitoring and inspection of environment, solid waste, recycling, sustainable development and international cooperation.It is led by the Minister for Environment. He is supported by two deputy ministers.

Environmental epidemiology

Environmental epidemiology is a branch of epidemiology concerned with determining how environmental exposures impact human health. This field seeks to understand how various external risk factors may predispose to or protect against disease, illness, injury, developmental abnormalities, or death. These factors may be naturally occurring or may be introduced into environments where people live, work, and play.

Environmental factor

An environmental factor, ecological factor or eco factor is any factor, abiotic or biotic, that influences living organisms. Abiotic factors include ambient temperature, amount of sunlight, and pH of the water soil in which an organism lives. Biotic factors would include the availability of food organisms and the presence of conspecifics, competitors, predators, and parasites.

Environmental hazard

An environmental hazard is a substance, a state or an event which has the potential to threaten the surrounding natural environment / or adversely affect people's health, including pollution and natural disasters such as storms and earthquakes.

Any single or combination of toxic chemical, biological, or physical agents in the environment, resulting from human activities or natural processes, that may impact the health of exposed subjects, including pollutants such as heavy metals, pesticides, biological contaminants, toxic waste, industrial and home chemicals.Human-made hazards while not immediately health-threatening may turn out detrimental to man's well-being eventually, because deterioration in the environment can produce secondary, unwanted negative effects on the human ecosphere. The effects of water pollution may not be immediately visible because of a sewage system that helps drain off toxic substances. If those substances turn out to be persistent (e.g. persistent organic pollutant), however, they will literally be fed back to their producers via the food chain: plankton -> edible fish -> humans. In that respect, a considerable number of environmental hazards listed below are man-made (anthropogenic) hazards.

Hazards can be categorized in four types:

Chemical

Physical (mechanical, etc.)

Biological

Psychosocial.

Environmental health officer

Environmental Health Officers (also known as Public Health Inspectors or Environmental Health Practitioners) are responsible for carrying out measures for protecting public health, including administering and enforcing legislation related to environmental health and providing support to minimize health and safety hazards. Environmental Health Practitioners are multi-skilled in many areas with individuals being highly trained, usually to degree level, and often requiring additional professional training, professional competency assessment and continuing professional development in order to continue to practise in the field.

They are involved in a variety of activities, for example inspecting food facilities, investigating public health nuisances, and implementing disease control, conducting work place safety assessments and accident investigation. Environmental health officers are focused on prevention, consultation, investigation, and education of the community regarding health risks and maintaining a safe environment.

EHOs bring to the position an understanding of microbiology, risk assessment, environmental science and technology, food science, knowledge of the built environment as well as the skills and knowledge related to the tracking and control of communicable disease, investigation of environmental health related incidents and criminal investigations. They therefore must also have strong investigative skills and a thorough understanding of the application of legislation related to public health, the built environment, pollution control and workplace safety. Working in partnership with Government Ministries (such as Health, Agriculture and Environment), local municipalities, businesses, community groups, other agencies and individual members of the community, the EHO plays a major role in protecting public health. They are allowed with a permit to select what to inspect.

Some past/historic titles include inspector of nuisances, sanitarian, and sanitary inspector. Other titles that currently exist include environmental health specialist/practitioner/professional, public health officer, health officer, health inspector, and health official. The legal title used will depend on the definitions found in local legislation/jurisdiction.

Environmental health professionals are usually employed by local government or state health authorities to advise on and enforce public health standards. However, many are employed in the private sector the military and other third sector agencies such as charities and NGOs.

Health effects from noise

Noise health effects are the physical and psychological health consequences of regular exposure, to consistent elevated sound levels. Elevated workplace or environmental noise can cause hearing impairment, hypertension, ischemic heart disease, annoyance, and sleep disturbance. Changes in the immune system and birth defects have been also attributed to noise exposure.Although presbycusis occur naturally with age, in many countries the cumulative impact of noise is sufficient to impair the hearing of a large fraction of the population over the course of a lifetime. Noise exposure has been known to induce tinnitus, hypertension, vasoconstriction, and other cardiovascular adverse effects. Chronic noise exposure has been associated with sleep disturbances and increased incidence of diabetes. Adverse cardiovascular effects occur from chronic exposure to noise due to the sympathetic nervous system's inability to habituate. The sympathetic nervous system maintains lighter stages of sleep when the body is exposed to noise, which does not allow blood pressure to follow the normal rise and fall cycle of an undisturbed circadian rhythm.Stress from time spent around elevated noise levels has been linked with increased workplace accident rates and aggression and other anti-social behaviors. The most significant sources are vehicles, aircraft, prolonged exposure to loud music, and industrial noise.There are an attributed 10 000 annual deaths as a result of noise in the European Economic Area.

Landscape epidemiology

Landscape epidemiology draws some of its roots from the field of landscape ecology. Just as the discipline of landscape ecology is concerned with analyzing both pattern and process in ecosystems across time and space, landscape epidemiology can be used to analyze both risk patterns and environmental risk factors. This field emerges from the theory that most vectors, hosts and pathogens are commonly tied to the landscape as environmental determinants control their distribution and abundance. In 1966, Evgeniy Pavlovsky introduced the concept of natural nidality or focality, defined by the idea that microscale disease foci are determined by the entire ecosystem. With the recent availability of new computing technologies such as geographic information systems, remote sensing, statistical methods including spatial statistics and theories of landscape ecology, the concept of landscape epidemiology has been applied analytically to a variety of disease systems, including malaria, hantavirus, Lyme disease and Chagas' disease.

National Institute of Environmental Health Sciences

The National Institute of Environmental Health Sciences (NIEHS) conducts research into the effects of the environment on human disease, as one of the 27 institutes and centers of the National Institutes of Health (NIH).

Trading Standards

In the United Kingdom, Trading Standards are the local authority departments, formerly known as Weights and Measures, that enforce consumer protection legislation.Sometimes, the Trading Standards enforcement functions of a local authority are performed by part of a larger department which enforces a wide range of other legislation: environmental health, health and safety, licensing and so on. These departments investigate commercial organisations that trade outside the law or in unethical ways. They attempt to remedy breaches by advice or by formal enforcement action.

Many Trading Standards services also offer Primary Authority Partnerships whereby a business can form a legal partnership with a regulator in order to obtain advice and support with compliance

United States National Library of Medicine

The United States National Library of Medicine (NLM), operated by the United States federal government, is the world's largest medical library.Located in Bethesda, Maryland, the NLM is an institute within the National Institutes of Health. Its collections include more than seven million books, journals, technical reports, manuscripts, microfilms, photographs, and images on medicine and related sciences, including some of the world's oldest and rarest works.

The current director of the NLM is Patricia Flatley Brennan.

Vermin

Vermin (colloquially varmint or varmit) are pests or nuisance animals, that spread diseases or destroy crops or livestock. Since the term is defined in relation to human activities, which species are included vary from area to area and person to person.

The term derives from the Latin vermis (worm), and was originally used for the worm-like larvae of certain insects, many of which infest foodstuffs. The term varmint (and vermint) has been found in sources from c. 1530–1540s.

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