[Possibilities and limitations of the organization of environmental protection in the hospital].
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Practically all municipal health authorities, including the Bremen health authorities, now offer advice with regard to healthy environmental protection, i. e. environmental-medical consulting activities. The majority of the consultantcy services deal with individual inquiries made by citizens. This is supplemented by counselling and discussions with groups in various contexts. It is frequent for extremely difficult counselling contents, situations and deficits in the conducting of the discussions by the consultants who are specialised in natural science subjects to coincide. Within the framework of a further training course designed for these specific needs, the staff of the Bremen health authorities, with specialist instruction, were successful in acquitting skill in the communication of risks, which is a qualification that should become self-evident also in this sphere.
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Environmental health science research, with its focus on fundamental science and disease prevention, is important for the development of rational and cost-effective public health and regulatory policies related to environmental protection. Environmentally related diseases are preventable, yet they impose a major burden on society in terms of human suffering and costs related to health care. Similarly, the expenditure of hundreds of billions of dollars for regulatory compliance is a major economic concern. There is considerable debate regarding current regulatory risk assessment practices for environmental agents. Implicit in all risk assessment schemes is the need to extrapolate from high-exposure studies to low-exposure situations and from known risks in rodents to probable risks in people. Both extrapolations are fraught with uncertainties. These uncertainties are accommodated in risk-assessment schemes by the incorporation of arbitrary "safety factors" and other default approaches. Since these factors are not derived experimentally, they may overestimate or under estimate actual risks. Risk-assessment methodology, its relevance to the human condition, and its use in protecting human health will greatly improve when our expanding knowledge of the basic biology of environmental effects is incorporated into toxicological testing and risk-assessment schemes. Moreover, exciting opportunities now exist to advance our understanding of the environmental and genetic bases of many common diseases and to design effective prevention and intervention strategies to combat their development. This report discusses some of the current opportunities and challenges.
The global challenge of meeting increased food demand and protecting environmental quality will be won or lost in cropping systems that produce maize, rice, and wheat. Achieving synchrony between N supply and crop demand without excess or deficiency is the key to optimizing trade-offs amongst yield, profit, and environmental protection in both large-scale systems in developed countries and small-scale systems in developing countries. Setting the research agenda and developing effective policies to meet this challenge requires quantitative understanding of current levels of N-use efficiency and losses in these systems, the biophysical controls on these factors, and the economic returns from adoption of improved management practices. Although advances in basic biology, ecology, and biogeochemistry can provide answers, the magnitude of the scientific challenge should not be underestimated because it becomes increasingly difficult to control the fate of N in cropping systems that must sustain yield increases on the world's limited supply of productive farm land.
This paper presents a review of various collaborative studies in comparative mutagenesis. The following studies are briefly described: (1) the chemical mutagenesis programme of the European Community, (2) Drosophila studies with various alkylating agents of different s (Swain-Scott) factors, (3) the evaluation by the International Commission for Protection against Environmental Mutagens and Carcinogens (ICPEMC) Committee 1, (4) the Environmental Protection Agency's Gene-Tox Programme, (5) the first and second United Kingdom Environmental Mutagen Society (UKEMS) collaborative studies, and (6) the International Programme on Chemical Safety (IPCS) collaborative study on in vitro tests. The need for chemical dosimetry is emphasized. One of the main conclusions is that, of the mammalian point mutation assays, the L5178Y (TFTR, trifluorothymidine resistant) system showed greatest detection capability in the second UKEMS study. The consensus conclusion of the IPCS in vitro study was that chromosomal aberrations are considered to be the optimal assay for complementing the Salmonella assay and offer the additional advantage that aneuploidy, polyploidy, and sister chromatid exchanges can also be easily assessed.
The U.S. Environmental Protection Agency Environmental Monitoring and Assessment Program (EMAP) uses water clarity as a water quality indicator for integrated assessments of coastal waters. After the publication of the first National Coastal Condition Report (USEPA, 2001c), the national water clarity reference value of 10% of ambient surface light at 1 m depth was reevaluated and modified to reflect expected differences in regional reference light conditions. These regional differences range from naturally turbid estuaries like those found in Mississippi and Louisiana to clear water estuaries expected to support extensive beds of submerged aquatic vegetation in, e.g., Florida and Tampa Bays. For the second National Coastal Condition Report, water clarity was assessed based on regional reference values (USEPA, 2004). Different regional water clarity reference values and data collection methods necessitated the development of a water clarity index based on light attenuation coefficients (k). This index incorporates regional reference conditions and is interchangeable with secchi depth and percent light transmission calculated from light meter measurements. Evaluation of the water clarity index shows that k values based on transmissivity at 1 m can be estimated from secchi depth measurements and successfully used as a surrogate for transmissivity calculated from light meter data. An approach for assessing water clarity in Gulf of Mexico estuaries using light meter data and secchi depth is presented.
The nature of both indoor air exposures and noncancer end points present significant issues for risk characterization. Noncancer end points are multidimensional, affecting various organs, and are assumed to have thresholds. Symptoms also vary in severity within a population. In addition to the complexity of noncancer risk assessment, indoor air exposures are typified by the presence of complex mixtures, which further complicates the complex nature of noncancer risk characterization. Most noncancer risk assessment efforts have focused on defining acceptable daily intakes or reference doses (RfD) rather than estimating incidence and severity of the wide range of effects within an exposed population. The risk characterization framework has been developed to accommodate the RfD approach but, more importantly, to address the multidimensional nature of noncancer risk characterization. Newly emerging methods and standard EPA risk assessment guidelines for noncancer effects and complex mixtures were used as guides for developing the framework. Information and data needs have been identified from the framework. Peak, average, and cumulative doses from indoor air exposures are highly dependent on variable indoor air concentrations and affected by time-activity patterns. Susceptibility also plays a significant role in noncancer end points and, unlike susceptibility in cancer risk assessment, is quantifiable. This paper highlights the risk characterization framework for noncancer health risks that we developed in cooperation with the U.S. Environmental Protection Agency Environmental Criteria and Assessment Office. Additionally, a preliminary application of the framework to a complex mixture of volatile organic compounds from indoor sources is illustrated.
Bioassessment of nonwadeable streams in the United States is increasing, but methods for these systems are not as well-developed as for wadeable streams. In this study, we compared six macroinvertebrate field sampling methods for nonwadeable streams adapted from those used by three major programs: the U.S. Environmental Protection Agency's Environmental Monitoring and Assessment Program-Surface Waters, the U.S. Geological Survey's National Water Quality Assessment Program, and the Ohio Environmental Protection Agency, Division of Surface Water Biocriteria Program. We performed all six methods at 60 sites across four rivers and measured water chemistry and physical habitat at each site to assess abiotic conditon. Sites were divided into two groups: those influenced by navigational lock and dam structures (restricted flow, or RF) and those free-flowing or with lowhead dams (run-of-the-river, or ROR). Metrics based on passive Hester-Dendy artificial substrate samplers differed greatly from active sampling methods (i.e., using nets) but represented abiotic conditions well in both ROR and RF sites. Although metric values were similar across certain sampling methods, the metrics significantly correlated with abiotic variables varied among methods and between ROR and RF sites. These results emphasize that methods are not interchangeable, and the ability to detect certain stressors depends on sampling method.
After an extensive review and assessment of the scientific evidence on the respiratory health effects of passive smoking, the U.S. Environmental Protection Agency has determined that the widespread exposure to environmental tobacco smoke in the United States presents a serious and substantial public health impact. The Environmental Protection Agency concluded that environmental tobacco smoke causes lung cancer in adult nonsmokers and increases the risk for a variety of noncancer respiratory disorders, especially in children. This article reviews evidence presented in the Environmental Protection Agency's 1992 report on the respiratory health effects of passive smoking and responds to critical allegations levied by Gio Gori in his article "Science, policy, and ethics: the case of environmental tobacco smoke", appearing in the same issue of this journal. Several recent studies appearing since the cutoff date for inclusion in the EPA report are also discussed.
The evolution of the Russian Federation legislation and regulation concerning the radiation protection of the population, the environment and the monitoring is presented. The main federal laws--"On the Environmental Protection", "On the Atomic Energy Use", "On the Radiation Safety of Population", etc. as well as standards of radiation safety, sanitary and hygienic norms, international agreements and conventions are briefly summarized. Main directions towards further improvement of the environmental radioprotection regulation in Russia are pointed out.
Chronic inhalation of diesel exhaust (DE) causes lung tumors in rats; epidemiologic studies suggest that DE may be a potential human carcinogen. We compared the DE unit risks for human lung cancer as derived by Smith and Stayner (1991), Hattis and Silver (1992), Pepelko and Chen (1993), California Environmental Protection Agency, Office of Environmental Health Hazard Assessment (1994), and the U.S. Environmental Protection Agency (USEPA) (1994). All five sets of authors used identical rat bioassay data (Mauderly et al., 1987). Although different in detail, the dose-response models were uniformly linear and nonthreshold. However, each set of authors chose a different approach in relating the rat data to DE unit risk in humans. The predicted unit risks for continuous lifetime exposure to 1 microgram/m3 DE differed by an 80-fold factor between the highest [8 x 10(-4), Hattis and Silver] and the lowest [0.1 x 10(-4), Pepelko and Chen]. The choice of dose-input parameters and how each group treated particle overload were the major factors affecting the different risk estimates. Several unanswered questions undermine the current use of the rat bioassay for DE risk assessment: (1) Differences in emission products and exposure scenarios between laboratory studies and human exposure, (2) occurrence of an apparent threshold in the rat-lung-tumor response, (3) uncertainty as to the appropriate lung-dose metric and its low-dose extrapolation, (4) the role of lung overload, and (5) the cause of species-specific biological susceptibility.
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Environmental protection must be accomplishable in a hospital. Thus the goals have to be set in such a way that they are achievable. The track towards a positive environmental balance should be passable, ie environmental protection has to be on the people's mind and not on some single persons'. Environmental protection in the hospital starts in the purchasing department. If hospitals show an environmentally conscious demand, the industry will react with the supply of non-polluting products in order to not lose this market sector. Medical and the remaining hospital services may contribute to the protection of the environment by avoiding, reducing, and recycling waste. The responsibility for environmentally protective measures, such as noise reduction, sewage- and waste treatment, and avoidance of air pollution lies with hospital engineering. Operations (measuring, controlling) and maintenance (inspecting, servicing, overhauling) have to be available, safe, and economical. Thus the ecological demands for operations control are identically satisfied. The only task of the administration remaining is to support environmental consciousness and practice of environmental protection, to distribute attained knowledge and to survey the developments. Good environmental practice has to quantify environmental protection in the hospital.
Careful, independent scientific reviews of issues of importance in mutagenesis and carcinogenesis evaluations have been made over the past seven years by a group of leading members of several environmental mutagen societies. The International Commission for Protection against Environmental Mutagens and Carcinogens (ICPEMC) supports five main committees concerned with general principles and has published working papers and reports on an unbiased scientific basis. The work and goals of the Commission are described and future plans outlined.
Bo Lindell, former chairman and emeritus member of ICRP, former chairman of UNSCEAR, former Director General and emeritus worker of the Swedish RAdiation Protection Institute, is a phenomenon. His profound influence on radiation protection, and indeed on environmental protection and risk research in general, includes a profuse flow of scientific publications on all aspects of protection of man against harmful effects of radiation. In this context, perhaps his most important efforts hitherto are those relating to nuclear power. The concept of dose commitment, invented by Bo Lindell, is used worldwide to regulate emissions of radioactive substances, taking into account not only the often trivial dose to immediate bystanders, but the global effect over long time-frames. In the long run, his continuing personal influence on radiation protection as a branch of science and a kind of role model for other types of environmental protection may attain an even greater importance.