[Environmental policies. Refuse in a hospital environment].
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Health Facility Environment↗
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[Parasitological problems in relation to environmental policies].
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Animals↗
Policy as intervention: environmental and policy approaches to the prevention of cardiovascular disease.
This paper describes the evolution of efforts to prevent cardiovascular disease, from individual health education approaches to broader community education efforts and, finally, to comprehensive and integrated programs addressing environmental, policy, and individual behavior change. Policies are divided into two areas: legislation/regulation and organizational policy. Environmental strategies are measures that alter or control the physical or social environment. Dimensions along which these strategies might be implemented are provided. Policy and environmental approaches can be justified on economic, strategic, and theoretical grounds. Experiences from other fields and other countries provide a framework for conceptualizing cardiovascular disease prevention approaches.
Cardiovascular Diseases↗
Setting policy on environmental issues. Interview by Karen Gardner.
Perhaps more than any other type of institution, hospitals are expected to be good neighbors, which involves respect for the community and respect for the environment. Louis Rasmussen, board chairman of Carondolet Health Corp., Kansas City, MO (the parent company for Saint Joseph Health Center, a 300-bed acute care hospital in Kansas City), and a retired executive of Kansas City Power and Light Co., sees the board's role in setting responsible environmental policy for the hospital as pivotal. In 1991, Rasmussen served on the American Hospital Association's Ad Hoc Committee on Recycling. Currently, he is a member of the AHA's Congress of Hospital Trustees. Participation in these activities, as well as his professional background in both engineering and law, gives him a broad view of both environmental issues and governance. Recently, Rasmussen spoke with Trustee editor Karen Gardner about the environmental issues confronting hospitals today and the board's role in dealing with those issues.
Chlorofluorocarbons, Methane↗
Risk assessment in environmental policy-making.
Environmental policy-making has become more dependent on formal, quantitative risk assessment because of increasing attention to the prevention of human health damage from toxic chemicals. Risk assessment helps set priorities for regulation of the very large numbers of chemicals that are of potential concern and helps direct limited social and government resources against the most significant risks. Although the scientific basis for risk assessment is often uncertain and the public and its representatives have often been confused by its use in regulatory decisions, the U.S. Environmental Protection Agency currently uses a variety of risk assessment techniques to set priorities, tailor regulations, and make decisions at particular sites. The Environmental Protection Agency also attempts to make the practice of risk assessment more consistent throughout the agency and to improve public understanding of the meaning of risk assessment and risk management.
Environmental Exposure↗
Strategies for increasing fruit and vegetable intake in grocery stores and communities: policy, pricing, and environmental change.
BACKGROUND: Grocery stores and community settings are important and promising venues for environmental, policy, and pricing initiatives to increase fruit and vegetable intake. This article examines supermarket-based and community environmental, policy, and pricing strategies for increasing intake of fruits and vegetables and identifies promising strategies, research needs, and innovative opportunities for the future. METHODS: The strategies, examples, and research reported here were identified through an extensive search of published journal articles, reports, and inquiries to leaders in the field. Recommendations were expanded with input from participants in the CDC/ACS-sponsored Fruit and Vegetable, Environment Policy and Pricing Workshop held in September of 2002. RESULTS: Four key types of grocery-store-based interventions include point-of-purchase (POP) information; reduced prices and coupons; increased availability, variety, and convenience; and promotion and advertising. There is strong support for the feasibility of these approaches and modest evidence of their efficacy in influencing eating behavior. Church-based programs, child care center policies, and multisectoral community approaches show promise. CONCLUSIONS: Both descriptive and intervention research are needed to develop and evaluate more effective environmental strategies to increase F&V intake in grocery stores and communities. Innovative strategies, partnerships, grass roots action involving economic development for low-income communities, and sustainability are important considerations.
Commerce↗
A quantitative evaluation of monitoring networks for region-specific nitrate reduction policies.
Modern environmental policy implementation in many developed countries is increasingly regionally oriented. Regional governments have undertaken measures designed for the specific needs of the region but, so far, the resulting change in environmental quality has hardly been monitored. This study develops a method for the quantitative evaluation of region-specific environmental policy. Two forms of monitoring are distinguished: monitoring of performance of policy measures and monitoring of environmental quality. This study investigates two regions in the Netherlands where region-specific policy has been implemented. Performance monitoring focused on reduction of nitrate leaching to groundwater. Leaching reductions were calculated with simple models or rules of thumb. Quality monitoring focused on nitrate concentrations under grassland and other land use. An analysis of variance showed significant differences between different soil units. Stratified kriging was applied for spatial interpolation, showing within-unit variability. The current monitoring network could be improved by using a more regular type of grid.
Data Interpretation, Statistical↗
How ethics shape the policy preferences of environmental scientists: What we can learn from Lomborg and his critics.
Some environmental ethicists have proposed that different environmental values lead in principle to different environmental policy preferences. The controversy provoked by Bjørn Lomborg's book, The Skeptical Environmentalist (2001), has provided an opportunity to test this hypothesis in practice for scientists and other technical experts. In analyzing the language of the argument between Lomborg and his critics, I find that environmental scientists participating prominently in the debate fall into one of two camps according to whether their valuations of nature tend to be anthropocentric or nonanthropocentric. I find further that for these scientists moral philosophies correlate both with policy preferences and with interpretations of data. I conclude that unexplored differences in environmental values make important and underappreciated contributions to the politicization of science and to polarization among scientists and other technical experts involved in environmental disputes.
Journal Article↗
A flexible environmental reuse/recycle policy based on economic strength.
Environmental policies based on fixed recycling rates may lead to increased environmental impacts (e.g., landfilled wastes) during economic expansion. A rate policy is proposed, which is adjusted according to the overall strength or weakness of the economy, as reflected by overall packaging demand and consumption, production and imports-exports. During economic expansion featuring rising consumption, production or exports, the proposed flexible policy suggests a higher reuse/recycle rate. During economic slowdown a lower rate results in lower impacts. The flexible target rates are determined in terms of annual data, including consumption, imports-exports and production. Higher environmental gains can be achieved at lower cost if the flexible policy is applied to widely consumed packaging products and materials associated with low rates, or if cleaner recycling technology is adopted.
Conservation of Natural Resources↗
Legislative incapacity: the congressional role in environmental policy-making and the case of Superfund.
Congress plays a central role in national environmental policy formation but appears ill equipped to set policy priorities and devise integrative legislation. Fragmentation of authority among a multiplicity of committees and subcommittees, especially in the House, contributes to these problems. This pattern is evident in the evolution of Superfund, the national program to clean up abandoned hazardous waste sites. The prolonged process of reauthorization in the 1980s contributed to serious program delay and failed to resolve a number of fundamental questions concerning the national cleanup effort. Institutional reforms could contribute to a more effective congressional role in future environmental policy deliberations.
Environmental Health↗
Environmental and policy approaches to cardiovascular disease prevention through physical activity: issues and opportunities.
The majority of Americans remain inactive despite evidence of significant health benefits from even moderately intense activity. Previous intervention efforts have generally focused on changing individual behavior. This article discusses the use of policy, legislative and regulatory, and environmental interventions in promoting physical activity to prevent cardiovascular disease (CVD) and other chronic diseases. The authors present evidence on the need, formulation, description, and effectiveness of policy and environmental intervention approaches. Types of approaches addressed to promote physical activity include federal, state, and local legislation and regulation, policy development and implementation, and environmental support. They also describe opportunities for state and local health departments to initiate and participate in environmental and policy approaches.
Cardiovascular Diseases↗
Environmental health policies in the 1990s.
After almost a decade of suspension between progress and retrogression, environmental issues are back at the top of the national agenda. The evidence is visible in many forums of public discussion. But the development and implementation of a new wave of environmental policies will require attention to at least three issues: setting priorities, emphasis on science and technology, and a focus on human resources development.
Environmental Health↗
Public policy and environmental noise: modeling exposure or understanding effects.
This paper argues that if the federal government is to successfully protect the public from the adverse effects of environmental noise, its policies will need to be informed by a scientific understanding of the psychological and social factors that determine when noise results in annoyance and when noise may affect health as an environmental stressor. The overreliance of federal agencies on mathematical modeling of average group responses to physical noise levels is discussed as oversimplifying and limiting the understanding of noise effects in crucial ways. The development of a more sophisticated information base is related to policy needs, such as the need to make accurate predictions about the annoyance of particular communities, the need to understand relationships between public participation in noise abatement efforts and annoyance, and the need to identify populations that may be susceptible to stress-related health effects.
Community Participation↗
Use of life cycle assessment as decision-support tool for water reuse and handling of residues at a Danish industrial laundry.
This analysis presents the results of a life cycle assessment (LCA) carried out on six alternative options for the recycling of water at a Danish industrial laundry for workwear. The study focuses on the handling and disposal of the wet residues generated when wastewater is treated for recycling, and in accounting for long-term potential toxicity impacts. The analysed options are a combination of two water-upgrading technologies: biofilter and ultrafiltration, and three residue disposal alternatives: biogas followed by incineration of sludge at local wastewater treatment plant, thermal vitrification treatment for production of vitrified sand, and mineralization in a sludge bed. It is concluded from the results that with the current Danish environmental policy priorities, the environmental impacts of highest priority are the toxicity effects derived from the presence of heavy metals in the residues. Heavy metals originate from the dirt in the workwear that is washed in the laundry. It is further concluded that the studied water treatment technologies satisfy both the need of clean water for recycling and simultaneously help controlling a safe disposal of pollutants by concentration of the residues. The results of the study also confirm the potential of LCA as a decision-support tool for assisting water recycling initiatives and for residue handling management. The handling of residues has been identified as a stage of the water recycling strategy that bears important environmental impacts. This holistic perspective provided by LCA can be used as input for the definition of environmental management strategies at an industrial laundry, and the prioritization of investments to the environmental profile of laundry processes. In this case-study, the results of the LCA are made operational by, for example, selecting the water treatment technology which is associated wih a safe disposal of the wet residue. It is important to bear in mind that such prioritization depends on national boundary conditions. In the case study analysed, the boundary conditions steer the weighing of the environmental impacts, following the current Danish environmental policy priorities.
Conservation of Natural Resources↗
Shaping the context of health: a review of environmental and policy approaches in the prevention of chronic diseases.
Given the growing attention on how environmental and policy interventions can affect chronic disease burden, our objectives are to describe (a) effective and promising interventions to address tobacco use, physical activity, and healthy eating and (b) lessons learned from the literature and practice experience in applying environmental and policy approaches. A total of 17 interventions were reviewed, organized across 3 domains affecting the physical environment/access, economic environment, and communication environment. Many of these interventions are effective. Several lessons are important to consider, such as the need to start with environmental and policy approaches, intervene comprehensively and across multiple levels, make use of economic evaluations, make better use of existing analytic tools, understand the politics and local context, address health disparities, and conduct sound policy research.
Chronic Disease↗
Environmental monitoring in the The Netherlands: past developments and future challenges.
During the past three decades environmental monitoring systems covering an immense variety of environmental problems emerged rapidly throughout the world. In The Netherlands the entire spectrum of monitoring systems is present. Their development is especially interesting because of the Dutch complex environmental landscape: a result of the combination of a natural setting with a high small-scale variation and an intense use of the available space by both industry and agriculture. This necessitates a well balanced environmental policy wherein monitoring of both environmental compartments and environmental policy itself plays an important role. In this article we focus on abiotic systems, whereby the development of monitoring will be related to that of environmental policy in general. Some general lines emerge: from quantity towards quality, from single pollutants towards environmentally harmful processes as a whole, and from a focus on human health and safety towards integrated environmental management. Because The Netherlands is a highly organized and highly educated society, reacting fast and flexible to new problems, this progression has happened quickly. However, still much remains to be desired and flexibility not necessarily guarantees optimal routes of development. Paramount is the development of sophisticated and robust monitoring systems that truly support integrated environmental management. This asks for clear objectives based on solid scientific insights.
Environment↗
A site-specific literature review of policy and environmental interventions that promote physical activity and nutrition for cardiovascular health: what works?
OBJECTIVE: To review the literature to determine whether policy and environmental interventions can increase people's physical activity or improve their nutrition. DATA SOURCES: The following databases were searched for relevant intervention studies: Medline, Chronic Disease Prevention File, PsychInfo, Health Star, Web of Science, ERIC, the U.S. Department of Transportation, and the U.S. Department of Agriculture. STUDY SELECTION: To be included in the review, studies must have (1) addressed policy or environmental interventions to promote physical activity and/or good nutrition; (2) been published from 1970 to October 2003; (3) provided a description of the intervention; and (4) reported behavioral, physiological, or organizational change outcomes. Studies that had inadequate intervention descriptions or that focused on determinants research, individual-level interventions only, the built environment, or media-only campaigns were excluded. DATA EXTRACTION: We extracted and summarized studies conducted before 1990 (n = 65) and during 1990-2003 (n = 64). DATA SYNTHESIS: Data were synthesized by topic (i.e., physical activity or nutrition), by type of intervention (i.e., point-of-purchase), and by setting (i.e., community, health care facility, school, worksite). Current studies published during 1990-2003 are described in more detail, including setting and location, sample size and characteristics, intervention, evaluation period, findings, and research design. Findings are also categorized by type of intervention to show the strength of the study designs and the associations of policy and environmental interventions with physical activity and nutrition. CONCLUSIONS: The results of our review suggest that policy and environmental strategies may promote physical activity and good nutrition. Based on the experimental and quasi-experimental studies in this review, the following interventions provide the strongest evidence for influencing these behaviors: prompts to increase stair use (N = 5); access to places and opportunities for physical activity (N = 6); school-based physical education (PE) with better-trained PE teachers, and increased length of time students are physically active (N = 7); comprehensive work-site approaches, including education, employee and peer support for physical activity, incentives, and access to exercise facilities (N = 5); the availability of nutritious foods (N = 33), point-of-purchase strategies (N = 29); and systematic officer reminders and training of health care providers to provide nutritional counseling (N = 4). Further research is needed to determine the long-term effectiveness of different policy and environmental interventions with various populations and to identify the steps necessary to successfully implement these types of interventions.
Adult↗
Environmental and policy interventions to promote physical activity.
BACKGROUND: Because most adults in industrialized countries do not meet physical activity guidelines, population-wide interventions are needed. Environmental and policy interventions are based on ecological models of behavior and have the potential to influence entire populations. Ecological models are particularly applicable to physical activity because the behavior must be done in specific physical settings. Cross-sectional data indicate that environmental and policy variables are associated with physical activity behaviors of young people and adults. METHOD: Seven published evaluations of environmental and policy interventions to increase physical activity were reviewed. RESULTS: Two studies showed that placing signs encouraging stair use can be effective. Quasi-experimental evaluations provided limited evidence that broad environmental changes can be effective. Large-scale policy interventions are currently being conducted in several countries. PROPOSED MODEL: A model describing the development of policy and environmental interventions is proposed, in the hope of stimulating more research in this area. Advocacy or planning groups identify and work with agencies that control policies and environments that can be altered to increase physical activity. Educational and policy/environmental interventions are seen as complementary. CONCLUSION: Lack of conceptual models and the inherent difficulties of evaluation have hampered research on environmental and policy interventions. Further research is needed, and practitioners and researchers should work together to evaluate programs.
Adult↗