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PubMed1999

Reducing uncertainty in the derivation and application of health guidance values in public health practice. Dioxin as a case study.

We were requested by the U.S. Environmental Protection Agency (EPA) to clarify the relationships among the minimal risk level (MRL), action level, and environmental media evaluation guide (EMEG) for dioxin established by the Agency for Toxic Substances and Disease Registry (ATSDR). In response we developed a document entitled "Dioxin and Dioxin-Like Compounds in Soil, Part I: ATSDR Interim Policy Guideline"; and a supporting document entitled "Dioxin and Dioxin-Like Compounds in Soil, Part II: Technical Support Document". In these documents, we evaluated the key assumptions underlying the development and use of the ATSDR action level, MRL, and EMEG for dioxin. We described the chronology of events outlining these different health guidance values for dioxin and identified the areas of uncertainty surrounding these values. Four scientific assumptions were found to have had a great impact on this process; these were: (1) the specific uncertainty factors used, (2) the toxicity equivalent (TEQ) approach, (3) the fractional exposure from different pathways, and (4) the use of body burdens in the absence of exposure data. This information was subsequently used to develop a framework for reducing the uncertainties in public health risk assessment associated with exposure to other chemical contaminants in the environment. Within this framework are a number of future directions for reducing uncertainty, including physiologically based pharmacokinetic modeling (PBPK), benchmark dose modeling (BMD), functional toxicology, and the assessment of chemical mixture interactions.

Benchmarking↗
PubMed1993

Passive smoking and lung cancer.

The findings of a multicenter national study of lung cancer in lifetime-never smokers are reported. An increased lung cancer risk of approximately 30% was found among women whose husbands smoked. Elevated risks of 40% to 60% were also found associated with workplace exposures and other exposures outside the home. The findings of this study have been included in the recent Environmental Protection Agency assessment of the health effects of passive smoking, and have implications for regulation of environmental tobacco smoke exposure in Louisiana.

Adenocarcinoma↗
PubMed1996

[Education in environmental medicine: practical aspects].

Rarely physicians educated in environmental medicine will be able to work as independent specialists. Most probably they will fulfill their mission besides a main job, usually in general medical care. On one hand this additional education may be applied in daily practice (diagnosis and investigation of environmentally induced diseases and disturbances) on the other hand by presentations in schools, courses, public meetings. Of special importance are political activities such as counselling, discussions with authorities of the environmental protection agency and other authorities, official statements etc. aiming at general medical prevention. Different topics of environmental medicine are outlined and the special importance of interdisciplinarity in thinking and research is stressed. Finally some informations for the practitioner concerning postgraduate education and literature-search are given.

Curriculum↗
PubMed1997

Environmental contamination and human exposure to airborne total and respirable manganese in Montreal.

Methylcyclopentadienyl manganese tricarbonyl (MMT) is an organometallic compound used as an octane improver in unleaded gasoline. The combustion of MMT leads to the formation of manganese (Mn) oxides, mainly Mn3O4. The objective of this study is to assess the variations over time and space of respirable (MnR) and total (MnT) Mn in the urban atmosphere and to evaluate human exposure by inhalation. Two sampling sites were selected on the island of Montreal based on their local traffic density (municipal botanical garden, C- = 10,000-15,000 vehicles d-1; Montreal Waterworks, C+ = 100,000-130,000 vehicles d-1). Air samplings were made during the day at stations located 10 m from the road using portable pumps, some of which were equipped with a cyclone. MnR and MnT and other metals were measured on Teflon filters by neutron activation. Mn exposure doses by inhalation were calculated using Monte-Carlo simulations. MnR and MnT average concentrations were significantly higher at site C+ (MnR = 0.024 microgram m-3; MnT = 0.050 microgram m-3) than at site C- (MnR = 0.015 microgram m-3; MnT = 0.027 microgram m-3). Temporal profiles at sites C+ and site C- were similar, with a coefficient of correlation of 0.24 for MnR and 0.26 for MnT. Trend analyses (ARIMA) also showed that the period of the week (work days vs. off days) was significantly related to MnR and MnT variations at both sites. The average exposure dose by inhalation to MnR and MnT ranged from 0.001 to 0.030 microgram kg-1 day-1 and 0.001 to 0.05 microgram kg-1 day-1. MnR and MnT concentrations reflected a positive relationship with traffic density. However, it remains difficult to attribute these results directly to the combustion of MMT in unleaded gasoline. On average, the MnR and MnT inhalation doses were 2 to 15 times lower than the reference dose (RfC) proposed by the U.S. Environmental Protection Agency (EPA) for the general population.

Air Pollutants↗
PubMedDate not supplied

Determination of polychlorinated biphenyls in sediments, using sonication extraction and capillary column gas chromatography-electron capture detection with internal standard calibration.

A sonication technique is presented for the extraction of polychlorinated biphenyls (PCBs) from sediments. In addition, a quantitation scheme is described which allows peak-specific and, in many cases, congener-specific determination of PCBs. PCBs are quantitated by capillary column gas chromatography-electron capture detection, with internal standard calibration. Results utilizing sonication extraction were compared with those obtained by Soxhlet and steam distillation extractions of 3 U.S. Environmental Protection Agency (EPA) quality control sediment samples and 3 lake sediments known to be contaminated with PCBs. Environmental lake sediments were extracted wet, with no drying prior to extraction. Recoveries by each technique varied depending on the sediment sample being extracted and degree of chlorination of PCB congeners. With proper selection of extraction solvent, the sonication technique can recover amounts of PCBs equivalent to and sometimes greater than recoveries by the Soxhlet or steam distillation techniques. A 24-h quiescent period in the extraction solvent between 2 sonications improved extraction efficiency for 2 freeze-dried sediments but did not affect results obtained for 3 environmentally contaminated sediments that were extracted without drying. Replacement of Soxhlet extraction with the sonication technique results in reduced sample preparation time, decreased volumes of solvents and sample, and substitution of common laboratory glassware in place of fragile, expensive Soxhlet glassware. Sonication extraction can also improve precision compared with Soxhlet extraction.

Chromatography, Gas↗
PubMed1979

Trends in university environmental health research and training.

A survey of 157 college and university programs in the United States indicates that, during the ten-year period from 1967 through 1976, the number of people completing graduate programs in environmental health specialties at the master's, doctoral, and post-doctoral levels doubled. In 1974-75, 75 per cent of those completing master's degree programs were in the specialty areas of water pollution, air pollution, and occupational health; 76 per cent of those completing doctoral programs were in water pollution, toxicology, radiation protection, air pollution, and cancer research; and 61 per cent of those completing post-doctoral programs were in cancer research and toxicology. Including those whose current positions could not be ascertained, less than 10 per cent of all graduates accepted employment outside the field of environmental health. Funding for university environmental health research continued to increase throughout this ten-year period. The sources of this funding, however, changed dramatically, with the relative contributions from the U.S. Department of Health, Education, and Welfare decreasing significantly, while those from industry and other federal agencies increased. In contrast, funding for university environmental health training increased significantly between 1966 and 1971, but showed no increase from 1971 to 1975. During this latter period, training support provided by HEW remained essentially constant, that by the Environmental Protection Agency decreased to less than half, while that from the universities approximately tripled. (Am. J. Public Health 69:125-129,1979.)

Education, Graduate↗
PubMedDate not supplied

Population-based dietary intakes and tap water concentrations for selected elements in the EPA region V National Human Exposure Assessment Survey (NHEXAS).

A National Human Exposure Assessment Survey (NHEXAS) field study was performed in U.S. Environmental Protection Agency (EPA) Region V, providing population-based exposure distribution data for selected elements in several personal, environmental, and biological media. Population distributions are reported for the 11 elements that were measured in water and dietary samples. Dietary intakes and home tap water concentrations of lead, arsenic, and cadmium were further examined for intermedia associations, for differences between dietary exposure for adults and children, and to estimate the proportion of the population above health-based reference values (dietary) or regulatory action levels or maximum contaminant levels (water). Water lead and arsenic concentrations were significantly associated with dietary intake. Intake of all elements was higher from solid foods than from liquid foods (including drinking water). Dietary intakes of Pb, As, and Cd were greater than those calculated for intake from home tap water or inhalation on a microg/day basis. Median dietary intakes for the Region V population for Pb, As, and Cd were 0.10, 0.13, and 0.19 microg/kg bw/day, respectively. While Pb, As, and Cd concentrations in the foods consumed by 0 to 6-year-old children were similar to or lower than those for adults, dietary intakes calculated on a body weight basis were 1.5 to 2.5 times higher for young children. Intrapersonal intake differences accounted for most of the variance in short-term (daily) dietary intakes for Pb and As, while interpersonal differences accounted for more of the intake variance for Cd. Only small percentages of the population exceeded health-based intake reference values or concentrations equal to regulatory levels in water for Pb, As, and Cd.

Adolescent↗
PubMed2005

Summary of a workshop on the development of health models and scenarios: strategies for the future.

A workshop was convened in July 2003 by the Global Change Research Program, Office of Research and Development at the U.S. Environmental Protection Agency, to review current strategies for developing human health models and scenarios in the context of global environmental change, particularly global climate change, and to outline a research agenda that effectively characterizes the interplay of global change with the health of human populations. The research agenda developed at the workshop focused on three issues: a) the development of health models, b) the development of health scenarios, and c) the use of health models and health scenarios to inform policy. The agenda identified research gaps as well as barriers to the development and use of models and scenarios. This report summarizes the workshop findings.

Environmental Health↗
PubMed2006

National environmental health measures for minority and low-income populations: tracking social disparities in environmental health.

Healthy People 2010 [US Department of Health and Human Services, 2004. Healthy People 2010. Available: http://www.healthypeople.gov/Publications/ [accessed May 22, 2004]] has established as a top priority the elimination of health disparities. Current research suggests that characteristics of the social, physical and built environment contribute to these disparities. In order to track progress and to assess the potential contributions of the various components of the "environment," tools specific to environmental health disparities are required. In this paper, we discuss one potential tool, a set of candidate measures that may be used to track disparities in outcomes, as well as measures that may be used analytically to assess potential causal pathways. Several other reports on health and environmental measures have been produced, including the Environmental Protection Agency's (EPA) America's Children and the Environment. However, there has not been a comprehensive discussion about environmental measures that focus on racial, ethnic and socioeconomic disparities in health. Therefore, we focus on measures specific to historically disadvantaged populations. Based on a conceptual framework that views health disparities as partially driven by differential access to resources and exposures to hazards, we group the measures into four categories: social processes, environmental contaminants/exposures, bodyburdens of environmental contaminants, and health outcomes. We provide a few examples to illustrate each category, including residential segregation, PM(2.5) exposures, blood mercury concentrations, and asthma morbidity and mortality. These measures and categories are derived from a review of environmental health disparities from several disciplines. As a next step in a long-term effort to better understand the relationship between social disadvantage, environment, and health disparities, we hope that the proposed measures and literature review serve as a foundation for future monitoring of environmental health disparities. These efforts may aid community organizations, local agencies, scientists and policy makers in allocating resources and developing interventions.

Asthma↗
PubMedDate not supplied

Application of biosafety principles in blood establishments.

In light of increasing public and employee concern over potential infectious hazards associated with blood and other body fluids, several government agencies (the Food and Drug Administration, the Centers for Disease Control, the Occupational Safety and Health Administration, the Environmental Protection Agency, the Health Care Financing Administration and the National Heart, Lung and Blood Institute) cosponsored a Biosafety Workshop in April 1988. The objective of the workshop was to identify appropriate biosafety practices and standard control procedures to protect workers involved in the collection, storage, and transportation of human blood donations with the least possible disruption of the nation's blood supply. Speakers focused on human immunodeficiency virus (HIV) and hepatitis B virus (HBV); however, the safety principles discussed were considered equally applicable to other known (e.g., non-A, non-B hepatitis and human T-lymphotropic virus type I (HTLV-1) blood-transmitted infections. The resulting consensus included the need for blood establishments to develop and apply thoughtful biosafety programs to address staff training, accident prevention, HBV vaccination, handling spills, managing contaminated waste and transporting blood specimens. There was lack of agreement, however, on the usefulness of gloves during the phlebotomy of healthy blood donors.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Environmental health and Hispanic children.

There are numerous indicators that Hispanics face a disproportionate risk of exposure to environmental hazards. Ambient air pollution, worker exposure to chemicals, indoor air pollution, and drinking water quality are among the top four threats to human health and are all areas in which indicators point to elevated risk for Hispanic populations. These data, juxtaposed with data on the health status of Hispanics, tell us that the environmental health status of Hispanics and their children is poor. At the same time, significant inadequacies in the collection of data on Hispanics make it difficult to make improving Hispanic environmental health status a priority. These inadequacies include the failure to use Hispanic identifiers in data collection and failure to collect sample sizes large enough to allow for breakouts of data by Hispanic subgroup. In addressing environmental justice issues, the U. S. Environmental Protection Agency (U.S. EPA) and the Department of Health and Human Services (DHHS) should prioritize improving the quantifiability of environmental exposures and risk based on race or ethnicity. However, improving data should not be the prerequisite to significant, affirmative steps by DHHS and U.S. EPA to address environmental and environmental health problems facing Hispanic communities. In particular, a health-based approach to environmental justice should be the priority.

Air Pollution↗
PubMedDate not supplied

[Indoor radon pollution in houses in the Apulian Region of Italy and evaluation of the probability of lung cancer in the population].

BACKGROUND: Radon-222 is a gaseous radioactive chemical which can be transformed into other radioactive chemicals, defined as "products of decay" or "radon's daughter". The modality of radon penetration into the buildings depends on the convection motion created in the ground, which suck it back, so causing the penetration. The principal effect on human health is the increase risk of lung cancer, in proportion to the concentration and the time people spend indoors with exposure to radon. OBJECTIVES: The study proposed to estimate the expected cases of radon-induced lung cancer in the population of Apulia due to contamination by indoor radon. METHODS: The study used the data obtained in a national survey made by ANPA (National Environmental Protection Agency) and ISS (High Health Institute), with the collaboration of the Regional Reference Centres for the Control of Environmental Radioactivity (CRR). In the Apulia Region 310 families (5000 nationwide) were involved, which were selected so as to constitute a representative sample both of the region and the country. Appropriate instruments for the measurement of mean concentrations of indoor radon (passive nuclear trace monitors were installed in the homes of the sample families in two different periods of year). We evaluated the variations of indoor radon concentration in the houses during spring-summer and autumn-winter periods, observing a predictable increase in the latter period. We assessed concentrations in relation to: 1. architectural features and location, 2. construction year, 3. building material, 4. presence of windows. RESULTS: We found higher contamination in the oldest non-cement buildings and on the lower floors. In Lecce and Castrì di Lecce we found a mean radon concentration higher than the national and the regional mean, which is equivalent to annual exposure of 0.54 and 0.46 WLM respectively. For these levels we estimated that the expected cases of radon-induced lung cancer will be 1.5 in Lecce and 1.3 in Castrì per 10,000 inhabitants. CONCLUSION: The results of our investigations confirm that indoor radon pollution is a significant problem as it is one of the main causes of lung cancer. Hence, precautionary measures to reduce as much as possible exposure to indoor radon are highly recommended.

Air Pollutants, Radioactive↗
PubMed2004

Looking inside the 2003 CDC dental infection control guidelines.

On Dec. 19, 2003, the Centers for Disease Control and Prevention published updated infection control guidelines for dentistry. The guidelines provide comprehensive information on all aspects of dental infection control. The recommendations are designed to prevent or reduce the potential for disease transmission from patient to dental health care personnel, from dental health care personnel to patient, and from patient to patient. Most recommendations will be familiar and are already practiced routinely. This article highlights major updates and additions in the CDC guidelines and provides additional information to assist readers in applying the latest guidelines. Almost a year ago, the CDC and Prevention published updated dental infection control guidelines in a supplement to the Morbidity and Mortality Weekly Report. The Guidelines for Infection Control in Dental Health Care Settings--2003 represent a collaborative effort between leading experts in infection control from other federal agencies, public health, and hospital epidemiology and infection control. Unlike regulatory agencies such as the Occupational Safety and Health Administration, the U.S. Food and Drug Administration, or the U.S. Environmental Protection Agency, the CDC cannot mandate certain practices; it can only recommend. However, the CDC is recognized as the nation's disease prevention agency and develops a broad range of guidelines intended to improve health care and to inform clinicians and the public. As a result, many dental licensing boards adopt CDC's recommendations, or variations of them, as the infection control standard for dental practice in their states. In contrast to the 1986 and 1993 CDC dental infection control recommendations, the 2003 CDC publication includes more background information and the scientific rationale for the recommendations. Also, readers will notice that each recommendation has a rank assigned to it categorizing the recommendation on the basis of existing scientific data, theoretical rationale, and applicability (Table 1). Most recommendations will be familiar and already are practiced routinely. As with previous CDC recommendations, the guidelines are designed to prevent or reduce the potential for disease transmission from patient to dental health care personnel; from dental health care personnel to patient, and from patient to patient. The following is an overview highlighting major updates and additions in the 2003 CDC guidelines. It is not intended to be a comprehensive review. Readers can access the complete document (Figure 1) by visiting www.cdc.gov/oralhealth/ infectioncontrol.

Centers for Disease Control and Prevention, U.S.↗
PubMed2004

'Gold standard' for remediation of WTC contamination.

The events of September 11, 2001 and thereafter resulted in arguably the worst environmental disaster in the history of New York City. Particulate matter and combustion by-products containing asbestos, lead, mercury, dioxin, PAHs, and other toxic substances, not only affected rescue and recovery workers but also infiltrated thousands of residences and workplaces. Government agencies did not acknowledge responsibility for residential indoor environmental quality until eight months later, and still have not accepted responsibility for indoor environmental quality in commercial or government buildings. In May 2002, 200 representatives from 38 community, labor, environmental, and public health organizations met to discuss unmet post-9/11 public health needs. They established a technical working group to press the Environmental Protection Agency to expand and improve its proposals for the cleanup of Lower Manhattan. This 2002 document, "The 'Gold Standard' for Remediation of WTC Contamination," articulates the environmental health concerns and suggestions of grassroots organizations active in 9/11 response efforts at that time.

Journal Article↗
PubMed2006

Mechanism of fiber carcinogenesis: from reactive radical species to silencing of the beta igH3 gene.

Although the U.S. Environmental Protection Agency has restricted the industrial use of regulated forms of asbestos in the United States since the early 1970s, environmental exposure to asbestos remains a health concern in the United States and is a significant health issue among developing countries. Exposure to asbestos is associated with chronic pulmonary diseases and cancer of the lung, pleura, and peritoneum. The mechanism of fiber carcinogenesis is far from clear and is likely to be complex, depending on fiber dimensions, surface properties, and physical durability. The induction of reactive oxygen and nitrogen species upon phagocytosis of fibers plays an important role in fiber genotoxicity. The beta igH3, a secreted protein induced by the transforming growth factor-beta and essential for cell adhesion, is downregulated in asbestos-induced tumorigenic human bronchial epithelial cells. Ectopic expression of the beta igH3 gene abrogates the tumorigenic phenotype and suggests that the gene plays a causal role in fiber carcinogenesis. A better understanding of the carcinogenic mechanism of asbestos and other mineral fibers will provide useful information on interventional and preventive measures for asbestos-mediated diseases such as human pleural and peritoneal mesotheliomas.

Asbestos↗
PubMed2005

Can lessons from public health disease surveillance be applied to environmental public health tracking?

Disease surveillance has a century-long tradition in public health, and environmental data have been collected at a national level by the U.S. Environmental Protection Agency for several decades. Recently, the Centers for Disease Control and Prevention announced an initiative to develop a national environmental public health tracking (EPHT) network with "linkage" of existing environmental and chronic disease data as a central goal. On the basis of experience with long-established disease surveillance systems, in this article we suggest how a system capable of linking routinely collected disease and exposure data should be developed, but caution that formal linkage of data is not the only approach required for an effective EPHT program. The primary operational goal of EPHT has to be the "treatment" of the environment to prevent and/or reduce exposures and minimize population risk for developing chronic diseases. Chronic, multifactorial diseases do not lend themselves to data-driven evaluations of intervention strategies, time trends, exposure patterns, or identification of at-risk populations based only on routinely collected surveillance data. Thus, EPHT should be synonymous with a dynamic process requiring regular system updates to a) incorporate new technologies to improve population-level exposure and disease assessment, b) allow public dissemination of new data that become available, c) allow the policy community to address new and emerging exposures and disease "threads," and d) evaluate the effectiveness of EPHT over some appropriate time interval. It will be necessary to weigh the benefits of surveillance against its costs, but the major challenge will be to maintain support for this important new system. Key words: environmental health, evaluation, intervention, registries, surveillance.

Chronic Disease↗
PubMed1980

Report of health and environmental effects of increased coal utilization by the Committee on Health and Environmental Effects of Increased Coal Utilization.

The National Energy Plan announced by President Carter on April 29, 1977 proposed a significant increase in the utilization of the vast domestic deposits of coal to replace the dwindling supplies of oil and natural gas, and increasingly expensive oil from foreign sources, to meet national energy needs. At the same time, in recognition of possible adverse health and ecological consequences of increased coal production and use, the President announced that a special committee would be formed to study this aspect of the National Energy Plan. The Committee held a series of public meetings during November and December 1977 to review a number of special papers on particular problems associated with increased coal utilization. These papers, which were prepared by scientists of the US Environmental Protection Agency; the Department of Energy; the HEW National Institute for Occupational Safety and Health, and the National Institute of Environmental Health Sciences; New York University; and Vanderbilt University; provided essential background information for the deliberations of the Committee and were published in EHP Vol. 33, pp. 127-314, 1979. One paper by A. P. Altschuler et al. is published in this volume of EHP. The Committee's basic finding was that it is safe to proceed with plans to increase the utilization of coal if the following environmental and safety policies are adhered to:* Compliance with Federal and State air, water, and solid waste regulations* Universal adoption and successful operation of best available control technology on new facilities* Compliance with reclamation standards* Compliance with mine health and safety standards* Judicious siting of coal-fired facilitiesThe Committee concluded that, even with the best mitigation policies, there will be some adverse health and environmental effects from the dramatic increase in coal use. However, these will not impact all regions and individuals uniformly. The Committee identified six major areas of uncertainty and concern requiring further investigation if the nation is to minimize undesirable consequences of increased coal utilization now, and in the future. Two critical health issues of concern are air pollution health effects and coal mine worker health and safety. Two critical environmental issues are global effects of carbon dioxide in the atmosphere and acid fallout. Two additional important issues of concern are trace elements in the environment and reclamation of arid land.Finally, because of the inadequate data and methodology used in the study of these matters, the Committee strongly recommended the establishment of an improved national environmental data collection, modeling and monitoring system.

Air Pollutants↗
PubMed2006

Analysis of polychlorinated n-alkanes in environmental samples.

Polychlorinated n-alkanes (PCAs), also known as chlorinated paraffins (CPs), are highly complex technical mixtures that contain a huge number of structural isomers, theoretically more than 10,000 diastereomers and enantiomers. As a consequence of their persistence, tendency to bioaccumulation, and widespread and unrestricted use, PCAs have been found in aquatic and terrestrial food webs, even in rural and remote areas. Recently, these compounds have been included in regulatory programs of several international organizations, including the US Environmental Protection Agency and the European Union. Consequently, there is a growing demand for reliable methods with which to analyze PCAs in environmental samples. Here, we review current trends and recent developments in the analysis of PCAs in environmental samples such as air, water, sediment, and biota. Practical aspects of sample preparation, chromatographic separation, and detection are covered, with special emphasis placed on analysis of PCAs using gas chromatography-mass spectrometry. The advantages and limitations of these techniques as well as recent improvements in quantification procedures are discussed.

Journal Article↗