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At least 19 recordsLinked to original sources

Lessons learned for the National Children's Study from the National Institute of Environmental Health Sciences/U.S. Environmental Protection Agency Centers for Children's Environmental Health and Disease Prevention Research.

This mini-monograph was developed to highlight the experiences of the National Institute of Environmental Health Sciences (NIEHS)/U.S. Environmental Protection Agency (EPA) Centers for Children's Environmental Health and Disease Prevention Research, focusing particularly on several areas of interest for the National Children's Study. These include general methodologic issues for conducting longitudinal birth cohort studies and community-based participatory research and for measuring air pollution exposures, pesticide exposures, asthma, and neurobehavioral toxicity. Rather than a detailed description of the studies in each of the centers, this series of articles is intended to provide information on the practicalities of conducting such intensive studies and the lessons learned. This explication of lessons learned provides an outstanding opportunity for the planners of the National Children's Study to draw on past experiences that provide information on what has and has not worked when studying diverse multiracial and multiethnic groups of children with unique urban and rural exposures. The Children's Centers have addressed and overcome many hurdles in their efforts to understand the link between environmental exposures and health outcomes as well as interactions between exposures and a variety of social and cultural factors. Some of the major lessons learned include the critical importance of long-term studies for assessing the full range of developmental consequences of environmental exposures, recognition of the unique challenges presented at different life stages for both outcome and exposure measurement, and the importance of ethical issues that must be dealt with in a changing medical and legal environment. It is hoped that these articles will be of value to others who are embarking on studies of children's environmental health.

Child↗

Improving the management of environmental health.

Environmental health regulation has been developed on the premise that both problems and solutions are obvious, requiring only attention and commitment. The result has been impossible legislative goals and frenetic, unfocused agency efforts to deal with too many issues. Preventing all environmental health problems is impossible and not the best approach; instead, attention ought to be shifted toward reacting quickly to problems before irreversible, severe health damage has occurred. Rather than having regulatory agencies attempt to manage all problems, they should be focused on exemplifying goals and productive approaches, and on handling a few major issues. Regulatory agencies should be managing the nonregulatory institutions to ensure that they are effective in dealing with the myriad issues that the agencies will never be able to handle. The inherent limitations of federal regulatory agencies must be recognized to restructure environmental health management to be more effective in lowering risks while being efficient, administratively simple, and more equitable.

Environmental Health↗

Identifying priority health conditions, environmental data, and infrastructure needs: a synopsis of the Pew Environmental Health tracking project.

In this article we describe the methodologic approaches of the Pew Environmental Health Commission at the Johns Hopkins Bloomberg School of Public Health used to identify priority environmental health conditions and develop recommendations to establish a national environmental public health tracking network. We present the results of a survey of public health and environmental practitioners to uncover state and local health tracking needs and priorities. We describe the steps that combined the findings from the state and local health tracking survey and a review of the state of the science on environmental impacts on health to identify priority health end points. Through an examination of national health and health care databases, we then describe trends and public health effects of those diseases that may be linked to the environment. Based on this analysis, respiratory diseases and neurologic diseases are recommended as priorities for tracking. Specific end points recommended for tracking include asthma and chronic respiratory diseases, and chronic neurodegenerative diseases such as multiple sclerosis. Based on trends in reported prevalence, consideration should also be given to developmental disabilities, reproductive disorders, and endocrine/metabolic disorders. Strengthening of current efforts to track cancer and birth defects should also be included as components of a nationwide health tracking network. Finally, we present the recommendations for environmental public health tracking. These recommendations provided the groundwork for the development of the Centers for Disease Control and Prevention's National Environmental Public Health Tracking Progam that now includes 21 states, three cities, and three academic centers throughout the nation.

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

Medicine and environmental health.

Environmental threats to health and welfare are receiving much attention today and will become an even greater concern in the future. Since they often are the only group able to produce much of the basic data concerning environmental health effects, physicians must become more involved in environmental health problems, individually and organizationally. The Linton Report offers one proposal for attaining a liveable environment and should be reviewed by all health professionals.

Environmental Health↗

Health promotion, environmental health and Agenda 21.

In 1992, at the Rio Earth Summit, many governments, including our own, committed themselves to developing local strategies for sustainable development in the form of Local Agenda 21. Sustainable development is discussed, as is the philosophy and practice of health promotion and environmental health. Common approaches are identified and the links in relation to key areas of activities, strategies, values and principles are outlined. Finally, recommendations are made and conclusions drawn in relation to the overlap between environmental health action, Agenda 21 strategies and health promotion practice.

Environmental Health↗

Environmental awareness among physicians: what are environmental health and environmental medicine?

Increased awareness of environmental health issues by the biomedical community and the general public places higher demands on all health and medical practitioners to understand the key terms and concepts related to environmental health and medicine. We all exist in 3 different environments (home, workplace, and community), each of which has its own array of hazards and means of exposure. Environmental medicine is a discipline that addresses preventive measures and provides assessment, diagnosis, and treatment of persons who experience adverse health effects of environmental exposures. In addition to basic clinical skills, environmental medicine uses specialized tools including biostatistics and epidemiologic studies, the science of toxicology and risk assessment, the discipline of industrial hygiene, and administrative and public policy skills. Examples of environmental issues that are faced by society today include asbestos exposure in public buildings as well as pesticide and other agricultural chemical residues present in various environmental media.

Attitude of Health Personnel↗

Environmental health promotion: bridging traditional environmental health and health promotion.

This article highlights the juncture between environmental health and health promotion and underscores the need for health promotion involvement in environmental health practice. It begins with a synopsis of current issues in environmental public health and deficiencies in environmental public health practice that could be partly ameliorated by an increased focus on environmental health promotion. Environmental health promotion lies at the intersection between the two disciplines and can be defined as any planned process employing comprehensive health promotion approaches to assess, correct, control, and prevent those factors in the environment that can potentially harm the health and quality of life of present and future generations. An introduction is also provided to the six articles contained in this special issue focused on environmental health promotion, and a brief discussion of crosscutting themes and issues is presented.

Environmental Health↗

Community environmental health assessment strengthens environmental public health services in the Peruvian Amazon.

In December 1999, the Centers for Disease Control and Prevention (CDC) and the Cooperative for Assistance and Relief Everywhere, Peru Country Office (CARE Peru), initiated the Urban Environmental Health Project (SAU, in Spanish) to strengthen environmental public health services in urban and periurban settlements in Peru. The project received funding from the Woodruff Foundation as part of the CARE-CDC Health Initiative (CCHI). The "Protocol for Assessing Community Excellence in Environmental Health" (PACE EH) guided the development of a community environmental public health assessment (CEHA) process in Cardozo, a settlement in Iquitos, Peru. The project developed a three-phase process that merged scientific understanding and community perception about local environmental health problems. In phase 1, local environmental health technicians assisted the community in understanding environmental health conditions in Cardozo and selecting priorities. During phase 2, local technicians assessed the community-selected priorities: water and sanitation. Results from recent water quality assessments revealed that 82% (9 of 11) of samples from shallow dug wells, 18% (2 of 11) from deeper drilled wells, and 61% (11/18) from household drinking containers were positive for thermotolerant coliforms. Phase 3 activities produced an action plan and an intervention to mitigate health problems associated with inadequate water and sanitation services in the Cardozo community. As a result of the CEHA process, CARE Peru obtained funding from the United States Agency for International Development (USAID) to develop and implement an environmental health risk monitoring system and the proposed water and sewage intervention in the settlement. CDC continues to provide technical assistance to the local environmental health services groups in Iquitos through an agreement with CARE Peru as part of the USAID-funded Urban Environmental Health Models Project (MUSA). Technical assistance activities and the development of the environmental health risk monitoring system have helped to strengthen the local environmental public health services delivery system.

Community-Institutional Relations↗

Fish health and environmental health.

Surveys conducted to evaluate the health of marine-bottom fishes have been conducted in the eastern and western North Atlantic for the past 15 years, usually in conjunction with fish stock assessment cruises. The health of the fish sampled was evaluated using certain integumental and skeletal lesions and anomalies as markers to signify compromised health status. The results of these surveys indicate that fish health is poorer in coastal waters that have been anthropogenically degraded. Monitoring programs to determine the status and trends in levels of inorganic and organic contaminants in fish tissue and sediments have disclosed high levels of chemical contaminants in several coastal areas of the northeastern United States. Histopathological examinations of liver tissues of winter flounder, Pseudopleuronectes americanus, from Boston Harbor, one of the more chemically contaminated sites, has revealed a high prevalence of hepatocarcinoma.

Animals↗