Environmental Health

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Our environment affects our health. Our average life span has almost doubled over the past century or so mainly because we have clean, safe drinking water. If parts of the environment, like air and water, or soil become polluted, it can lead to health problems. For example, asthma attacks can result from pollutants and other chemicals in the air and in the home.  Some environmental risks are a part of the natural world, like radon in the soil. Others are the result of human activities, like lead poisoning from paint, or exposure to asbestos or mercury from mining or industrial use.
Source: National Institutes of Health, National Institute of Environmental Health Sciences

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.
Environmental Health Defined by the World Health Organization (WHO)[1]

Disciplines

Three basic disciplines generally contribute to the field of environmental health: environmental epidemiology, toxicology, and exposure science. Each of these disciplines contributes different information to describe problems 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.

Information from these three disciplines can be combined to conduct a risk assessment for specific chemicals or mixtures of chemicals to determine whether an exposure poses significant risk to human health. 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]


Concerns

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

• Air quality, including both ambient outdoor air and indoor air quality, which also comprises concerns about environmental tobacco smoke.
• Body art safety, including tattooing, body piercing and permanent cosmetics.
• Climate change and its effects on health.
• Disaster preparedness and response (e.g. FEMA, American Red Cross, CDC, WHO).
• Food safety, including in agriculture, transportation, food processing, wholesale and retail distribution and sale.
• Hazardous materials management, including hazardous waste management, contaminated site remediation, the prevention of leaks from underground storage tanks and the prevention of hazardous materials releases to the environment and responses to emergency situations resulting from such releases.
• Housing (building codes by state), including substandard housing abatement and the inspection of jails and prisons.
• Childhood lead poisoning prevention.
• Land use planning, including smart growth.
• Liquid waste disposal, including city waste water treatment plants and on-site waste water disposal systems, such as septic tank systems and chemical toilets.
• Medical waste management and disposal.
• Noise pollution control.
• Occupational health and industrial hygiene.
• Radiological health, including exposure to ionizing radiation from X-rays or radioactive isotopes.
• Recreational water illness prevention, including from swimming pools, spas and ocean and freshwater bathing places.
• Safe drinking water.
• Solid waste management, including landfills, recycling facilities, composting and solid waste transfer stations.
• Toxic chemical exposure whether in consumer products, housing, workplaces, air, water or soil.
• Vector control, including the control of mosquitoes, rodents, flies, cockroaches and other animals that may transmit pathogens.

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]

Information

The Toxicology and Environmental Health Information Program (TEHIP)[6] at the United States National Library of Medicine (NLM) maintains a comprehensive toxicology and environmental health web site that includes access to resources produced by the TEHIP and by other government agencies and organizations. This web site includes links to databases, bibliographies, tutorials, and other scientific and consumer-oriented resources. The TEHIP also is responsible for the Toxicology Data Network (TOXNET),[7] an integrated system of toxicology and environmental health databases that are available free of charge on the web.

Mapping

There are many environmental health mapping tools. TOXMAP: Environmental Health e-Maps is a geographic information system (GIS) from the Division of Specialized Information Services[8] 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 U.S. federal government. TOXMAP's chemical and environmental health information is taken from the NLM's Toxicology Data Network (TOXNET)[7] and PubMed, and from other authoritative sources.

External Links

Bisphenol A (BPA) Information for Parents: What is BPA? - U.S. Department of Health and Human Services.
Bisphenol A (BPA): Questions and Answers - The National Institute of Environmental Health Services.
What is BPA, and what are the concerns about BPA? - Mayo Foundation for Medical Education and Research.
Bisphenol A (BPA): Use in Food Contact Application - U.S. Food and Drug Administration.
bisphenol-A - Environmental Working Group.
Bisphenol A (BPA) - Breast Cancer Fund.
Facts About BPA - American Chemistry Council, Inc.
Concern over canned foods: Our tests find wide range of Bisphenol A in soups, juice, and more - Consumer Reports magazine: December 2009. Consumers Union of U.S., Inc.
Bisphenol A: Welcome to the Bisphenol - A Website - This web site is sponsored by the Polycarbonate/BPA Global Group, which is organized regionally at the American Chemistry Council, PlasticsEurope, and the Japan Chemical Industry Association.
Bisophenol A - National Geographic.
Chapel Hill Bisphenol A Expert Panel Consensus Statement: Integration of Mechanisms, Effects in Animals and Potential to Impact Human Health at Current Levels of Exposure - Environmental Health News.
Tox Town - Bisphenol A (BPA) - Toxic chemicals and environmental health risks where you live and work - Text Version - U.S. National Library of Medicine.
NLM Resource: Tox Town - Bisphenol A (BPA) Page. NLM Technical Bulletin. 2010 Mar–Apr - National Library of Medicine | National Institutes of Health.
Tox Town - National Library of Medicine.
Environmental Diseases from A to Z - National Institute of Environmental Health Sciences.
Environmental Health Topics from A to Z - National Institute of Environmental Health Sciences.
Family Guide: 20 Easy Steps to Personal Environmental Health Now - National Institute of Environmental Health Sciences.
New Environmental Health - National Institute of Environmental Health Sciences.
Food Topics - U.S. Food and Drug Administration.
Cosmetic Topics - U.S. Food and Drug Administration.
Radiation-Emitting Products - U.S. Food and Drug Administration.

News Articles
Environmental Health News - A foundation-funded journalism organization founded in 2002, published daily.
Study links plastic chemical BPA, childhood obesity (September 18, 2012) - Boston Herald
BPA news, articles and information - NaturalNews Network.
F.D.A. Makes It Official: BPA Can’t Be Used in Baby Bottles and Cups (July 17, 2012) - The New York Times.

Specific Conditions
Acid Rain - Environmental Protection Agency.
Bisphenol A - National Library of Medicine.
Bisphenol A (BPA) - National Toxicology Program.
Design for the Environment: Partnership Projects - Environmental Protection Agency.
Endocrine Disruptors - National Institute of Environmental Health Sciences.
Environmental Factors and Breast Cancer Risk - National Institute of Environmental Health Sciences.
Health Effects - Centers for Disease Control and Prevention.
Heat Island Effect - Environmental Protection Agency.
RadTown USA: Basic Information - Environmental Protection Agency.
Respiratory Disease and the Environment - National Institute of Environmental Health Sciences.
ToxGuides: Quick Reference Pocket Guide for Toxicological Profiles - Agency for Toxic Substances and Disease Registry.
Transportation and Air Quality - Environmental Protection Agency.

Related Issues
Choosing Where You Live: A Consumer Self Help Guide to the U.S. and U.S. Territories - Environmental Protection Agency.
Exposure - Agency for Toxic Substances and Disease Registry.
Healthy Homes - Centers for Disease Control and Prevention.
Known and Probable Human Carcinogens - American Cancer Society.
Linking Early Environmental Exposures to Adult Diseases - National Institute of Environmental Health Sciences.
Meet the Experts: Environmental Health - Maryland Public Television, Johns Hopkins Bloomberg School of Public Health.
TOXNET: Databases on toxicology, hazardous chemicals, environmental health, and toxic releases. - National Library of Medicine.

Clinical Trials
ClinicalTrials.gov: "Environmental Health" or "Environmental Exposure" - National Institutes of Health.
Our Stolen Future: Background on BPA: Studies - Our Stolen Future.org

Research
Bisphenol A (BPA) - National Institute of Environmental Health Sciences.
Decade of Children's Environmental Health Research: Highlights from EPA's Science to Achieve Results Program - Environmental Protection Agency.
Does the Plastic Chemical Bisphenol A Contribute to Type 2 Diabetes? - American College of Physicians.
National Children's Study - National Institute of Environmental Health Sciences, Centers for Disease Control and Prevention, National Institute of Child Health and Human Development.
National Report on Human Exposure to Environmental Chemicals - Centers for Disease Control and Prevention.
New Directions in Children's Environmental Health Research - National Institute of Environmental Health Sciences.
New Technology for Detecting Biological Responses to Environmental Factors - National Institute of Environmental Health Sciences.

Dictionaries/Glossaries
ATSDR Glossary of Terms - Agency for Toxic Substances and Disease Registry.
Glossary of Children's Environmental Health Terms - Children's Environmental Health Network.
Terms & Acronyms - Environmental Protection Agency.

Directories
Association of Occupational and Environmental Clinics Directory - Association of Occupational and Environmental Clinics.
Wastes-Where You Live: State Programs - Environmental Protection Agency, Office of Solid Waste.

Organizations
U.S. Environmental Protection Agency.
Agency for Toxic Substances and Disease Registry.
Centers for Disease Control and Prevention.
World Health Organization.
U.S. Food and Drug Administration.
National Center for Environmental Health - Centers for Disease Control and Prevention.
National Institute of Environmental Health Sciences.
National Toxicology Program.
Association of Public Health Laboratories (APHL).
British Society for Ecological Medicine (BSEM).
Canadian Institute of Public Health Inspectors (CIPHI).
Chartered Institute of Environmental Health (CIEH).
Environmental Health Australia (EHA).

Statistics
Envirofacts Data Warehouse - Environmental Protection Agency.
TOXMAP: Environmental Health eMaps - National Library of Medicine.

Children
America's Children and the Environment - Environmental Protection Agency.
EPA Student Center - Environmental Protection Agency.
Fish Kids - Environmental Protection Agency.
Healthy Environments for Children - Pan American Health Organization.
Learn about Chemicals Around Your House - Environmental Protection Agency, Office of Pesticide Programs.
National Institute of Environmental Health Sciences Kids' Pages - National Institute of Environmental Health Sciences.
ToxMystery - National Library of Medicine.
What You Can Do to Protect Children from Environmental Risks - Environmental Protection Agency, Office of Children's Health Protection.
Your Baby's Environment - March of Dimes Birth Defects Foundation.

Teenagers
Environment and Your Health - Dept. of Health and Human Services, Office on Women's Health.

Women
Environment and Women's Health - Dept. of Health and Human Services, Office on Women's Health.

Seniors
Aging Initiative - Environmental Protection Agency.

References
1. Novice, Robert (editor) (1999-03-29). "Overview of the environment and health in Europe in the 1990s"http://www.euro.who.int/document/e66792.pdf. World Health Organization.
2. California Health and Safety Code, section 106615(e)
3. Environmental Health: from Global to Local http://books.google.com/books?id=uTgSBW8jE8QC&lpg=PP1&dq=environmental%20health%20from%20global%20to%20local%20by%20howard%20frumkin&pg=PP1#v=onepage&q=environmental%20health%20from%20global%20to%20local%20by%20howard%20frumkin&f=false. 2nd. edition. Edited by Howard Frumkin. John Wiley & Sons. San Francisco. 2010.
4. National and regional story (Netherlands) - Environmental burden of disease in Europe: the Abode project http://www.eea.europa.eu/soer/countries/nl/national-and-regional-story-netherlands-1. EEA.
5. Knows and unknowns on burden of disease due to chemicals: a systematic review http://www.ehjournal.net/content/10/1/9. Press-Ustinov, A., et al. 2011. Environmental Health 10:9.
6. Environmental Health & Toxicology http://sis.nlm.nih.gov/enviro.html.
7. TOXNET: Toxicology Data Network http://toxnet.nlm.nih.gov/.
8. Specialized Information Services (SIS) http://sis.nlm.nih.gov/.

Further Reading
Andrew M. Pope and David P. Rall, editors; Committee on Curriculum Development in Environmental Medicine, Institute of Medicine. (1995). Environmental Medicine — Integrating a Missing Element into Medical Education, National Academies Press.
Jouko Tuomisto. Arsenic to zoonoses — One hundred questions about the environment and health. 

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