Best Practices for Environmental Health

Environmental Pollution, Protection, Quality and Sustainability

Herman Koren

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781351645584
• Edition: 1
• Topic: Médecine
• Subtopic: Prestation de soins de santé

In a present where there are countless opportunities for the spread of exotic diseases, the expansion and creation of far more illness in our global population through globalization and rapid transportation, and the contamination of water, air and land, we find ourselves accountable. In this day and age we are confronted by global warming, Ebola, the Zika virus, lead in our water supply, enormous problems of infrastructure including aging sewer lines, water lines, electrical grids, roads and bridges, and the list goes on and on.

Best Practices for Environmental Health: Environmental Pollution, Protection, Quality and Sustainability is a one source major response to all of the environmental issues that affect global health and the worldwide protection and preservation of the natural environment. It compiles broad-based and comprehensive coverage of environmental topics, broken down by specialized fields. Topics range from children's environmental health to food protection and technology, water and waste systems, infection control, bioterrorism and pandemic health emergencies, and HAZMAT. Plus, it includes an overview of the current state of the profession and sections on programmatic techniques. This book helps solve the problems of disease and injury by presenting expert, evidence-based best practices.

This first of the kind handbook is essential reading for all environmental and public health undergraduate students, as well as a fantastic overview for professionals in all environmental health, pollution and protection areas.

1 Necessity for Effective Programming Techniques

AUTHOR’S THOUGHTS

The major thrust of this book is the provision of Best Practices in all environmental areas for students, practitioners, and all other stakeholders so they can use them to effectively and economically improve existing programs and in the development of new programs. Best Practices are the practical applications of knowledge and successful experiences in program areas used to prevent disease and injury as well as promote good health, while protecting and sustaining the natural environment.

Although it is not necessary to read the first two chapters of the Handbook of Environmental Health-Biological, Chemical and Physical Agents of Environmentally Related Disease by Dr. Herman Koren and Dr. Michael Bisesi (Lewis Publishers, CRC Press, Boca Raton, FL, 2003) to understand the present book and how to utilize the material it contains, it would enhance the learning experience of the reader if their knowledge was refreshed or they were exposed for the first time to the background knowledge found in that book. Chapter 1, Environment and Humans, includes a brief discussion on ecosystems, energy, health and environmental problems, concepts of chemistry, transport and alteration of chemicals in the environment, environmental health problems and the economy, risk–benefit analyses, environmental health problems and the law, creating federal laws and regulations, and environmental impact statements. Similarly, it would also be helpful to read Chapter 2, Environmental Problems and Human Health, which includes information on human systems, toxicological principles, applicable concepts of microbiology, principles of communicable disease, epidemiological principles, and risk assessment and risk management.

INTRODUCTION

The health, safety, environmental degradation, and environmental sustainability problems of our society, including global warming, continue to grow, while we have less money than ever to resolve them. At the same time, the previous concerns related to environmental degradation, environmental sustainability, injuries, and spread of disease have not subsided, but rather have increased in scope and complexity.

We need to use all of our existing resources in an effective manner including integrating the knowledge and practices of professionally trained personnel, generalists and specialists, both in environmental health and in environmental protection, while exposing them to a broad understanding of the inter-relationships between the various environmental media and the affect that a single action in one area may have on other environmental problems. We have to recognize the significance of the knowledge, experience, and enthusiasm of the large numbers of people and organizations in the environmental movement, the conservationists, the preservationists, the ecologists, the environmental justice groups, the sustainability groups, the public health and occupational health oriented groups, etc. We have to incorporate and utilize the knowledge and practical experience of the various professional associations, the high school students and teachers interested in protecting the environment, the college and university students and teachers who are working toward degrees in environmental health and environmental protection through a multitude of Bachelors and Masters programs ranging from environmental health to ecology to pollution control to environmental quality to environmental sustainability; the various news media; and the numerous politicians at the local, state, national, and international level.

We have to increase the numbers of professionally trained people working with the latest scientific knowledge and an understanding of successful programs utilizing Best Practices that have actually worked in the past and present. These techniques need to be used as examples for developing programs to help resolve current and future problems. The professionals then need to adapt this knowledge to meet the specific concerns of their community.

We need to share, adapt, and use the existing tools that we have by making available Best Practices and special resources for the multitude of existing and planned inter-related environmental programs.

We also need new tools to resolve these problems. We need to understand the major concerns of today and tomorrow and how to use available knowledge to fulfill the promise made in the Constitution of the United States of America that we all have the right to life, liberty, and the pursuit of happiness, which includes good health, the avoidance of disease and injury, and the protection and preservation of the environment for future generations.

MAJOR CONCERNS IN OUR SOCIETY TODAY

Eight major factors are interacting in our society today that require we make substantial changes in how we design practical programs, which prevent disease and injury, promote good health, protect the environment, and enhance environmental sustainability. These factors are: financial stress; regulatory reform; environmental justice; our changing planet; a multitude of environmental pollutants and their interactions; emerging and re-emerging infectious diseases, primarily of a zoonotic nature; where we live, work, play, and are educated; and the potential increase in acute and chronic disease in our mobile, growing, and aging population.

FINANCIAL STRESS

Financial stress at the personal level has led to increased homelessness and poverty. The largest numbers of new homeless are women and children. Hunger is another factor which contributes to disease, especially when there are negative environmental factors involved.

Financial stress at the state and local level of government has led to the reduction of many programs meant to protect the health and welfare of our citizenry in a time when more services are needed, not less. A research brief from the National Association of County and City Health Officials dated December 2011 stated that there has been a widespread reduction in essential services including environmental health services at the local and state level. In 2011, 55% of all local health departments cut at least one program protecting citizens in the communities. This affected 68% of the US population. Local health departments reduced environmental health services by 18% overall and by 21% excluding food safety programs. Epidemiology and surveillance was reduced by 9% and emergency preparedness was reduced by 20%. All of these losses are extreme.

There has also been a loss of trained professionals from local health departments. From 2008 through 2011, a total of 34,400 jobs were eliminated. Negative job impact has affected not only essential program areas but also the morale of working professionals. Emergency management is an example of this dire situation. Disasters and acts of terrorism can only be contained by highly trained individuals who need to be available to respond when the emergency occurs. The reality of disasters and the potential for terrorist acts has increased substantially. With the political situation constantly in flux, federal, state, and local officials must be prepared to respond immediately to the disaster to prevent loss of life and destruction of facilities and infrastructure, which leads to even further compression of the funds available to help the citizenry.

At the federal level, there have also been substantial changes in the budget for Environmental Health Programs. From 2010 to 2012, there was a 30% reduction in funding for the Centers for Disease Control and Prevention’s (CDC’s) National Center for Environmental Health and the Agency for Toxic Substances and Disease Registry, which provide funding and services to states and other groups. The new Healthy Home and Community Environments Program will be funded at a 51% decrease from the merged Healthy Homes and Lead Poisoning Prevention Program and the CDC’s National Asthma Control Program. There will also be substantial reductions to the Basic Environmental Health and Radiation Preparedness Programs, Climate Change Program, Environmental Health Tracking Program, Healthy Community Design Program, and Safe Water, Food, and Waterborne Illnesses Programs. In the past, the federal government helped support state and local health departments through grants, loans, and tax subsidies, when there was a serious need, but now this help will be reduced. (See endnotes 1, 2, 3, 4, 5, 6.)

Preparation for bioterror and health emergencies has deteriorated across the country because of severe budget cuts. In 2011, the Trust for America’s Health and the Robert Wood Johnson Foundation in their ninth annual report, Protecting the Public from Diseases, Disasters, and Bioterrorism, stated that 51 of the 72 cities in the Cities Readiness Initiative are at risk of being eliminated; 24 states are at risk of losing CDC epidemiologists; and all 50 states would lose the support of the CDC during a response to nuclear, radiological, chemical, and natural disasters. Although the public health and national security communities have repeatedly discussed the serious need for new funding for dealing with bioterrorism and other disasters and emergencies, funds continue to be cut in these areas. (See endnote 7.)

The President’s budget for the remainder of the 2016–2017 budget year was issued in March 2017. The Department of Health and Human Services received a total cut of 18% of its existing budget, including the National Institutes of Health 20% cut of $5.8 billion; CDC loses funds to fight Ebola outbreaks research and operational funds. This is devastating for medical research.

REGULATORY REFORM IN ENVIRONMENTAL HEALTH AND PROTECTION PROGRAMS

America with its free-market system has always prospered because the nation has adopted common sense laws to help protect individuals and communities from environmental stresses and to resolve current and future problems. This has resulted in the implementation of many rules protecting younger people, workers, and citizens in general. Although a given rule may have a financial cost, over time the improvement in health and reduction in injuries to a given population has far exceeded the cost of resolving the problem. A good example is the removal of lead from gasoline and paint, and the reduction in lead poisoning in children. Further, the new rules and regulations have led to innovations and new products which have stimulated the economy.

The manufacturing, processing, use, and disposal of chemicals and materials by industry often affect environmental and occupational health, and result in safety hazards and damage to the environment, which can initiate or exacerbate various health problems from before birth to old age. All body systems are at risk. Potential toxins are not always tested before use and only come to the attention of public health authorities after the harm to people is proven and widespread. Further, air, water, and land become contaminated and a variety of ecosystems may be altered or destroyed. All of these issues need appropriate rules and regulations to protect the public from potential disastrous consequences which are an unwanted side effect of the manufacturing, processing, use, and disposal of chemicals and materials which help make our society better in some respect.

At times, a rule becomes obsolete and therefore should be removed. However, the elimination of rules and regulations for the sake of improving the economy may end up being very costly, as in shale oil extraction, because of the collateral damage done to the health and welfare of people and the destruction of the environment. Another poor approach is the defunding of programs and professionals who enforce the rules and regulations.

Cost-benefit analysis does not always apply in relation to regulations which improve the environment and/or the health and safety of individuals in the community. All costs are easy to express, but benefits may not be realized for many years. Benefits include improved quality of life and good health of the individual over long periods of time. Benefits also include reduction in medical expenses, greater productivity from individuals because of les...