Environmental Health

From Global to Local

Howard Frumkin, Howard Frumkin

• Publisher: Jossey-Bass
• Year: 2016
• ISBN:
  9781118988060
• Edition: 3
• Topic: Medicine
• Subtopic: Occupational & Industrial Medicine

The bestselling environmental health text, with all new coverage of key topics

Environmental Health: From Global to Local is a comprehensive introduction to the subject, and a contemporary, authoritative text for students of public health, environmental health, preventive medicine, community health, and environmental studies. Edited by the former director of the CDC's National Center for Environmental Health and current dean of the School of Public Health at the University of Washington, this book provides a multi-faceted view of the topic, and how it affects different regions, populations, and professions. In addition to traditional environmental health topics—air, water, chemical toxins, radiation, pest control—it offers remarkably broad, cross-cutting coverage, including such topics as building design, urban and regional planning, energy, transportation, disaster preparedness and response, climate change, and environmental psychology. This new third edition maintains its strong grounding in evidence, and has been revised for greater readability, with new coverage of ecology, sustainability, and vulnerable populations, with integrated coverage of policy issues, and with a more global focus.

Environmental health is a critically important topic, and it reaches into fields as diverse as communications, technology, regulatory policy, medicine, and law. This book is a well-rounded guide that addresses the field's most pressing concerns, with a practical bent that takes the material beyond theory.

• Explore the cross-discipline manifestations of environmental health
• Understand the global ramifications of population and climate change
• Learn how environmental issues affect health and well-being closer to home
• Discover how different fields incorporate environmental health perspectives

The first law of ecology reminds is that 'everything is connected to everything else.' Each piece of the system affects the whole, and the whole must sustain us all for the long term. Environmental Health lays out the facts, makes the connections, and demonstrates the importance of these crucial issues to human health and well-being, both on a global scale, and in our homes, workplaces, and neighborhoods.

Part 1
Methods and Paradigms

Chapter 1
Introduction to Environmental Health

Howard Frumkin

Dr. Frumkin's disclosures appear in the front of this book, in the section titled “Potential Conflicts of Interest in Environmental Health: From Global to Local.”

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Key Concepts

1. Environmental health is the field of public health that addresses physical, chemical, biological, social, and psychosocial factors in the environment. It aims both to control and prevent environmental hazards and to promote health and well-being through environmental strategies.
2. People have always been concerned with environmental health, but the nature of their concerns has evolved with the transition from prehistoric, to agricultural, to industrial, to postindustrial life.
3. Many disciplines contribute to environmental health: epidemiology and toxicology, psychology and communications, urban planning and food science, law and ethics, and more.
4. Environmental health utilizes the geographic concept of spatial scales, from the global (with issues such as climate change), to the regional (air quality), to the local (neighborhood design), to the hyperlocal (ergonomics).
5. Environmental health thinking takes a systems approach, embracing complexity, and focusing on “upstream” factors as well as on “downstream” health impacts.

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Please stop reading.

That's right. Close this book, just for a moment. Lift your eyes and look around. Where are you? What do you see?

Perhaps you're in the campus library, surrounded by shelves of books, with carpeting underfoot and the heating or air-conditioning humming quietly in the background. Perhaps you're home—a dormitory room, a bedroom in a house, a suite in a garden apartment, maybe your kitchen. Perhaps you're outside, lying beneath a tree in the middle of campus, or perhaps you're on a subway or a bus or even an airplane. What is it like? How does it feel to be where you are?

Is the light adequate for reading? Is the temperature comfortable? Is there fresh air to breathe? Are there contaminants in the air—say, solvents off-gassing from newly laid carpet or a recently painted wall? Does the chair fit your body comfortably?

If you're inside, look outside. What do you see through the window? Are there trees? Buildings? Is the neighborhood noisy or tranquil? Are there other people? Are there busy streets, with passing trucks and busses snorting occasional clouds of diesel exhaust?

Now imagine that you can see even farther, to a restaurant down the block, to the nearby river, to the highway network around your city or town, to the factories and assembly plants in industrial parks, to the power plant in the distance supplying electricity to the room you're in, to the agricultural lands and forests some miles away. What would you see in the restaurant? Is the kitchen clean? Is the food stored safely? Are there cockroaches or rats in the back room? What about the river? Is your municipal sewage system dumping raw wastes into the river, or is there a sewage plant discharging treated, clean effluent? Are there chemicals in the river water? What about fish? Could you eat the fish? Could you swim in the river? Do you drink the water from the river?

As for the highways, factories, and power plant…are they polluting the air? Are the highways clogged with traffic? Are people routinely injured and killed on the roads? Are workers in the factories being exposed to hazardous chemicals or to noise or to machines that may injure them or to stress? Are trains pulling up to the power plant regularly, off-loading vast piles of coal? And what about the farms? Are they applying pesticides, or are they controlling insects in other ways? Are you confident that you're safe eating the vegetables that grow there? Drinking the milk? Are the farmlands shrinking as residential development from the city sprawls outward?

Finally, imagine that you have an even broader view. Floating miles above the Earth, you look down. Do you notice the hundreds of millions of people living in wildly differing circumstances? Do you see vast megacities with millions and millions of people, and do you see isolated rural villages three days' walk from the nearest road? Do you see forests being cleared in some places, rivers and lakes drying up in others? Do you notice that the Earth's surface temperature is slightly warmer than it was a century ago? Do you see cyclones forming in tropical regions, glaciers and icecaps melting near the poles?

OK, back to the book.

Everything you've just viewed, from the room you're in to the globe you're on, is part of your environment. And many, many aspects of that environment, from the air you breathe to the water you drink, from the roads you travel to the wastes you produce, may affect how you feel. They may determine your risk of being injured before today ends, your risk of coming down with diarrhea or shortness of breath or a sore back, your risk of developing a chronic disease in the next few decades, even the risk that your children or your grandchildren will suffer from developmental disabilities or asthma or cancer.

What Is Environmental Health?

Merriam-Webster's Collegiate Dictionary first defines environment straightforwardly as “the circumstances, objects, or conditions by which one is surrounded.” The second definition it offers is more intriguing: “the complex of physical, chemical, and biotic factors (as climate, soil, and living things) that act upon an organism or an ecological community and ultimately determine its form and survival.” If our focus is on human health, we can consider the environment to be all the external (or nongenetic) factors—physical, nutritional, social, behavioral, and others—that act on humans.

A widely accepted definition of health comes from the 1948 constitution of the World Health Organization: “A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” This broad definition reaches well beyond blood pressure readings and X-ray results to include many dimensions of our lives: well-being, comfort, even happiness.

Environmental health has been defined in many ways (see Text Box 1.1). Some definitions evoke the relationship between people and the environment—a systems-based, ecological approach—while others focus more narrowly on addressing particular environmental conditions. Some focus on controlling hazards, while others focus on promoting health-enhancing environments. Some focus on physical and chemical hazards, while others extend more broadly to aspects of the social and built environments. In the aggregate the definitions in Text Box 1.1 make it clear that environmental health is many things: an interdisciplinary academic field, an area of research, and an arena of applied public health practice.

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Text Box 1.1 Definitions of Environmental Health

“Environmental health comprises those aspects of human health, including quality of life, that are determined by physical, chemical, biological, social and psychosocial factors in the environment. It also refers to the theory and practice of assessing, correcting, controlling, and preventing those factors in the environment that can potentially affect adversely the health of present and future generations.” (World Health Organization)

“Environmental health is the branch of public health that protects against the effects of environmental hazards that can adversely affect health or the ecological balances essential to human health and environmental quality.” (Agency for Toxic Substances and Disease Registry)

“Environmental health 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 aesthetic environment, which includes housing, urban dev...