Barry L. Johnson

Environmental justice: the central role of research in establishing a credible scientific foundation for informed decision making.

Although much of the evidence is anecdotal and circumstantial, there are mounting concerns that environmental health risks are borne disproportionately by members of the population who are poor and nonwhite. We examine the central role of environmental health research in defining the dimensions of the problem, understanding its causes, and identifying solutions. Environmental health sciences, including epidemiology, exposure analysis, pharmacokinetics, toxicology, and surveillance monitoring, must be employed to determine the extent to which society has achieved “equity” and “justice” in safeguarding the health and safety of its citizens. By improving our ability to identify, evaluate, prevent, and/or reduce risks for all members of society, environmental health research can contribute directly to fair and equitable protection for everyone, regardless of age, ethnicity, gender, race, or socioeconomic status.

Hazardous waste: human health effects.

Concerns about uncontrolled hazardous waste sites (HWS) and other sources of unplanned releases of hazardous substances into the environment are wide ranging. Specific concerns regarding HWS include adverse impact on human health, expensive cleanup costs, depreciated property values, and ecological damage. In particular, the potential adverse health impact of exposure to hazardous substances from waste sites continues to be of great concern to the public. These concerns are evident in many countries. For instance, Cortinas de Nava observes that Agenda 21, which was developed by the United Nations Conference on Environment and Development in 1992, endorses control and management of toxic wastes (Cortinas de Nava, 1994). She also notes that about 90 countries have prohibited the importation of hazardous wastes, to protect against health and ecologic damage. Similarly, Winter records that national legislation to control toxic wastes began to appear in Europe in the 1970s and that concern for public health was the key underpinning of this legislation (Winter, 1994).

Strategic elements of ATSDR's Great Lakes Human Health Effects Research Program.

The goal of the Agency for Toxic Substances and Disease Registrys (ATSDR) Great Lakes Human Health Effects Research Program is to identify at-risk populations and to prevent potential human health effects associated with exposure to chemical contaminants in the Great Lakes basin. While this research effort is mandated by the Great Lakes Critical Programs Act of 1990, it also represents a significant opportunity to define a broader model or strategy for other regional or systems-level studies of potential health effects in at-risk populations. This article describes the strategy developed by ATSDR for this purpose in the Great Lakes Basin, as well as the programs specific research objectives and current status. It also outlines the projected implications of this research effort for greater comprehension of the potential health effects of exposure to contaminants in the Great Lakes Basin.

A review of health-based comparative risk assessments in the United States.

Comparing the risks posed by specific environmental hazards has become attractive to policy makers and legislative bodies as an aid to budgeting and other policy decisions. This paper reviews the human health-based findings from the first federal comparative risk assessment project and subsequent reviews conducted by 15 states and local government agencies in the United States. Methods are described on conducting comparative risk assessments that include substantive involvement of the public and special interest organizations. A consolidation of the comparative risk assessments of 15 states revealed good agreement with federal health-based environmental hazard priorities and partial agreement with local-government health departments. In descending order of priority, indoor air pollutants (excluding radon), criteria air pollutants, hazardous air pollutants, indoor radon, lead contamination, inactive hazardous waste sites, and drinking water at the tap are the highest ranked environmental hazards to human health.

Neurophysiological and neuropathological evaluation of primates exposed to ethylene oxide and propylene oxide.

Over 500 000 workers in the United States are exposed to ethylene oxide and propylene oxide. These two solvents are used as chemical intermediates, as well as components in the manufacture of fumigants and food preparation. The neurophysiologic and neuropathologic effects of these two organic oxides were investigated in five groups of 12 primates after exposure to 50 or 100 ppm ethylene oxide, 100 or 300 ppm propylene oxide, or no chemical (sham-exposed). Animals were exposed for 7 h/day, 5 dayslwkfor 24 months. Body weights, electroencephalograms, and motor nerve conduction velocities of the sciatic and ulnar nerves were assessed six times throughout the exposure period. Although the monkeys exposed to 100 ppm ethylene oxide had significantly lower mean weights, nerve conduction velocities did not differ significantly among the groups. Following termination of exposures, ten animals (two from each exposure group) were

Cancer policy framework for: public health assessment of carcinogens in the environment.

Cancer remains at the forefront of public health concerns in the United States and throughout the world. Over the past 20 years a wide range of federal agencies and other organizations have been involved in developing policy statements, classification strategies, and assessment methods to address carcinogenesis and health risks. Each of these documents was developed in response to issues confronted by those organizations in pursuing their mission, often as a direct function of legislative mandates. In pursuing its mandated responsibilities, the Agency for Toxic Substances and Disease Registry (ATSDR) must address public health concerns associated with exposure to carcinogens in the context of all available relevant information. This information includes both technical data as well as science policy positions adopted by the range of organizations with programs germane to the assessment and/or regulation of carcinogens. Because of distinct differences in perspective, practice, and policy dictated by the mandated activities of these organizations and the rapidly evolving understanding of carcinogenesis, apparently divergent positions may be reflected in their conclusions. The differences outlined above, coupled with requests from the public, other agencies, and the private sector for a statement reflecting the Agencys position on science and science policy issues related to cancer, prompted the development of this policy. This document is intended to serve as a framework to guide the Agency in its programs and actions regarding carcinogens and to harmonize such efforts with those of other federal agencies and relevant organizations. This framework reflects an assessment of current practice within the Agency and defines the appropriate roles of conclusions derived by other groups, professional judgment, and emerging scientific principles in ATSDRs public health assessments of exposures to carcinogens. This Cancer Policy Framework is not intended to encompass the development of operational guidelines per se, although the Agency recognizes the utility of such efforts. A central theme of this Cancer Policy Framework is the use of risk analysis as an organizing construct based on sound biomedical and other scientific judgment to define plausible exposure ranges of concern rather than single numerical conclusions that may convey an artificial sense of precision. The development and use of innovative tools for exposure and dose response assessment (with particular emphasis on molecular epidemiology) are also endorsed.

Role of Risk Assessment in Public Health Practice

The Agency for Toxic Substances and Disease Registry (ATSDR) is one of eight Public Health Service agencies within the U.S. Department of Health and Human Services. ATSDR was created by the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), also known as Superfund. The mission of ATSDR is to prevent exposure and adverse human health effects and diminished quality of life associated with exposure to hazardous substances from waste sites, unplanned releases, and other sources of pollution present in the environment (ATSDR, 1994a). In order to fulfil this mission, ATSDR conducts programs of health assessment, epidemiology, health surveillance, applied research, health education, and toxicologic database development. Risk assessment principles and practices have influenced how ATSDR conducts these programs. This paper describes the influence of risk assessment on agency programs, and ATSDR’s departure from some aspects of risk assessment.

Workshop on toxicological data quality indicators.

1. This workshop, which took place in Atlanta, Georgia on September 16-18, 1992, was sponsored by the International Programme on Chemical Safety, Geneva, Switzerland. The workshop was organized by the U.S. Department of Health and Human Services, Public Health Service, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia, U.S.A. 2. Address all correspondence to: Dr. Chris DeRosa, ATDSR, Division of Toxicology, 1600 Clifton Road (E-29), Atlanta, GA 30333.