Rebuilding the unity of health and the environment : a new vision of environmental health for the 21st Century

96 Pages·2001·1.273 MB·English

by  Hanna, Kathi E., Coussens, Christine

Rebuilding the Unity
of Health and
the Environment:
A New Vision of
Environmental Health
for the 21st Century
Kathi Hanna
Christine Coussens
National Academy Press
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ge bry ins Rebuilding the Unity of Health and
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al typhave A NEW VISION OF ENVIRONMENTAL HEALTH FOR THE 21ST
originmay CENTURY
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original ed, and Roundtable on EnvDiriovnismioenn toafl HHeeaalltthh SScciieenncceess ,P Roelisceyarch, and Medicine
he ain INSTITUTE OF MEDICINE
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eakerte NATIONAL ACADEMY PRESS 2101 Constitution Avenue, N.W. Washington, DC 20418
ge bry ins NbeOrsT aIrCeE d:r Tawhen pfrroomjec tth teh acto uisn tchiles soufb tjheec tN oaf ttihoinsa rle Apocratd wemasy aopfp Srocvieendc besy, tthhee GNoavtieornnailn gA cBaodaermd yo fo tfh Ee nNgaintieoenrainl gR, easneda rtchhe CInosutintcuitle, owfh Moseed miceinme-.
Paall The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
s. ent Support for this study was provided by the National Institute of Environmental Health Sciences (Contract No. NO1-OD-4-2139, Task
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al typhave 2101, Constitution Avenue, N.W. , Box 285 , Washington, DC 20055 . Call [phone] or [phone] (in the Washington metropoli-
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m terr Copyright 2001 by the National Academy of Sciences. All rights reserved.
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m terr The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished
k, not froographic stCecochhnongloarelrossg se yin nag na1dg8 e6tod3 ,ti hnthe sierc Aiuescneat idffoeirc m tahyne d gh eeannsge ari anmle waenreidlnfagatr ere e.t shUeaapt rorcneh qt,hu deier aedusi ctihato tteroid tay td oov fti hstheee ft hucehrt ahfreetderrae nrgacrlae ng otoefv dse ctroine mint cebeny ta tonhnde
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er bome ty scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences.
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ps The National Academy of Engineering was established in 1964, under the charter of the National Academy
original ed, and othfe S sceileenccteiosn, aosf a i tpsa mraelmlelb oerrgs,a snhizaaritniogn w oift ho uthtset aNnadtiinogn aeln Agicnaedeersm. yIt oisf Sauctioennocemso tuhse irne siptso andsmibiinliitsyt rfaotrio and vanisdi nign
he ain the federal government. The National Academy of Engineering also sponsors engineering programs aimed at
m tret meeting national needs, encourages education and research, and recognizes the superior achievements of
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ea The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the
es crer, c services of eminent members of appropriate professions in the examination of policy matters pertaining to
L filwev the health of the public. The Institute acts under the responsibility given to the National Academy of
XMho Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative,
m g, to identify issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute
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ge bry ins ROUNDTABLE ON ENVIRONMENTAL HEALTH SCIENCES, RESEARCH, AND
Paall MEDICINE
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al typhave M. BMReOdiWcalN CEoLllLeg AesN, WDEasRhSinOgNto,n ,A DsCsociate Vice President for Medical Education, Association of American
originmay ROGER BULGER, President, Association of Academic Health Centers, Washington, DC
he ors MAUREEN K. BYRNES, Director of Health and Human Services, The Pew Charitable Trusts, Philadelphia, PA
m terr RUTH ETZEL, Chairperson, Committee on Environmental Health, American Academy of Pediatrics,
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ps LYNN GOLDMAN, Professor, Department of Environmental Health Sciences, John Hopkins University
original ed, and BERSNcAhoRoDl o fD P. uGblOicL HDeSalTthE, IBNa,l tiDmiroercet,o Mr, DEnvironmental and Occupational Health Sciences Institute, Robert
he ain Wood Johnson Medical School, Piscataway, NJ
m tret ROBERT GRAHAM, Scholar in Residence, The Robert Graham Center for Policy Studies, Family Practice,
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ea Bethesda, MD
es crer, c JAN HEINRICH, Associate Director, Health Finance and Public Health, U.S. General Accounting Office,
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XMho CAROL HENRY, Vice President for Science and Research, Chemical Manufacturers Association, Arlington, VA
m g, RICHARD J. JACKSON, Director, National Center for Environmental Health, Centers for Disease Control and
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the original work has bation of and other typesettiding styles, for attributiauthoritative version RFROAGPNEaKrRk , M MNICCRCELRE, DLiLreAcNto,r ,P Hreesaildthe natn dE mSaefreittuys, ,I nCtehrenmatiicoanl aIl nUdnuisotrny, UInnsittietdu tAe uotfo TWooxrikceorlso,g Dy,e tRroeist,e aMrcIh Triangle
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eakerte ALAN R. NELSON, Special Advisor to the CEO, American College of Physicians–American Society of
ge bry ins NORInINteErn aNl OMOedNicAinNe,, FAasisrifsatxa,n Vt AAdministrator for Research and Development, U.S. Environmental Protection
s. Paallent Agency, Washington, DC
ed KENNETH OLDEN, Director, National Institute of Environmental Health Sciences, National Institutes of
ting filesetbeen acci LINDCHoAean ltRtrhoO,l RSanEedsNe PaSrrTcehvO eTCnrtKiiao,nn gD, lWeir ePacsathrokirn,, gNNtoCant,i oDnCal Institute for Occupational Safety and Health, Centers for Disease
al typhave SAMUEL H. WILSON, Deputy Director, National Institute of Environmental Health Sciences, National
ginay Institutes of Health, Research Triangle Park, NC
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he ors IOM Liaisons to the Roundtable
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k, not froographic RENICRHIQAUREDT MAE BRORNIDLL, P, rDesaindieenl tC, Bapulrirno uPgrohfse Wssoerl locof mLaew F,u Undn,i vDeursrhitaym o,f NVCirginia School of Law, Charlottesville,
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original ed, and JONATHAN DAVIS, Study Director (until August 2000)
he ain CHRISTINE COUSSENS, Study Director (from August 2000)
m tret SARAH PITLUCK, Research Associate (until June 2000)
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original typmay have VisioInt ohfa sE nbveierno n3m menotnatlh Hs esainltche ftohre t hweo 2rk1ssht oCpe notnu rRye, baunidld tihneg qtuhael iUtyn oitfy doifs cHuessailothn sa bnyd bthoeth E tnhvei rsopneamkeenrts: aAn dN tehwe
he ors participants still impresses me. It is only appropriate that at the dawn of the new millennium, we stop and
m terr examine environmental health. Current environmental health concerns are conveying a sense of urgency. The
k, not froographic tdiimffee rTteohn aet c stm ciisee nnanoceiwn o gbfse efondrveeip rfeounnrdmthineegnr tdaalo mnh eaagalenth t hiisrne ada itbverniodsau odau lt’ros p phipcye sarinscpdae ls cautnifvdfee er. sm fEornotivmoinr aothln ewm leealnclk-tab loe ifn hage .parltehc ishe adse fimniatnioyn ; fiat cheatss
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ps and environmental issues. Where this workshop was successful was in bringing together architects,
original ed, and pstsaytceh ooflfoigciisatlss,, pinodliucsytmrya ksetarsk,e hreoglduelarsto, rayn dag ceonnciceesr,n escdi ecnittiisztesn, sc, oamllmowuninitgy trheepmre steon tianttievreasc,t haenadlt hh ecaarr et hper ovvairdieoruss,
he ain perspectives on the relationship between the environment and citizen health.
m tret While we strive to correct problems in our environment, we need to continue to reach out to all Americans.
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ed frat bnnot Isto ims eth ien piunbdluics ttrhya tm sauyff efrese lo rt hbaetn ethfiet se ansv iwroen amtteenmt pits tore rleaatecdh otou rr eggouallas.t iSoonm aen dm eemcobneorms oicfs t;h teh gise nise rnalo tp utrbuliec. aAnldl
ea environmental laws are public health laws! I remember when we passed the Clean Air Act in the 1970s, once
es crer, c people understood the problems
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eakerte facing our access to cleaning the air and what could be done, they strongly supported the effort. The Safe
ge bry ins DWrainshkiinnggt oWn,a Dte.rC .A, catn dp rNoevwid eYdo rak sCaiftey . wAalttehro usguhp pthlye sefo ar rem oannlyy tcwitoie es xtahmropulegsh, otuhte yt hilel uUstnraitteed t hSatta etensv,i rionncmluednitnagl
s. Paallent laws are in reality public health laws.
ed Our communities need to embrace a broader view of environmental health. Combating urban sprawl and
ting filesetbeen acci pfCosOrywc2 haerodmlo igtshissiintoskn, issn cgai.er enS tiitsnwtcsoe, aotnhfde cthloaemn dmimmumanriektdy i laleetgeai dscelahrstai lonlneene dgo eft so t hrfeeat che1idn9 k7b 0tyhs, e tichr oean pshpiurdomearacanhb .l epS oorpleuustleiaaotrnicoshn r .e hqBausui rilebd eieenrnns, o dvdoaetnsieoig.n n Taenrhsde,
al typhave foundation of legislation has been laid, but we need to build on the past. Our approaches should look at what
ginay needs to be done and concentrate on how to get there. The overarching message from the workshop stated that
orim we need to work on innovative solutions to properly handle future problems.
he ors We have accomplished significant changes in many health-related issues, but more has to be done in the
m terr future. The Institute of Medicine’s Environmental Health Sciences Roundtable was formed to provide a neutral
ok, not fropographic pHinlaafoncrenm af aoatrin oddn eaCbl ahdtroeissct uionmfe e tnChteo tuhcsaustre rnpesrno,t v siiusdmseusme asa rmiinze esessn avtghiereo tndhmiastce unwstaoslir okhnsesha oltpthh a.pt aTorthciiccsiu prwarenodtrs k dschuaornip nt gas kutemh ebm a2ac-rkdy a,t oyp ormeupera efrteienddge .rb ayIlt , Ksistaa ttaheni,
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er bme t and local agencies, companies, academic institutions, and other organizations and indeed the public itself.
apo Paul G. Rogers
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original ed, and Chair
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ge bry ins REVIEWERS
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he ors purpose of this independent review is to provide candid and critical comments that will assist the institution in
m terr making its published report as sound as possible and to ensure that the report meets institutional standards for
k, not froographic octhobenjiefrci drteievvniitteiyaw,l eotvofi dtpherinosc treeec, pta ontrhdte: r einstpeognrsitiyv eonfe sths et od tehlieb setruadtiyv ec hparrogcee.s Ts.h We ree vwieiswh ctoom thmaennkt st haen df odlrloafwt imnga niunsdcirviipdtu raelms afoinr
op
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er bme t Eula Bingham, University of Cincinnati Medical Center
p
paso Richard Lynch, Rutgers, The State University of New Jersey
original ed, and HAulgthho MugchK tihnen ornev, Uienwiteerds Sltiastteesd E anbvoirvoen mhaevneta lp Prorovtiedcetido nm Aagneyn ccyonstructive comments and suggestions, they were
he ain not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its
m tret release. The review of this report was overseen by Mel Worth, Scholar-in-Residence, Institute of Medicine, who
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es crer, c content of this report rests entirely with the authoring committee and the institution.
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