Traditional View and Evolving Definition of Environmental Health

Traditionally, the field of public health has developed a working model of the relationship to health and disease that takes into account the role of such features such as genetic susceptibility, biology, and behaviors in determining health. As illustrated in Figure I-1, these features can interact and converge to result in disease. Environmental health builds on this model by identifying those environmental factors that can interact with the features in this primary model (see Figure I-1) to influence the disease state.

FIGURE I-1

When taking into consideration the relationship of health and disease we need to take into account the role of multiple contributing factors. SOURCE: Wilson, unpublished.

The definition of environmental health continues to change. In recent years, the field has evolved toward a more holistic view of the effect of environment on health and has recognized the challenges and the opportunities inherent in this broader view in advancing the field. The World Health Organization defines environmental health as the direct pathological effects on health of chemical, physical, and biological agent and of the effects of the broad physical and social environment on human health (World Health Organization, 1986). This definition is one of many examples that not only apply to air, water, and soil, but in the broadest sense to the pathological effect on health of the broad physical and social environment. Considering these and other definitions, the Roundtable began to define environmental health as the human health impact of the holistic environment—one comprised of the natural, built, and social environments. This view superimposes a holistic view of the influence of various environments in which we live, play, and work. The Roundtable continues to look at how socioeconomic factors, the natural environment, and the built environment can interact to impact human health.

Environmental Health: New Challenges, New Strategies

Medical science is advancing and developing new and far more precise tools to investigate the linkages between health and the environment. One example is advances in the field of genetics due to the work under the aegis of the Human Genome Project. With sequence of the 20,000–25,000 genes in human genome DNA, we are beginning a new age from the standpoint of research opportunities on gene-environment interactions. In environmental health, this will have tremendous implication. We will be able to better understand the complex question, Why does one individual when exposed to a toxicant develop disease, while another with the same exposure does not?

With the adoption of a broader view of environmental health, environmental health scientists’ strategies for addressing issues have changed. In a speech in 1997, then President of MIT, Charles Vest, suggested that “For the past 30 years, environmental concerns in this country have been dominated by a mentality of government regulation and remediation.” He further noted that, “In the future, industry and academia must instead play an increasingly important role in exercising environmental responsibility. We must educate engineers, managers, scientists, economics and policy experts to analyze environmental issues and synthesize sound solutions. Sound thinking about and commitment to sustainable development and environmental stewardship must be an integral part of the general education and practice of engineering management. Proactive environmentalism is good business in the growing commitment to a healthy environment on the part of both industry and academia in setting the stage for new partnerships between the public and private sectors,” (Vest, 1997). His remarks frame an important concept for industry, for the field of engineering, and for this workshop, in the sense of exploring environmental stewardship.

This workshop was planned to examine some of the issues surrounding international regulations and concept of corporate social responsibility (CSR) and to understand the impact they will have for environmental health. Currently, there are pressures from shareholders and environmentally-minded individuals to encourage or require the adoption of “environment-friendly” practices, standards, and policies. Although it is clear that global regulatory standards will always be a major driver in the field of environmental health, there is growing understanding of the value of voluntary standards to fill in gaps or to work in concert with formal regulations.

Overall, this workshop was planned to help define the term corporate social responsibility, identify best practices, and consider cost-benefit issues. The workshop planning group hopes to challenge the industry to identify ways that best practices can be more efficiently shared and to address issues of privacy or trade secrets, which will allow for data to be more transparent. Federal research agencies also have roles to play, meaning that research needs to help reduce risk, especially up front, before the harm is introduced into the environment. Finally, the planning group would like to see the workshop define needs for strategic partnerships in global environmental health. This Roundtable has done an excellent job in the past on this point of identifying new partnership opportunities, and this is also a priority as we begin this exciting workshop today.