Environmental Health And Safety Research Paper

1. The Scope And Significance Of Environmental Factors On Health

Much disease is caused by substances and conditions in people’s surrounding environment, including chemicals and air particles in factories, pesticides in agriculture, toxic wastes in residential neighborhoods, and radiation in the atmosphere. The ‘environment’ is so broad a term that we could virtually subsume all disease processes under the umbrella of unhealthy living and working conditions. But when experts speak of social aspects of environmental health, they generally focus on the health effects caused by toxic substances in people’s immediate surroundings. These chemical-related, air-pollution-related, and radiationrelated diseases and symptoms are the phenomena that have generated much conflict, policy making, legislation, public awareness, media attention, and social movement activity.

These social outcomes were prefigured by prior developments in occupational health. Many harmful effects of chemicals and substances are first found in the work setting, and then generalized to the community level. There was much corporate, governmental, and scientific opposition to detecting and remediating occupational causes of disease, setting a tone for responses to environmental conditions. Even a clearly work-related condition such as black lung disease was the source of great contention, with coal miners pitted against corporations and the federal government (Smith 1981). Mesothelioma (a form of lung cancer) and asbestosis (a pulmonary disease) are now generally understood to be caused by asbestos, although there was great conflict until quite recently (Brodeur 1985).

Rachel Carson’s Silent Spring (1962) sparked the first mass public attention to environmental health effects. Carson demonstrated how pesticides, especially DDT (dichlorodiphenyltrichloroethane), caused morbidity and mortality in animals and humans. Her work led to significant pesticide regulation in the USA, the National Environmental Protection Act, the Environmental Protection Agency (EPA), and the new wave of the environmental movement.

The 1978 Love Canal situation was the first occasion on which human health was central in an environmental crisis, prompting the creation of the Superfund Program by the US EPA. Residents were warned by state health officials that toxic chemicals permeated their neighborhood in Niagara Falls, New York, where a chemical company had donated a dump site to the city to build a school. The revelation meshed with residents’s awareness of a history of experiencing health effects. Residents and their scientist allies discovered elevated rates of miscarriage, birth defects, cancer, and chromosome damage (Levine 1982). The residents organizing to get action by state and federal governments led many other communities around the country to act similarly.

2. Types Of Environmental Health Effect

2.1 Lay Discovery Of Environmental Health Effects

Much of the knowledge about environmental health effects has come from actually or potentially affected people. Some situations involved immediate health effects, such as the dioxin-laced waste oil in Times Beach, Missouri (USA). Others involved episodes without immediate effects, but where effects were expected to follow, as at the Three Mile Island (TMI) nuclear plant. Sometimes there was the discovery of prior contamination episodes, such as in the case of radiation releases from the Hanford, Washington (USA) nuclear facility. Sometimes there are unexplained clusters of disease, of which people are seeking the cause, but do not yet have a specific emission to trace it to, as with Gulf War illnesses.

Environmental justice activism expanded these concerns as Blacks, Latinos, and Native Americans in the USA discovered excess lead poisoning and disproportionate placement of landfills, incinerators, and toxic waste sites in poor and minority areas (Bullard 1993, Bryant and Mohai 1992). Women’s growing involvement in toxic waste activist groups has heightened the importance of gender issues (Blocker and Eckberg 1989).

Laypeople’s success in identifying environmentally induced diseases and their likely causes is striking. A valuable example is the lay discovery of the health effects of the Hanford nuclear reservation. Citizens began with initial questioning, followed by extensive self-education through reading, talking with neighbors, querying officials, and analyzing primary sources. Ultimately, they compelled the release of massive numbers of documents, documented many accidental and planned radioactivity releases, identified thyroid disease among ‘downwinders,’ and were instrumental in US Energy Secretary Hazel O’Leary’s ‘openness’ policy that brought to light many releases and accidents, as well as many unethical radioactivity experiments on captive populations (Kaplan 1997).

2.2 Physical Health Effects

People are exposed through many routes: water supply, contamination of foodstuffs and animal feed, chemical factory and transportation leakages and explosions, trash incineration, contamination from toxic waste sites, and exposure to household chemicals, fertilizers, and pesticides.

Toxic substances have been implicated in diseases of all organ systems. The physical health effects of toxins are not a separate category of symptoms and diseases, but are best understood as forms of poisoning. The disputes over environmental health effects are therefore usually not about the symptoms per se, but about their etiology. Although a few toxins have ‘signature’ diseases (e.g., asbestosis and mesothelioma), most do not. Hence, neither sufferers nor clinicians are likely to attribute individual cases to a toxic exposure. There has also been intense debate on the presence of abnormalities that are not specific diseases, such as chromosome damage, eye blink reflexes, and reproductive abnormalities (Brown and Mikkelsen 1997, Colborne et al. 1996).

2.3 Mental Health Effects

Toxic contamination episodes often leave a residue of fear and anxiety, and case studies show that depression is common. In contrast with natural disaster situations, people have to fight to gain public recognition of the pollution in human-caused disasters. Litigation contributes to the ongoing depression by forcing people to relive their illness experience through the seemingly endless process of depositions, testimony, and consultations with independent experts. During the year after the TMI accident, mothers experienced new episodes of affective disorder at a rate three times higher than a nonexposed control group in another location (Bromet et al. 1982).

Post-traumatic stress disorder (PTSD) has been found in many toxic waste sites. People retained a ‘death imprint’ of memories of the disaster, and felt a strong ‘death anxiety.’ Many experienced ‘death guilt’ concerning what they thought they should have done to prevent a loved one’s death (Lifton and Olson 1976).

Bruce Dohrenwend (1981) compared demoralization (the emotional state of the nonmentally ill general population) of TMI-area residents with the clientele of a community mental health center. With a higher score indicating more disorder, the overall mean score of the mental health center clients was 28.3, for TMI-area women 30, and for TMI-area men 25. Of those interviewed directly after the accident 26 percent showed severe demoralization. Even two years later, TMI residents had more symptoms, poorer task performance, and higher levels of serum catechol-amines (a biochemical marker of stress) than did controls who lived near an undamaged nuclear facility (Baum et al. 1983).

People in contaminated communities often reassess the environment, seeing it as a malevolent force. Even the home may become threatening. Residents lose faith that the world is just, and may even think that they deserve their fate (Edelstein 1988). Victims lose trust in government and in the ordinary operations of the economy and polity, since the established institutions do not help them. This failure precipitates further emotional distress.

2.4 Community-Wide Effects

Contamination episodes harm communities, disrupting ordinary social relations as well as damaging health. Victims suffer loss of community bonds (Erikson 1976), have conflict with local government officials (Levine 1982), develop anxiety about their surroundings (Edelstein 1988), and may argue with other residents over what to do (Couch and Kroll-Smith 1992). Communities facing contamination episodes are often in the midst of ‘chronic technological disasters’ (Couch and Kroll-Smith 1985), long-term, unfolding problems that often haveno visible starting point, but which eat at the social fabric. These ‘invisible environmental contaminants’ are felt by residents as ‘occult,’ mysterious factors (Vyner 1988).

2.5 Social Responsibility

Disease sufferers and their allies target the corporations they hold responsible for contamination episodes. Residents have often expected local, state, and federal government support for their claims. Government failure to support victims’s claims has led to increased mistrust of government. Residents in many contaminated communities have become radicalized in response to the combination of corporate pollution and government inaction (Szasz 1994). Toxic contamination episodes at a local level can have dramatic national effects. The dioxin release at Seveso in Italy led to major conflict in parliament over many issues, from remediation to abortion access for exposed women. In Japan, PCB ( polychlorinated biphenyl) contamination of cooking oil resulted in national-level wrangling, as political parties took up the issue (Reich 1991). In the case of the Chernobyl meltdown in the USSR, there were many international repercussions as radiation passed over borders. Citizen response to toxic contamination has been a major element of popular social movements in the USA, at a time when social movements have otherwise been in decline. This has been less the case in other countries, perhaps because many of them already have powerful Green parties and other similar movements.

3. Issues And Conflicts In The Definition And Measurement Of Environmental Health

3.1 Standards Of Proof

Environmental health effects pose difficult research issues, such as inadequate history of the site, lack of clarity of the route of contaminants, determining appropriate sampling locations, small numbers of cases, getting appropriate control groups, migration in and out of exposed areas, lack of knowledge about the characteristics and effects of certain chemicals, and unknown or varying latency periods for toxins. Epidemiology studies usually have such small numbers of exposed persons that observed rates must often be 20 times that of expected rates in order to attain statistical significance (Neutra 1990). New approaches argue that small effect sizes should not be viewed as obstacles, since even low relative risks are very powerful if large numbers of people are affected. Similarly, consistency across many studies should be acceptable as evidence of etiological linkages, even if not all of those studies meet statistical significance (National Research Council 1991). Ozonoff and Boden (1987) distinguish statistical significance from public health significance, since an increased disease rate may be of great public health significance even if statistical probabilities are not met. They believe that epidemiology should mirror clinical medicine more than laboratory science, by erring on the safe side of false positives. Although it is not always easy to evaluate the effects of removal of a hazard, researchers have produced such findings. In the well-known childhood leukemia cluster in Woburn, Massachusetts (USA), no new cases of leukemia developed after contaminated wells were shut, and birth weights returned to normal at the Love Canal and the Lipari, New Jersey (USA) landfill sites after exposure declined (National Research Council 1991).

Despite the many shortcomings in environmental epidemiology data, reviews of the research show that most controlled studies find associations between hazardous waste sites and human health (National Research Council 1991).

3.2 Other Obstacles To Knowledge On Environmental Health

In medical training, environmental medicine is relegated to a minor position (Institute of Medicine 1988). In one survey of all Massachusetts physicians, those whose practices are located in communities with Superfund sites were no more knowledgeable about environmental health hazards than other physicians (Brown and Kelley 1996). Medical centers and research institutions are not necessarily interested, since environmental health has low prestige and little funding, and can put medical facilities in conflict with local centers of power.

Corporations have fought against recognition of environmental health effects because of the financial cost involved in settlements, fines, production restructuring, and alternative forms of disposal. Government agencies have been reluctant to affirm most relationships between contaminants and disease. One reason is the fear that business will be harmed. Another is that governmental failures to regulate chemicals and other toxic substances are a source of public anger, and governments do not want to be criticized for their shortcomings.

3.3 Lay Involvement

Environmental health has become a major public concern due to dramatic environmental catastrophes such as the contamination at Love Canal, the dioxin exposure at Times Beach the dioxin explosion at Seveso, and the Union Carbide explosion of methyl isocyanate in Bhopal, India. Citizens were often the first to point out problems, and even when they were not, they typically took the lead in studying the situation. Lay-initiated health studies have been central to the development of environmental epidemiology.

However, many epidemiologists and government officials have criticized lay involvement, assuming that it must be biased. An example can be seen in the Woburn toxic waste crisis, where a major health survey was conducted by an alliance of Harvard biostatisticians and Woburn residents. They examined childhood leukemia, pregnancy outcomes, and childhood disorders from 5,010 interviews, covering 57 percent of residences with telephones. The researchers trained 235 volunteers to conduct the survey, taking precautions to avoid bias. Childhood leukemia was found to be significantly associated with exposure to water from two municipal wells. Use of that well water had been associated with perinatal deaths since 1970, eye ear anomalies, and CNS chromosomal oral cleft anomalies. Water exposure was associated with kidney urinary tract and lung respiratory disease. This study would not have been possible without community involvement, yet government agencies and the American Cancer Society charged that the study was biased (Brown and Mikkelsen 1997).

4. New Methods And Measures Needed For Improved Knowledge And Action

Much environmental epidemiology is carried out in crisis situations, using very small samples. More routine monitoring is necessary, such as through regular national health surveys and toxic disease registries. Scholars need to decide what size of geographical area is most useful and must make clear connections between community contexts, environmental variables, and health outcomes. They need to decide what are the best health outcomes, both in terms of data access and in terms of plausible connections to environmental quality. Better environmental measures are needed to avoid the problem of existing data sources that give a wide array of units of measurement for such items as toxic releases, type of releasing facilities, water quality, and air quality. Extracting data from the US EPA is cumbersome, requiring tedious Freedom of Information Act requests and lengthy waits. In the USA it is also important to link cross-state data, since researchers are unable to match exposure in one state with morbidity and mortality in another. Cancer incidence and mortality is not sufficient. Other less serious illness must also be studied.

Scholars need to come up with creative models that study health outcomes in relation to a variety of inputs, including political structure, public participation, access to health services, economic factors, population density, racial ethnic proportions, environmental quality, and access to the natural environment.

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