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A world focused on the threat of a pandemic has not paid attention to an even greater threat that is upon us – one no longer looming in the far distance but arriving in strength and crashing on top...

The traditional way of teaching environmental health is to concentrate on the hazard: how toxic or dangerous is it, what is the risk, who is most susceptible, who is most vulnerable, where does it ...

Environmental health is where public health began, in the middle of the nineteenth century in Europe. The core model of environmental health, what distinguishes it, has been the “source-exposure-re...

The relationship between scientific freedom and human rights is as deep on the side of science as it is on the side of human rights. On the one hand, issues of the application of science and techno...

The environmental health sciences, including occupational health, are front and center in the current battle for respect of science. Partly because of the policy implications of environmental resea...

Anyone reading this journal or following the world literature knows perfectly well that environmental health is a global concern, because pollution and ecosystem change know no boundaries. However,...

In environmental and occupational health we are accustomed to thinking about target organs for toxic exposures. We are concerned with effects on the lungs, kidney, and liver. We seldom think of the...

A political development in the United States, the Green New Deal,1 unexpectedly opens new possibilities for environmental and occupational health research. Far from being an “unserious” partisan po...

On April 22, 2017, over 100,000 scientists, engineers, students, and people concerned for the scientific enterprise marched in mass demonstrations in major cities and more than a few small towns an...

We who have made our careers in environmental and occupational health are proud of the progress we have made in managing difficult problems and understanding complexity and interdependent relations...

When it comes to the city of science, we who work in environmental and occupational health live in a bad neighborhood. We are often at the center of controversial issues and in the crossfire of com...

Distrust of science is an ascendant trend of our times. No, after years of being an obstacle to environmental improvement and health protection has suddenly become a possibly existential threat by ...

(2008). The Peer-Review Process and Its Relationship With Environmental and Occupational Health. Archives of Environmental & Occupational Health: Vol. 63, No. 1, pp. 3-7.

Background Although stainless steel has been produced for more than a hundred years, exposure-related mortality data for production workers are limited. Aims To describe cause-specific mortality in Finnish ferrochromium and stainless steel workers. Methods We studied Finnish stainless steel production chain workers employed between 1967 and 2004, from chromite mining to cold rolling of stainless steel, divided into sub-cohorts by production units with specific exposure patterns. We obtained causes of death for the years 1971–2012 from Statistics Finland. We calculated standardized mortality ratios (SMRs) as ratios of observed and expected numbers of deaths based on population mortality rates of the same region. Results Among 8088 workers studied, overall mortality was significantly decreased (SMR 0.77; 95% confidence interval [CI] 0.70–0.84), largely due to low mortality from diseases of the circulatory system (SMR 0.71; 95% CI 0.61–0.81). In chromite mine, stainless steel melting shop and metallurgical laboratory workers, the SMR for circulatory disease was below 0.4 (SMR 0.33; 95% CI 0.07–0.95, SMR 0.22; 95% CI 0.05–0.65 and SMR 0.16; 95% CI 0.00–0.90, respectively). Mortality from accidents (SMR 0.84; 95% CI 0.67–1.04) and suicides (SMR 0.72; 95% CI 0.56–0.91) was also lower than in the reference population. Conclusions Working in the Finnish ferrochromium and stainless steel industry appears not to be associated with increased mortality.

Building Health Sciences, Inc. (BHS), investigated environmental conditions by many modalities in 71 discreet areas of 12 buildings in a government building complex that had experienced persistent occupant complaints despite correction of deficiencies following a prior survey. An online health survey was completed by 7,637 building occupants (49% response rate), a subset of whom voluntarily wore personal sampling apparatus and underwent medical evaluation. Building environmental measures were within current standards and guidelines, with few outliers. Four environmental factors were consistently associated with group-level building-related health complaints: physical comfort/discomfort, odor, job stress, and glare. Several other factors were frequently commented on by participants, including cleanliness, renovation and construction activities, and noise. Low relative humidity was significantly associated with lower respiratory and "sick building syndrome"-type symptoms. No other environmental conditions (including formaldehyde, PM10 [particulate matter with an aerodynamic diameter

Background Polyvinyl chloride plastics (PVC), made flexible through the addition of di-2-ethylhexyl phthalate (DEHP), are used in the production of a wide array of medical devices. From the late 1960s, leaching of DEHP from PVC medical devices and ultimate tissue deposition have been documented. Methods A critical review of DEHP exposure, metabolism, and toxicity data from human and animals studies was undertaken. A brief analysis of alternatives to DEHP-plasticized PVC for use in medical device manufacture was completed. Results DEHP leaches in varying concentrations into solutions stored in PVC medical devices. Certain populations, including dialysis patients and hemophiliacs may have long-term exposures to clinically important doses of DEHP, while others, such as neonates and the developing fetus, may have exposures at critical points in development. In vivo and in vitro research links DEHP or its metabolites to a range of adverse effects in the liver, reproductive tract, kidneys, lungs, and heart. Developing animals are particularly susceptible to effects on the reproductive system. Some adverse effects in animal studies occur at levels of exposure experienced by patients in certain clinical settings. DEHP appears to pose a relatively low risk of hepatic cancer in humans. However, given lingering uncertainties about the relevance of the mechanism of action of carcinogenic effects in rodents for humans and interindividual variability, the possibility of DEHP-related carcinogenic responses in humans cannot be ruled out. Conclusions The observed toxicity of DEHP and availability of alternatives to many DEHP-containing PVC medical devices presents a compelling argument for moving assertively, but carefully, to the substitution of other materials for PVC in medical devices. The substitution of other materials for PVC would have an added worker and community health benefit of reducing population exposures to DEHP, reducing the creation of dioxin from PVC production and disposal, and reducing risks from vinyl chloride monomer exposure. Am. J. Ind. Med. 39:100–111, 2001. © 2001 Wiley-Liss, Inc.

Acute exposure to hydrogen sulfide (H2S) causes 4 dose-dependent responses: hyperpnea, unconsciousness or knockdown, apnea, and death. At present, scientific mechanisms for these effects are unknown, but inhibition of cytochrome oxidase in the central nervous system (CNS) by sulfide has been suggested. In this study, the premise of brain as target is examined by comparing peripheral with direct delivery of sulfide to brain. NaHS was administered to anesthetized Sprague-Dawley male rats, by femoral intravenous, or carotid intra-arterial injection. With apnea as the test, ED100 values of 0.6 and 3.0 mg kg(-1) were found for peripheral and direct delivery to brain, respectively. Peripheral delivery is 5 times as effective as direct delivery to the brain, and greater if the relative dilution factors are considered. Lidocaine, applied to the vagus, prevented apnea, so lung-brain transmission was essential. It was therefore concluded that the lung is the peripheral site of action. Hyperpnea increased in duration with dose. The carotid body, located distal to the arterial catheter, sensed the high doses of NaHS but did not trigger apnea. Intravenous infusion or intraperitoneal injection with NaHCO3 prevented hyperpnea, apnea, and death. The following conclusions are drawn: the carotid body is not implicated in NaHS-induced apnea, the lung and not brain harbors the primary site of action of H2S, and an afferent neural signal from the lung via the vagus induces the apnea. Finally, NaHCO3 appears to prevent toxicity from sulfide, and therefore H2S, by some unexplained mechanism. Practical emergency treatment for acute toxicity in the field may be possible.

Trace element profile analysis detects and quantifies the presence of several metals simultaneously at low concentrations in the body. In occupational medicine, it may be used to monitor exposure or to evaluate suspected toxicity. Clinical interpretation is often difficult because, with the exception of lead and possibly cadmium, there is little firm information on toxicity thresholds. For these tests, the reference ranges typically reflect low levels of exposure in the general population and it is expected that workers handling metals in occupations such as welding and industries such as steelmaking will have higher levels. Interpretation requires some knowledge of the toxicokinetics of the metal of interest and the preferred medium for analysis for each: serum, whole blood or urine (preferably 24-hour collection). Trends are often more informative than concentrations at one time. Trace element values are reported together with a reference range which must be distinguished from the normal range of other clinical tests. As a practical matter, the greatest interpretation problems tend to be found with manganese because serum levels have a poor correlation with both recent exposure and neurological symptoms. Molybdenum and vanadium are often found to be elevated among workers exposed to metals who show no evidence of clinical illness. Interpretation of the trace element profile analysis overall when an elevation occurs generally requires close attention to the pattern of elevation, clinical context, absolute and relative magnitude of the elevation and knowledge of the exposure history.

(2005). When a Journal Cannot Stand Behind a Published Paper. Archives of Environmental & Occupational Health: Vol. 60, No. 3, pp. 115-117.

Reproductive hazards make many employers uncomfortable. They raise issues of equity and responsibility beyond worker health protection. Fear of liability for adverse birth outcomes, such as miscarr...

The US Centers for Disease Control and Prevention (CDC) recently announced a change that is not really a change but a change in point of view, accompanied by a new number with the same significance...

Asbestos is a significant occupational carcinogen; it is responsible for a global epidemic of lung cancer and mesothelioma, and other cancers as well, as well as smaller epidemics of nonmalignant r...

The literature specific to respiratory disorders associated with firefighting is expanding with the appearance of new longitudinal studies of responders to the World Trade Center (WTC) tragedy, whi...

In 1848, railroad foreman Phineas Gage was 25 years old, energetic, and modest in demeanor despite being very handsome. On 13 September, at 4:30 pm, while working on construction of a railbed near ...

Those of us who practice occupational and environmental medicine (OEM) have a special set of challenges to contend with. Our patients know that this field is underrepresented and that most physicia...

Decisions are not made on the basis of knowledge and scientific evidence. At best, they rest on values and at worst they rest on personal aggrandizement, petty politics, and coercion. We would like...

Panels convened to review evidence on an issue often (perhaps, usually) face the problem of what to do and what to say when the body of evidence is deemed insufficient. That may seem obvious to any...

Communication among fellow scientists, through the invention of journals and scientific societies, was the foundation of the creation of modern science. Not only did it allow for the dissemination ...

Hydrogen sulfide is a relatively common, frequently lethal, and unique occupational hazard for which research since 1990 has uncovered many anomalies and subtleties and a previously unsuspected physiological role for the endogenous agent. The result has been uncertainty and misunderstanding, particularly for persons new to the literature. This review addresses evidence that settles past controversies, guides practical issues in evaluating human toxicity, addresses unresolved issues involving chronic exposure, and points the way to a deeper understanding of the agent and its effects.

Sawmills in the Canadian province of Alberta were surveyed in order to identify occupations at greatest risk and to guide compliance measures. Two hundred and ten wood dust samples (inhalable) were collected from nine Alberta sawmills using Institute of Occupational Medicine (IOM) personal samplers. Nine percent of samples exceeded 5 mg/m3 8-hour time-weighted average (TWA) for total dust. There was a significant statistical difference (p < .001) between the median and geometric mean inhalable particulate matter (IPM) dust levels for 4 aggregated occupational groups. Levels were highest for cleanup workers (3.5 mg/m3), followed by the maintenance, planermill, and sawmill occupational groups, as were other measures of dust levels. In response to these findings, the Alberta Forest Products Association undertook a program to train sawmill managers to implement these recommendations on engineering controls, administrative controls, and personal protective equipment.

(2009). Chairing a Session at a Scientific Meeting. Archives of Environmental & Occupational Health: Vol. 64, No. 2, pp. 141-144.