Evolution of Federalism in Environmental Health: Federal, State, and Local Government Control.

Environmental health sits at the intersection of public health and environmental protection. Governments often confront environmental health concerns through environmental laws. Authority to take actions like passing these laws is determined by federalism, which divides the authority to make laws and policies on various issues between those levels of government. However, tensions often arise when these levels of government attempt to share regulatory authority over environmental issues. Issues of federalism are especially prevalent in environmental health issues, where incidents not only cross state and local borders and affect different levels of government but may also involve both environmental and health agencies. This article describes the history of environmental federalism in the United States through the lens of public health, including how the regulatory structure transitioned from primarily state control to a more centralized federal system of governance. It also describes modern federalism in environmental health, the levels of government involved in environmental health decisions, and the legal authorities that allow these governments to regulate environmental health in the United States. Finally, this article describes the implications of federalism in environmental health.

Some current challenges in research on air pollution and health.

This commentary addresses some of the diverse questions of current interest with regard to the health effects of air pollution, including exposure-response relationships, toxicity of inhaled particles and risks to health, multipollutant mixtures, traffic-related pollution, accountability research, and issues with susceptibility and vulnerability. It considers the challenges posed to researchers as they attempt to provide useful evidence for policy-makers relevant to these issues. This commentary accompanies papers giving the results from the ESCALA project, a multi-city study in Latin America that has an overall goal of providing policy-relevant results. While progress has been made in improving air quality, driven by epidemiological evidence that air pollution is adversely affecting public health, the research questions have become more subtle and challenging as levels of air pollution dropped. More research is still needed, but also novel methods and approaches to address these new questions.

Management of clandestine drug laboratories: need for evidence-based environmental health policies.

Clandestine drug laboratories (CDLs) have been emerging and increasing as a public health problem in Australia, with methamphetamine being the dominant illegally manufactured drug. However, management and remediation of contaminated properties are still limited in terms of regulation and direction, especially in relation to public and environmental health practice. Therefore, this review provides an update on the hazards and health effects associated with CDLs, with a specific look at the management of these labs from an Australian perspective. Particularly, the paper attempts to describe the policy landscape for management of CDLs, and identifies current gaps and how further research may be utilised to advance understanding and management of CDLs and inform public health policies. The paper highlights a significant lack of evidence-based policies and guidelines to guide regulatory authority including environmental health officers in Australia. Only recently, the national Clandestine Drug Laboratory Guidelines were developed to assist relevant authority and specialists manage and carry out investigations and remediation of contaminated sites. However, only three states have developed state-based guidelines, some of which are inadequate to meet environmental health requirements. The review recommends well-needed inter-sectoral collaborations and further research to provide an evidence base for the development of robust policies and standard operating procedures for safe and effective environmental health management and remediation of CDLs.

[Citizens' veillance on environmental health through ICT and Genomics]. / La vigilanza dei cittadini sulla salute ambientale tra tecnologie digitali e genomica.

In the last decade three different phenomena have merged: the widespread use of ICT devices to collect and potentially share personal and scientific data, and to build networked communities; biobanking for genomics, namely the organized storage of human biological samples and information; and the collaboration between scientists and citizens in creating knowledge, namely peer-production of knowledge, for shared social goals. These different forms of knowledge, technical tools, and skills have merged in community based scientific and social, as well as legal, initiatives, where scientists and citizens use genetic information and ICT as powerful ways to gain more control over their health and the environment. These activities can no longer be simply qualified as epidemiological research and surveillance. Instead, they can be framed as new forms of citizens' participatory "veillance:" an attitude of cognitive proactive alertness towards the protection of common goods. This paper illustrates two Italian case-studies where citizens and scientists, by making use of both ICT and biobanking, have joined with the goal of protecting environmental health in highly polluted contexts. The statute of these initiatives still needs to be defined as to both the validity of the underlying citizen science and the lack of adequate legal tools for structuring them. However, as to their scientific quality and use of sophisticated technologies, these activities cannot be compared to previous experiences, such as those inspired by so-called popular epidemiology. Moreover, the deep awareness towards the data to be transparent, reliable, and accessible, as well as towards funding mechanisms to be crowdsourced, allows these experiences to go beyond the mere confrontation with institutional knowledge, and to represent a potential model for knowledge production for institutional implementation.

Bridging research and environmental regulatory processes: the role of knowledge brokers.

Federal funding agencies increasingly require research investigators to ensure that federally sponsored research demonstrates broader societal impact. Specifically, the National Institutes of Environmental Health Sciences (NIEHS) Superfund Research Program (SRP) requires research centers to include research translation and community engagement cores to achieve broader impacts, with special emphasis on improving environmental health policies through better scientific understanding. This paper draws on theoretical insights from the social sciences to show how incorporating knowledge brokers in research centers can facilitate translation of scientific expertise to influence regulatory processes and thus promote public health. Knowledge brokers connect academic researchers with decision-makers, to facilitate the translation of research findings into policies and programs. In this article, we describe the stages of the regulatory process and highlight the role of the knowledge broker and scientific expert at each stage. We illustrate the cooperation of knowledge brokers, scientific experts and policymakers using a case from the Brown University (Brown) SRP. We show how the Brown SRP incorporated knowledge brokers to engage scientific experts with regulatory officials around the emerging public health problem of vapor intrusion (VI). In the Brown SRP, the knowledge broker brought regulatory officials into the research process, to help scientific experts understand the critical nature of this emerging public health threat, and helped scientific experts develop a research agenda that would inform the development of timely measures to protect public health. Our experience shows that knowledge brokers can enhance the impact of environmental research on public health by connecting policy decision-makers with scientific experts at critical points throughout the regulatory process.

2013 environmental health legislation.

The NEHA Government Affairs program has a long and productive association with the National Conference of State Legislatures (NCSL). The organizations have worked together on any number of legislative and policy areas that directly impact the environmental health profession. One of the keys to the successes of the NEHA/NCSL collaboration has been the recognition of the fact that often some of the most significant legislation and policy initiatives related to environmental public health occur in state legislatures. The states have, in a very real sense, been the innovators in developing new programs and practices. In recognition of this fact, we have asked NCSL to provide occasional overviews of state environmental public health legislative activity, covering topics that are of the most pressing public concern. Doug Farquhar, program director for NCSI's Environmental Health Program, has worked with NCSL since 1990. Mr. Farquhar directs development, management, and research for the Environmental Health Program. These projects encompass consultation and policy analysis of state and federal policies and statutes, regulations, and programs regarding environmental and related topics for state legislatures and administrative programs. Amy Ellis is a law clerk for NCSL within the Environment, Energy, and Transportation Group. As a law clerk she has researched a wide variety of environmental health policies. She is expected to obtain her JD from the University of Colorado Law School in 2015.

[Greenstones mining is a risk for public health?]. / L'estrazione di pietre verdi è un rischio per la salute pubblica?

This article refers to the decision 3195/2012 issued by the State Administrative Council which maintains that operating in a greenstone quarry with consequent extraction and grinding of asbestos containing minerals can cause unacceptable risks to the public health. Therefore, the refusal to authorize the emissions into the atmosphere is highly justified, if properly motivated. The judgment states that the emission of the asbestos fibres into the atmosphere should be assessed from the health standpoint, and not just from the environmental one. Moreover, making reference only to the «release index¼ is not sufficient nor determining. The decision acknowledges the soundness of the criteria used by Local Health Unit of Chiavarese (Liguria, Northen Italy) in evaluating the danger caused to the human health and appreciates the reference made to the EU regulations on precaution and prevention, that state that well-grounded reasons are needed to postulate harmful consequences for the human health and the environment. This implies that the detailed data presented by the Local Health Unit can be considered «well-grounded reasons¼.

Management of healthcare waste: developments in Southeast Asia in the twenty-first century.

In many Southeast Asian countries, significant challenges persist with regard to the proper management and disposal of healthcare waste. The amount of healthcare waste in these countries is continuously increasing as a result of the expansion of healthcare systems and services. In the past, healthcare waste, if it was treated at all, was mainly incinerated. In the last decade more comprehensive waste management systems were developed for Southeast Asian countries and implementation started. This also included the establishment of alternative healthcare waste treatment systems. The developments in the lower-middle-income countries are of special interest, as major investments are planned. Based upon sample projects, a short overview of the current development trends in the healthcare waste sector in Laos, Indonesia and Vietnam is provided. The projects presented include: (i) Lao Peoples Democratic Republic (development of the national environmental health training system to support the introduction of environmental health standards and improvement of healthcare waste treatment in seven main hospitals by introducing steam-based treatment technologies); (ii) Indonesia (development of a provincial-level healthcare waste-management strategy for Province Nanggroe Aceh Darussalam (NAD) and introduction of an advanced waste treatment system in a tertiary level hospital in Makassar); and (iii) Vietnam (development of a healthcare waste strategy for five provinces in Vietnam and a World Bank-financed project on healthcare waste in Vietnam).

[Sociology of health, social ecology and media democracy]. / Egészségszociológia, szociális ökológia, médiademokrácia.

The correlation of the sociology of health, social ecology and media democracy is demonstrated in the study. In societies of today, the role of the media is unquestionable in disseminating information relating to health and the environment. According to Paragraph (1) of Article XXI of the Hungarian Constitution of 2011, everyone has the right to a healthy environment. An environmentalist media democracy may forward environmental justice, environmental education, and environmentalist economy, etc. All these are required in order to establish a society where the healthy environment is an objective value.

Precautionary principle and normativity: brief remarks on the complex relationship between law and the risks.

The precautionary principle is objet of an intense discussion in different legal orders. It is easy to understand the reason why: the regulation of risks challenges the legal thought. The positivist approach has shown its limits. It is now important to ask ourselves about the way in which we can deal with uncertainty effectively. The task is difficult, but we can point out two different aspects. Firstly, it is important to understand the complexity of the technological risks in a transdisciplinary way. This is an unavoidable step in evaluating the ability of the law to prevent them. Secondly, the precautionary principle presupposes a pluralistic conception of nature in which the economic sphere can be seen as a tool to express the relationship between man and nature.

[Correlation between legal protection of the environment and health]. / Correlazione tra tutela giuridica dell'ambiente e della salute.

Health promotion is a priority of our time and planning and the evaluation of health and hygiene should be directed towards strategies to improve the well-being and lifestyles of the community. At the legislative level in Italy, the Ministry of Health, was established in 1958 with the task of providing for the collective health of the whole nation and in 1978, with Law 833, the National Health Service (NHS) was created which secured assistance and healthcare to all Italian citizens. The most important component of the entire health system is the Local Health Unit (USL) which has responsibility for prevention, treatment and rehabilitation, and highlights the importance of safeguarding the health, hygiene and safely at home and at work and the "hygiene of urban settlements and communities", ie environmental protection. One of the reasons for the delays in the promotion of environmental protection initiatives in Italy is to be found in the referendums of 1993, including the one which removed the tasks regarding environmental controls from the NHS. The temporary skills gap in the environmental field was filled with the 'National Agency for Environmental Protection (ANPA), which later became the Agency for Environmental Protection and Technical Services (APAT), and the regional level, the Regional Agencies Environmental Protection Agency (ARPA). Law 61/21 January 1994 joined the ARPA to the National Institute for Environmental Research and Protection (ISPRA). It is now necessary to implement a program that takes account of the damage caused to the environment and consequently the individual, which is totally committed the combination of the environment and human health and not, as in the recent past, as two distinct entities. In this sense, it is of fundamental importance the role of prevention departments to promote the organization networking and of individual companies' and individuals' skills, in fact. The integration of planning processes, environmental monitoring intiatives and health planning are an inescapable element necessary to produce positive effects on public health.

[The role of Health Impact Assessment (HIA) in the decision-making]. / La valutazione di impatto sanitario (VIS) nei processi decisionali.

The review describes the evolution of the environmental policies in Italy underlying current delays and discords between the environment and its effects on human health. It also tries to define the major barriers to the introduction of the health impact assessment (HIA) in government policy-making process in Italy; the lack of regulations and the lack of methods to perform an HIA are the main reasons for its limited use. Epidemiology is a fundamental tool to produce effective health impact assessments along with a deep knowledge of medicine, environmental hygiene and risk communication. In conclusion, should the Italian scientific community agreed on a common and constructive approach avoiding possible exploitations and conflicts of interest, HIA could be a valuable method for helping to develop environmental policies and assisting policy-makers in important decisions.