Environment-related Health Problems Research Articles

Urinary metabolic modulation in human participants residing in Siachen: a 1H NMR metabolomics approach

The main physiological challenge in high altitude environment is hypoxia which affects the aerobic metabolism reducing the energy supply. These changes may further progress toward extreme environment-related diseases. These are further reflected in changes in small molecular weight metabolites and metabolic pathways. In the present study, metabolic changes due to chronic environmental hypoxia were assessed using 1H NMR metabolomics by analysing the urinary metabolic profile of 70 people at sea level and 40 people at Siachen camp (3700 m) for 1 year. Multivariate statistical analysis was carried out, and PLSDA detected 15 metabolites based on VIP score > 1. ROC analysis detected cis-aconitate, Nicotinamide Mononucleotide, Tyrosine, Choline and Creatinine metabolites with a high range of sensitivity and specificity. Pathway analysis revealed 16 pathways impact > 0.05, and phenylalanine tyrosine and tryptophan biosynthesis was the most prominent altered pathway indicating metabolic remodelling to meet the energy requirements. TCA cycle, Glycine serine and Threonine metabolism, Glutathione metabolism and Cysteine alterations were other metabolic pathways affected during long-term high-altitude hypoxia exposure. Present findings will help unlock a new dimension for the potential application of NMR metabolomics to address extreme environment-related health problems, early detection and developing strategies to combat high altitude hypoxia.

Environment and Health Research in China: The State of the Field

AbstractIn the context of this symposium, this article reviews social science research in the emerging field of environment and health in China, with a particular focus on the impacts of pollution. It begins with a discussion of the particular nature of China's environment-related health problems, distinguishing the different challenges presented by diseases of poverty, affluence and transition. It then reviews recent developments in policy and civil society with regard to environment and health, and the extent to which work in the social sciences has advanced our knowledge of these and of state–society interactions. The article concludes with some reflections on the need for and challenges of interdisciplinary and international collaboration in this area.

China's Rural Health System and Environment-Related Health Risks

This paper presents a chronology of the development of the Chinese rural health system and its responses to environment-related health problems. During the early years of the People's Republic, the health system was very successful in reducing the transmission of infectious diseases through environmental improvements. Since the transition to a market economy, environment-related preventive programmes have been given less priority and a variety of new environment-related health problems and risks have emerged. More recently, the Chinese government has made strong commitments to improve the performance of the health system and increase access by all. Its focus has been on strengthening medical care and developing new forms of health finance. It has paid little attention to environment-related problems. However, as the pace of health reform accelerates, it will be important to ensure that it take environment-related problems into account.

Aufgaben des ÖGD im Rahmen der Umweltmedizin

In 1999, the Special Committee for Environmental Medicine affiliated to the Federal Association of Doctors in the German public health service, prepared a consensus paper on the latter's request entitled "Environmental medicine in the public health service -- a social role and its consequences: propositions with regard to the situation, aims, strategies, and opportunities for action". The propositions provide guidelines to public health departments for implementing the "Environment and Health" action programme launched by the Federal Ministry of Environmental Protection and the Federal Ministry of Health. Joint action by health and environmental authorities on the municipal, state and federal levels is considered essential. Furthermore, the comprehensive knowledge and expertise available within the public health service, including its in-depth knowledge of local and regional environmental pollution, should be further utilized in order to clarify cause and effect relationships and to initiate necessary action for minimizing any imminent risks. Environment-related public health protection is one of the major responsibilities of the public health departments within their general responsibility to provide public health care and ensure disease prevention. Doctors in private practices specializing in environmental medicine and public health departments' counselling centres for environmental medicine work closely together in terms of patient care and citizens' counselling in order to identify potential causes of environment-related health problems in the population. They issue recommendations on how to live a healthy life. Furthermore, they utilize available data and information for health policy directions. In this regard, health and environmental findings provide an important basis for an appropriate response to current developments based on the correct assessment of a particular situation, and for raising public awareness of preventive measures.

Are environmental medicine problems relevant in Switzerland?

In Switzerland, the prevalence of health problems attributed to environmental exposures is unknown, and views differ regarding its magnitude. In the present study we investigated the frequency of environmentally related health problems amongst the patients of Swiss sentinel physicians and assessed symptoms and suspected environmental exposures. During 2002, nearly 250 "Swiss Sentinel Surveillance Network" physicians were asked to record the number of patients presenting with environmental health problems and to complete a questionnaire inquiring about suspected environmental exposures and health problems. Physicians offering "alternative" medical therapies also participated in the study. The results were compared with the experience of a Basel University pilot project which evaluated patients with environment-related health problems simultaneously from the medical, psychiatric and environmental viewpoint. 354 environment-related consultations were reported by 72 physicians, corresponding to 0.03% of all sentinel-physician consultations. There were considerable differences both within the group of Sentinella physicians, and between physicians offering "alternative" medical therapies and the Sentinella physicians, in the frequency of environmentally-related consultations, the character of the reported symptoms and the suspected environmental exposures. Overall, environmental medicine consultations in general practice were rare. However, experience of the environmental medicine pilot project showed that concerned persons seek help from various health care providers and from environmental agencies. Effective treatment should include counselling by medical, psychiatric and environmental professionals.

Are environmental medicine problems relevant in Switzerland?

In Switzerland, the prevalence of health problems attributed to environmental exposures is unknown, and views differ regarding its magnitude. In the present study we investigated the frequency of environmentally related health problems amongst the patients of Swiss sentinel physicians and assessed symptoms and suspected environmental exposures. During 2002, nearly 250 "Swiss Sentinel Surveillance Network" physicians were asked to record the number of patients presenting with environmental health problems and to complete a questionnaire inquiring about suspected environmental exposures and health problems. Physicians offering "alternative" medical therapies also participated in the study. The results were compared with the experience of a Basel University pilot project which evaluated patients with environment-related health problems simultaneously from the medical, psychiatric and environmental viewpoint. 354 environment-related consultations were reported by 72 physicians, corresponding to 0.03% of all sentinel-physician consultations. There were considerable differences both within the group of Sentinella physicians, and between physicians offering "alternative" medical therapies and the Sentinella physicians, in the frequency of environmentally-related consultations, the character of the reported symptoms and the suspected environmental exposures. Overall, environmental medicine consultations in general practice were rare. However, experience of the environmental medicine pilot project showed that concerned persons seek help from various health care providers and from environmental agencies. Effective treatment should include counselling by medical, psychiatric and environmental professionals.

Monitoring air quality in Healthy People 2000.

The quality of the environment has historically played a significant role in public health (1). One of the early successes of public health involved limiting access to a contaminated water supply (1). While focusing on the environment is an obvious and sometimes successful approach to improving public health, the scope of such efforts is complex (2). This complexity is reflected in measurement of the levels of pollutants in the environment, the levels of individual exposure to these pollutants, individual susceptibility to the pollutants’ toxic effects and the health effects attributable to the pollutants versus other influences. Measurement of pollution levels is complicated by the diverse sources of pollution and the varied media of pollution migration and exposure (e.g., air, water). Lengthy time periods may be required to accurately monitor pollution levels; similarly, some environment-related health problems (e.g., some forms of cancer) may also require considerable time to develop before they are detected (3). Measurement of pollution levels is also related to physical characteristics of the environment (e.g., temperature, wind). While location may be a proxy measure for individual exposure to specific pollutants, its utility is somewhat compromised by individual behavior which may mitigate exposure to specific media. For example, an individual who spends a great deal of time indoors may be less affected by ambient air quality, but more susceptible to the effects of tobacco smoke or fungi. Similarly, individual susceptibility to the effects of pollutants may be affected by both genetic characteristics and/or health promotion/health care utilization. Data to monitor both individual exposure and susceptibility are not readily available for large area monitoring. Finally, attributing health effects to specific pollutants is complicated by both the previously described factors affecting measurement and also the impact of non-environmental causes of the same health effects (e.g., smoking, dieting). In chapter 11 (Environmental Health) of Healthy People 2000 there are 16 objectives related to a wide range of environment-related public health problems. The objectives measure progress in health status, risk reduction, and services and protection related to these problems at the national level. Some of the measurement issues in the preceding paragraphs affect the monitoring of these objectives. This report focuses on one of these objectives (11.5 ambient air quality), which poses special problems in measurement and interpretation. The report presents background information on the environmental problems associated with the objective, including the health risks, the source (s) of the problem, and the media of transmission. It also discusses how Healthy People 2000 monitors the objective, the data source used, issues related to the data source, and the interpretation of the data. The authors wish to acknowledge the technical consultation of Tom Curran and Barbara Parzygnat of U.S. EPA’s Office of Air Quality Planning and Standards. Number 9 September 1995