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Environmental health decision making can be a complex undertaking,
as there is the need to navigate and find balance among three core
elements: science, policy, and the needs of the American public.
Policy makers often grapple with how to make appropriate decisions
when the research is uncertain. The challenge for the policy maker
is to make the right decision with the best available data in a
transparent process. The Environmental Health Sciences Decision
Making workshop, the first in a series, was convened to inform the
Roundtable on Environmental Health Sciences, Research, and Medicine
on emerging issues in risk management, "weight of evidence," and
ethics that influence environmental health decision making. The
workshop, summarized in this volume, included an overview of the
principles underlying decision making, the role of evidence and
challenges for vulnerable populations, and ethical issues of
conflict of interest, scientific integrity, and transparency. The
workshop engaged science interest groups, industry, government, and
the academic sector.
Natural gas extraction from shale formations, which includes
hydraulic fracturing, is increasingly in the news as the use of
extraction technologies has expanded, rural communities have been
transformed seemingly overnight, public awareness has increased,
and regulations have been developed. The governmental public health
system, which retains primary responsibility for health, was not an
early participant in discussions about shale gas extraction; thus
public health is lacking critical information about environmental
health impacts of these technologies and is limited in its ability
to address concerns raised by regulators at the federal and state
levels, communities, and workers employed in the shale gas
extraction industry. Health Impact Assessment of Shale Gas
Extraction is the summary of a workshop convened in 2012 by the
Institute of Medicine (IOM) Roundtable on Environmental Health
Sciences, Research, and Medicine to discuss the human health impact
of shale gas extraction through the lens of a health impact
assessment. Eminent scientists, physicians, public health experts,
and representatives from government agencies at federal and state
levels, from nongovernment organizations, from the business sector,
and from interest groups representing the interests of the citizens
met to exchange ideas and to inform on hydraulic fracturing as a
means of extraction of natural gas. This report examines the state
of the science regarding shale gas extraction, the direct and
indirect environmental health impacts of shale gas extraction, and
the use of health impact assessment as a tool that can help
decision makers identify the public health consequences of shale
gas extraction. Table of Contents Front Matter 1 Introduction 2
Opening Session 3 Geographic Footprint of Shale Gas Extraction 4
Occupational Health and Community Impacts 5 Air Quality 6 Water
Quality 7 Sustainable Energy 8 Research Opportunities: Research
Community 9 Research Opportunities: Federal Representatives
Appendix A: Agenda Appendix B: Speaker Biosketches Appendix C:
Acronyms
The issues surrounding water services are some of the most critical
challenges facing not only the United States, but also the global
community today. The Roundtable on Environmental Health Sciences,
Research, and Medicine of the Institute of Medicine convened a
workshop in October 2007, summarized in this volume, to address
objectives related to Sustainable Water, Sanitation, and Hygiene
Services. One of the objectives of the workshop was to think about
the interdependence of environmental health and human health as
connected through water. Organizations cannot discuss water without
considering the interrelationship of sanitation and hygiene. It is
the convergence of these strategies that promotes healthy outcomes
for both individuals and the environment. A second objective of the
workshop was to consider how planning, management, and
interdisciplinary approaches-including technology, social
behavioral issues, gender, health, environment, economic, and
political aspects-can be integrated to arrive at sustainable
solutions. Many organizations and agencies are trying to forge a
path toward sustainable practices in water, but the various sectors
utilizing and governing water services are not interconnected. More
integration and a greater understanding of holistic approaches are
needed. Table of Contents Front Matter 1 Workshop Introduction 2
Global Water Services: Short- and Long-Range Views 3 The Technology
Pillar of Sustainable Water: Technology, Economics, and Health 4
Panel Discussion: Coordination and Prioritization of Water Needs 5
Achieving Water and Sanitation Services for Health in Developing
Countries 6 The Environmental Pillar of Sustainable Water:
Ecological Services 7 The Social Pillar of Sustainable Water:
Health Research Gaps 8 Panel Discussion: Moving Forward 9 Thinking
About New Visions of Water Services 10 Breakout Group: Meeting
Goals for Water, Sanitation, and Hygiene References Appendix A:
Workshop Agenda Appendix B: Speakers and Panelists Appendix C:
Workshop Participants
Throughout much of its history, the United States was predominantly
a rural society. The need to provide sustenance resulted in many
people settling in areas where food could be raised for their
families. Over the past century, however, a quiet shift from a
rural to an urban society occurred, such that by 1920, for the
first time, more members of our society lived in urban regions than
in rural ones. This was made possible by changing agricultural
practices. No longer must individuals raise their own food, and the
number of person-hours and acreage required to produce food has
steadily been decreasing because of technological advances,
according to Roundtable member James Merchant of the University of
Iowa. The Institute of Medicine's Roundtable on Environmental
Health Science, Research, and Medicine held a regional workshop at
the University of Iowa on November 29 and 30, 2004, to look at
rural environmental health issues. Iowa, with its expanse of rural
land area, growing agribusiness, aging population, and increasing
immigrant population, provided an opportunity to explore
environmental health in a region of the country that is not as
densely populated. As many workshop participants agreed, the
shifting agricultural practices as the country progresses from
family operations to large-scale corporate farms will have impacts
on environmental health. This report describes and summarizes the
participants' presentations to the Roundtable members and the
discussions that the members had with the presenters and
participants at the workshop. Table of Contents FrontMatter Summary
Introduction 1 Environmental Health in Rural America 2 The Social
Environment in Rural America 3 The Role of the Natural Environment
in Rural America 4 The Built Environment and Health in Rural Areas
References A Workshop Agenda B Speakers and Panelists C Meeting
Participants
The Roundtable on Environmental Health Sciences, Research, and
Medicine wanted to address the link between environmental factors
and the development of cancer in light of recent advances in
genomics. They asked what research tools are needed, how new
scientific information can be applied in a timely manner to reduce
the burden of cancer, and how this can be flexible enough to treat
the individual. Table of Contents Front Matter Summary 1. Charge to
Participants and Workshop Objectives 2. Keynote Addresses 3. The
Links between Environmental Factors, Genetics, and the Development
of Cancer 4. Gene-Environment Interaction in Special Populations 5.
Gene-Environment Interaction in Site-specific Cancers 6. Special
Address: A Novel Approach to Cancer Treatment Based on Immune
Stimulations and Other Environmental Approaches 7. Cancer and the
Environment: A View from the Hill 8. Moving Forward Abstracts of
Talks References Appendix A Glossary Appendix B Workshop Agenda
Appendix C Speakers and Panelists Appendix D Workshop Participants
Biological threats like SARS and natural disasters like the tsunami
in Indonesia have devastated entire regions, and quickly exhausted
budgetary resources. As the field of environmental health continues
to evolve, scientists and others must focus on gaining a better
understanding of the links between human health and various
environmental factors, and on creating new paradigms and
partnerships needed to address these complex environmental health
challenges facing society. Global Environmental Health in the 21st
Century: From Governmental Regulations to Corporate Social
Responsibility: Workshop Summary discusses the role of industry in
environmental health, examines programs designed to improve the
overall state of environmental health, and explores how
governmental and corporate entities can collaborate to manage this
industry. Stakeholders in both the public and private sectors are
looking for viable solutions as the complexity of societal problems
and risks associated with management and varying regulatory
standards continue to increase. Global Environmental Health in the
21st Century draws critical links and provides insight into the
current shape of global environmental health. The book recommends
expanding environmental management systems (EMS) to encompass a
more extensive global network. It also provides a complete
assessment of the benefits and costs resulting from implementation
of various environmental management systems. Table of Contents
Front Matter Summary Introduction 1 Tools for Monitoring
Environmental Health 2 Moving Beyond Compliance: Can Industry Get
Ahead of the Curve? 3 Global Implication of Environmental Standards
4 Improving Community Health Globally 5 Corporate Social
Responsibility 6 Panel Discussion References Appendix A Workshop
Agenda Appendix B Speakers and Panelists Appendix C Workshop
Participants
This is a summary of the workshop Rebuilding the Unity of Health
and the Environment: A New Vision of Environmental Health for the
21st Century. The goal of this workshop was to emphasize the
connection between human health and the natural, built, and social
environments. This workshop integrated talks from many fields and
created a dialogue among various environmental health stakeholders.
The language presented in this respect should not be viewed as an
endorsement by the Environmental Health Sciences Roundtable or the
Institute of Medicine of what action is needed for the future, but
rather as an effort to synthesize the various perspectives
presented. Table of Contents Front Matter Summary 1 Introduction 2
Keynote Address 3 Human Health and the Natural Environment 4 Human
Health and the "Built" Environment 5 Human Health and the Social
Environment 6 Toward an Integrative Approach to Environmental
Health References Abstracts of Talks APPENDIX A Workshop Agenda
APPENDIX B Speakers and Panelists APPENDIX C Workshop Participants
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