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Unit 9 – Public Health Environmental Issues in Public Health: Part II Chapter 22 – Solid and Hazardous Wastes: What To Do With the Garbage? Before 1970s Open dumps Outlawed by Resource Conservation and Recovery Act (RCRA), 1976 Burned in incinerators or in the open Outlawed by Clean Air Act, 1970 Poured into rivers, lakes, or oceans Outlawed by Clean Water Act (1972) and Marine Protection, Research, and Sanctuaries Act (1972) Sanitary Landfills Site should be dry, impervious clay soil Lined with plastic Drains for liquids Vents to control explosive gases Tipping fee Cost of disposing of one ton of municipal waste Highest cost is in northeast New York City – Fresh Kills, Staten Island Alternatives to Landfills Three R’s: Reduce, Reuse, Recycle Reduce: buy only what’s needed; avoid excessive packaging Reuse: Use reusable items rather than disposable Recycle Encouraged by deposits on bottles and cans Yard sales Composting Waste to energy incineration Special incinerators -- still concern about pollution Hazardous Wastes Love Canal, New York – 1978 Times Beach, Missouri – 1972-1976 Resource Conservation and Recovery Act, (RCRA), 1976, 1984 All hazardous wastes accounted for “from cradle to grave” Wastes from petroleum refining, pesticide manufacturing, some pharmaceuticals Ignitable, corrosive, reactive, toxic wastes Superfund Comprehensive Environmental Response, Compensation, and Liability Act – 1980 Emergency cleanup of old waste sites, paid for by a tax on industry Mired in controversy; much effort focused on determining who is liable Tax not reauthorized in 1995 NIMBY Not In My Back Yard Unit 9 – Public Health Environmental Issues in Public Health: Part II Chapter 23 – Safe Foods and Drugs: An Ongoing Regulatory Battle Causes of Food-Borne Illness Bacteria Salmonella -- eggs, poultry, meat E. coli O157:H7 – ground beef, alfalfa sprouts, unpasteurized apple juice, raw milk, lettuce Viruses Hepatitis A – green onions from Mexico, shellfish Norwalk virus -- shellfish Parasites Cyclospora – raspberries from Guatemala Parasites in sushi, sashimi, ceviche Government Food Safety Activities Responsibility is divided among many agencies Department of Agriculture (USDA) – meat, poultry, processed eggs Food and Drug Administration (FDA) – all other foods States regulate shellfish State and local governments regulate stores, restaurants, institutions (schools, nursing homes) Irrationality of System USDA has bigger budget, more authority Regulates 20% of food Detailed laws on regulation of meat FDA has smaller budget, less authority Regulates 80% of food Inspects only 1% proportion of imported food 55% of seafood is imported 12% of vegetables 30% of fruit Safety Measures Hazard Analysis Critical Control Point (HACCP) Focuses on procedures; reduces need for inspections Irradiation – kills bacteria, parasites, pests CDC surveillance for food-borne disease FoodNet Pulsenet – DNA fingerprinting of bacteria Additives and Contaminants FDA sets tolerance levels for pesticide residues Hormones Estrogen banned in chickens Bovine growth hormone allowed for cows (does not get into milk) Antibiotics – causes antibiotic resistance Organic foods – USDA set standards in 2004 Additives To prevent deficiency diseases Preservatives or to improve color, flavor or texture Must be approved by FDA, or GRAS Drugs FDA must approve after studies by pharmaceutical company New Drug Application Three phases of trial I. Small number of subjects, measure absorption, distribution, metabolism, excretion; look for side effects and toxicities II. Signs of effectiveness III. Clinical trial Post-marketing surveillance Food and Drug Labeling and Advertising FDA regulates labeling of foods with information on specified nutrients, recommended daily intakes FDA regulates labeling of drugs Labeling of over-the-counter drugs is by Federal Trade Commission Dietary Supplements Dietary Supplement Health and Education Act – 1994 Forbids FDA from regulating herbs and food supplements Can remove substance from market only if proven harmful Ephedra removed only after many deaths Politics of the FDA FDA subject to intense political pressures Complaints it is too slow in approving drugs Drug companies pay a fee to speed up review process Now complaints that the FDA is too cozy with industry Politics of the FDA, ctd. Too many drugs found to be unsafe only after approved for marketing Fen-phen Vioxx Antidepressants for children Problems with the way clinical trials are reported Calls for a database of all clinical trials, to be registered at the beginning of the trial, with all results to be reported Unit 9 – Public Health Environmental Issues in Public Health: Part II Chapter 24 – Population: The Ultimate Environmental Health Issue Population Biology Patterns of population growth: S curve and J curve Carrying capacity – number of organisms that can be supported without degrading environment Thomas Malthus predicted in about 1800 that population growth would outgrow food supply Paul Ehrlich – The Population Bomb, 1968 Population growth has slowed, but many negative effects of overpopulation are occurring Public Health and Population Growth Public health has contributed to population growth by reducing death rates, especially among children, in developing countries Birth rates tend to fall as a result of falling death rates – demographic transition Excess population settles in cities – homelessness, shantytowns – poor sanitation HIV/AIDS shortening life expectancies in Africa Depletion of Global Resources Fresh water Drinking, cooking, washing Agriculture Unevenly distributed Fuel Deforestation – leads to degradation of land Arable land Amount of land under cultivation is declining Food from the sea Decline of harvests of fish and shellfish Climate Change Greenhouse effect from burning fossil fuels Rise of 1 degree during 20th century Predict 3 to 8 degree rise during 21st century U.S. has 5% of world’s population, contributes 21% of greenhouse gases Kyoto Protocol – Bush administration has rejected Prospects for Population Control U.N. conference in Cairo, 1994 Opposition to contraception by Catholics and Muslims Rich and poor countries blame each other 20 year Programme of Action Education for women Empowering women to choose fewer children Population stabilization comes with modernization and economic viability