Transcript document

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