Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology
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Public Health and Risk Assessment (2nd of 10 Lectures on Toxicologic Epidemiology). Michael H. Dong MPH, DrPA, PhD.  readings. Taken in the early ’90s, when desktop computers were still a luxury. Learning Objectives.

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Public Health and Risk Assessment (2nd of 10 Lectures on Toxicologic Epidemiology)

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Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Public Healthand Risk Assessment(2nd of 10 Lectures onToxicologic Epidemiology)

Michael H. Dong

MPH, DrPA, PhD

readings


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Taken in the early ’90s, when desktop computers were still a luxury.


Learning objectives

Learning Objectives

  • Revisit the mission of public health (PH), and learn the impact of social choice on PH.

  • Revisit the concept of health risk assessment (RA) and learn the various RA activities performed in the U.S.A. and worldwide.

  • Learn that exposure monitoring and mitigating are bridges between PH and RA.


Performance objectives

Performance Objectives

  • Integrate social choice with health risk assessment (RA) through public health (PH).

  • Realize that various RA activities can be performed to promote PH.

  • Appreciate the concept that exposure monitoring and exposure mitigating are guided by RA with the goal of promoting and improving PH.


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

The mission of public health is to “fulfill society’s interest in assuring conditions in which people can be healthy.”


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Social Choice on Public Health

  • A process through which collective goals are pursued and appropriate methods resolved (by and large) systematically.

  • Public health activities and mission are a subset of this process.


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Administrative Structures of Public Health

  • Systems - Canada/U.S. VeteransAdministration.

  • Partnerships - Sweden/U. K.

  • Alliances - United States.


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

as a core function of public health . . . .

“Assessment and monitoring of the health of communities and populations at risk to identify health problems and priorities.”


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Health Risk Assessment:

The process by which the potential adverse health effects of human exposure to etiologic agents (usually chemicals) are characterized.


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Health Risk Assessment Components

Hazard Identification

Risk Characterization

Dose-Response Assessment

Exposure Assessment


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Risk Assessment Activities in U.S. A. and Worldwide

  • United States:DHHS; EPA; CPSC; OSHA.

  • Worldwide: Development Policies and/or Projects (DPP).


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Risk Assessments in the U.S. DHHS (I)

  • Substance Abuse and Mental Health Services Administration (SAMHSA)

  • Predecessor agency: ADAMHA.

  • Substance abuse prevention; addict treatment; mental health services.


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Risk Assessments in the U.S. DHHS (II)

  • Centers for Disease Control and Prevention (CDC)

  • Established as Communicable Disease Center in 1946.

  • Monitoring disease trends; injury control; outbreak investigation.


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Risk Assessments in the U.S. DHHS (III)

  • Agency for Toxic Substances and Disease Registry (ATSDR)

  • Prevent exposure to hazardous substances from waste sites.

  • Conduct health risk assessments and health studies per EPA’s risk prioritization list.


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Risk Assessments in the U.S. DHHS (IV)

  • National Institutes of Health (NIH)

  • Medical research organization with 18 separate health institutes.

  • Diseases studied including: AIDS; cancer; Alzheimer’s; diabetes; eye; heart; lung; arthritis; blood, etc.


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Risk Assessments in the U.S. DHHS (V)

  • Office of the Assistant Secretary for Health (OASH)

  • Office of Public Health and Science.

  • Public Health Service agencies and program offices.

  • U.S. Surgeon General.


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Risk Assessments in the U.S. DHHS (VI)

  • Food and Drug Administration (FDA)

  • Assures safety of foods and safety of cosmetics.

  • Assures safety and efficacy of drugs, biological products, and medical devices.


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Risk Assessments in the U.S. CPSC

  • Created in 1972 by the Consumer Product Safety Act.

  • An independent regulatory agency.

  • Saving lives and keeping families safe (from household products).


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Risk Assessments in the U.S. EPA

  • Established in 1970; active in both research and regulation.

  • Most important U.S. federal agency for the regulation of toxic chemicals and pesticides.

  • Important influence over the design and conduct of toxicity testing and toxicologic studies.


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Risk Assessments in the U.S. OSHA

  • Created by the Occupational Safety and Health Act of 1970.

  • An administration office of the U.S. Department of Labor.

  • Mission is to save lives, to prevent injuries, and to protect the health of America’s 100 million plus workers.


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

DPP on Health Risk Assessment (I)

  • Impact of development policies and projects (DPP): more subtle & indirect.

  • Use environmental impact assessment (EIA) to address public concerns about unintended effects.

  • EHIA (environmental health impact assessment) is now a component of EIA.


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

DPP on Health Risk Assessment (II)

  • Six common steps for EIA; one of the steps requires some form of health risk assessment for EHIA.

  • Courses and study programs on EHIA and EIA available worldwide.

  • DPP exacerbates poverty and health problems of industrialization.


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

DPP on Health Risk Assessment (III)

  • Unintended effects from DPP:five(5) basic types.

  • Housingandeconomic growth: health; utility services; and nutrition problems.

  • Agricultural growth,industrialization, andenergy: exposure to pesticides; to toxic wastes; and to radiation.


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Exposure Monitoring and Mitigation

  • Used as health protection, surveillance, and regulation tools.

  • Mitigation: to lower potential or current exposure to an acceptable level.

  • Monitoring: to ensure and maintain a safe exposure level.


Public health and risk assessment 2nd of 10 lectures on toxicologic epidemiology

Overview of Next Lecture:

Toxicology and Risk Assessment

  • Impacts of statutes and regulations.

  • Toxicity testing procedures and data acquisition for health risk assessment.

  • Effects of risk and health perception.

  • Advances in assessment techniques.


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