Environmental Health Matters Initiative – serie
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People spend the vast majority of their time inside their homes and other indoor environments where they are exposed to a wide range of chemicals from building materials, furnishings, occupants, cooking, consumer products, and other sources. Despite research to date, very little is known about how exposures to indoor chemicals across complex chemical phases and pathways affect human health. The COVID-19 pandemic has only increased public awareness of indoor environments and shed light on the many outstanding questions about how best to manage chemicals indoors. This report identifies gaps in current research and understanding of indoor chemistry and new approaches that can be applied to measure, manage, and limit chemical exposures. Why Indoor Chemistry Matters calls for further research about the chemical transformations that can occur indoors, pathways and timing of indoor chemical exposure, and the cumulative and long-term impacts of exposure on human health. Research priorities should consider factors that contribute to measurable environmental health disparities that affect vulnerable populations, such as the age, location, and condition of buildings that can alter exposures to indoor chemicals.
Principles and Obstacles for Sharing Data from Environmental Health Research
Workshop Summary
Häftad, Engelska, 2016
638 kr
Skickas inom 3-6 vardagar
On March 19, 2014, the National Academies of Sciences, Engineering, and Medicine held a workshop on the topic of the sharing of data from environmental health research. Experts in the field of environmental health agree that there are benefits to sharing research data, but questions remain regarding how to effectively make these data available. The sharing of data derived from human subjects--making them both transparent and accessible to others--raises a host of ethical, scientific, and process questions that are not always present in other areas of science, such as physics, geology, or chemistry. The workshop participants explored key concerns, principles, and obstacles to the responsible sharing of data used in support of environmental health research and policy making while focusing on protecting the privacy of human subjects and addressing the concerns of the research community. Principles and Obstacles for Sharing Data from Environmental Health Research summarizes the presentations and discussions from the workshop.
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Climate change poses risks to human health and well-being through shifting weather patterns, increases in frequency and intensity of heat waves and other extreme weather events, rising sea levels, ocean acidification, and other environmental effects. Those risks occur against a backdrop of changing socioeconomic conditions, medical technology, population demographics, environmental conditions, and other factors that are important in determining health. Models of health risks that reflect how health determinants and climate changes vary in time and space are needed so that we can inform adaptation efforts and reduce or prevent adverse health effects. Robust health risk models could also help to inform national and international discussions about climate policies and the economic consequences of action and inaction. Interest in resolving some of the challenges facing health effects modelers and health scientists led the National Research Council's Standing Committee on Emerging Science for Environmental Health Decisions to hold a workshop on November 3-4, 2014, in Washington, DC, to explore new approaches to modeling the human health risks of climate change.Throughout the workshop, the discussions highlighted examples of current application of models, research gaps, lessons learned, and potential next steps to improve modeling of health risks associated with climate change. Modeling the Health Risks of Climate Change summarizes the presentation and discussion of the workshop.
Future of Atmospheric Chemistry Research
Remembering Yesterday, Understanding Today, Anticipating Tomorrow
Häftad, Engelska, 2016
511 kr
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Our world is changing at an accelerating rate. The global human population has grown from 6.1 billion to 7.1 billion in the last 15 years and is projected to reach 11.2 billion by the end of the century. The distribution of humans across the globe has also shifted, with more than 50 percent of the global population now living in urban areas, compared to 29 percent in 1950. Along with these trends, increasing energy demands, expanding industrial activities, and intensification of agricultural activities worldwide have in turn led to changes in emissions that have altered the composition of the atmosphere. These changes have led to major challenges for society, including deleterious impacts on climate, human and ecosystem health. Climate change is one of the greatest environmental challenges facing society today. Air pollution is a major threat to human health, as one out of eight deaths globally is caused by air pollution. And, future food production and global food security are vulnerable to both global change and air pollution. Atmospheric chemistry research is a key part of understanding and responding to these challenges.The Future of Atmospheric Chemistry Research: Remembering Yesterday, Understanding Today, Anticipating Tomorrow summarizes the rationale and need for supporting a comprehensive U.S. research program in atmospheric chemistry; comments on the broad trends in laboratory, field, satellite, and modeling studies of atmospheric chemistry; determines the priority areas of research for advancing the basic science of atmospheric chemistry; and identifies the highest priority needs for improvements in the research infrastructure to address those priority research topics. This report describes the scientific advances over the past decade in six core areas of atmospheric chemistry: emissions, chemical transformation, oxidants, atmospheric dynamics and circulation, aerosol particles and clouds, and biogeochemical cycles and deposition. This material was developed for the NSFa (TM)s Atmospheric Chemistry Program; however, the findings will be of interest to other agencies and programs that support atmospheric chemistry research.
Microbiomes of the Built Environment
A Research Agenda for Indoor Microbiology, Human Health, and Buildings
Häftad, Engelska, 2017
614 kr
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People's desire to understand the environments in which they live is a natural one. People spend most of their time in spaces and structures designed, built, and managed by humans, and it is estimated that people in developed countries now spend 90 percent of their lives indoors. As people move from homes to workplaces, traveling in cars and on transit systems, microorganisms are continually with and around them. The human-associated microbes that are shed, along with the human behaviors that affect their transport and removal, make significant contributions to the diversity of the indoor microbiome. The characteristics of "healthy" indoor environments cannot yet be defined, nor do microbial, clinical, and building researchers yet understand how to modify features of indoor environments—such as building ventilation systems and the chemistry of building materials—in ways that would have predictable impacts on microbial communities to promote health and prevent disease. The factors that affect the environments within buildings, the ways in which building characteristics influence the composition and function of indoor microbial communities, and the ways in which these microbial communities relate to human health and well-being are extraordinarily complex and can be explored only as a dynamic, interconnected ecosystem by engaging the fields of microbial biology and ecology, chemistry, building science, and human physiology. This report reviews what is known about the intersection of these disciplines, and how new tools may facilitate advances in understanding the ecosystem of built environments, indoor microbiomes, and effects on human health and well-being. It offers a research agenda to generate the information needed so that stakeholders with an interest in understanding the impacts of built environments will be able to make more informed decisions.
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Over the last decade, several large-scale United States and international programs have been initiated to incorporate advances in molecular and cellular biology, -omics technologies, analytical methods, bioinformatics, and computational tools and methods into the field of toxicology. Similar efforts are being pursued in the field of exposure science with the goals of obtaining more accurate and complete exposure data on individuals and populations for thousands of chemicals over the lifespan; predicting exposures from use data and chemical-property information; and translating exposures between test systems and humans. Using 21st Century Science to Improve Risk-Related Evaluations makes recommendations for integrating new scientific approaches into risk-based evaluations. This study considers the scientific advances that have occurred following the publication of the NRC reports Toxicity Testing in the 21st Century: A Vision and a Strategy and Exposure Science in the 21st Century: A Vision and a Strategy.Given the various ongoing lines of investigation and new data streams that have emerged, this publication proposes how best to integrate and use the emerging results in evaluating chemical risk. Using 21st Century Science to Improve Risk-Related Evaluations considers whether a new paradigm is needed for data validation, how to integrate the divergent data streams, how uncertainty might need to be characterized, and how best to communicate the new approaches so that they are understandable to various stakeholders.
Protecting the Health and Well-Being of Communities in a Changing Climate
Proceedings of a Workshop
Häftad, Engelska, 2018
495 kr
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On March 13, 2017, the Roundtable on Environmental Health Sciences, Research, and Medicine and the Roundtable on Population Health Improvement jointly convened a 1-day public workshop in Washington, DC, to explore potential strategies for public health, environmental health, health care, and related stakeholders to help communities and regions to address and mitigate the health effects of climate change. Participants discussed the perspectives of civic, government, business, and health-sector leaders, and existing research, best practices, and examples that inform stakeholders and practitioners on approaches to support mitigation of and adaptation to climate change and its effects on population health. This publication summarizes the presentations and discussions from the workshop.
Environmental Chemicals, the Human Microbiome, and Health Risk
A Research Strategy
Häftad, Engelska, 2018
488 kr
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A great number of diverse microorganisms inhabit the human body and are collectively referred to as the human microbiome. Until recently, the role of the human microbiome in maintaining human health was not fully appreciated. Today, however, research is beginning to elucidate associations between perturbations in the human microbiome and human disease and the factors that might be responsible for the perturbations. Studies have indicated that the human microbiome could be affected by environmental chemicals or could modulate exposure to environmental chemicals.Environmental Chemicals, the Human Microbiome, and Health Risk presents a research strategy to improve our understanding of the interactions between environmental chemicals and the human microbiome and the implications of those interactions for human health risk. This report identifies barriers to such research and opportunities for collaboration, highlights key aspects of the human microbiome and its relation to health, describes potential interactions between environmental chemicals and the human microbiome, reviews the risk-assessment framework and reasons for incorporating chemical–microbiome interactions.
Improving Characterization of Anthropogenic Methane Emissions in the United States
Häftad, Engelska, 2018
786 kr
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Understanding, quantifying, and tracking atmospheric methane and emissions is essential for addressing concerns and informing decisions that affect the climate, economy, and human health and safety. Atmospheric methane is a potent greenhouse gas (GHG) that contributes to global warming. While carbon dioxide is by far the dominant cause of the rise in global average temperatures, methane also plays a significant role because it absorbs more energy per unit mass than carbon dioxide does, giving it a disproportionately large effect on global radiative forcing. In addition to contributing to climate change, methane also affects human health as a precursor to ozone pollution in the lower atmosphere. Improving Characterization of Anthropogenic Methane Emissions in the United States summarizes the current state of understanding of methane emissions sources and the measurement approaches and evaluates opportunities for methodological and inventory development improvements. This report will inform future research agendas of various U.S. agencies, including NOAA, the EPA, the DOE, NASA, the U.S. Department of Agriculture (USDA), and the National Science Foundation (NSF).
Monitoring and Sampling Approaches to Assess Underground Coal Mine Dust Exposures
Häftad, Engelska, 2018
638 kr
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Coal remains one of the principal sources of energy for the United States, and the nation has been a world leader in coal production for more than 100 years. According to U.S. Energy Information Administration projections to 2050, coal is expected to be an important energy resource for the United States. Additionally, metallurgical coal used in steel production remains an important national commodity. However, coal production, like all other conventional mining activities, creates dust in the workplace. Respirable coal mine dust (RCMD) comprises the size fraction of airborne particles in underground mines that can be inhaled by miners and deposited in the distal airways and gas-exchange region of the lung. Occupational exposure to RCMD has long been associated with lung diseases common to the coal mining industry, including coal workers' pneumoconiosis, also known as "black lung disease."Monitoring and Sampling Approaches to Assess Underground Coal Mine Dust Exposures compares the monitoring technologies and sampling protocols currently used or required by the United States, and in similarly industrialized countries for the control of RCMD exposure in underground coal mines. This report assesses the effects of rock dust mixtures and their application on RCMD measurements, and the efficacy of current monitoring technologies and sampling approaches. It also offers science-based conclusions regarding optimal monitoring and sampling strategies to aid mine operators' decision making related to reducing RCMD exposure to miners in underground coal mines.
Exploring Early Childhood Care and Education Levers to Improve Population Health
Proceedings of a Workshop
Häftad, Engelska, 2019
455 kr
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On September 14, 2017, the Roundtable on Population Health Improvement of the National Academies of Sciences, Engineering, and Medicine convened a workshop to explore the intersection of health and early childhood care and education, two key social determinants of health. This workshop follows a 2014 roundtable workshop that considered the interface between the education and health sectors broadly, from research and metrics to cross-sectoral partnerships and financing. The 2017 workshop continued that discussion, with a deeper focus on early childhood (birth through age 5) as a critical period in human development and an important opportunity for educational and related interventions. This publication summarizes the presentations and discussions from the 2017 workshop.
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From 1962 to 1971, the U.S. military sprayed herbicides over Vietnam to strip the thick jungle canopy that could conceal opposition forces, to destroy crops that those forces might depend on, and to clear tall grasses and bushes from the perimeters of US base camps and outlying fire-support bases. Mixtures of 2,4-dichlorophenoxyacetic acid (2,4-D), 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), picloram, and cacodylic acid made up the bulk of the herbicides sprayed. The main chemical mixture sprayed was Agent Orange, a 50:50 mixture of 2,4-D and 2,4,5-T. At the time of the spraying, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), the most toxic form of dioxin, was an unintended contaminant generated during the production of 2,4,5-T and so was present in Agent Orange and some other formulations sprayed in Vietnam.Because of complaints from returning Vietnam veterans about their own health and that of their children combined with emerging toxicologic evidence of adverse effects of phenoxy herbicides and TCDD, the National Academies of Sciences, Engineering, and Medicine was asked to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange, other herbicides used in Vietnam, and the various components of those herbicides, including TCDD. Updated evaluations were conducted every two years to review newly available literature and draw conclusions from the overall evidence. Veterans and Agent Orange: Update 11 (2018) examines peer-reviewed scientific reports concerning associations between various health outcomes and exposure to TCDD and other chemicals in the herbicides used in Vietnam that were published between September 30, 2014, and December 31, 2017, and integrates this information with the previously established evidence database.
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The U.S. military has a stockpile of approximately 400,000 tons of excess, obsolete, or unserviceable munitions. About 60,000 tons are added to the stockpile each year. Munitions include projectiles, bombs, rockets, landmines, and missiles. Open burning/open detonation (OB/OD) of these munitions has been a common disposal practice for decades, although it has decreased significantly since 2011.OB/OD is relatively quick, procedurally straightforward, and inexpensive. However, the downside of OB and OD is that they release contaminants from the operation directly into the environment. Over time, a number of technology alternatives to OB/OD have become available and more are in research and development. Alternative technologies generally involve some type of contained destruction of the energetic materials, including contained burning or contained detonation as well as contained methods that forego combustion or detonation.Alternatives for the Demilitarization of Conventional Munitions reviews the current conventional munitions demilitarization stockpile and analyzes existing and emerging disposal, treatment, and reuse technologies. This report identifies and evaluates any barriers to full-scale deployment of alternatives to OB/OD or non-closed loop incineration/combustion, and provides recommendations to overcome such barriers.
Gulf War and Health
Volume 11: Generational Health Effects of Serving in the Gulf War
Häftad, Engelska, 2018
809 kr
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For the United States, the 1991 Persian Gulf War was a brief and successful military operation with few injuries and deaths. However, soon after returning from duty, a large number of veterans began reporting health problems they believed were associated with their service in the Gulf. At the request of Congress, the National Academies of Sciences, Engineering, and Medicine has been conducting an ongoing review of the evidence to determine veterans' long-term health problems and potential causes.Some of the health effects identified by past reports include post-traumatic stress disorders, other mental health disorders, Gulf War illness, respiratory effects, and self-reported sexual dysfunction. Veterans' concerns regarding the impacts of deployment-related exposures on their health have grown to include potential adverse effects on the health of their children and grandchildren. These concerns now increasingly involve female veterans, as more women join the military and are deployed to war zones and areas that pose potential hazards.Gulf War and Health: Volume 11 evaluates the scientific and medical literature on reproductive and developmental effects and health outcomes associated with Gulf War and Post-9/11 exposures, and designates research areas requiring further scientific study on potential health effects in the descendants of veterans of any era.
474 kr
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In the last twenty years, citizen science has blossomed as a way to engage a broad range of individuals in doing science. Citizen science projects focus on, but are not limited to, nonscientists participating in the processes of scientific research, with the intended goal of advancing and using scientific knowledge. A rich range of projects extend this focus in myriad directions, and the boundaries of citizen science as a field are not clearly delineated. Citizen science involves a growing community of professional practitioners, participants, and stakeholders, and a thriving collection of projects. While citizen science is often recognized for its potential to engage the public in science, it is also uniquely positioned to support and extend participants' learning in science.Contemporary understandings of science learning continue to advance. Indeed, modern theories of learning recognize that science learning is complex and multifaceted. Learning is affected by factors that are individual, social, cultural, and institutional, and learning occurs in virtually any context and at every age. Current understandings of science learning also suggest that science learning extends well beyond content knowledge in a domain to include understanding of the nature and methods of science.Learning Through Citizen Science: Enhancing Opportunities by Design discusses the potential of citizen science to support science learning and identifies promising practices and programs that exemplify the promising practices. This report also lays out a research agenda that can fill gaps in the current understanding of how citizen science can support science learning and enhance science education.
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On August 1 and 2, 2018, the National Academies of Sciences, Engineering, and Medicine hosted a public workshop in Washington, DC, on sustainable diets, food, and nutrition. Workshop participants reviewed current and emerging knowledge on the concept of sustainable diets within the field of food and nutrition; explored sustainable diets and relevant impacts for cross-sector partnerships, policy, and research; and discussed how sustainable diets influence dietary patterns, the food system, and population and public health. This publication briefly summarizes the presentations and discussions from the workshop.
Exploring Tax Policy to Advance Population Health, Health Equity, and Economic Prosperity
Proceedings of a Workshop
Häftad, Engelska, 2019
488 kr
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The National Academies of Sciences, Engineering, and Medicine's Roundtable on Population Health Improvement has been focused on the subject of dependable resources for population health since its inception in 2013. On December 7, 2017, the roundtable convened a workshop to explore tax policy as it relates to advancing population health, health equity, and economic prosperity. This publication summarizes the presentations and discussions from the workshop.
Current Status and Response to the Global Obesity Pandemic
Proceedings of a Workshop
Häftad, Engelska, 2019
459 kr
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The increasing prevalence and burden of obesity transcends borders, straining populations worldwide. Data shows that 50 million girls, 74 million boys, 390 million women, and 281 million men were estimated to have obesity in 2016 (NCD-RisC, 2017). The National Academies of Sciences, Engineering, and Medicine convened a workshop on October 9, 2018 to address the status of the global obesity pandemic and discuss diverse approaches to manage this problem. Speakers examined the collective prevalence, costs, and drivers of obesity around the world using cross-cultural comparisons. Panels and group discussions emphasized the need to reduce disparities in prevention and treatment efforts and to generate new policy and system initiatives related to nutrition and physical activity worldwide. This publication summarizes the presentations and discussions from the workshop.
Global Health Transitions and Sustainable Solutions
The Role of Partnerships: Proceedings of a Workshop
Häftad, Engelska, 2019
459 kr
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On June 13-14, 2018, the National Academies of Sciences, Engineering, and Medicine convened a multistakeholder workshop to examine the transitions affecting global health and innovative global health solutions. The goal of bringing these two topics together was to collectively explore models for innovative partnerships and private-sector engagement with the potential to support countries in transition. This publication summarizes the presentations and discussions from the workshop.
Achieving Behavioral Health Equity for Children, Families, and Communities
Proceedings of a Workshop
Häftad, Engelska, 2019
507 kr
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In November 2017, the The Forum on Promoting Children's Cognitive, Affective, and Behavioral Health, in collaboration with the Roundtable on the Promotion of Health Equity, convened a workshop on promoting children's behavioral health equity. The workshop used a socio-ecological developmental model to explore health equity of children and families, including those with complex needs and chronic conditions. Particular attention was paid to challenges experienced by children and families in both rural and urban contexts, to include but not limited to poverty, individual and institutional racism, low-resourced communities, and hindered access to educational and health care services. Workshop participants also engaged in solution-oriented discussions of initiatives, policies, and programs that aim to improve social determinants of health, opportunities for behavioral health promotion, and access to quality services that address the behavioral health of all children and families. This publication summarizes the presentations and discussion of the event.
Exploring Medical and Public Health Preparedness for a Nuclear Incident
Proceedings of a Workshop
Häftad, Engelska, 2019
638 kr
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The National Academies of Sciences, Engineering, and Medicine held a workshop on August 22-23, 2018, in Washington, DC, to explore medical and public health preparedness for a nuclear incident. The event brought together experts from government, nongovernmental organizations, academia, and the private sector to explore current assumptions behind the status of medical and public health preparedness for a nuclear incident, examine potential changes in these assumptions in light of increasing concerns about the use of nuclear warfare, and discuss challenges and opportunities for capacity building in the current threat environment. This publication summarizes the presentations and discussions from the workshop.
Faith–Health Collaboration to Improve Community and Population Health
Proceedings of a Workshop
Häftad, Engelska, 2021
446 kr
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On March 22, 2018, the National Academies of Sciences, Engineering, and Medicine convened a workshop to examine the collaboration between the faith and health sectors, and to highlight the unique opportunities these collaborations offer to help improve population health outcomes. This publication summarizes the presentations and discussions from the workshop.
Building and Measuring Community Resilience
Actions for Communities and the Gulf Research Program
Häftad, Engelska, 2019
539 kr
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The frequency and severity of disasters over the last few decades have presented unprecedented challenges for communities across the United States. In 2005, Hurricane Katrina exposed the complexity and breadth of a deadly combination of existing community stressors, aging infrastructure, and a powerful natural hazard. In many ways, the devastation of Hurricane Katrina was a turning point for understanding and managing disasters, as well as related plan making and policy formulation. It brought the phrase "community resilience" into the lexicon of disaster management.Building and Measuring Community Resilience: Actions for Communities and the Gulf Research Program summarizes the existing portfolio of relevant or related resilience measurement efforts and notes gaps and challenges associated with them. It describes how some communities build and measure resilience and offers four key actions that communities could take to build and measure their resilience in order to address gaps identified in current community resilience measurement efforts. This report also provides recommendations to the Gulf Research Program to build and measure resilience in the Gulf of Mexico region.
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Even as malnutrition in the form of hunger and obesity affect the health and well-being of millions of people worldwide, a significant amount of food is lost or wasted every day, in every country, and at every stage in the supply chain from the farm to the household. According to a 2011 estimate by the Food and Agriculture Organization of the United Nations (FAO), about one-third of food produced is lost or wasted globally. Beyond quantity estimates, however, less is known about the impacts on farmers, food prices, food availability, and environment of reducing food loss and waste. On October 17, 2018, the National Academies of Sciences, Engineering, and Medicine organized a workshop to examine key challenges that arise in reducing food loss and waste throughout the supply chain and discussed potential ways to address these challenges. This publication summarizes the presentations and discussions from the workshop.
Role of Nonpharmacological Approaches to Pain Management
Proceedings of a Workshop
Häftad, Engelska, 2019
455 kr
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Pain is a leading cause of disability globally. The dramatic increase in opioid prescriptions within the past decade in the United States has contributed to the opioid epidemic the country currently faces, magnifying the need for longer term solutions to treat pain. The substantial burden of pain and the ongoing opioid crisis have attracted increased attention in medical and public policy communities, resulting in a revolution in thinking about how pain is managed. This new thinking acknowledges the complexity and biopsychosocial nature of the pain experience and the need for multifaceted pain management approaches with both pharmacological and nonpharmacological therapies. The magnitude and urgency of the twin problems of chronic pain and opioid addiction, combined with the changing landscape of pain management, prompted the National Academies of Sciences, Engineering, and Medicine to convene a workshop on December 4-5, 2018, in Washington, DC. The workshop brought together a diverse group of stakeholders to discuss the current status of nonpharmacological approaches to pain management, gaps, and future directions. This publication summarizes the presentations and discussions from the workshop.
Innovations in the Food System
Exploring the Future of Food: Proceedings of a Workshop
Häftad, Engelska, 2020
526 kr
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On August 7-8, 2019, the National Academies of Sciences, Engineering, and Medicine hosted a public workshop in Washington, DC, to review the status of current and emerging knowledge about innovations for modern food systems and strategies for meeting future needs. The workshop addressed different perspectives on the topic of food systems and would build on a workshop on the topic of sustainable diets hosted by the Food Forum in August 2018. This publication summarizes the presentations and discussions from the workshop.
Implications of the California Wildfires for Health, Communities, and Preparedness
Proceedings of a Workshop
Häftad, Engelska, 2020
555 kr
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California and other wildfire-prone western states have experienced a substantial increase in the number and intensity of wildfires in recent years. Wildlands and climate experts expect these trends to continue and quite likely to worsen in coming years. Wildfires and other disasters can be particularly devastating for vulnerable communities. Members of these communities tend to experience worse health outcomes from disasters, have fewer resources for responding and rebuilding, and receive less assistance from state, local, and federal agencies. Because burning wood releases particulate matter and other toxicants, the health effects of wildfires extend well beyond burns. In addition, deposition of toxicants in soil and water can result in chronic as well as acute exposures.On June 4-5, 2019, four different entities within the National Academies of Sciences, Engineering, and Medicine held a workshop titled Implications of the California Wildfires for Health, Communities, and Preparedness at the Betty Irene Moore School of Nursing at the University of California, Davis. The workshop explored the population health, environmental health, emergency preparedness, and health equity consequences of increasingly strong and numerous wildfires, particularly in California. This publication is a summary of the presentations and discussion of the workshop.
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When communities face complex public health emergencies, state local, tribal, and territorial public health agencies must make difficult decisions regarding how to effectively respond. The public health emergency preparedness and response (PHEPR) system, with its multifaceted mission to prevent, protect against, quickly respond to, and recover from public health emergencies, is inherently complex and encompasses policies, organizations, and programs. Since the events of September 11, 2001, the United States has invested billions of dollars and immeasurable amounts of human capital to develop and enhance public health emergency preparedness and infrastructure to respond to a wide range of public health threats, including infectious diseases, natural disasters, and chemical, biological, radiological, and nuclear events. Despite the investments in research and the growing body of empirical literature on a range of preparedness and response capabilities and functions, there has been no national-level, comprehensive review and grading of evidence for public health emergency preparedness and response practices comparable to those utilized in medicine and other public health fields.Evidence-Based Practice for Public Health Emergency Preparedness and Response reviews the state of the evidence on PHEPR practices and the improvements necessary to move the field forward and to strengthen the PHEPR system. This publication evaluates PHEPR evidence to understand the balance of benefits and harms of PHEPR practices, with a focus on four main areas of PHEPR: engagement with and training of community-based partners to improve the outcomes of at-risk populations after public health emergencies; activation of a public health emergency operations center; communication of public health alerts and guidance to technical audiences during a public health emergency; and implementation of quarantine to reduce the spread of contagious illness.
Social Isolation and Loneliness in Older Adults
Opportunities for the Health Care System
Häftad, Engelska, 2020
685 kr
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Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions.A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults.Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.
Final Review of the Study on Supplemental Treatment Approaches of Low-Activity Waste at the Hanford Nuclear Reservation
Review #4
Häftad, Engelska, 2020
568 kr
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The U.S. Department of Energy's Office of Environmental Management is responsible for managing and cleaning up the waste and contamination at the Hanford Nuclear Reservation, the nation's biggest and most complex nuclear cleanup challenge. At the site, 177 underground tanks collectively contain about 211 million liters of waste that includes high-activity and low-activity materials.At the request of Congress, Final Review of the Study on Supplemental Treatment Approaches of Low-Activity Waste at the Hanford Nuclear Reservation: Review #4 focuses on approaches for treatment and disposal of the supplemental portion of the low-activity waste from the tanks. This review report discusses developments since the publication of Review #3 and provides a summary of public comments on the third committee review report. The authoring committee then shares their views on these comments and whether they change any of the findings or recommendations in the third review report.