Some Lessons Learned from Public Health on the Process of Adaptation

Lessons learned from more than 150 years of public health research and intervention can provide insights to guide public health professionals and institutions as they design and implement specific strategies, policies, and measures to increase resilience to climate variability and change. This paper identifies both some modifications to public health systems that may enhance adaptive capacity, and lessons drawn from the history of managing environmental and other threats in the public health sector that may have relevance for other sectors as they design approaches to increase their adaptive capacity to more effectively cope with climate variability and change. The views expressed are the author’s own and do not represent official US EPA policy.     

Tributyltin partitioning in sediments: effect of aging

The effect of aging on the solid/pore-water partitioning and desorption behaviour of tributyltin (TBT) in sediments was examined. Three sediment samples with contrasting physical and chemical properties were spiked with 10 mg/kg TBT and aged under sterile conditions for periods of time ranging from 1 to 84 days. Aging had a negligible effect on partitioning and desorption behaviour in a sandy sample with very low organic carbon content (0.2% w/w). In contrast, for samples with larger amounts of organic carbon (2.6% and 4.8% w/w), aging caused substantial increases in TBT sorption. For these samples, apparent distribution coefficients (KD,app) obtained from sequential 2 h desorption experiments also exhibited a twofold increase between spiked sediments subjected to aging for 1 day and 84 days. This study demonstrates that aging effects may be an important aspect of TBT fate in contaminated sediments.     

Evaluation of diffusive gradients in thin film (DGT) samplers for measuring contaminants in the Antarctic marine environment

This work has been the first application of DGT samplers for measuring metals in water and sediment porewater in the Antarctic environment, and whilst DGT water sampling was restricted to quantification of Cd, Fe and Ni, preconcentration using Empore chelating disks provided results for an additional nine elements (Sn, Pb, Al, Cr, Mn, Co, Cu, Zn, As). Although higher concentrations were measured for some metals (Cd, Ni, Pb) using the Empore technique, most likely due to particulate-bound or colloidal species becoming entrapped in the Empore chelating disks, heavy metal concentrations in the impacted Brown Bay were found to be comparable with the non-impacted O'Brien Bay. Sediment porewater sampling using DGT also indicated little difference between Brown Bay and O'Brien Bay for many metals (Cd, Al, Cr, Co, Ni, Cu), however, greater amounts of Pb, Mn, Fe and As were accumulated in DGT probes deployed in Brown Bay compared with O'Brien Bay, and a higher accumulation of Sn was observed in Brown Bay inner than any of the other three sites sampled. Comparison of DGT derived porewater concentrations with actual porewater concentrations showed limited resupply of Cd, Pb, Al, Cr, Mn, Co, Ni, Cu, Zn and As from the solid phase to porewater, with these metals appearing to be strongly bound to the sediment, however, resupply of Fe and Sn was apparent. Based upon our observations here, we suggest that Sn, and to a lesser extent Pb, are critical contaminants.     

Release of persistent organic contaminants from carcasses of Lake Ontario Chinook salmon (Oncorhynchus tshawytscha)

About 20,000 Chinook salmon (Oncorhynchus tshawytscha) from Lake Ontario enter the Credit River, Ontario, Canada every fall to spawn and die. In this study, samples of muscle and eggs collected from female Chinook salmon entering the Credit River contained total PCBs, DDT compounds and other organochlorine (OC) compounds at mug/kg concentrations. Semi-permeable membrane devices (SPMDs) were deployed at a reference site above the spawning grounds and at two downstream sites at intervals over a 14-month period that spanned two spawning runs. There was an increase in the concentrations of total PCBs, total DDT and other classes of OCs in the SPMDs deployed at the two downstream sites during and after both spawning runs; indicating that the decay of salmon releases contaminants into the river. Based upon the concentrations of contaminants in the salmon tissues, approximately 75 g of total PCBs and 35 g of total DDT compounds would be transported annually into the Credit River from this source.     

Cognitive skills underlying driving in patients discharged following self-poisoning with central nervous system depressant drugs

Background: Central nervous system-depressant (CNS-Ds) drugs can impair cognitive functions and driving. They are also the most common drugs taken in overdose in hospital-treated episodes of self-poisoning. In Australia most of these patients are discharged within 48?h, while they still have possible subclinical drug effects. We aimed to determine whether patients treated for self-poisoning with CNS-Ds are impaired in the Trail-Making Test (TMT, parts A and B), a neuropsychological test that is known to correlate with driving performance. Methods: This study was a conducted from November 2008 to April 2011 in a referral center for poisonings in New South Wales, Australia. One hundred seven patients discharged from the clinical toxicology unit following treatment for self-poisoning of CNS-Ds (benzodiazepines, atypical antipsychotics, or opioids) and a control group of 68 discharged following self-poisoning of non-CNS-depressant drugs (acetaminophen or nonsedating antidepressants) were tested with the TMT (parts A and B). Due to the known association of impaired TMT with driving impairment and increased risk of traffic accidents, performance less than the 10th percentile for age was defined as significant impairment in each part of the TMT. The odds ratio (OR) for impairment in each part was calculated in multivariate logistic regression (MLR) models adjusted for gender, education, IQ, and the presence of a major psychiatric illness. A secondary MLR analysis was conducted only for those patients (78 CNS-D and 54 control group participants) who were directly discharged home, after excluding those who were transferred for further psychiatric care. Results: The odds of impairment in the CNS-D group was 2.8?times that of the control group on the TMT-A (38 [35.5%] vs. 11 [16.2%]: adjusted OR = 2.76, 95% confidence interval [CI]: 1.28-5.97), and 4.6?times on the TMT-B (67 [62.6%] vs. 22 [32.4%]: adjusted OR = 4.63, 95% CI: 2.06-10.42). The results were similar in the subgroup of patients discharged home, and the odds of impairment in the CNS-D group was 3.3?times that of the control group on the TMT-A (25 [32.1%] vs. 7 [13.0%]: adjusted OR = 3.30, 95% CI: 1.28-8.52), and 3.6?times on the TMT-B (46 [59.0%] vs. 17 [31.5%]: adjusted OR = 3.64, 95% CI: 1.44-9.20). TMT-B impairment in the CNS-D group remained significant even after adjusting for TMT-A performance. Conclusions: Patients with CNS-D overdose may have significant impairment in cognitive skills underlying driving at the time of discharge from hospitals. Clinicians should warn these patients that their driving skills might still be impaired, even if they are considered clinically recovered and advise them not to drive during the first 1 to 2?days following discharge.     

Reflections on 40 years of Disasters, 1977–2017

This reflection, based on a keynote address to celebrate the fortieth anniversary of Disasters on 14 September 2017, begins by considering some of the prevailing assumptions that existed at the time of the journal's creation. Next is a summary of significant milestones during the past 40 years, covering major global trends, changing disaster impacts, and key developments in disaster risk management. Contrasting approaches in the first and fourth decade of the journal's history are then followed by examples of changes in terminology in the disaster field as an indication of shifting values. The paper goes on to explore the context of 2017, with observations of problem areas such as the loss of knowledge, failures to tackle the root causes of disasters, shortfalls in international assistance, and some negative attitudes. It closes by evaluating some current positive occurrences, including a reduction in casualties, sharing of experience, technological advances, and dramatic improvements in disaster warning.     

Spatial cost–benefit analysis of blue restoration and factors driving net benefits globally

Marine coastal ecosystems, commonly referred to as blue ecosystems, provide valuable services to society but are under increasing threat worldwide due to a variety of drivers, including eutrophication, development, land-use change, land reclamation, and climate change. Ecological restoration is sometimes necessary to facilitate recovery in coastal ecosystems. Blue restoration (i.e., in marine coastal systems) is a developing field, and projects to date have been small scale and expensive, leading to the perception that restoration may not be economically viable. We conducted a global cost–benefit analysis to determine the net benefits of restoring coral reef, mangrove, saltmarsh, and seagrass ecosystems, where the benefit is defined as the monetary value of ecosystem services. We estimated costs from published restoration case studies and used an adjusted-value-transfer method to assign benefit values to these case studies. Benefit values were estimated as the monetary value provided by ecosystem services of the restored habitats. Benefits outweighed costs (i.e., there were positive net benefits) for restoration of all blue ecosystems. Mean benefit:cost ratios for ecosystem restoration were eight to 10 times higher than prior studies of coral reef and seagrass restoration, most likely due to the more recent lower cost estimates we used. Among ecosystems, saltmarsh had the greatest net benefits followed by mangrove; coral reef and seagrass ecosystems had lower net benefits. In general, restoration in nations with middle incomes had higher (eight times higher in coral reefs and 40 times higher in mangroves) net benefits than those with high incomes. Within an ecosystem type, net benefit varied with restoration technique (coral reef and saltmarsh), ecosystem service produced (mangrove and saltmarsh), and project duration (seagrass). These results challenge the perceptions of the low economic viability of blue restoration and should encourage further targeted investment in this field.     

Flooding and schools: experiences in Hull in 2007

Hull, a city in the East Riding of Yorkshire, United Kingdom, suffered severe flooding in June 2007, affecting some 8,600 households and most schools. Despite the potential for damage in such disasters, no studies of the effects of floods on teachers and schools in the UK appear to have been published previously. This study analysed the impacts of the floods on teachers in Hull in two stages: first through correspondence with Hull City Council and a mailed questionnaire to 91 head teachers of primary, secondary, and special schools; and second, through in‐depth interviews with head teachers from six flooded schools, representing different degrees of flood experience, and a questionnaire completed by eight teachers from the same schools. The findings reveal the importance and the complexity of the role of the school in the wider community in a time of crisis. The study highlights issues concerning preparedness for floods, support for schools, and flood protection for schools.