Equity-focused health impact assessment: A tool to assist policy makers in addressing health inequalities

In Australasia (Australia and New Zealand) the use of health impact assessment (HIA) as a tool for improved policy development is comparatively new. The public health workforce do not routinely assess the potential health and equity impacts of proposed policies or programs. The Australasian Collaboration for Health Equity Impact Assessment was funded to develop a strategic framework for equity-focused HIA (EFHIA) with the intent of strengthening the ways in which equity is addressed in each step of HIA. The collaboration developed a draft framework for EFHIA that mirrored, but modified the commonly accepted steps of HIA; tested the draft framework in six different health service delivery settings; analysed the feedback about application of the draft EFHIA framework and modified it accordingly. The strategic framework shows promise in providing a systematic process for identifying potential differential health impacts and assessing the extent to which these are avoidable and unfair. This paper presents the EFHIA framework and discusses some of the issues that arose in the case study sites undertaking equity-focused HIA.     

Overestimates of black carbon in soils and sediments

Several recent reports suggest that black carbon (BC), which broadly encompasses charcoal, soot, and other forms of pyrogenic carbon, may constitute a significant proportion of the refractory carbon in soil and sedimentary organic matter. BC is a sink for biospheric and atmospheric carbon dioxide, and is intimately tied to the biogeochemical cycling of both carbon and oxygen through its role in organic matter cycling. Additionally, BC may represent a large fraction of the missing carbon sink in global carbon accounting. Here, we demonstrate that documented measurements of BC may be the result of methodological artifacts, which inadvertently overestimate the amount of BC. We found that a widely used thermal oxidative method can create a residue that falls under the operational definition of BC in samples that are relatively BC-free. Moreover, during this procedure, labile organic matter constituents are condensed into pyrogenic carbon, implying that the labile components are present in lesser quantities. These methodological deficiencies are promoting overestimates in the amount of refractory carbon in soil and sedimentary organic matter and may endorse inaccuracies in the rates of carbon fluxes, the mean residence times of terrestrial carbon, and organic matter burial rates in oceanic environments.     

Detection of low-grade mosaicism in fetal cells isolated from maternal blood

Recovering and analysing fetal erythrocytes from maternal blood is being pursued for non-invasive prenatal genetic diagnosis. We report the observation of 46, XY/47, XXY mosaicism in fetal cells from a woman whose first-trimester chorionic villus sampling (CVS) initially showed only 46, XY. Only after exhaustive (500 cells) analysis were four XXY cells found in cultured villi.     

Vitamins,folic acid and neural tube defects: Comments on investigations in the United States

No clear answer concerning whether multivitamin/folate supplementation prevents neural tube defects (NTDs) is provided by three studies in the United States. All these studies are occurrence in nature, no recurrence studies having been conducted. The Atlanta Birth Defects Study is subject to pronounced memory and recall biases, the length between event and interview being as long as 16 years. In a second study (Boston University), objections can be raised to certain aspects of the experimental design, and the claim that 22 per cent of women started vitamins sufficiently early after pregnancy diagnosis to influence NTD formation is suspicious. Our NICHD case control study of 541 women in California and Illinois revealed no evidence for multivitamins or folic acid preventing NTDs. U.S. public policy-makers face difficulties in applying results of recurrence or occurrence studies in high-risk areas to low-risk areas in the U.S.     

Radiogenic Lead Isotopes and Time Stratigraphy in the Hudson River, New York

Radionuclide, radiogenic lead isotope and trace metal analyses on fine-grained sediment cores collected along 160 km of the upper and tidal Hudson River were used to examine temporal trends of contaminant loadings and to develop radiogenic lead isotopes both as a stratigraphic tool and as tracers for resolving decadal particle transport fluxes. Very large inputs of Cd, Sb, Pb, and Cr are evident in the sediment record, potentially from a single manufacturing facility. The total range in radiogenic lead isotope ratios observed in well-dated cores collected about 24 km downstream of the plant is large (e.g., maximum difference in ²⁰⁶Pb/²⁰⁷Pb is 10%), characterized by four major shifts occurring in the 1950s, 1960s, 1970s and 1980s. The upper Hudson signals in Cd and radiogenic lead isotopes were still evident in sediments collected 160 km downstream in the tidal Hudson. The large magnitude and abrupt shifts in radiogenic lead isotope ratios as a function of depth provide sensitive temporal constraints that complement information derived from radionuclide analyses to significantly improve the precision of dating assignments. Application of a simple dilution model to data from paired cores suggests much larger sediment inputs in one section of the river than previously reported, suggesting particle influxes to the Hudson have been underestimated.     

Molecular tools for bathing water assessment in Europe: Balancing social science research with a rapidly developing environmental science evidence-base

The use of molecular tools, principally qPCR, versus traditional culture-based methods for quantifying microbial parameters (e.g., Fecal Indicator Organisms) in bathing waters generates considerable ongoing debate at the science–policy interface. Advances in science have allowed the development and application of molecular biological methods for rapid (~2 h) quantification of microbial pollution in bathing and recreational waters. In contrast, culture-based methods can take between 18 and 96 h for sample processing. Thus, molecular tools offer an opportunity to provide a more meaningful statement of microbial risk to water-users by providing near-real-time information enabling potentially more informed decision-making with regard to water-based activities. However, complementary studies concerning the potential costs and benefits of adopting rapid methods as a regulatory tool are in short supply. We report on findings from an international Working Group that examined the breadth of social impacts, challenges, and research opportunities associated with the application of molecular tools to bathing water regulations.     

Assessment of the effects of nickel on benthic macroinvertebrates in the field

A field-based evaluation of the biological effects of potential nickel (Ni) exposures was conducted using monitoring data for benthic macroinvertebrates and water chemistry parameters for streams in England and Wales. Observed benthic community metrics were compared to expected community metrics under reference conditions using RIVPACS III+?software. In order to evaluate relationships between Ni concentrations and benthic community metrics, bioavailable Ni concentrations were also calculated for each site. A limiting effect from Ni on the 90th percentile of the maximum achievable ecological quality was derived at “bioavailable Ni” exposures of 10.3 μg l^?1. As snails have been identified as particularly sensitive to nickel exposure, snail abundance in the field in response to nickel exposure, relative to reference conditions, was also analysed. A “low effects” threshold for snail abundance based on an average of spring and autumn data was derived as 3.9 μg l^?1 bioavailable Ni. There was no apparent effect of Ni exposure on the abundance of Ephemeroptera (mayflies), Plecoptera (stoneflies) or Tricoptera (caddisflies) when expressed relative to a reference condition within the range of “bioavailable Ni” exposures observed within the dataset. Nickel exposure concentrations co-vary with the concentrations of other stressors in the dataset, and high concentrations of Ni are also associated with elevated concentrations of other contaminants.     

Dynamic workplans and field analytics: Metals assessment by inductively coupled plasma/optical emission spectroscopy

Hazardous waste site investigations were carried out at the Marine Corps Air Station (MCAS) in Yuma, Arizona and at Hanscom Air Force Base (HAFB) in Bedford, Massachusetts. The purpose of the first was to determine the location and extent of metals contamination throughout the base. The objective of the second was to evaluate the risk of metals contamination to groundwater from soil at three locations within the airfield. Dynamic workplans were developed and an adaptive sampling and analysis plan carried out with the data produced in the field used to support the goals of each project. An inductively coupled plasma/optical emission spectrometer (ICP/OES) was modified for field operation. A more efficient microwave digestion method and pressurized Teflon filtration system were developed for the HAFB project. Results were comparable to standard Environmental Protection Agency (EPA) methods, which must rely on two digestion procedures to recover EPA-targeted metals within the prescribed recovery range. The MCAS investigation, conducted over a five-month period, advanced the Navy's efforts from 30 months behind schedule to 18 months ahead of schedule, while the data generated at HAFB showed no risk to groundwater from metals.