Education in environmental health of health care professionals: What needs to be done?

BackgroundHealth professionals are key actors in environmental health. Taking on this role requires a certain degree of competence. That is the reason why education in environmental health of health care professionals became a major concern at international level, notably at WHO level. However, in the European Union only the individual Member States are responsible for organizing education and no official body seems to have started outlining recommendations on how to set up this kind of training.ObjectivesWe set out to draw up some propositions for training in environmental health on the basis of the practice of educational institutions involved in training health care professionals.MethodsA survey was conducted in 934 educational institutions involved in training health care professionals in 11 European countries and in Canada.ResultsOur data reveal that, whereas there are many establishments — nearly half of those that replied — engaged in educating health care professionals in environmental health, they do so in a great variety of ways, whether in terms of objectives, content, the number of teaching hours, or their target groups. Moreover, there is only limited evaluation of this training, which makes the question of recognition a very difficult one.ConclusionsNumerous difficulties have been raised in relation to education in environmental health, both by trainers and trainees. Some solutions to these difficulties are suggested but the need of official guidelines keeps going.     

Estrogenic and androgenic activities in total plasma measured with reporter-gene bioassays: relevant exposure measures for endocrine disruptors in epidemiologic studies?

Measurements of estrogenic and androgenic activities in total plasma with Chemically Activated LUciferase gene eXpression (CALUX?) bioassays could provide biologically relevant measures for exposure to endocrine disruptors in epidemiologic studies. The objective of this study was to explore the effects of a variety of sources of potential endocrine disruptors on estrogenic and androgenic activities in total plasma measured by CALUX?. Plasma samples and interview data on sources of potential endocrine disruptors were collected from 108 men with different exposures profiles. CALUX? measurements (BioDetection Services) involved human U2-OS cell lines controlled by the estrogen receptor alpha and the androgen receptor. Mean differences (beta) in 17β-estradiol equivalents (EEQs) and dihydrotestosterone equivalents (AEQs) between exposure groups were estimated using general linear models. Mean plasma AEQs and EEQs were 9.1×10(-1)ng/ml and 12.0pg/ml, respectively. Elevated AEQs were found in smokers (beta 1.9 (95%CI 0.1-3.6)×10(-1)ng/ml) and heavy drinkers (1.4 (0.2-3.1)×10(-1)ng/ml), and in men occupationally exposed to disinfectants (1.6 (0.3-3.5)×10(-1)ng/ml) or welding/soldering fumes (1.4 (-0.2-2.9)×10(-1)ng/ml). Occupational exposure to pesticides, disinfectants, and exhaust fumes seemed to be associated with increased plasma EEQs: 1.5 (-0.2-3.2)pg/ml, 2.1 (0.2-3.9)pg/ml, and 2.9 (0.6-5.2)pg/ml, respectively. Moderate to high plasma dioxin levels, measured in a subgroup by the dioxin-responsive CALUX?, were accompanied by a 20% increase in AEQs. This is the first study in which CALUX? was used to assess hormone activities in total plasma. Although the results are not yet readily interpretable, they indicate that these measurements can be valuable for epidemiologic studies on endocrine disruptors and give direction for further research.     

Vertical heterogeneity in physiological characteristics of Ulva spp. mats

In eutrophic areas, green macroalgae are frequently and for long periods arranged in mats, resulting in a steep light gradient. This study investigates the effect of this gradient on physiological characteristics [tissue nitrogen content, maximal photosynthetic efficiency (F_v/F_m), glutathione levels and redox ratio, absorbance and absorption spectra] of the green macroalga Ulva spp. Mats were sampled during the build-up (June), stationary (July), and decomposing (September) phases of a macroalgal bloom in the Veerse Meer, a eutrophic brackish (salinity 15–20 psu) lake in the southwest Netherlands. Water samples were taken for nutrient analyses. At all three sampling dates, the mats were composed almost entirely of Ulva spp.; in September the mats were in decay and covered with silt and epiphytes. In June and July, total dissolved inorganic nitrogen concentration (DIN) of the water within the mat was significantly higher than outside the mat. Pronounced vertical differences were found in tissue N, F_v/F_m values, total glutathione levels, glutathione redox ratios, and absorbance. In June and July, tissue N decreased from over 2.2% dry weight (DW; N-sufficient) in the bottom layers to around 1% DW (minimum level for survival) in the top layers. Wide-band absorption increased with depth in the mat and throughout the season, probably due to higher Chl a and b and lutein contents. The shape of the absorption spectrum was similar for all layers. The absorption of the silt/epiphyte film on the top Ulva layer was highest; its absorption spectrum (high absorption in the 500–560 nm range) indicates that the film on the top layers of the macroalgal mats mainly consisted of diatoms. In June, F_v/F_m and the glutathione redox ratio of the algae increased with depth in the layer, while total glutathione decreased. Low F_v/F_m values in the bottom and middle layers in September reflect the bad condition of the algae; the mats were largely decaying. It is concluded that multiple growth-limiting gradients occur in macroalgal mats: upper layers suffer from nitrogen limitation and photoinhibition while bottom layers are light limited. The algae in the mat acclimatize to low light conditions by increasing their absorption through increased pigment contents and by higher photosynthetic efficiency during the build-up and stationary period. This study qualifies the glutathione redox ratio as a promising candidate for stress indicator in macroalgae and provides suggestions for its further development.Communicated by S.A. Poulet, Roscoff     

Low hepatic 7-ethoxyresorufin-O-deethylase (EROD) activity and minor alterations in retinoid and thyroid hormone levels in flounder (Platichthys flesus) exposed to the polychlorinated biphenyl (PCB) mixture, Clophen A50

The effect of the polychlorinated biphenyl (PCB) mixture Clophen A50 on hepatic cytochrome P4501A1 dependent EROD (7-ethoxyresorufin-O-deethylase) activity, plasma thyroid hormone levels and plasma, kidney and liver retinoid concentrations of the euryhaline flatfish flounder (Platichthys flesus) was determined 2 and 10 days after i.p. (intraperitoneal) injection with 20, 100 and 500 mg Clophen A50/kg body weight. No effect of Clophen A50 on total cytochrome P450 content in flounder liver was observed at both time points. A six-fold, dose-dependent, significant increase in EROD activity was found at exposure day 10 in flounder receiving 100 or 500 mg Clophen A50/kg body weight. Plasma retinol concentrations were not altered at both time points after Clophen A50 administration, whereas renal retinol levels showed a minor dose-related increase at day 2 and day 10 of exposure. Significant alterations in hepatic retinoid concentrations were observed, which were not dependent on the dose of PCB administered. In addition Clophen A50 administration did not result in a dose-related alteration of total T4 concentrations in plasma. Total T3 concentrations in plasma were only significantly increased at day 2 after exposure, whereas free T4 concentrations were increased at both time points after Clophen A50 administration. These data indicate that with regard to the parameters investigated and in contrast to other fish species studied, the flounder is not a sensitive species to PCB exposure.     

Transthyretin (prealbumin) binding of PCBS, a model for the mechanism of interference with vitamin A and thyroid hormone metabolism

In this study a direct interaction of a metabolite of 3,4,3′,4′-tetrachlorobiphenyl with transthyretin (prealbumin) was observed, leading to reduced plasma levels of retinol, RBP and thyroxin in rats and mice.     

Does interspecific competition alter effects of early season ozone exposure on plants from wet grasslands? Results of a three-year experiment in open-top chambers

Chronic effects of ozone on wet grassland species early in the growing season might be altered by interspecific competition. Individual plants of Holcus lanatus, Lychnis flos-cuculi, Molinia caerulea and Plantago lanceolata were grown in monocultures and in mixed cultures with Agrostis capillaris. Mesocosms were exposed to charcoal-filtered air plus 25 nl l(-1) ozone (CF+25), non-filtered air (NF), non-filtered air plus 25 nl l(-1) ozone (NF+25) and non-filtered air plus 50 nl l(-1) ozone (NF+50) early in the growing seasons of 2000 through 2002. Ozone-enhanced senescence and visible foliar injury were recorded on some of the target plants in the first year only. Ozone effects on biomass production were minimal and plant response to ozone did not differ between monocultures and mixed cultures. After three years, above-ground biomass of the plants in mixed culture compared to monocultures was three times greater for H. lanatus and two to four times smaller for the other species.     

Are brominated flame retardants endocrine disruptors?

Brominated flame retardants (BFRs) are a group of compounds that have received much attention recently due to their similarity with "old" classes of organohalogenated compounds such as polychlorinated biphenyls (PCBs), in terms of their fate, stability in the environment and accumulation in humans and wildlife. Toxic effects, including teratogenicity, carcinogenicity and neurotoxicity, have been observed for some BFR congeners, in particular the brominated diphenyl ethers (BDEs). This concise review focuses on the potency of BFRs and to disrupt endocrine systems, and attempts to answer the question whether or not BFRs are endocrine disruptors. Evidence is provided on the disruption of the thyroid hormone system by BFRs, with particular emphasis on the BDEs, as most recent data is available on this class of flame retardants. Similar to the hydroxylated PCBs, in vitro mechanistic studies as well as animal experiments have demonstrated the effects of BDEs on thyroid hormone transport and metabolism. An overview of possible effects of BFRs on the estrogen system is also provided. Research gaps are outlined, as well as ongoing and future studies in the European community aimed at contributing to comprehensive risk assessments based on the endocrine-disrupting effects of BFRs.     

Application of a value-based equivalency method to assess environmental damage compensation under the European Environmental Liability Directive

The Environmental Liability Directive (ELD) establishes a framework of liability based on the ‘polluter-pays’ principle to prevent and remedy environmental damage. The ELD requires the testing of appropriate equivalency methods to assess the scale of compensatory measures needed to offset damage. The aim of this paper is to contribute to fill the existing knowledge gap on the application of the value equivalency approach for damage compensation in this context. We analyze the toxic spill damaging the Doñana National Park (Spain) in 1998. The welfare losses associated with the resource damage are estimated using non-market valuation and compared to the value of the compensatory measures taken after the accident. Our results show that the in-kind compensation may have been insufficient to offset the welfare losses. We conclude that a more comprehensive knowledge of the human welfare effects caused by environmental damage is of substantial importance to determine compensatory remediation, as insufficient information in this respect can lead to erroneous decisions causing loss to society.     

About bridges and bonds: community responses to the 2000 floods in Mabalane district, Mozambique

Massive floods hit Mozambique in 2000.1 Many of the affected regions benefited from external aid. This paper investigates how the floods impacted on two communities in the interior of the Limpopo Valley, which did not receive significant assistance during the event and in the immediate aftermath. Drawing on the livelihood approach, it focuses on the role of two types of local resources: knowledge and social capital. The paper shows that the scale of the 2000 floods surpassed the response capacity of these resources and looks at how wealth and gender influenced access by households to the local support mechanisms that enhance survival and recovery. It appears that the floods mainly affected wealthier households, as these more frequently lost houses and cattle. The paper points to the importance of ploughs and cattle for local support mechanisms, which, in turn, most likely reduced the capacities of communities to recover from the disaster.     

Immobilisation of PAH in waste materials

This paper gives an overview of the results of a research project into the possibilities of immobilising polycyclic aromatic hydrocarbons (PAH), that are present in waste materials. The results show that with hydraulic binders the waste materials can be solidified. The PAH do still leach to a relatively high extent. However, this PAH leaching can be decreased by more than a factor 10 by means of the addition of a specific additive. The immobilisation product fulfils technological requirements for the use as a road base construction material, such as compressive strength.