Health impact, measurement

Exposure to sulfur dioxide in the ambient air has been associated with reduced lung function, increased incidence of respiratory symptoms and diseases, irritation of the eyes, nose, and throat, and premature mortality. Children, the elderly, and those already suffering from respiratory ailments, such as asthmatics, are especially at risk. Health impacts appear to be linked especially to brief exposures to ambient concentrations above 1,000 ixg/in (acute exposures measured over 10 minutes). Some epidemiologic studies, however, have shown an association between relatively low annual mean levels and excess mortality. It is not clear whether long-... 

I have been asked to discuss the human health impacts of TSCA. Any examination of such "impacts" of the Act should focus on effects that can be measured or estimated. However, in cases where the statutory goals are primarily preventive in nature, measurement or even estimation of health benefits may prove elusive. Although TSCA contains language that appears to require some consideration of the impact of regulation, it is unlikely that Congress intended that precise quantitative evaluation of the effects of TSCA be undertaken. As we shall see, such an evaluation is not feasible. 

In the first section of my talk I hope to show why measurement of these effects as a function of regulatory actions under TSCA is not practical. If such effects are not measurable, then for regulatory purposes they must be estimated, usually by extrapolation from animal experiments. I will briefly indicate that quantitative extrapolation is an uncertain business. In the second section, I will summarize TSCA s probable impact on health, methodological difficulties in measurement notwithstanding. I will conclude with some remarks about recent regulatory pronouncements which seem to indicate that if past policies have had little discernible health impact, future ones may have even less. 

Measurement or estimation of health impacts under TSCA would be premature, since relatively little has been done to regulate new or existing chemicals that could result in health benefits. The principal exception to this generalization is the ban on aerosol uses of CFCs, whose chronic effects on human health derive from their environmental impact rather than direct biological toxicity. Compared with other environmental laws, such as the Clean Air Act, the regulatory accomplishments of TSCA are somewhat insubstantial. 

There are two potential problems with the Optional Reward system. First, its system relies on direct measurements and estimates of health impacts of new drugs. Such measurements are imperfect there are numerous, incompatible, methodologies yielding different answers obtaining the information is expensive and there could be fraud, lobbying, and other such influences. Nevertheless, direct measurement is the best that one can do. 

There are really only three possible routes (1) use the commercial market through the patent system to determine the rewards to the innovator, (2) base rewards to innovators on therapeutic benefits, and (3) do not bother measuring at all. Option (1) is the patent system, but this functions poorly for neglected diseases. Advanced Purchase Commitments use option (2) in a half-hearted way, as I describe below. A system of Transferable Intellectual Property Rights, described below, uses option (3). The key issue is that in the absence of meaningful measurement of health impacts, it is necessary to base rewards only on commercial success, and that is not consistent with a mission to improve the health of the poor. 

From the beginning of the development of nuclear power, nuclear scientists had agonized about what safety measures were needed in power plants and what health impacts radioactivity releases might cause. They published their analyses and arguments for all to see, and it took little effort for the antinuclear activists to collect, organize selectively, and distort this information into ammunition for their battle. People experienced in debate and political fights are well prepared to do that... 

Danesi et al.96 applied SIMS, in addition to X-ray fluorescence imaging, by using a microbeam (p-XRF) and scanning electron microscope equipped with an energy dispersive X-ray fluorescence analyzer (SEM-EDXRF) to characterize soil samples and to identify small DU particles collected in Kosovo locations where depleted uranium (DU) ammunition was employed during the 1999 Balkan conflict. Knowledge of DU particles is needed as a basis for the assessment of the potential environmental and health impacts of military use of DU, since it provides information on possible resuspension and inhalation. The measurements indicated spots where hundreds of thousands of particles may be present in a few mg of contaminated soil. The particle size distribution showed that most of the DU particles were < 5 pm in diameter and more than 50 % of the particles had a diameter of < 1.5 p.m.96... 

Morawska L, Jayaratne ER, Rnibbs LD, Megatmokhtar M (2010) Regulations and policy measures related to the reduction of ambient particulate matter. In Zereini F, Wiseman C (eds) Urban particulate matter origins, chemistry, fate and health impacts. Springer, Berlin... 

Risk is not always a useful measure of health impact in evaluating the risk index, because risk is not proportional to dose when a hazardous substance is assumed to have a threshold dose-response relationship. For this type of substance, the risk is presumed to be zero at any dose below a nominal threshold. Since the allowable dose of such substances should always be less than the threshold in order to prevent the occurrence of adverse responses, expressing the risk index in terms of risk would result in an indeterminate value when the dose is below the threshold and, more importantly, a lack of distinction between doses near the nominal thresholds and lower doses of much less concern. For any hazardous substance, including carcinogens for which risk is assumed to be proportional to dose without threshold, a generally useful form of risk indexes (Rid is in terms of dose ... 

Classification of radioactive waste has been facilitated by two considerations. The first is that radiation dose provides a common measure of potential health impacts from exposure to any radionuclide and for any exposure situation (see Section 3.2.2). All classification systems for radioactive waste take into account, at least to some... 

The health impacts of chemicals are significant, though difficult to quantify. Some estimates are available (WHO 2002) indicating that about 5% of the global burden of disease can be attributed to environmental chemicals exposures. The distribution of effects across the globe is the result of the combined effect of the volume of chemicals use and the effectiveness of chemical safety measures. In the countries of the OECD (Organisation for Economic Co-operation and Development) in general... 

Bergner, M. Bobbitt, R. Kressel, S. Pollard, W. Gilson, B. Morris, J. The sickness impact profile Conceptual formulation and methodology for the development of a health status measure, Int, J. Flealth Serv. 1976, 6, 393-415. 

Meenan RF, Gertman PM, et al. Measuring health status in arthritis the arthritis impact measurement scales. Arthritis Rheum 1980 23 146-52. 

With typically 30 or more different emissions to each of air, to water, and in the form of solid waste, it is extremely difficult to draw meaningful conclusions based on examination of Usts of outputs that are developed as part of the LCI. To get beyond numbers overload, each LCI inventory value is assigned to a small number of different impact categories so that a composite of a large number of LCI values can be reduced to just a few key impact measures. The characterization of how much impact each compound has on a given category is based on models that estimate relative importance to human or ecological health or landscape impacts. 

In summary, the chemistry of a cigarette smoke is very complex, with a vast number of elements and compounds generated in particle, vapour and gaseous phases. Some of these elements and compounds are generated in very small quantities, while others are in larger, easily measurable quantities. Some of the combustion products are specific to tobacco smoking, such as nicotine, others are also emitted by different, particularly combustion, sources. These compounds which are specific to ETS have been used as a marker of the smoke, but also compounds that are nonspecific to the smoke have been used for this purpose as well. The applicability of a compound as a marker of cigarette smoke does not necessarily point out the health impact of this particular compound. 

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