Volume 31, Issue 1 - Special Issue: Invited Reviews from the 16th International Conference of the Pacific Basin Consortium for Environment and Health

The Pacific Basin Consortium (PBC) was formed 25 years ago to address significant public health challenges to vulnerable populations imposed by environmental threats in the region, including areas surrounding the rim of and in the Pacific Ocean. Originally focused on toxic waste pollution, the PBC has broadened its efforts over the years, embracing a health focus and more of a balance between engineering and public health. This move was informed by the PBC’s close relationship with the National Institutes of Health (NIH) National Institute of Environmental Health Sciences (NIEHS) Superfund Hazardous Substances Basic Research and Training Program (Superfund Research Program, or SRP), which played a dynamic role in the PBC from its early days. In addition, a sub-focus on children’s environmental health emerged, which helped set the agenda for children’s environmental health research in the region. Progress has also been made in reducing harm from some threats, particularly via extensive interventions to remediate arsenic in drinking water in Bangladesh, western Thailand, and Vietnam. However, many of the environmental health problems in the Pacific Basin region persist, including air pollution, inadequate safe drinking water, undernutrition, and a growing electronic waste problem. In the Pacific Basin and elsewhere, people with the lowest incomes often live in areas with the worst pollution. Although it is difficult to implement, dynamic strategic networking efforts are vital to understanding and correcting the inequities that persist in global environmental health. The PBC can help accomplish this by continuing and expanding its work to foster and enhance collaborations and communications between environmental health and engineering investigators and to integrate investigator-initiated research. As the PBC looks forward, there is also a need to exert increased effort to establish and maintain partnerships, to develop community-based primary-care and health services for vulnerable populations, as well as to connect with researchers in the eastern side of the Pacific basin and those in smaller island states.

Early life exposure to inorganic arsenic is associated with a wide range of malignant and chronic disease outcomes in humans. Prenatal arsenic exposure may give rise to adverse effects on child health and development as arsenic readily passes through the placenta in human beings. The impact of maternal arsenic exposure on fetal gene expression was conducted in pregnant women living in Southern Thailand. Arsenic exposed newborns had significantly higher levels of arsenic in cord blood, and a set of genes associated with numerous biological pathways, including cell signaling, apoptosis, inflammatory and stress response. A slight increase in promoter methylation of p53 in cord blood lymphocytes which correlated with arsenic accumulation in nails was observed in these exposed newborns. A follow-up study on these exposed children showed a significant increase in oxidative DNA damage, measured as 8-hydroxydeoxyguanosine (8-OHdG) in saliva. In addition, levels of urinary 8-OHdG excretion and salivary hOGG1 expression were significantly decreased in exposed children suggesting a defect in repair of 8-OHdG in arsenic-exposed children. Our study indicates that prenatal arsenic and continued exposure through early childhood can trigger various genetic and epigenetic alterations that may lead to disease development later in life.

In Indonesia, more than 200 illegal used lead acid battery (ULAB) smelters are currently operating. Only a few health studies support the finding of lead-related symptoms and diseases among populations living near the smelters. To assess the blood lead levels (BLLs) and potential health impacts among the population surrounding ULAB recycling smelters, we evaluated health effects reported from 2003 to 2013, conducted focus group discussions with lead smelter owner/workers and a group of 35 female partners of smelter owners or workers not actively engaged in smelter work, and retook and measured BLLs. It was found that many children in the areas were having difficulty achieving high grades at school and having stunting or other problems with physical development. The average mean of BLLs increased by almost double in 2015, compared with in 2011. The risk of having hypertension, interference in the ability to make red blood cells in females occurred among 24% of respondents; Elevated blood pressure, hearing loss, and interference in the ability to make red bloods cell occurred in 20% of males; Kidney damage, infertility in male, nerve problems, including decreased sensation and decreased ability to move quickly occurred in 13%; Decreased ability to make red blood cells (20%), and; Frank anemia, decreased life-span, coma/seizures were experienced by 22%. The populations living in areas surrounding ULAB smelters are experiencing severe chronic health problems. It is recommended that the smelters must be moved and placed far away from the municipality.

Mercury (Hg) is a global contaminant whose presence in the biosphere has been increased by human activity, particularly coal burning/energy production, mining, especially artisanal scale gold mining, and other industrial activities. Mercury input to the surface ocean has doubled over the past century leading governments and organizations to take actions to protect humans from the harmful effects of this toxic element. Recently, the UN Environmental Program led 128 countries to negotiate and sign a legally binding agreement, the 2013 Minimata Convention, to control Hg emissions and releases to land and water globally. In an effort to communicate science to this emerging international policy, the Dartmouth Superfund Research Program formed the Coastal and Marine Mercury Ecosystem Research Collaborative (C-MERC) in 2010 that brought together more than 70 scientists and policy experts to analyze and synthesize the science on Hg pollution in the marine environment from Hg sources to MeHg in seafood. The synthesis of the science revealed that the sources and inputs of Hg and their pathways to human exposure are largely determined by ecosystem spatial scales and that these spatial scales determine the organizational level of policies. The paper summarizes the four major findings of the report.

During the past two decades, mercury has come under increasing scrutiny with regard to its safety both in the general population and in occupationally exposed groups. It’s a growing issue of global concern because of its adverse environmental and health impacts. Very few investigations on mercury amalgam use in the dentistry sector have been carried out in South Asia and there is little data reported on mercury contamination of indoor/outdoor air at dental sites. According to an earlier SDPI study, reported in 2013, alarmingly high mercury levels were observed in air (indoor as well as outdoor) at 11 of the 34 visited dental sites (17 dental teaching institutions, 7 general hospitals & 10 dental clinics) in five main cities of Pakistan. 88% of the sites indicated indoor mercury levels in air above the USA EPA reference level of 300 ng/m 3 . According to our study, carried out at 38 dental teaching institutions in 12 main cities (in Khyber Pakhtunkhwa, Punjab and Sindh provinces) of Pakistan, respondents were of the opinion that the currently offered BDS curriculum does not effectively guide outgoing dental professionals and does not provide them adequate knowledge and training about mercury/mercury amalgam and other mercury related human health and mercury waste issues. 90% of respondents supported the review and revision of the present dental curriculum offered at dental teaching institutions in the country, at the earliest. A study has also been conducted to assess the status of mercury amalgam use in private dental clinics in Gilgit, Hunza, Peshawar, Rawalpindi and Islamabad. More than 90 private dental clinics were visited and dental professionals/private clinics in-charge were interviewed during June–July, 2015. The focus areas of the study were Hg amalgam toxicity, its waste management practices and safety measures practiced among the dental practitioners. In the light of the findings described and discussed in this brief report, to safeguard public health and for the protection of environment, it is strongly recommended that since mercury amalgam use cannot be banned immediately in the country, its use may be regularized and allowed subject to use of “Amalgam Separators,” “Capsulated Mercury” and “Mechanized Mixing,” use of mercury amalgam be banned for children (below 12 years age) and pregnant women. The curriculum currently being taught at medical and dental colleges in the country be reviewed and revised, to ensure adequate training towards minimizing mercury exposure.

Drinking water is essential to us as human beings. According to the World Health Organization “The quality of drinking-water is a powerful environmental determinant of health” (http://www.who.int/water_sanitation_health/dwq/en/), but clean drinking water is a precious commodity not always readily available. Surface and ground water are the major sources of drinking water. Both can be contaminated, surface water with bacteria while ground water frequently contains salts of metals that occur naturally or are introduced by human activity. This paper will briefly review the metallic salts found in drinking water in areas around the world, as well as list some of the methods used to reduce or remove them. It will then discuss our research on reducing the risk of pollution of drinking water by removal of metal ions from wastewater.

Aim: Exposure assessment of lead (Pb) and Arsenic (As) from food, water, and house dust intake were assessed among pregnant women, their children and fetuses in Pakistan and Japan, as well as their body burden of the metals in their blood. Method: Fifty families which included a pregnant woman, a fetus and the 1–3-year-old siblings were recruited in Karachi and Khairpur in Pakistan, and Shimotsuke and Asahikawa in Japan, respectively. Their dietary exposure to Pb and As was measured in 3-day food duplicates and drinking water by ICP-MP. Pb in house dust and respirable dust was evaluated with an energy dispersive X-ray fluorescence spectrometry. Non-radioactive isotope Pb profiles of blood specimens will be compared with those of the exposure origins, such as food duplicates, respirable house dust, the soils nearby, and gasoline. Results: Judging from the data collected and analyzed so far, contribution from dietary intake is highly correlated to higher body burden of Pb among Pakistani mothers. Additional data analyses will reveal the status of Pb and As body burden in Pakistani mothers, fetuses and their siblings, and causal sources of high body burden is delineated by Pb isotope profile analysis of different sources of Pb exposure.

The overall project objective at the Iron King Mine Superfund site is to determine the level and potential risk associated with heavy metal exposure of the proximate population emanating from the site’s tailings pile. To provide sufficient size-fractioned dust for multi-discipline research studies, a dust generator was built and is now being used to generate size-fractioned dust samples for toxicity investigations using in vitro cell culture and animal exposure experiments as well as studies on geochemical characterization and bioassay solubilization with simulated lung and gastric fluid extractants. The objective of this study is to provide a robust method for source identification by comparing the tailing sample produced by dust generator and that collected by MOUDI sampler. As and Pb concentrations of the PM 10 fraction in the MOUDI sample were much lower than in tailing samples produced by the dust generator, indicating a dilution of Iron King tailing dust by dust from other sources. For source apportionment purposes, single element concentration method was used based on the assumption that the PM 10 fraction comes from a background source plus the Iron King tailing source. The method’s conclusion that nearly all arsenic and lead in the PM 10 dust fraction originated from the tailings substantiates our previous Pb and Sr isotope study conclusion. As and Pb showed a similar mass fraction from Iron King for all sites suggesting that As and Pb have the same major emission source. Further validation of this simple source apportionment method is needed based on other elements and sites.

In this paper, our group reports the use of a new framework in sites contaminated with mercury. This is significant because under the Minamata Convention on Mercury each Party shall endeavor to develop appropriate strategies for identifying and assessing sites contaminated by mercury or mercury compounds. This new approach, the “CHILD” framework has five steps: i) Community-based risk characterization; ii) Habilitation; iii) Intervention; iv) Laws and Regulation; and v) Development. We are using this framework in three mercury artisanal mining sites, and preliminary results are depicted in this report.

Shale deposits exist in many parts of the world and contain relatively large amounts of natural gas and oil. Recent technological developments in the process of horizontal hydraulic fracturing (hydrofracturing or fracking) have suddenly made it economically feasible to extract natural gas from shale. While natural gas is a much cleaner burning fuel than coal, there are a number of significant threats to human health from the extraction process as currently practiced. There are immediate threats to health resulting from air pollution from volatile organic compounds, which contain carcinogens such as benzene and ethyl-benzene, and which have adverse neurologic and respiratory effects. Hydrogen sulfide, a component of natural gas, is a potent neuro- and respiratory toxin. In addition, levels of formaldehyde are elevated around fracking sites due to truck traffic and conversion of methane to formaldehyde by sunlight. There are major concerns about water contamination because the chemicals used can get into both ground and surface water. Much of the produced water (up to 40% of what is injected) comes back out of the gas well with significant radioactivity because radium in subsurface rock is relatively water soluble. There are significant long-term threats beyond cancer, including exacerbation of climate change due to the release of methane into the atmosphere, and increased earthquake activity due to disruption of subsurface tectonic plates. While fracking for natural gas has significant economic benefits, and while natural gas is theoretically a better fossil fuel as compared to coal and oil, current fracking practices pose significant adverse health effects to workers and near-by residents. The health of the public should not be compromized simply for the economic benefits to the industry.

Patent classification systems have traditionally evolved independently at each patent jurisdiction to classify patents handled by their examiners to be able to search previous patents while dealing with new patent applications. As patent databases maintained by them went online for free access to public as also for global search of prior art by examiners, the need arose for a common platform and uniform structure of patent databases. The diversity of different classification, however, posed problems of integrating and searching relevant patents across patent jurisdictions. To address this problem of comparability of data from different sources and searching patents, WIPO in the recent past developed what is known as International Patent Classification (IPC) system which most countries readily adopted to code their patents with IPC codes along with their own codes. The Cooperative Patent Classification (CPC) is the latest patent classification system based on IPC/European Classification (ECLA) system, developed by the European Patent Office (EPO) and the United States Patent and Trademark Office (USPTO) which is likely to become a global standard. This paper discusses this new classification system with reference to patents on bioremediation.

Genome wide expression profiling of Sphingobium indicum B90A revealed induction of lin genes, linA and linB, involved in dechlorination of hexachlorocyclohexane (HCH), in the presence of all four isomers of HCH. Supporting proteomics data, the qPCR and promoter assay showed upregulation of linA transcription in the presence of HCH isomers. Analysis of the upstream region of the linA gene revealed the existence of the GntR binding site overlapping the -10 hexamer of the putative promoter motif. As GntR is a known transcription repressor its dissociation from the linA promoter is expected to induce lin genes in the presence of HCH isomers. Comparison of in situ and in-culture proteomics indicated expression lin genes at the dumpsite, an indication for the in situ HCH degradation.

Conventional industrial effluent treatment systems are designed to reduce biochemical oxygen demand (BOD), chemical oxygen demand (COD) but not total dissolved solids (TDS), mainly contributed by chlorides. In addition to the removal of TDS, it is necessary to recover water for reuse to meet the challenges of shortage of quality water. To recover water, the wastewater needs to be further treated by adopting treatment systems including microfilters, low pressure membrane units such as ultrafiltration (UF), membrane bioreactors (MBR), etc., for the application of reverse osmosis (RO) systems. By adopting the RO system, 75%–80% of quality water with <500 mg/L of TDS is recovered from treated effluent. The management of 20%–25% of the saline water rejected from the RO system with high TDS concentration is being addressed by methods such as forced evaporation systems. The recovery of water from domestic and industrial waste for reuse has become a reality. The membrane system has been used for different applications. It has become mandatory to achieve zero liquid discharge (ZLD) in many states in India and other countries such as Spain, China, etc., and resulted in development of new treatment technologies to suit the local conditions.

Mercury is a pollutant of pressing global concern. National and international efforts are focused on reducing mercury in the environment to prevent its adverse health impacts. Better sensors would aid in these efforts. This paper details ongoing efforts to deploy novel plasmonic mercury sensors. The authors describe the research efforts to develop the fundamental technology in a research lab and the experience translating that fundamental research into a viable field-ready sensor. Lessons learned along the way are explored.

Human behaviors including consumption of drugs and use of personal care products, climate change, increased international travel, and the advent of water reclamation for direct potable use have led to the introduction of significant amounts of emerging organic contaminants into the aqueous environment. In addition, the lower detection limits associated with improved scientific methods of chemical analysis have resulted in a recent increase in documented incidences of these contaminants which previously were not routinely monitored in water. Such contaminants may cause known or suspected adverse ecological and/or human health effects at very low concentrations. Conventional drinking water treatment processes may not effectively remove these organic contaminants. Advanced oxidation process (AOP) is a promising treatment process for the removal of most of these emerging organic contaminants, and has been accepted worldwide as a suitable treatment process. In this study, different groups of emerging contaminants were studied for decomposition efficiency using pilot-scale UV/H 2 O 2 oxidation setup, including EDCs, PPCPs, taste and odor (T&O), and perfluorinated compounds. Results found that MP UV/H 2 O 2 AOP was efficient in removing all the selected contaminants except perfluorinated compounds. Study of the kinetics of the process showed that both light absorption and quantum yield of each compound affected the decomposition performance. Analysis of water quality parameters of the treated water indicated that the outcome of both UV photolysis and UV/H 2 O 2 processes can be affected by changes in the feed water quality.

Pharmaceuticals, newly recognized classes of environmental pollutants, are becoming increasingly problematic contaminants of either surface water or ground water around industrial and residential communities. Pharmaceuticals are constantly released into aquatic environments, mainly due to their widespread consumption and complicated removal in wastewater treatment plants. Heterogeneous photocatalysis appear to be one of the most destructive advanced oxidation processes (AOPs) for organic contaminants and are possible to obtain complete mineralization of organic pollutants into eco-friendly end products under visible and solar light irradiation. In this study, flower-like In 2 S 3 hierarchical nanostructures were successfully prepared via a facile solution-phase route, using thioacetamide as both sulfur source and capping agent. X-ray diffractometry (XRD) of the flowers revealed that the cubic structure of In 2 S 3 ; morphological studies examined by scanning electron microscopy (SEM) showed the synthesized In 2 S 3 nanostructure was flower-like hierarchitecture assembled from nanoscale flakes. X-ray photoelectron spectroscopy (XPS) analysis confirmed the stoichiometry of In 2 S 3 nanoflowers. Furthermore, the photocatalytic activity studies revealed that the prepared indium(III) sulfide(In 2 S 3 ) nanoflowers exhibit an excellent photocatalytic performance, degrading rapidly the aqueous pharmaceutical solution of Lisinopril under visible light irradiation. These results suggest that In 2 S 3 nanoflowers will be a promising candidate of photocatalyst working in thevisible light range.

The Navajo Nation is the largest and one of the driest Native American reservations in the US. The population in the Navajo Nation is sporadically distributed over a very large area making it extremely ineffective to connect homes to a centralized water supply system. Owing to this population distribution and the multi decadal drought prevailing in the region, over 40% of the 300,000 people living on Navajo Tribal Lands lack access to running potable water. For many people the only alternative is hauling water from filling stations, resulting in economic hardship and limited supply. A solution to this problem is a de-centralized off-grid water source. The University of Arizona and US Bureau of Reclamation’s Solar Membrane Distillation (SMD), stand-alone, pilot desalination system on the Navajo Reservation will provide an off-grid source of potable water; the pilot will serve as a proximal water source, ease the financial hardships caused by the drought, and provide a model for low-cost water treatment systems in arid tribal lands. Bench-scale experiments and an earlier field prototype plant showed viable operation of a solar heated, membrane distillation (MD) system, but further optimization is required. The objectives of the Navajo pilot study are to i) demonstrate integration of solar collectors and membrane distillation, ii) optimize operational parameters, iii) demonstrate and monitor technology performance during extended duration operation, and iv) facilitate independent system operation by the Navajo Water Resources Department, including hand-over of a comprehensive operations manual for implementation of subsequent SMD systems. The Navajo SMD system is designed as a perennial installation that includes remote communication of research data and full automation for remote, unmanned operation.

The World Health Organization (WHO) reports some progress on the global problem of a lack of improved water and sanitation. Between 1990 and 2012, the number of people that gained improved access to improved drinking water reached 2.3 billion people, while the number of children that have died from diarrheal diseases has fallen from 1.5 million deaths to just above 600,000 deaths (1, 2). However, it is estimated that there are still 1.8 billion people using a fecally contaminated source of drinking water (3). In addition, 748 million people continue to lack clean water, 1 billion continue to practice open defecation, and 2.5 billion people still lack adequate sanitation (3). In response to this global issue, Engineers Without Borders USA (EWB-USA) began with a mission to build a better world through engineering projects that empower communities to meet their basic human needs and equip leaders to solve the world’s most pressing challenges. Their 15,000+ members work with communities to find appropriate solutions to improve water supply, sanitation, energy, agriculture, civil works and structures. Their development approach is based on standard engineering methodology, including problem identification, assessment, alternatives analysis, implementation, and monitoring and evaluation. EWB-USA began in 2002 and currently has members working in over 40 countries around the world. The majority of their work is focused in Latin America and Africa, but their programs are expanding to Asia and the Pacific Basin. Currently, EWB-USA members are working in 17 programs in six countries, including the Philippines, Thailand, Cambodia, India, Nepal, and Fiji. Success in these programs is defined by measuring overall impact and learning from failure. Impact is measured through Standard Monitoring Indicators and learning is accomplished by documenting failures and lessons learned. Through this work, the organization has impacted 2.5 million lives through primarily water supply and sanitation projects by focusing on sustainable engineering solutions, community-education, capacity building, and appropriate technologies and local resources.

The environmental mobilization of contaminants by “natural disasters” is a subject of much interest, however, little has been done to address these concerns, especially in the developing world. Frequencies and predictability of events, both globally and regionally as well as the intensity, vary widely. It is clear that there are greater probabilities for mobilization of modern contaminants in sediments. Over the past 100 years of industrialization many chemicals are buried in riverine, estuarine and coastal sediments. There are a few studies, which have investigated this potential risk especially to human health. Studies that focus on extreme events need to determine the pre-existing baseline, determine the medium to long term fate and transport of contaminants and investigate aquatic and terrestrial pathways. Comprehensive studies are required to investigate the disease pathways and susceptibility for human health concerns.

Environmental exposures are changing dramatically in location, intensity, and frequency. Many developing countries are undergoing a transition in which they face the double burden of infectious diseases as well as chronic diseases. Noncommunicable diseases have emerged as the leading cause of death and disability in developing countries. Globally, pollution is insufficiently appreciated and inadequately quantified as a cause of disease. The health burden from both noninfectious diseases and infectious disease, especially parasites, is high among exposed people. Mothers and children are particularly vulnerable to pollution-related diseases in developing countries. Exposures to pollution can cause protracted noncommunicable diseases across their life span. A global initiative to promote human health sciences and technologies would enhance collaborations and communications amongst investigators and public environmental health officials. Existing models that facilitate the transfer of information and research results exist and can provide insight into building such an international network, allowing better prediction of disease risk and provide ways to reduce exposure to environmental contaminants. A global network would bring together scientists from multiple disciplines and countries to work toward a better understanding of the double burden of disease, especially in low and middle income countries, and promote ways to improve public health.

The UN General Assembly has just adopted the post 2015 Sustainable Development Agenda articulated in the 17 Sustainable Development Goals (SDGs). Achieving the SDGs will be furthered by the closer integration of the climate change adaptation (CCA) and disaster risk reduction (DRR) agendas. Gender provides us a valuable portal for considering this integration. Acknowledging that gender relaters to both women and men and that men and women experience climate variability and disasters differently, in this paper the role of women in both CCA and DRR is explored, shifting the focus from women as vulnerable victims to women as critical agents for change with respect to climate change mitigation and adaptation and reduction of disaster risks. Appropriately targeted interventions can also empower women and contribute to more just and inclusive sustainable development.

Dramatic changes taking place locally, regionally, globally, demand that we rethink strategies to improve public health, especially in disadvantaged communities where the cumulative impacts of toxicant exposure and other environmental and social stressors are most damaging. The emergent field of Sustainability Science, including a new bioregionalism for the 21st Century, is giving rise to promising place-based (territorially rooted) approaches. Embedded in this bioregional approach is an integrated planning framework (IPF) that enables people to map and develop plans and strategies that cut across various scales (e.g. from regional to citywide to neighborhood scale) and various topical areas (e.g. urban land use planning, water resource planning, food systems planning and “green infrastructure” planning) with the specific intent of reducing the impacts of toxicants to public health and the natural environment. This paper describes a case of bioregionally inspired integrated planning in San Diego, California (USA). The paper highlights food-water-energy linkages and the importance of “rooted” community-university partnerships and knowledge-action collaboratives in creating healthy and just bioregions.

Among children, infections with soil-transmitted helminths (STH) can cause anemia, impaired growth, and absence from school. Sustainable control of STH infection requires that appropriate latrines be integrated with health-promotion education. We report a pilot study of the effects of a combined latrine-education intervention in Central Java, Indonesia. The participants were 99 children (3–13 years old) in two villages (intervention and control) south of Semarang city. Stool samples were collected from the children and were examined for the presence of helminth eggs. After baseline data were collected, latrines were constructed and health education was given in the intervention village. Then, in both villages, all children who had STH infection at baseline were given 400 mg of albendazole. Eight months later, follow-up stool samples were collected and examined. In both villages, 20% of the children had STH infection at baseline. At follow-up, the incidence of STH infection was much lower in the intervention village than in the control village (4.0% vs. 20.4%; p<0.02). The results of this small pilot study give some confidence that a scaled-up study involving many more children and cluster-randomization of the intervention will be feasible and could provide more conclusive evidence of the intervention’s effectiveness.

We have studied rates of diabetes in 601 members of the Mohawk Nation at Akwesasne, ages 18–84 years, in relation to serum concentrations of 101 polychlorinated biphenyl (PCB) congeners and three chlorinated pesticides [dichlorodiphenyldichloroethylene (DDE), hexachlorobenzene (HCB) and mirex]. Diabetes was determined from either a diagnosis by a physician or by having a fasting glucose concentration of >125 mg/dL. Rates of diabetes are high in this community. Three models were used. In the first model rate ratios (RR) were determined for quartiles of total PCBs after adjustment for age, sex, body mass index (BMI) and total serum lipids. For total PCBs RR=2.21 (1.2–4.2), while for total pesticides RR=3.75 (1.3–10.7). When the total PCB results were also adjusted for total pesticides and the total pesticide results were also adjusted for total PCBs (Model 2) the RRs were somewhat reduced. In Model 3 we considered subgroups of PCBs based on numbers of chlorines on the molecule (tri-/tetra, penta-/hexa, hepta plus) and numbers of ortho chlorines (non-/mono; di-, tri-/tetra-), and considered each of the pesticides individually after adjustment for all other contaminants as well as age, sex, BMI and serum lipids. We found a highly significant association between diabetes and PCBs with only three or four chlorines (RR=5.02), but no significant association with those with greater chlorination. When evaluating PCBs based on numbers of ortho chlorines only, those with no or one ortho chlorine showed significant associations. As mono- ortho PCBs include some with dioxin-like activity, we compared those with and without a TEF, and found that the association with diabetes was exclusively with the non-dioxin-like congeners. Of the pesticides only hexachlorobenzene showed a small but significant association with diabetes. Because lower chlorinated PCBs are more volatile and do not greatly accumulate in fish, these results suggest that inhalation is the major route of exposure to those PCBs that increase risk of diabetes.

Background: Pollution is the largest cause of death in low- and middle-income countries. WHO estimates that 8.9 million persons die each year of diseases caused by pollution – 94% of them in poor countries. By comparison, HIV/AIDS causes 1.5 million deaths per year, and malaria and tuberculosis cause fewer than 1 million each. Diseases caused by pollution are very costly. Prevention: Pollution can be prevented. In high-income countries, legal and technical control strategies have been developed and yielded great health and economic benefits. The removal of lead from gasoline increased the mean IQ of all American children and has generated an annual economic benefit of $213 billion. Unmet need: Despite its enormous human and economic costs, pollution has been overlooked in the international development agenda. Pollution control currently receives <0.5% of development spending. Solution: We have formed The Lancet-GAHP-Mount Sinai Commission on Pollution, Health and Development. This Commission will develop robust analyses of the impacts of pollution on health, economics, and development. It will inform heads of state and global funders about the enormous scale pollution’s effects. The ultimate goal is to raise the priority of pollution and increase the resources allocated to control of this urgent public health problem.

Renewed effort to understand the social-ecological context of health is drawing attention to the dynamics of land and water resources and their combined influence on the determinants of health. A new area of research, education and policy is emerging that focuses on the land-water-health nexus: this orientation is applicable from small wetlands through to large-scale watersheds or river basins, and draws attention to the benefits of combined land and water governance, as well as the interrelated implications for health, ecological and societal concerns. Informed by research precedents, imperatives and collaborations emerging in Canada and parts of Oceania, this review profiles three integrative, applied approaches that are bringing attention to the importance the land-water-health nexus within the Pacific Basin: wetlands and watersheds as intersectoral settings to address land-water-health dynamics; tools to integrate health, ecological and societal dynamics at the land-water-health nexus; and indigenous leadership that is linking health and well-being with land and water governance. Emphasis is given to key characteristics of a new generation of inquiry and action at the land-water-health nexus, as well as capacity-building, practice and policy opportunities to address converging environmental, social and health objectives linked to the management and governance of land and water resources.

In many low- and middle-income countries, handling and disposal of discarded electrical or electronic equipment (EEE) is frequently unregulated. e-Waste contains hazardous constituents such as lead, mercury, and chromium, certain chemicals in plastics, and flame retardants. There is increasing concern about health effects related to contamination in air, soil, and water for people working and living at or near informal e-waste processing sites, especially to the most vulnerable populations, pregnant women and children. The observed adverse health effects and increasing number of e-waste sites make protecting human health and the environment from e-waste contamination an expanding challenge. Through international cooperation, awareness can be elevated about the harm that e-waste processing poses to human health. Here we discuss how international researchers, public health practitioners, and policymakers can employ solutions to reduce e-waste exposures.

Over the last decades the electronics industry and ICT Industry in particular has revolutionized the world: electrical and electronic products have become ubiquitous in today’s life around the planet. After use, those products are discarded, sometimes after re-use cycles in countries different from those where they were initially sold; becoming what is commonly called e-waste. Compared to other traditional waste streams, e-waste handling poses unique and complex challenges. e-Waste is usually regarded as a waste problem, which can cause environmental damage and severe human health consequences if not safely managed. e-Waste contains significant amounts of toxic and environmentally sensitive materials and is, thus, extremely hazardous to humans and the environment if not properly disposed of or recycled. On the other hand, e-waste is often seen as a potential source of income for individuals and entrepreneurs who aim to recover the valuable materials (metals in particular) contained in discarded equipment. Recently, for a growing number of people, in developing countries in particular, recycling and separation of e-waste has become their main source of income. In most cases, this is done informally, with no or hardly any health and safety standards, exposing workers and the surrounding neighborhoods to extensive health dangers as well as leading to substantial environmental pollution. Treatment processes of e-waste aim to remove the hazardous components and recover as much reusable material (e.g. metals, glass and plastics) as possible; achieving both objectives is most desired. The paper discuss societal implications of proper e-waste management and key elements to be considered in the policy design at country level.

E-waste is hazardous, complex and expensive to treat in an environmentally sound manner. The management of e-waste is considered a serious challenge in both developed and developing countries and Sri Lanka is no exception. Due to significant growth in the economy and investments and other reasons the consumption of electronic and electrical equipment in Sri Lanka has increased over the years resulting in significant generation of e-waste. Several initiatives such as introduction of hazardous waste management rules, ratification of the Basel Convention in 1992 and the introduction of a National Corporate E-waste Management Program have been undertaken in Sri Lanka to manage e-waste. Strengthening policy and legislation, introducing methods for upstream reduction of e-waste, building capacity of relevant officers, awareness raising among school children and the general public and development of an e-waste information system are vital. Research on e-waste needs to be developed in Sri Lanka. The health sector could play a leading role in the provision of occupational health and safety for e-waste workers, advocacy, capacity building of relevant staff and raising awareness among the general public about e-waste. Improper e-waste management practices carried out by informal sector workers need to be addressed urgently in Sri Lanka.

Electrical and electronic waste (e-waste) has become an emerging environmental and human health problem in the world in the 21st century. Recently, the developing nations of West Africa (e.g. Ghana and Nigeria) have become a major destination for e-waste worldwide. In Ghana, the e-waste recyclers use primitive methods (mechanical shredding and open burning) to remove plastic insulation from copper cables. This technique can release highly toxic chemicals and severely affect the environment and human health if improperly managed. It is as a result of the adverse impact on human health that some interventions are being made in Ghana to reduce exposure. The present mode of recycling/dismantling, which happens at Agbogbloshie must be replaced by official receiving/recycling centers to be established. Currently, equipment to strip both large and small cables are available in the country via the Blacksmith Institute (USA) and it is expected that the e-waste workers will embrace the use of these machines. This technology will go a long way to help prevent the burning of e-waste and will be replicated in other smaller e-waste centers in the country.

Xenobiotic detection systems-chemically activated luciferase expression (XDS-CALUX) bioassay in determining the toxic equivalency (TEQ) of PCDD/Fs from contaminated sites reported in several papers has been discussed in this study. CALUX bioassay method has been validated by an effective combined column clean-up system followed by addition of samples to monolayer cell cultures of H1L6.1c3 cell line in 96 well plates. Cultures are then examined under microscope after 24 h incubation followed by rinsing with 75 μL phosphate buffer saline and 30 μL of cell culture lysis. The response is observed in the luminometer and expressed in relative light unit (RLUs). CALUX-TEQ is estimated from a TCDD standard curve for unknown samples. Quality control in CALUX is done by selecting the range of CALUX values falling in the center of the linear standard curve. For developing nations CALUX biossay can be used as a cost effective and rapid screening technique for screening xenobiotic compounds from the hotspots like open solid waste burning sites, informal e-waste recycling workshops and industrial zones where constant monitoring for such compounds is required.

Cancer surveillance is a fundamental component of national or sub-national cancer control planning and research. Cancer incidence and mortality data allow countries to monitor change in cancer incidence, mortality, and survival over time, by geographic region, and by demographic characteristics. Such data provide important clues to form hypotheses for cancer etiologic research, including research to examine environmental contributions to cancer. Strengthening cancer surveillance systems is urgently needed to conduct high quality research in environmental pollution and cancer in many countries. The United States National Cancer Institute Center for Global Health organized the first symposium on Environmental Contributions to Cancer during the 16th International Conference of Pacific Basin Consortium (PBC) for Environment and Health. PBC provided an important forum for dialog to establish partnerships and collaborations among researchers of environmental pollution and cancer.

While there is strong evidence for the association between household air pollution and lung cancer among non-smoking women, the association between domestic incense use and lung cancer risk has been inconsistent. We conducted a systematic review of PubMed articles authored between 1969 and August 25, 2015 before performing a manual review of each study, and found a total of seven published studies on this topic. Most of the studies are case-control in design and did not further stratify by sex and smoking status. Of the seven studies, three reported positive associations, three reported null associations and one study found a negative association between incense use and lung cancer. Only one study reported estimates for non-smoking women. Future studies should be larger in sample size, stratify by both sex and smoking status in their analyses, and collect more detailed information on incense use in order to facilitate the understanding of the association between domestic incense use and lung cancer risk among non-smoking women in Asia.

It is detrimental to anyone’s health to live with conditions of inadequate water, sanitation and hygiene (WaSH). Research suggests that the impact is greatest on children, and that poor WaSH conditions during the formative years can lead to decreased physical, mental and social well-being throughout one’s life. Little research has investigated how such poor WaSH conditions are negatively impacting children in the South Pacific region, and hence contributing to disease and social burden. To increase children’s opportunities to develop physically and intellectually in a healthy and sustained manner, it is important that practitioners take a holistic approach to improving WaSH by acknowledging it as a core component of environmental health.

In order to assess progress in improving children’s health objectively standardized measurements are required. The World Health Organization (WHO) undertook a pilot project to develop and implement a series of children’s environmental health indicators (CEHI) to facilitate this process. No countries in Oceania were included in this pilot. This project was undertaken to determine whether data collected and publicly available in Australia were sufficient to address the CEHI. Government documents and websites were searched to obtain publicly available data. These data adequately reflected outcome indicators but data addressing many exposure indicators were either missing or not available in a child-specific format. Australia does collect data on child health and well-being but not in a form compatible with the WHO CEHI.

This case study of mainly Karen and Mon communities in Kanchanaburi Province, western Thailand, offers insight into the challenges that these rural villages face with regard to food security and environmental health issues. As non-Thai communities, these villages receive little support from the Thai government, and are often vulnerable in terms of access to food markets, infrastructure, and education and livelihood opportunities. This discussion further considers the involvement of Pattanarak Foundation, a Thai NGO, in health promotion and economic development in these villages as an example of a community partnership at the grassroots level. Examining Pattanarak’s efforts to build skills in household vegetable gardening and livestock-raising, raise awareness about child nutrition issues, and improve community sanitation illustrates the value of a participatory process, and also demonstrates some of the challenges associated with on-the-ground health promotion in disadvantaged rural communities. Applying a community-based participatory research (CBPR) framework to pursue partnerships between communities, NGOs, and researchers may offer an avenue for effective interventions to improve health in marginalized communities.

Globally, infectious diseases are responsible for a significant burden on human health. Drivers of disease transmission depend on interactions between humans, the environment, vectors, carriers, and pathogens; transmission dynamics are therefore potentially highly complex. Research in infectious disease eco-epidemiology has been rapidly gaining momentum because of the rising global importance of disease emergence and outbreaks, and growing understanding of the intimate links between human health and the environment. The scientific community is increasingly recognising the need for multidisciplinary translational research, integrated approaches, and innovative methods and tools to optimise risk prediction and control measures. Environmental health experts have also identified the need for more advanced analytical and biostatistical approaches to better determine causality, and deal with unknowns and uncertainties inherent in complex systems. In this paper, we discuss the use of Bayesian networks in infectious disease eco-epidemiology, and the potential for developing dynamic tools for public health decision-making and improving intervention strategies.

Introduction: The mass rapid transit (MRT) is the largest transport infrastructure project under the national key economic area (NKEA) in Malaysia. As urban rail is anticipated to be the future spine of public transport network in the Greater Kuala Lumpur city, it is important to mainstream climate change mitigation and public health benefits in the local transport development. This study quantifies the health co-benefits in terms of mortality among the urbanites when the first line of the 150 km MRT system in Kuala Lumpur commences by 2017. Method: Using comparative health risk assessment, we estimated the potential health co-benefits from the establishment of the MRT system. We estimated the reduced CO 2 emissions and air pollution (PM2.5) exposure reduction among the general population from the reduced use of motorized vehicles. Mortality avoided from traffic incidents involving motorcycles and passenger cars, and from increased physical activity from walking while using the MRT system was also estimated. Results: A total of 363,130 tonnes of CO 2 emissions could be reduced annually from the modal shift from cars and motorcycles to the MRT system. Atmospheric PM2.5 concentration could be reduced 0.61 μg/m 3 annually (2%). This could avoid a total of 12 deaths, mostly from cardio-respiratory diseases among the city residents. For traffic injuries, 37 deaths could be avoided annually from motorcycle and passenger cars accidents especially among the younger age categories (aged 15–30). One additional death was attributed to pedestrian walking. The additional daily physical activity to access the MRT system could avoid 21 deaths among its riders. Most of the mortality avoided comes from cardiovascular diseases. Overall, a total of 70 deaths could be avoided annually among both the general population and the MRT users in the city. Conclusion: The implementation of the MRT system in Greater Kuala Lumpur could bring substantial health co-benefits to both the general population and the MRT users mainly from the avoidance of mortality from traffic injuries.

Exposure to fine particulate matter (PM 2.5 ) in both the short and long term has been known to cause deaths and health effects, especially related to the heart, blood vessels, and lungs. Based on this information, researchers conducted this study at a motor vehicle testing center unit at Pulo Gadung, in Jarkarta, to determine the concentration of PM 2.5 that workers were exposed to. The major source of PM 2.5 in this area is from the exhaust of gas emissions from motor vehicles, which is one of the largest contributors to the levels of PM in urban areas. Ten mechanics were picked from 16 mechanics that work in this station. Four administration workers from different posts were also picked to participate. The researcher conducted the PM 2.5 personal exposure measurement during weekdays from 6 to 14 April 2015 (2 workers/day). This research was conducted to measure the particle number concentration with size <2.5 μm. The average personal exposure concentrations of PM 2.5 in the study period received by the group of mechanics amounted to 149.01 μm/m 3 while the administrative officer group that consisted of four administrative workers were exposed to an average of 103.28 μm/m 3 . Once converted and compared with the World Health Organization Air Quality Guidelines, the PM 2.5 exposure of the mechanics and administrative officers exceeded the recommended exposure (25 μm/m 3 ).

In 2013 the population of dairy cattle in Indonesia had reached 636,000 head with a 4.61% growth rate per year. The inputs were energy, water, and feed. These inputs produced outputs, such as emissions, solid waste and liquid waste. This research compared the maintenance systems in modern farms and local farms. The data were collected from 30 local farmers and one modern farm. This research used the life cycle assessment (LCA) method. LCA is based on ISO 14040. LCA consists of several stages: the goal and scope definition, inventory analysis, impact assessment, and interpretation. This research used the cradle to gate concept and fat corrected milk (FCM) as the function unit. The impacts of these activities could generate global warming potential (GWP), acidification potential (AP), and eutrophication potential (EP). The calculations showed that the systems in local farms had the greatest emissions result over all impacts. In the case of local farms, the GWP was 2.34 kg CO 2 eq/L of milk FCM, AP was 0.12 g SO 2 eq/L of milk FCM, and EP was 18.28 g PO43−$P{O_{\rm{4}}}^{{\rm{3}} - }$ eq/L milk FCM. While the impact from the modern farm was GWP of 1.52 kg CO 2 eq/L of milk FCM, AP of 0.02 g SO 2 eq/L of milk FCM, and EP of 0.353 g PO43−$P{O_{\rm{4}}}^{{\rm{3}} - }$ eq/L of milk FCM. Based on the total-weighted result, the GWP had the greatest impact from the overall life cycle phase of milk production. The total-weighted result obtained was of 0.298 EUR/L of FCM from a local farm and 0.189 EUR/L of FCM from the modern farm. This amount could be used to remediate the global warming, acidification, and eutrophication impacts of milk production.