The environment and the lung: changing perspectives

Article Abstract:

At one time, the focus of environmental medicine was on a small number of individuals who were potentially exposed to high levels of some harmful substance. However, now that some of the more egregious pollutants and environmental poisons have been controlled, the focus has moved to lower levels of exposure affecting a far greater number of people. The focus also becomes one of analyzing the risk for a population, rather than the studying the development of disease in specific patients. To evaluate the risk resulting from exposure to some environmental pollutants, it is not sufficient to identify a hazard. Often, the relationship between dose level and patient response is not known and must be estimated. The variation in exposure among many individuals in a population must also be estimated. These two factors are then combined to estimate the actual population risk. Of course, any estimate of risk should also include an estimate of the uncertainties of analysis. Environmental hazards that affect the lungs and are currently being evaluated in this manner include asbestos, so-called 'second-hand' tobacco smoke, sulfur dioxide and acidic aerosols, and ozone and similar oxidants found in 'smog'. Estimates of hazards must be made using some sort of mathematical model, and the choice of model can alter the indicated risks. For example, when 10,000 to 20,000 cases of lung cancer are attributed to radon, these numbers come from simplistic model. Unfortunately, arguments about the appropriateness of a particular model may obscure fundamental risks that are well established. There is also a tendency for some studies to examine cancer particularly closely; this tendency is due at least in part to the precise and unambiguous diagnostic categories that exist for cancer. This should not divert attention from concerns about other forms of lung disease. Little is known, for example, of the long-term effects of urban air pollution or the effects of breathing polluted indoor air. The air may contribute to many lung disorders besides cancer, but it is only by careful epidemiological study that this will eventually be determined. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Pollution, Lung diseases, Environmental health

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Environmental Tobacco Smoke Exposure and Asthma in Adults

Article Abstract:

The authors examine the relationship between secondhand smoke and asthma in non-smoking adults. Topics include exposure rates, workplace smoking and nonsmokers health.

Evaluation, History, Asthma, Epidemiological research, Cross sectional studies, Passive smoking, Respiratory tract diseases

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The legacy of World Trade Center dust

Article Abstract:

The health risk posed due to inhaling the dust after the World Trade Center disaster is discussed.

Environmental aspects, Airborne infection, Airborne infections, World Trade Center and Pentagon Attacks, 2001, Dust

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