Picture of waterfowl in wetlands setting.

 

 

AN ENSEMBLE OF DEFINITIONS
OF ENVIRONMENTAL HEALTH


November 20, 1998

 

U.S. Department of Health and Human Services
Environmental Health Policy Committee
Risk Communication and Education Subcommittee

 

 

BACKGROUND
The Environmental Health Policy Committee (EHPC) advises the Assistant Secretary for Health, Department of Health and Human Services, on scientific and policy issues that pertain to environmental hazards. The EHPC comprises agencies of the department and liaison members who represent other Federal departments that have environmental programs.

The Risk Communication and Education Subcommittee is a standing component of the EHPC. The subcommittee conducts studies of contemporary risk communication methods and select environmental education efforts by EHPC member organizations.

In 1997, the EHPC asked the subcommittee to consider various definitions of "environmental health," given the absence of an accepted definition by the EHPC. The subcommittee surveyed EHPC members and other government agencies to collect their definitions of environmental health. In addition, the subcommittee sought definitions from professional associations such as the National Environmental Health Association and the National Association of County and City Health Officials.

The 28 definitions collected by the subcommittee and presented in this report should be viewed as a broad sweep of possible definitions and by no means the totality of existing definitions.

The subcommittee acknowledges that each definition was developed thoughtfully and represents the views and needs of the defining agency or organization. The content of the 28 definitions thus varies, but it is possible, without rising to a level of formal analysis, to observe some features that are prevalent across the definitions.

  • All definitions mention human health, public health, or humans, or similar words.
  • In addition to mention of human health, some definitions mention ecologic health or ecological balances.
  • A few definitions mention specific environmental stressors, such as physical, chemical, and biologic agents.

Before presenting the ensemble of definitions of environmental health, it is useful to cite the World Health Organization's definition of health—Health is a complete state of physical, mental, and social well-being, not just the absence of infirmity or disease.

 

DEFINITIONS OF ENVIRONMENTAL HEALTH

Agency for Toxic Substances and Disease Registry—Environmental health is the branch of public health that protects against the effects of environmental hazards that can adversely affect health or the ecological balances essential to human health and environmental quality.(1)

Archives of Environmental Health(2)The Archives of Environmental Health publishes articles dealing with the effects of environmental agents on human health. These include epidemiological, clinical, or experimental studies of man. "Environment" involves occupational or personal environments as well as the global environment, land, water, and air.

Buchner, Dr. Virginia; editor, Reviews on Environmental Health (Israel)(3)Environmental health is the study of the effects on human health of all external abiotic conditions and influences, including naturally occurring phenomena and anthropogenic environmental pollutants.

European Charter on Environment and Health(4)Environmental health includes both the direct pathological effects of chemicals, radiation and some biological agents, and the effects (often, indirect) on health and well-being of the broad physical, psychological, social, and aesthetic environment, which includes housing, urban development, land use, and transport.

Gordon, Larry(5)Environmental health strives to link environmental quality of both the natural and built environments, with the level of public health and well being. Though lacking consensus in definition, environmental health addresses the interrelationship between human health and the environment. It has been described as the "the art and science of protecting against environmental factors that may adversely affect human health and environmental quality. Such factors include, but are not limited to air, food, and water contaminants; radiation; toxic chemicals; wastes; disease vectors; safety hazards; and habitat alterations.

Hawaii Department of Health(6)Environmental health is to protect and enhance environmental quality for all people of Hawaii, thus preserving our quality of life.

Idaho Department of Health(7)

(1st draft definition)—Environmental health is that branch of public health which is directed towards controlling environmental hazards; preserving and improving environmental factors for the achievement of optimum health, safety, comfort, and well-being. (This is a variation of the NEHA definition.)

(2nd draft definition)—Environmental health is that branch of public health that deals with the human health effects of exposure to chemical, physical, and biological agents in the community, workplace, and/or home.

Institute of Environmental Health (Australia)(8)Environmental health is the professional practice of improving and preserving residential and industrial hygienic environments and housing for individuals and communities, and improving and preserving public health and allied matters including the control and management of the total environmental and ecological balance by educating processes and enforcement of statutory provisions by the application of preventive science and practice.

Institute of Medicine(9)Environmental health refers to freedom from illness or injury related to exposure to toxic agents and other environmental conditions that are potentially detrimental to human health.

Moeller, DW.(10)Environmental health is the subfield of public health concerned with assessing and controlling the impact of people on their environment. The field is defined more by problems faced than by the specific approach used.

National Aeronautics and Space Administration (Occupational Health Office)—Environmental health is the science devoted to the recognition, evaluation, and control of those occupational and environmental hazards or stresses arising in or from the workplace that may cause sickness, impaired health and well-being, or significant discomfort and inefficiency to employees.

National Association of County and City Health Officials(11)Environmental health focuses on the health interrelationships between people and their environment, promotes human health and well-being, and fosters a safe and healthful environment.

National Association of County and City Health Officials(12)The practice of environmental public health is the discipline that focuses on the health interrelationships between people and their environment, promotes human health and well-being, and fosters a safe and healthful environment.

National Center for Environmental Health of the Centers for Disease Control and Prevention(13)Environmental public health is the discipline that focuses on the interrelationships between people and their environment, promotes human health and well-being, and fosters a safe and healthful environment.

National Environmental Health Association (NEHA)—Environmental health and protection refers to protection against environmental factors that may adversely impact human health or the ecological balances essential to long-term human health and environmental quality, whether in the natural or man-made environment.

National Institute of Environmental Health Sciences(14)"Environment" or "environmental agents" include:

  • foods and nutrients
  • physical agents such as heat and ionizing and non-ionizing radiation
  • social and economic factors that affect health and behavior
  • lifestyle choices including substance abuse
  • synthetic and naturally occurring chemicals

New Zealand Institute of Environmental Health(15)Environmental health is the art and science of protecting and promoting good health through the organized efforts of society and includes:

  • promotion of aesthetic, social, economic, cultural, and amenity values.
  • fostering positive environmental factors.
  • reduction of potential hazards (physical, biological, chemical, and radiological).

Reviews on Environmental Health (Israel)—Studies on the physiological and psychosociological interrelationships between man and his surroundings will be considered for publication in Reviews on Environmental Health (REH). Papers submitted to REH may reflect the ecological aspects of man's life at rest and work; the impact of pollution stressors on humans; water, air, and soil quality control; as well as environmental toxicology and environmental medicine.

Royal Environmental Health Institute of Scotland(16)Environmental health shall embrace all aspects of public health, hygiene, and safety in all or any of their branches and shall include the subject-matter of all environmental health laws, regulations, directives, or guidelines be they of a local, national, international, or supra-national character, and the expression "environmental health measures" will be construed as encompassing all or any of the same.

Teknisk Hygienisk Forum (Norway)(17)Environmental health care concerns all factors known at any time to have direct or indirect effects on health. These include i.e. biological, chemical, physical, and social factors in the environment.

Unknown Sources(18)—-Environmental health is the art and science of protecting against environmental factors that may adversely affect human health or ecological balances essential to long-term health and environmental quality.

Environmental health is the systematic development, promotion, and conduct of measures which modify or otherwise control those external factors in the indoor and outdoor environment which might cause illness, disability, or discomfort through interaction with the human system. This includes not only health and safety factors, but also aesthetically desirable conditions in accordance with community demands and expectations.

Environmental health focuses on the prevention and control of environmental exposures and associated adverse health effects. It addresses the effect of environmental sources on human health, including the human impact on the environment and how that might influence the health of humans as well as the environment itself. Thus, environmental health stresses the protection of the public from environmental hazards, as contrasted with protection of the environment.

Wisconsin Department of Health(19)Environmental health is the assessment, management, control, and prevention of environmental factors that may adversely affect the health, comfort, safety, or well-being of individuals.

World Health Organization (WHO) Scientific Group (1972 definition)—Environmental health is concerned with the control of all physical, chemical, and biological processes, influences, and factors that exercise or may exercise, by direct or indirect means, a significant effect on the physical and mental health and social well being of man and his society.

WHO, Environmental Health Services (1989 definition)—Environmental health is comprised of those aspects of human health and disease that are determined by factors in the environment. It also refers to the theory and practice of assessing and controlling factors in the environment that can potentially affect health.

WHO (draft definition developed at a WHO consultation in Sofia, Bulgaria, 1993)—Environmental health comprises of those aspects of human health, including quality of life, that are determined by physical, chemical, biological, social, and psychosocial factors in the environment. It also refers to the theory and practice of assessing, correcting, controlling, and preventing those factors in the environment that can potentially affect adversely the health of present and future generations.

 

RECOMMENDATIONS

The subcommittee reviewed the ensemble of definitions of environmental health. Each member of the subcommittee was asked to select their three top-ranked definitions, using criteria of brevity, clarity, and contemporary relevance. The following were the top-ranked definitions in descending order:

World Health Organization (WHO) (draft definition developed at a WHO consultation in Sofia, Bulgaria, 1993)—Environmental health comprises of those aspects of human health, including quality of life, that are determined by physical, chemical, biological, social, and psychosocial factors in the environment. It also refers to the theory and practice of assessing, correcting, controlling, and preventing those factors in the environment that can potentially affect adversely the health of present and future generations.

National Environmental Health Association (NEHA)—Environmental health and protection refers to protection against environmental factors that may adversely impact human health or the ecological balances essential to long-term human health and environmental quality, whether in the natural or man-made environment.

Institute of Environmental Health (Australia)—Environmental health is the professional practice of improving and preserving residential and industrial hygienic environments and housing for individuals and communities, and improving and preserving public health and allied matters including the control and management of the total environmental and ecological balance by educating processes and enforcement of statutory provisions by the application of preventive science and practice.

Whether the EHPC should adopt a definition of environmental health requires further discussion. There are pros and cons for adopting or foregoing a definition. Adopting a definition would provide a statement that could be useful for considering which issues are to be brought before the EHPC. Moreover, an EHPC definition would add the imprimatur of the department and perhaps help move the public health community toward a consensus definition of environmental health. However, arguments can be brought that EHPC has functioned well without a specific definition of environmental health and the adoption of a definition might just constitute another addition to the list of existing definitions.

 

(Click on the number of the reference to go back to its place in the text.)

1. Johnson, BL. Personal communication: 1997.

2. Archives for Environmental Health. Instructions to authors: 1997.  Instructions to authors: 1997.

3. Buchner, V. Memo to Risk Communication and Education Subcommittee: 1997.

4. Johnson, BL. Agency for Toxic Substances and Disease Registry, Atlanta. Personal communication: 1997.

5. Gordon, L. Department of Political Science, University of New Mexico, Albuquerque. Personal communication: 1997.

6. Resnick, B. National Association of County and City Health Officials, Washington, DC. Personal communication: 1998.

7. West, S. Idaho Department of Health and Services, Boise. Personal communication: 1997.

8. Gist, G. Agency for Toxic Substances and Disease Registry, Atlanta. Personal communication: 1997.

9. Pope, AM, Snyder MA, Mood LH, eds. Nursing, Health & the Environment. Institute of Medicine, Washington, DC, 3: 1995.

10. Moeler, DW. Environmental Health. Boston, Harvard University Press: 1992.

11. Milne, TL. NACCHO. Environmental Health Assessment Workgroup, 1996: 1998.

12. Milne, TL. NACCHO. Environmental Health Advisory Committee, November 1995:1998.

13. DiSirio, M. National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta. Personal communication: 1998.

14. Newton, S. National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina. Personal communication: 1998.

15. Gist, G. Agency for Toxic Substances and Disease Registry, Atlanta. Personal communication: 1997.

16. Gist, G. Agency for Toxic Substances and Disease Registry, Atlanta. Personal communication: 1997.

17. Gist, G. Agency for Toxic Substances and Disease Registry, Atlanta. Personal communication: 1997.

18. Milne, TL. National Association of County and City Health Officials, Washington, DC. Personal communication: 1998.

19. Resnick, B. National Association of County and City Health Officials, Washington, DC. Personal communication: 1998.