©2014 Probal Rashid, Courtesy of Photoshare
In Dhaka, Bangladesh, workers wash plastic for recycling in river water
polluted by chemical factories' wastes.
By Shana Potash
Air pollution, pesticides, lead and other toxic metals, are among the hazardous environmental exposures that are major contributors to noncommunicable diseases, which are increasing worldwide. Climate change is expected to alter weather and ecosystems in ways that will worsen current health threats and pose new ones, particularly for vulnerable populations. Investigating and increasing awareness of such environmental health challenges is the work of the NIH's National Institute of Environmental Health Sciences (NIEHS), which marks its 50th anniversary this year. The Institute's primary research focus is on disease prevention. With its $770 million budget, NIEHS supports scientific discovery, training and dissemination of knowledge throughout the world.
"Environmental health is inherently global," says NIEHS Director Dr. Linda S. Birnbaum. "For a research institute devoted to environmental health, we must be active where the rates and burden of environmentally-related diseases and disability are highest."
Environmental risk factors cause nearly a quarter of all global deaths, according to the WHO, with the greatest disease burden in developing countries. There are longstanding problems such as smoke from cookstoves and polluted water, plus new concerns brought by globalization, industrialization and urbanization. Air, water and land pollution; changes in diet; living circumstances that reduce physical activity - all of these contribute to heart, respiratory and other diseases. The health problems, in turn, cause lost wages and lower productivity that take an economic toll.
NIEHS-supported research in developing countries tackles health problems from farm to factory, village to city, and through all stages of life. For instance, scientists have made major breakthroughs in the understanding of aflatoxins, fungal poisons that contaminate crops and, when combined with a virus, pose a cancer risk. Research on heavy metals including arsenic, lead, manganese and mercury has demonstrated their toxic effects on health including neurodevelopment and psychosocial disorders. NIEHS also encourages the study of the developmental origins of health and disease, which looks at the connection between exposures early in life - even while in the womb - and cancer, diabetes, heart disease and other conditions later in life.
The Institute provides global leadership as a WHO Collaborating Centre for Environmental Health Sciences. The Centre works in tandem with the WHO to promote cooperation among research institutions around the world; support education and training; and raise awareness of emerging issues such as climate change and electronic waste. The Centre designation in 2013 followed decades of work with the WHO including the development of its International Programme on Chemical Safety.
NIEHS also is home to the National Toxicology Program (NTP), which tests and evaluates the safety of substances and exposures. NIEHS and NTP scientists conduct and support toxicology studies worldwide and share expertise with organizations such as the International Agency for Research on Cancer.
© 2006 Rakesh Yogal Shrestha, Courtesy of Photoshare
On a cold day, a mother in Gatlang village at Rasuwa district,
Nepal keeps her baby warm in front of the traditional stove.
Fogarty and NIEHS are frequent partners on research and capacity building projects in low- and middle-income countries (LMICs). Indoor air pollution caused by inefficient cookstoves is one area of longtime collaboration. Both Fogarty and NIEHS support NIH's involvement in the Global Alliance for Clean Cookstoves and its efforts to reduce the more than 4 million deaths a year attributed to cooking with solid fuels. The Institute is also a co-funder with Fogarty of a recently announced program to test the impact of improved cookstoves and fuel interventions.
NIEHS is a key partner and co-funder with Fogarty in the new Global Environmental and Occupational Health (GEOHealth) program that supports research on pesticide use, air pollution, mining hazards, and other occupational and environmental risk factors in LMICs. This new effort builds on a previous partnership that supported more than 460 trainees in over 40 countries. The NIEHS also funds about 100 international scientists who come to the NIH each year as visiting fellows.
In addition, the Institute plays a vital role in the global dissemination of research findings. It produces the monthly, peer-reviewed journal, Environmental Health Perspectives (EHP), and makes all content freely available online. Selected articles are translated into Chinese, Spanish and French and distributed via partnerships with journals in other countries. As part of the Africa Journals Partnership, EHP mentored the staff and hosted the website of the journal Mali Medicale. NIEHS regularly sponsors scientific writing and publishing workshops to help researchers in LMICs increase their ability to publish their work in top international journals.
These efforts are critical to improving global health, says Birnbaum. "Advancing environmental health research offers us the best opportunity for preventing disease - because you can't change your genes, but you can change your environment."