Analysis of Selected Environmental Risk Factors

Patterns of Potential Human Progress Volume 3: Improving Global Health 90 People have recognized the relationship between the state of the environment and human health for many years. Dr. John Snow, considered the father of modern epidemiology, is best remembered for linking the 1854 London cholera outbreak to the local drinking water supply (McMichael 2001). The smog episodes in Donora, Pennsylvania, in late October 1948 and in London in December 1952 (Davis 2002), as well as Rachel Carson’s work on the effects of agricultural chemicals (Carson 1962) were key events in initiating the modern environmental movement. In recent years, concern about the implications of the environment for health has expanded to include such emerging threats as climate change, stratospheric ozone depletion, antibiotic resistance, and the potential effect of hormonally active agents in the environment (Daily and Ehrlich 1996; Diamanti-Kandarakis et al. 2009; National Research Council 1999; WHO 2008b).1 Smith and Ezzati (2005), in their concept of an environmental risk transition, captured the progression from more local and traditional to more global and modern environmental threats to human health as societies develop. In this chapter, we explore the changing relationships between selected aspects of environment and human health and how these may play out in the context of environmental change. In doing so, we must cope with significant uncertainty, not only in identifying the specific roles that the environment plays as a determinant of human health, but also in incorporating environmental change into our projections of health outcomes. As Corvalán and Campbell-Lendrum noted, while