Health effects of air pollution: some historical notes.

As I understand the objectives of this symposium, they are at least 2-fold: to describe some of the advances in the environmental health sciences in the past 40 years, and to acknowledge some of the roles of the Institute of Environmental Medicine in these scientific advances. This is a pleasant task and the occasion for a happy anniversary celebration. In my comments on air pollution, I expect to emphasize what is known to all of you-that environmental health sciences differ significantly from other health sciences in the extent to which they are intertwined with important public policy issues; in fact, the directions and progress of environmental health science research are often driven by public policy concerns and needs. The history of the Environmental Medicine Institute and the career of Norton Nelson are full of examples of these science/policy interactions. Before 1948, which is approximately the founding date of the Institute, there was very little interest in air pollution as a cause of adverse health effects in this country. There was concern about dusts and other chemicals in the workplace, but so far as outdoor pollution was thought about, it was largely a question of pathologists speculating whether the carbonaceous appearance ofpostmortem lungs of city dwellers might have influenced the frequency of pneumonia or other respiratory diseases. That picture changed rapidly after the lethal episode of air pollution in Donora, PA, and the severe episodes observed in London in 1952. By 1957 the U.S. Public Health Service had organized an air pollution division in the Bureau of State Services and started a program of health effects research, as well as training programs in universities to increase the number of people qualified to assess and regulate air pollution. The government-funded training lasted for only a few years, but the research on all aspects of community air pollution, including health effects, has expanded greatly and is still going strong. When the Public Health Service started the health effects of air pollution research program in the mid-1950s,