Publications by authors named "John M Balbus"

Environmental health indicators are helpful for tracking and communicating complex health trends, informing science and policy decisions, and evaluating public health actions. When provided on a national scale, they can help inform the general public, policy makers, and public health professionals about important trends in exposures and how well public health systems are preventing those exposures from causing adverse health outcomes. There is a growing need to understand national trends in exposures and health outcomes associated with climate change and the effectiveness of climate adaptation strategies for health.

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Background: Significant mitigation efforts beyond the Nationally Determined Commitments (NDCs) coming out of the 2015 Paris Climate Agreement are required to avoid warming of 2°C above pre-industrial temperatures. Health co-benefits represent selected near term, positive consequences of climate policies that can offset mitigation costs in the short term before the beneficial impacts of those policies on the magnitude of climate change are evident. The diversity of approaches to modeling mitigation options and their health effects inhibits meta-analyses and syntheses of results useful in policy-making.

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Background: Policy decisions regarding climate change mitigation are increasingly incorporating the beneficial and adverse health impacts of greenhouse gas emission reduction strategies. Studies of such co-benefits and co-harms involve modeling approaches requiring a range of analytic decisions that affect the model output.

Objective: Our objective was to assess analytic decisions regarding model framework, structure, choice of parameters, and handling of uncertainty when modeling health co-benefits, and to make recommendations for improvements that could increase policy uptake.

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Background: Nearly 3 billion people worldwide rely on solid fuel combustion to meet basic household energy needs. The resulting exposure to air pollution causes an estimated 4.5% of the global burden of disease.

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Background: According to a wide variety of analyses and projections, the potential effects of global climate change on human health are large and diverse. The U.S.

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Global climate change (GCC) is likely to alter the degree of human exposure to pollutants and the response of human populations to these exposures, meaning that risks of pollutants could change in the future. The present study, therefore, explores how GCC might affect the different steps in the pathway from a chemical source in the environment through to impacts on human health and evaluates the implications for existing risk-assessment and management practices. In certain parts of the world, GCC is predicted to increase the level of exposure of many environmental pollutants due to direct and indirect effects on the use patterns and transport and fate of chemicals.

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This is the first of seven papers resulting from a Society of Environmental Toxicology and Chemistry (SETAC) international workshop titled "The Influence of Global Climate Change on the Scientific Foundations and Applications of Environmental Toxicology and Chemistry." The workshop involved 36 scientists from 11 countries and was designed to answer the following question: How will global climate change influence the environmental impacts of chemicals and other stressors and the way we assess and manage them in the environment? While more detail is found in the complete series of articles, some key consensus points are as follows: (1) human actions (including mitigation of and adaptation to impacts of global climate change [GCC]) may have as much influence on the fate and distribution of chemical contaminants as does GCC, and modeled predictions should be interpreted cautiously; (2) climate change can affect the toxicity of chemicals, but chemicals can also affect how organisms acclimate to climate change; (3) effects of GCC may be slow, variable, and difficult to detect, though some populations and communities of high vulnerability may exhibit responses sooner and more dramatically than others; (4) future approaches to human and ecological risk assessments will need to incorporate multiple stressors and cumulative risks considering the wide spectrum of potential impacts stemming from GCC; and (5) baseline/reference conditions for estimating resource injury and restoration/rehabilitation will continually shift due to GCC and represent significant challenges to practitioners.

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Exposure to indoor air pollution from household burning and solid fuels affects nearly half of the world’s population.

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Climate change can be expected to have differential effects on different subpopulations. Biological sensitivity, socioeconomic factors, and geography may each contribute to heightened risk for climate-sensitive health outcomes, which include heat stress, air pollution health effects, extreme weather event health effects, water-, food-, and vector-borne illnesses. Particularly vulnerable subpopulations include children, pregnant women, older adults, impoverished populations, people with chronic conditions and mobility and cognitive constraints, outdoor workers, and those in coastal and low-lying riverine zones.

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In this report we present the findings from a nanotoxicology workshop held 6-7 April 2006 at the Woodrow Wilson International Center for Scholars in Washington, DC. Over 2 days, 26 scientists from government, academia, industry, and nonprofit organizations addressed two specific questions: what information is needed to understand the human health impact of engineered nanoparticles and how is this information best obtained? To assess hazards of nanoparticles in the near-term, most participants noted the need to use existing in vivo toxicologic tests because of their greater familiarity and interpretability. For all types of toxicology tests, the best measures of nanoparticle dose need to be determined.

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Nanotechnology, the design and manipulation of materials at the atomic scale, may well revolutionize many of the ways our society manufactures products, produces energy, and treats diseases. Innovative nanotechnology products are already reaching the market in a wide variety of consumer products. Some of the observed properties of nanomaterials call into question the adequacy of current methods for determining hazard and exposure, and for controlling resulting risks.

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Risk factors for waterborne enteric infections are deduced primarily from outbreak surveillance data; however, in the United States, only a fraction of the estimated water-related outbreaks are reported through passive surveillance. In the past several years, advances in molecular detection techniques have furthered our knowledge about foodborne and waterborne causes of gastroenteritis, allowing the association of certain pathogens with biologic and exposure-related susceptibilities in their hosts. This article summarizes some of the recent data characterizing susceptibility to three common waterborne pathogens:Cryptosporidium, a protozoan; Norwalk-like virus; and the bacterium Escherichia coli O157:H7.

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Purpose: This pilot project, carried out under the National Strategies for Health Care Providers: Pesticides Initiative, assessed the attitudes, beliefs and practices of pediatricians, nurse practitioners, physicians assistants, and nurses in the metropolitan Washington, D.C., area and the surrounding rural counties regarding health effects of pesticide toxicity and continuing education on pesticide toxicity in the years 2001-2002.

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New scientific tools spawned by the genomics revolution promise to improve our ability to identify causative factors in human diseases. But as these new tools elucidate the complex interactions between chemical toxins and biologic systems, the strain on traditional ways of understanding toxic effects grows. Despite major advances in the science and technology of these new toxicogenomics tools, scientific and political complexities threaten to delay the use of toxicogenomics to further the public interest or--worse--to advance its use initially to weaken the regulation and safety of widely used chemicals.

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