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The politics and science of health and disease remain contested terrain among scientists, health practitioners, policy makers, industry, communities, and the public. Stakeholders in disputes about illnesses or conditions disagree over their fundamental causes as well as how they should be treated and prevented. This thought-provoking book crosses disciplinary boundaries by engaging with both public health policy and social science, asserting that science, activism, and policy are not separate issues and showing how the contribution of environmental factors in disease is often overlooked.

Background Understanding, characterizing, and quantifying human exposures to environmental chemicals is critical to protect public health. Exposure assessments are key to determining risks to the general population and for specific subpopulations given that exposures differ between groups. Exposure data are also important for understanding where interventions, including public policies, should be targeted and the extent to which interventions have been successful. In this review, we aim to show how inadequacies in exposure assessments conducted by polluting industries or regulatory agencies have led to downplaying or disregarding exposure concerns raised by communities; that underestimates of exposure can lead regulatory agencies to conclude that unacceptable risks are, instead, acceptable, allowing pollutants to go unregulated; and that researchers, risk assessors, and policy makers need to better understand the issues that have affected exposure assessments and how appropriate use of exposure data can contribute to health-protective decisions. Methods We describe current approaches used by regulatory agencies to estimate human exposures to environmental chemicals, including approaches to address limitations in exposure data. We then illustrate how some exposure assessments have been used to reach flawed conclusions about environmental chemicals and make recommendations for improvements. Results Exposure data are important for communities, public health advocates, scientists, policy makers, and other groups to understand the extent of environmental exposures in diverse populations. We identify four areas where exposure assessments need to be improved due to systemic sources of error or uncertainty in exposure assessments and illustrate these areas with examples. These include: (1) an inability of regulatory agencies to keep pace with the increasing number of chemicals registered for use or assess their exposures, as well as complications added by use of ‘confidential business information’ which reduce available exposure data; (2) the failure to keep assessments up-to-date; (3) how inadequate assumptions about human behaviors and co-exposures contribute to underestimates of exposure; and (4) that insufficient models of toxicokinetics similarly affect exposure estimates. Conclusion We identified key issues that impact capacity to conduct scientifically robust exposure assessments. These issues must be addressed with scientific or policy approaches to improve estimates of exposure and protect public health.

Background Emerging evidence about the effects of endocrine disruptors on asthma symptoms suggests new opportunities to reduce asthma by changing personal environments. Right-to-know ethics supports returning personal results for these chemicals to participants, so they can make decisions to reduce exposures. Yet researchers and institutional review boards have been reluctant to approve results reports in low-income communities, which are disproportionately affected by asthma. Concerns include limited literacy, lack of resources to reduce exposures, co-occurring stressors, and lack of models for effective reporting. To better understand the ethical and public health implications of returning personal results in low-income communities, we investigated parents’ experiences of learning their children’s environmental chemical and biomonitoring results in the Green Housing Study of asthma. Methods The Green Housing Study measured indoor chemical exposures, allergens, and children’s asthma symptoms in “green”-renovated public housing and control sites in metro-Boston and Cincinnati in 2011–2013. We developed reports for parents of children in the study, including results for their child and community. We observed community meetings where results were reported, and metro-Boston residents participated in semi-structured interviews in 2015 about their report-back experience. Interviews were systematically coded and analyzed. Results Report-back was positively received, contributed to greater understanding, built trust between researchers and participants, and facilitated action to improve health. Sampling visits and community meetings also contributed to creating a positive study experience for participants. Participants were able to make changes in their homes, such as altering product use and habits that may reduce asthma symptoms, though some faced roadblocks from family members. Participants also gained access to medical resources, though some felt that clinicians were not responsive. Participants wanted larger scale change from government or industry and wanted researchers to leverage study results to achieve change. Conclusions Report-back on environmental chemical exposures in low-income communities can enhance research benefits by engaging residents with personally relevant information that informs and motivates actions to reduce exposure to asthma triggers. Ethical practices in research should support deliberative report-back in vulnerable communities.

During April–May 2010 the UK Facility for Airborne Atmospheric Measurements (FAAM) BAe‐146 aircraft flew 12 flights targeting volcanic ash clouds around the UK. The aircraft observed ash layers between altitudes of 2–8 km with peak mass concentrations typically between 200–2000μg/m3, as estimated from a Cloud and Aerosol Spectrometer (CAS). A peak value of 2000–5000 μg/m3 was observed over Scotland on 14 May 2010, although with considerable uncertainty due to the possible contamination by ice. Aerosol size distributions within ash clouds showed a fine mode (0.1–0.6 μm) associated with sulphuric acid and/or sulphate, and a coarse mode (0.6–35 μm) associated with ash. The ash mass was dominated by particles in the size range 1–10 μm (volume‐equivalent diameter), with a peak typically around 3–5μm. Electron‐microscope images and scattering patterns from the SID‐2H (Small Ice Detector) probe showed the highly irregular shape of the ash particles. Ash clouds were also accompanied by elevated levels of SO2 (10–100 ppbv), strong aerosol scattering (50–500 × 10−6 m−1), and low Ångstrom exponents (−0.5 to 0.4) from the 3‐wavelength nephelometer. Coarse‐mode mass specific aerosol extinction coefficients (kext), based on the CAS size distribution varied from 0.45–1.06 m2/g. A representative value of 0.6 m2/g is suggested for distal ash clouds (∼1000 km downwind) from this eruption. Key Points Assessing the risk of volcanic ash to aviation Validating ash forecasts from dispersion models Providing key physical/optical parameters for ash remote sensing

Psychosocial stress during pregnancy has been associated with adverse pregnancy outcomes including preterm birth (PTB). This has not been studied in Puerto Rico, an area with high PTB rates. Our objective was to develop a conceptual model describing the interrelationships between measures of psychosocial stress and depression, a result of stress, among pregnant women in Puerto Rico and to examine their associations with PTB. We used data from the Puerto Rico Testsite for Exploring Contamination Threats pregnancy cohort (PROTECT, N = 1,047) to examine associations among depression and different continuous measures of psychosocial stress using path analysis. Psychosocial stress during pregnancy was assessed using validated measures of perceived stress, negative life experiences, neighborhood perceptions and social support. Logistic regression was used to examine associations between psychosocial stress measures in tertiles and PTB. Perceived stress, negative life experiences, and neighborhood perceptions influenced depression through multiple pathways. Our model indicated that perceived stress had the strongest direct effect on depression, where one standard deviation (SD) increase in perceived stress was associated with a 57% SD increase in depression. Negative life experiences were directly but also indirectly, through perceived stress, associated with depression. Finally, neighborhood perceptions directly influenced negative life experiences and perceived stress and consequently had an indirect effect on depression. Psychosocial stress was not associated with PTB across any of the measures examined. Our study examined interrelationships between multiple measures of psychosocial stress and depression among a pregnant Puerto Rican population and identified negative neighborhood perceptions as important upstream factors leading to depression. Our findings highlight the complex relationship between psychosocial stress measures and indicate that psychosocial stress and depression, assessed using 5 different scales, were not associated with PTB. Future research should investigate other environmental and behavioral risk factors contributing to higher rates of PTB in this population.

Background The goals of this study were (1) to determine early intervention (EI) Speech-Language Pathologists’ (SLPs) level of training and knowledge on environmental toxicants and their effect on infant and child development; and (2) to examine the effectiveness of a continuing education (CE) event designed to enhance the knowledge of EI SLPs on environmental toxicants and their effects on child development. Methods A survey was launched via Qualtrics and posted on the American Speech-Language Hearing Association’s Early Intervention Community page to assess environmental health knowledge of SLPs. Results from this survey were used to create an environmental health CE event targeted towards EI SLPs. Attendees were given a pre- and post-test to assess the effectiveness of our program. Results One hundred and fifty-eight participants completed the online survey and a majority (61%, n  = 97) of participants reported some level of dissatisfaction with their previous training in regards to environmental exposures. Fifty-six percent ( n  = 89) of the participants also reported feeling unprepared to be a health advocate regarding environmental exposure concerns within their community. Forty-eight people (26 SLPs and 22 SLP master’s students) attended the CE event. Paired t-tests revealed significant improvements from the pre- to the post- test results among all attendees. Conclusions These findings suggest that SLPs who work in EI feel undertrained and unprepared to advocate for environmental health to the families they serve. This study reveals that CE is one way by which to increase the knowledge base of SLPs on environmental health.

We investigate why companies collaborate within the circular oriented innovation process. The purpose is to understand what motives trigger collaborative circular oriented innovation, as well as conditions, drivers and barriers. First, we define circular oriented innovation building on sustainable oriented innovation literature. Subsequently, we investigate 11 leading circular economy companies operating within the Netherlands, who developed collaborative circular oriented innovation activities. ‘Hard’ and ‘soft’ dimensions for innovation are identified and applied to delineate the drivers and barriers for collaborative circular oriented innovation. Our findings indicate that collaborations are conducted by entrepreneurially-minded actors through sharing a vision, enthusiasm, and crucially, a credible proposition for a circular economy. Furthermore, collaboration is sought early, to co-develop the problem and solution space and integrate disparate knowledge from across the value network, to mitigate increased complexity. Motives to collaborate vary between personal and organisational, and intrinsic and extrinsic levels. Collaborations start based on a relational basis between ‘CE front-runners’ to advance knowledge through experimentation. ‘Soft’ challenges to advance collaborations towards the competitive remain around culture, and the mindset to share rewards and risks. Without suitable solutions to these challenges, collaborative circular oriented innovation could remain underdeveloped within the transition towards the systemic level.

Background Exposure assessment has shifted from pollutant monitoring in air, soil, and water toward personal exposure measurements and biomonitoring. This trend along with the paucity of health effect data for many of the pollutants studied raise ethical and scientific challenges for reporting results to study participants. Methods We interviewed 26 individuals involved in biomonitoring studies, including academic scientists, scientists from environmental advocacy organizations, IRB officials, and study participants; observed meetings where stakeholders discussed these issues; and reviewed the relevant literature to assess emerging ethical, scientific, and policy debates about personal exposure assessment and biomonitoring, including public demand for information on the human health effects of chemical body burdens. Results We identify three frameworks for report-back in personal exposure studies: clinical ethics; community-based participatory research; and citizen science 'data judo.' The first approach emphasizes reporting results only when the health significance of exposures is known, while the latter two represent new communication strategies where study participants play a role in interpreting, disseminating, and leveraging results to promote community health. We identify five critical areas to consider in planning future biomonitoring studies. Conclusion Public deliberation about communication in personal exposure assessment research suggests that new forms of community-based research ethics and participatory scientific practice are emerging.

The present investigation uses proton transfer reaction mass spectrometry (PTR-MS) combined with multivariate and univariate statistical analyses to study potential biomarkers for altered metabolism in urine due to strenuous walking. Urine samples, in concurrence with breath and blood samples, were taken from 51 participants (23 controls, 11 type-1 diabetes, 17 type-2 diabetes) during the Dutch endurance walking event, the International Four Days Marches . Multivariate analysis allowed for discrimination of before and after exercise for all three groups (control, type-1 and type-2 diabetes) and on three out of 4 days. The analysis highlighted 12 molecular ions contributing to this discrimination. Of these, acetic acid in urine is identified as a significant marker for exercise effects induced by walking; an increase is observed as an effect of walking. Analysis of acetone concentration with univariate tools resulted in different information when compared to breath as a function of exercise, revealing an interesting effect of time over the 4 days. In breath, acetone provides an immediate snapshot of metabolism, whereas urinary acetone will result from longer term diffusion processes, providing a time averaged view of metabolism. The potential to use PTR-MS measurements of urine to monitor exercise effects is exhibited, and may be utilized to monitor subjects in mass participation exercise events.

PurposePuerto Rican children experience high rates of asthma and obesity. Further, infants born in Puerto Rico are more at risk for being born prematurely compared with infants on the mainland USA. Environmental exposures from multiple sources during critical periods of child development, potentially modified by psychosocial factors, may contribute to these adverse health outcomes. To date, most studies investigating the health effects of environmental factors on infant and child health have focused on single or individual exposures.ParticipantsInfants currently in gestation whose mother is enrolled in Puerto Rico Testsite for Exploring Contamination Threats (PROTECT) cohort, and infants and children already born to mothers who participated in the PROTECT study.Findings to dateData collection and processing remains ongoing. Demographic data have been collected on 437 mother–child pairs. Birth outcomes are available for 420 infants, neurodevelopmental outcomes have been collected on 319 children. Concentrations of parabens and phenols in maternal spot urine samples have been measured from 386 mothers. Center for Research on Early Childhood Exposure and Development mothers have significantly higher urinary concentrations of dichlorophenols, triclosan and triclocarban, but lower levels of several parabens compared with reference values from a similar population drawn from the National Health and Nutrition Examination Survey.Future plansData will continue to be collected through recruitment of new births with a target of 600 children. Seven scheduled follow-up visits with existing and new participants are planned. Further, our research team continues to work with healthcare providers, paediatricians and early intervention providers to support parent’s ability to access early intervention services for participants.