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Over the course of nearly thirty years, the environmental justice movement has changed the politics of environmental activism and influenced environmental policy. In the process, it has turned the attention of environmental activists and regulatory agencies to issues of pollution, toxics, and human health as they affect ordinary people, especially people of color. This book argues that the environmental justice movement has also begun to transform science and engineering. The chapters present case studies of technical experts' encounters with environmental justice activists and issues, exploring the transformative potential of these interactions. Technoscience and Environmental Justice first examines the scientific practices and identities of technical experts who work with environmental justice organizations, whether by becoming activists themselves or by sharing scientific information with communities. It then explore scientists' and engineers' activities in such mainstream scientific institutions as regulatory agencies and universities, where environmental justice concerns have been (partially) institutionalized as a response to environmental justice activism. All of the chapters grapple with the difficulty of transformation that experts face, but the studies also show how environmental justice activism has created opportunities for changing technical practices and, in a few cases, has even accomplished significant transformations.The hardcover edition does not include a dust jacket.

People are increasingly concerned about potential environmental health hazards and often ask their physicians questions such as: \"Is the tap water safe to drink?\" \"Is it safe to live near power lines?\" Unfortunately, physicians often lack the information and training related to environmental health risks needed to answer such questions.

Junctures in Women's Leadership: Health Care and Public Health offers an eclectic compilation of case studies telling the stories of women leaders in public health and health care, from Katsi Cook, Mohawk midwife, to Virginia Apgar, Katharine Dexter McCormick and Florence Schorske Wald, to Marilyn Tavenner, Suerie Moon, and more. The impact of their work is extraordinarily relevant to the current public discourse including subjects such as the global COVID-19 pandemic, disparities in health outcomes, prevention of disease and the impact of the Affordable Care Act. The leadership lessons gleaned from these chapters can be applied to a broad array of disciplines within government, private business, media, philanthropy, pharmaceutical, environmental and health sectors. Each chapter is authored by a well versed and accomplished woman, demonstrating the book's theme that there are many paths within health care and public health. The case study format provides an introductory section providing biographical and historical background, setting the stage for a juncture, or decision point, and the resolution. The women are compelling characters and worth knowing.

No detailed description available for \"Hyping Health Risks\".

Background, aim, and scope One of the most important sources of global carbon dioxide emissions is the combustion of fossil fuels for power generation. Power plants contribute more than 40% of the worldwide anthropogenic CO 2 emissions. Therefore, the increased requirements for climate protection are a great challenge for the power producers. In this context a significant increase in power plant efficiency will contribute to reduce specific CO 2 emissions. Additionally, CO 2 capture and storage (CCS) is receiving considerable attention as a greenhouse gas (GHG) mitigation option. CCS allows continued use of fossil fuels with no or little CO 2 emissions given to the atmosphere. This could approve a moderate transition to a low-carbon energy generation over the next decades. Currently, R&D activities in the field of CCS are mainly concentrated on the development of capture techniques, the geological assessment of CO 2 storage reservoirs, and on economic aspects. Although first studies on material and energy flows caused by CCS are available, a broader environmental analysis is necessary to show the overall environmental impacts of CCS. The objectives in this paper are coal-based power plants with and without CO 2 capture via mono-ethanolamine (MEA) and the comparison of their environmental effects based on life cycle assessment methodology (LCA). Methods This LCA study examines the environmental and human health effects of power generation of five coal-based steam power plants, which differ in the year of installation (2005, 2010, 2020), the conversion efficiency, and in the ability and efficiency to capture CO 2 . For the removal of CO 2 from combustion and gasification processes in power plants, three main technology concepts exist: (1) pre-combustion technology, (2) oxyfuel combustion systems, and (3) post-combustion separation. As post-combustion technology shows the highest level of maturity, this study concentrates on this route, focusing on capture using mono-ethanolamine (MEA). The analysis regards the post-combustion retrofit of coal power plants with MEA to be a general option in 2020. Results Material and energy flows are balanced on the level of single processes as well as for the whole process chains. The life cycle inventory clearly shows decreasing inputs and outputs according to the efficiency increase from 43% to 49% in case of the power plants without CO 2 capture. In case of the MEA plants, all inputs and emissions raise, according to the additional energy consumption, except CO 2 and sulphur dioxide. The strong decrease of SO 2 partly results from the necessary improvement of desulphurisation if MEA wash is used. The influence of up and downstream activities on the results is determined. For the MEA plants, a considerable effect of up and downstream activities on the overall results is observed. Finally, the inventory results are assigned to selected impact categories. Global warming (GWP), human toxicity (HTP), acidification (AP), photo-oxidant formation (POCP), eutrophication (EP), and primary energy demand are adopted as impact categories. The impact assessment indicates decreasing impacts for all categories with increasing combustion efficiency for the coal plants without carbon capture. As expected, the GWP for the MEA plants is much lower than for the power plants without CO 2 capture. In contrast to this, the HTP and the EP are much higher (up to three times) for the MEA plants. Sensitivity analysis reveals that the origin of coal and the corresponding transport distances have a significant impact on the overall results. Furthermore, it is concluded from the sensitivity analysis that for CCS systems the length of CO 2 pipeline has a negligible effect in comparison with the effect of capture efficiency. The LCA is completed by a normalisation of the environmental impact categories. Discussion The development of combustion efficiency in case of the power plants without CO 2 capture has the main influence on the decreasing mass flows at the input side. The energy penalty of the MEA plants affects the use of the inputs into the opposite direction. Although the power producer’s focus is on the power plant, the sense of a life cycle assessment is an integrated environmental assessment of the full life cycle of a product (here 1 kWh) including up and downstream processes. Therefore, the inventory results are presented without and with up and downstream processes. The inventory analysis clearly shows the significant influence of the up and downstream processes on the overall emissions. This influence is higher for the MEA plants than for the power plants without capture. In case of CO 2 emissions, the significance of up and downstream processes is especially considerable (approx. 30%). Sensitivity analysis reveals that the origin of coal and the corresponding transport distances have a significant impact on the overall results. Conclusions The results point out that the reduction of carbon dioxide emissions into the atmosphere is achieved at the expense of increasing other emissions and corresponding environmental impacts. In most cases the influence of up and downstream processes is significant. Therefore, life cycle approaches are necessary to get a holistic evaluation. It also shows that the implementation of new techniques can change the environmental assessment of the process chain and, thus, positive and negative effects have to be compared and weighed up against each other. Perspectives As there exist several possible technical options for CO 2 capture, further studies are necessary to compare the overall environmental effects of competing capture concepts such as pre-combustion and oxyfuel technology. Additionally, gas separating membranes should be part of further studies as they have the potential to contribute to all three main capture technology routes. Further studies with more detail and reliable inventories for CO 2 compression and liquefaction as well as for gas conditioning as an interface between CO 2 capture and transport are needed. Furthermore, the environmental effects including long-term CO 2 emission from the storage sites are recommended.

Background Practitioners and decision makers in the medical and insurance systems need knowledge on the relationship between work exposures and burnout. Many burnout studies – original as well as reviews - restricted their analyses to emotional exhaustion or did not report results on cynicism, personal accomplishment or global burnout. To meet this need we carried out this review and meta-analyses with the aim to provide systematically graded evidence for associations between working conditions and near-future development of burnout symptoms. Methods A wide range of work exposure factors was screened. Inclusion criteria were: 1) Study performed in Europe, North America, Australia and New Zealand 1990–2013. 2) Prospective or comparable case control design. 3) Assessments of exposure (work) and outcome at baseline and at least once again during follow up 1–5 years later. Twenty-five articles met the predefined relevance and quality criteria. The GRADE-system with its 4-grade evidence scale was used. Results Most of the 25 studies focused emotional exhaustion, fewer cynicism and still fewer personal accomplishment. Moderately strong evidence (grade 3) was concluded for the association between job control and reduced emotional exhaustion and between low workplace support and increased emotional exhaustion. Limited evidence (grade 2) was found for the associations between workplace justice, demands, high work load, low reward, low supervisor support, low co-worker support, job insecurity and change in emotional exhaustion. Cynicism was associated with most of these work factors. Reduced personal accomplishment was only associated with low reward. There were few prospective studies with sufficient quality on adverse chemical, biological and physical factors and burnout. Conclusion While high levels of job support and workplace justice were protective for emotional exhaustion, high demands, low job control, high work load, low reward and job insecurity increased the risk for developing exhaustion. Our approach with a wide range of work exposure factors analysed in relation to the separate dimensions of burnout expanded the knowledge of associations, evidence as well as research needs. The potential of organizational interventions is illustrated by the findings that burnout symptoms are strongly influenced by structural factors such as job demands, support and the possibility to exert control.

Background: Environmental health risks are disproportionately colocated with communities in poverty and communities of color. In some cases, participatory research projects have effectively addressed structural causes of health risk in environmental justice (EJ) communities. However, many such projects fail to catalyze change at a structural level. Objectives: This review employs Critical Interpretive Synthesis (CIS) to theorize specific elements of participatory research for environmental health that effectively prompt structural change in EJ communities. Methods: Academic database search was used to identify peer-reviewed literature describing participatory research with EJ communities to address environmental health. Synthetic constructs were developed iteratively related to study characteristics, design elements, and outcomes; and data were extracted for included records. Statistical analyses were performed to assess correlations between study design elements and structural change outcomes. Through critical, comparative, and contextual analyses of the \"structural change\" case study group and \"non-structural change\" group, informed by relevant theoretical literature, a synthesizing argument was generated. Results: From 505 total records identified, eligibility screening produced 232 case study articles, representing 154 case studies, and 55 theoretical articles for synthesis. Twenty-six case studies resulted in a structural change outcome. The synthesizing argument states that participatory research with EJ communities may be more likely to result in structural change when a) community members hold formal leadership roles; b) project design includes decision-makers and policy goals; and c) long term partnerships are sustained through multiple funding mechanisms. The assumption of EJ community benefit through research participation is critically examined. Discussion: Recommended future directions include establishing structural change as a goal of participatory research, employing participatory assessment of community benefit, and increased hiring of faculty of color at research institutions. The power, privilege, and political influence that academic institutions are able to leverage in partnership with EJ communities may be as valuable as the research itself.

Background The two-stage design has become a standard tool in environmental epidemiology to model multi-location data. However, its standard form is rather inflexible and poses important limitations for modelling complex risks associated with environmental factors. In this contribution, we illustrate multiple design extensions of the classical two-stage method, all implemented within a unified analytic framework. Methods We extended standard two-stage meta-analytic models along the lines of linear mixed-effects models, by allowing location-specific estimates to be pooled through flexible fixed and random-effects structures. This permits the analysis of associations characterised by combinations of multivariate outcomes, hierarchical geographical structures, repeated measures, and/or longitudinal settings. The analytic framework and inferential procedures are implemented in the R package mixmeta. Results The design extensions are illustrated in examples using multi-city time series data collected as part of the National Morbidity, Mortality and Air Pollution Study (NMMAPS). Specifically, four case studies demonstrate applications for modelling complex associations with air pollution and temperature, including non-linear exposure–response relationships, effects clustered at multiple geographical levels, differential risks by age, and effect modification by air conditioning in a longitudinal analysis. Conclusions The definition of several design extensions of the classical two-stage design within a unified framework, along with its implementation in freely-available software, will provide researchers with a flexible tool to address novel research questions in two-stage analyses of environmental health risks.

Background The National Development Plan (NDP) strives that South Africa, by 2030, in pursuit of Universal Health Coverage (UHC) achieve a significant shift in the equity of health services provision. This paper provides a diagnosis of the extent of socio-economic inequalities in health and healthcare using an integrated conceptual framework. Method The 2012 South African National Health and Nutrition Examination Survey (SANHANES-1), a nationally representative study, collected data on a variety of questions related to health and healthcare. A range of concentration indices were calculated for health and healthcare outcomes that fit the various dimensions on the pathway of access. A decomposition analysis was employed to determine how downstream need and access barriers contribute to upstream inequality in healthcare utilisation. Results In terms of healthcare need, good and ill health are concentrated among the socio-economically advantaged and disadvantaged, respectively. The relatively wealthy perceived a greater desire for care than the relatively poor. However, postponement of care seeking and unmet need is concentrated among the socio-economically disadvantaged, as are difficulties with the affordability of healthcare. The socio-economic divide in the utilisation of public and private healthcare services remains stark. Those who are economically disadvantaged are less satisfied with healthcare services. Affordability and ability to pay are the main drivers of inequalities in healthcare utilisation. Conclusion In the South African health system, the socio-economically disadvantaged are discriminated against across the continuum of access. NHI offers a means to enhance ability to pay and to address affordability, while disparities between actual and perceived need warrants investment in health literacy outreach programmes.