Health & Environment

Environmental health materials for clinicians

In this month’s H&E we described some work being done in the US to make environmental health science relevant to clinical practice. Key concepts include trust and transparency, where environmental health science is presented in such a way as to inspire clinicians’ confidence in its accuracy and relevance.

However, the clinicians and public health practitioners trying to do this have a difficult impasse to break: because of differences in the evidence streams between clinical medicine and environmental health, little environmental health makes its way into medical education.

But that lack of education itself feeds the perception that environmental health issues are not immediately relevant to healthcare, making it still more difficult to introduce that information into medical education and clinical guidance.

One source of inspiration has been the American Academy of Pediatrics (AAP), which is considered in many ways to be ahead of the game. Over 50 years ago the AAP established its committee on environmental health and in 1999 published its first practical text, Pediatric Environmental Health, now in its third edition.

The work by the AAP is being used as a platform for developing other environmental health tools in the US. Some of the best of these, and other resources for information, are listed below.

Educational Materials and Toolkits

• PSR toolkit: US Physicians for Social Responsibility developed this toolkit for clinicians, which has been endorsed by the AAP.
• USCDC Continuing Medical Education: An accredited on-line learning module about environmental health issues, from the US Centers for Disease Control and Prevention.
• ARHP Clinical Proceedings: A clinical guidance document by the US Association of Reproductive Health Professionals, designed to explain some of the issues and provide assurance on the merits of the science around environmental influences on reproductive health.
• AAP Pediatric Environmental Health [PDF, chapter list]: List of the topics covered by the Third Edition of the AAP guide to environmental health as relating to children.
• Pediatric Perspectives on Environmental Medicine [PDF]: A book chapter by Mark Miller MD, head of the Pediatric Environmental Health Specialty Unit at the University of California, San Francisco.

Other Information

• Navigating the Science Workshop: A podcast describing the project and a range of supporting documentation exploring what needs to be done in order for environmental health science to become better-incorporated into clinical practice and public health policy.
• Sustainability for Health: an Evidence Base for Action (SHEBA): Still in beta but something to keep an eye on, this project is looking at how to gather together environmental health science and best practice, and then review and present that information in a way which provides an adequate evidence-base for decision-making and health policy.