Health and the Environment: The Risks Are Real and We Can All Do Something About Them

Much of today’s discussion and research on health is focused on genetics, biotechnology and potential new therapies. These advances are important, but they do not address some of the basic issues related to the health of populations. Why are we seeing a steady increase in the incidence of lymphoma in many countries? Why are over 50% of people in Spain overweight? Why in cities like Barcelona and Madrid are we still living with concentrations of air pollutants far in excess of those deemed “acceptable”. A strictly biomedical model of health and sickness does not provide any answers to the question of why 6000 people died in Bangladesh following a moderate storm like cyclone Aila. Nor does it address the question of how the impact of the effects of climate change could be reduced.

In contrast to the story presented by the main economic interests, which only promote biotechnology, and contrary to what many people believe, socioeconomic and environmental factors have a more direct influence on the health of populations than sophisticated biotechnologies and advances in genetics. World Environment Day is an appropriate occasion to call for a more comprehensive global analysis of the environmental factors associated with health and disease and to demand that the authorities take steps to deal with the very serious threats to health faced by the world’s population today. These threats are not theoretical, they are a reality that affects our everyday life and they are here to stay.

We need to determine whether widespread exposure to endocrine disruptors, that is, environmental exposure to pollutants that mimic the action of hormones, is in fact associated with effects on the reproductive system in men and cancer in women. It is difficult to answer this question through research for a simple reason: we are all exposed to these compounds. For example, dioxin (one of the most toxic chemicals in the world) tends to be found at similar concentrations in people from all over Spain. In spite of the fact that 90% of our exposure comes from fatty foods, even people who eat a very particular diet have dioxin concentrations in the same range as everyone else. This situation complicates research in humans. It does not, however, mean that the effects are not real; we know that they exist because of evidence from experiments in animals. Moreover, the effects of dioxins have also been demonstrated in sectors of the population exposed to very high levels of these compounds, such as workers in pesticide factories. The developing foetus is most sensitive to dioxin exposure. We have documented that maternal exposure to dioxins in food is associated in newborns with effects on the male reproductive system, such as reduced anogenital distance.

While the same difficulty applies to the study of the effects of air pollution—we are all exposed—the problem is easier to investigate. Large-scale European studies have shown ambient air pollution to be associated with low birth weight and increased risk for lung cancer. The findings showed that the risks persisted even when air pollution concentrations were below the current European Union air quality limit value—25 micrograms per cubic metre in the case of fine particles (less than 2.5 micrometers).

Environmental health research has identified numerous risks. The acquisition of knowledge is a prerequisite to, but not synonymous with, prevention. What is needed is a greater commitment to research but above all to action. And we are all responsible for making this commitment—governments, researchers, private companies and individuals. We can make a difference, but we have to act! Everyone can do something on an individual level to reduce their contribution to environmental contamination (air pollutants and waste production, for example), and we can act on the community level (local, national or international) to promote a more sustainable model for our societies.

Manolis Kogevinas is the Co-Director of CREAL, an ISGlobal research centre.