Shared Vision

NCEH/ATSDR Leadership Role in Environmental Public Health

In infectious disease, CDC plays the traditional public health role of disease detection and tracking, prevention research, and health promotion. CDC’s public health role falls between that of NIH (which contributes biomedical research) and FDA (which provides the regulatory muscle). In environmental public health, NCEH and ATSDR play the same disease detection/prevention and health promotion roles, with NIH serving the biomedical research role, and with EPA and FDA filling the regulatory role.

NCEH/ATSDR apply the basic biomedical research findings of NIH (primarily the National Institute of Environmental Health Sciences) in their prevention program activities. Conversely, NCEH/ATSDR feed information back to NIH on the applicability of their basic research findings to disease prevention and identify where critical gaps of information exist so that NIH’s basic research programs can address these gaps. Ties between NCEH/ATSDR and NIH do exist, but they need to be strengthened.

The relationship between NCEH/ATSDR and the regulatory agencies is equally important. ATSDR has maintained a particularly strong relationship with EPA, providing environmental public health advice to the EPA Superfund program – primarily because of EPA’s and ATSDR’s statutory mandates. ATSDR has an excellent record of EPA acceptance of site-specific recommendations. NCEH has also worked extensively with EPA and FDA on a variety of specific environmental public health problems. To have a major impact on environmental public health issues, NCEH/ATSDR must strengthen their ties with all relevant programs at EPA and FDA and provide them with real-time health data that they can use in their regulatory decision- making. Too often regulatory decisions are based upon animal data rather than human data, or on data derived from mathematical modeling. To establish this more effective relationship with EPA, NCEH/ATSDR need expertise in the environmental sciences (e.g., geologists, hydrologists, physicists, and engineers) related to air, water, soil, food, and other physical agents not only so we can talk the same language, but also so we can effectively communicate public health messages to the public and into the regulatory and enforcement programs of these agencies.