The role of the medical profession in the environmental arena.
Environmental agencies at both federal and state levels have enormous powers to control economic activities, yet these agencies must use these powers knowing very little about the actual effects of pollutants on human health or the environment. The author describes how this situation came about by reviewing (1) the history of the 19th-century sanitarians and how their traditions (especially of taking preventive action in the absence of definitive data, in order to ensure a margin of safety) later influenced the policies of the U.S. Public Health Service and, more recently, those of the Environmental Protection Agency (EPA); (2) the tradition of recovering damages from someone who harms your property or person; (3) the tradition of engineers to eliminate pollutants without concern for their effects; and (4) the value system of conservationists and ecologists. He then outlines four difficulties that these sometimes-conflicting traditions and values create for the EPA and other similar bodies. After reviewing the progress that has been made despite these difficulties, the author states the global nature of the environmental challenge that is upon us and how the public health tradition of prudent action will compel us to gather more data about global problems, which in turn will lead to more fine-tuned and appropriate actions. Finally, he states how important it is for health professionals to use their technical and scientific knowledge--especially their "habits of mind"--to help develop more intelligent and prudent environmental policies, and describes the crucial role of "citizen-health professionals" in the environmental arena of the future.