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FOIA Number: 2012-0769-F
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This is not a textual record. This is used as an
administrative marker by the William J. Clinton
Presidential Library Staff.
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Clinton Presidential Records
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Council on Environmental Quality
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Scott Klug
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61
5
9
2
OFFICE OF THE VICE PRESIDENT
WASHINGTON
June 16, 1993
The Honorable Scott Klug
Congress of the United States
House of Representatives
Washington, D.C. 20515
Dear Congressman Klug:
grott
Thank you for your letter and the information you enclosed
regarding Dr. John Scott's work as a delegate to the
International Society of Physicians for the Environment (ISPE).
It was good to hear from you, and I apologize for the delay in
responding.
I share President Clinton's commitment to the preservation
of our global environment in a way that leads to strong and
sustainable economic growth. As you know, in his Earth Day
Address in April, the President announced his intention to sign
the Biodiversity Treaty, as well as initiatives to promote
recycling, the use of energy efficient computers, and an
environmental audit of the White House. Be assured that this
Administration will continue in its efforts to protect our
natural heritage and the delicate balance of the diversity of the
ecosystems of our planet. Similarly, I appreciate hearing of Dr.
Scott's efforts to increase public awareness of health problems.
The problems of health and the environment are closely linked.
Again, thank you for sharing this information with me.
Sincerely,
are
Al Gore
AGJ/avl
SCOTT KLUG
ENERGY AND COMMERCE COMMITTEE
SECOND DISTRICT, WISCONSIN
SUBCOMMITTEES:
HEALTH AND THE ENVIRONMENT
ENERGY AND POWER
Congress of the United States
house of Representatives
Mashington, DC 20515-4902
March 31, 1993
The Honorable Al Gore
Vice President
The White House
1400 Pennsylvania Avenue, N.W.
Washington, D.C. 20500
Dear The Honorable Gore:
My constituent, Dr. John K. Scott asked me to forward the
enclosed packet of information on to you. I would appreciate any
attention you can give to it.
Dr. Scott is a delegate to the International Society of
Physicians for the Environment (ISPE) and wanted you to be aware
of ISPE's work. He would be grateful if you could respond to his
concerns about preserving our global environment as well as
address his upcoming meeting with Mikhail Gorbachev in Lucerne,
Switzerland.
Again, thanks for you help in this matter. If your have any
questions or concerns, please let me know.
Sincerely,
88
Congress
SK/jc
PLEASE RESPOND TO:
1224 LONGWORTH HOUSE OFFICE BUILDING
16 NORTH CARROLL STREET
WASHINGTON, DC 20515-4902
Room 800
(202) 225-2906
MADISON, WI 53703
(608) 257-9200
THIS STATIONERY PRINTED ON PAPER MADE OF RECYCLED FIBERS
Madison physician joins global fight against pollution
D
EPLETION OF THE stratospheric ozone,
Since the organization was founded in
widespread water pollution, air
January 1989, ISDE has grown to 7,000
pollution, and groundwater contamina-
physician members. The roster also in-
tion are some of the pressing global
cludes dentists, veterinary surgeons,
pollution problems that prompted the
pharmacists and other health workers.
United States' recent participation in the
Approximately 35 physicians attended
assembly of the International Society of
the Stockholm meeting, representing 30
Doctors for the Environment (ISDE), ac-
countries.
cording to a Madison physician who served
The aim of the international society is
as the sole US delegate.
to inform and make the worldwide public
John K. Scott, MD, a Wisconsin otolar-
aware of the problems linked with pollu-
yngologist and past SMS president, trav-
tion produced by human activity to pro-
eled to Stockholm, Sweden, in late Sep-
tect health and the continuity of life on
tember to discuss the role physicians can
the planet Earth. ISDE's mission also calls
play in addressing pollution problems
for members to fight against every type of
posing a threat to the inhabitants of the
environmental degradation of air, weather
Earth, current and future. ISDE is working
and the soil, both in the world and locally.
to bring worldwide environmental health
ISDE concerns are diverse. Members
issues to the forefront of public concern.
decry the lack of insight which has re-
Although the recent forum was the
sulted in dying forests; poisoning of air,
John K. Scott, MD
third assembly of ISDE, the United States
water and soil; destruction of the strato-
had never before participated in the global
spheric ozone layer; development of the
environmental health discussion. But in
potentially negative greenhouse effect
fresh water supply, is a special concern
1992, Dr Scott said, the United States has
caused by industrial and automotive
for ISDE, according to Dr Scott. Many of
declared an end to isolationism. The past
emissions; and extinction of thousands of
the countries in the world are experienc-
chair of the AMA's Long Range Planning
species of animals and plants. Mankind
ing severe water pollution problems. For
Council, which has been working with the
must be considered, members urge, as
example, Dr Scott said, one third of the
Council of Scientific Affairs in matters of
only part of nature; the environment
groundwater in Poland is unusable.
the environment, Dr Scott was asked to
must be considered the basis of health
"Germans have been working to clean up
represent the newly organized National
and welfare. In an ongoing appeal to all
the Rhine River, but at great financial
Association of Physicians for the Environ-
doctors of the world, ISDE urges physi-
cost," he said.
ment (NAPE) as its first delegate.
cians to make the public aware of dangers
Another notable concern is the contin-
Still in fledgling stages, NAPE was
and their causes exert influence within
ued use of cadmium in gold mining which
founded earlier this year by John T.
medical and sanitary associations; to gain
results in kidney problems among resi-
Grupenhoff, PhD, of Potomac, MD, with
the attention of administrators and poli-
dents living near the mines. Everyone
physicians Jerome C. Goldstein, MD, ex-
ticians; and to search for new problem-
must work together to eliminate this
ecutive vice president of the American
solving procedures with the industrial
health hazard, Dr Scott said.
Academy of Otolaryngology-Head and
and labor worlds and environmental or-
ISDE members are also troubled by
Neck Surgery, Inc., and Peyton E. Weary,
ganizations.
predictions stemming from the sheer
MD, chair of the department of dermatol-
"There are no winners. We're all losers
numbers of people; the Earth's popula-
ogy at the University of Virginia in Arling-
when it comes to pollution," Dr Scott said,
tion is expected to double in the next
ton. Grupenhoff has worked as a consult-
stressing that problems with the ozone
century. Dr Scott said scientists have
ant and representative of physicians
aren't limited to geographical borders.
reason to believe the second generation
groups for the last 20 years. He served,
Production in the US corn belt is down
after the year 2001 will experience wide-
under the Johnson administration, as
30% because of the ozone problem, and
spread environmental deterioration,
deputy assistant secretary for health and
the destruction of the ozone layer will
causing-among other problems-starva-
environmental legislation of the (then)
continue until chlorofloral carbons are
tion, and many people will die.
Department of Health, Education and
eliminated, he said.
In developing solutions to problems
Welfare and worked on the nation's first
The contamination of the Great Lakes,
with agricultural chemicals and contami-
major air quality legislation in 1967.
which account for one fifth of the world's
Continued on next page
Wisconsin Medical Journal
December 1992
695
Continued from preceding page
The US National Association of Physi-
nology; family physicians; neurology;
nants, Dr Scott said physicians all over the
cians for the Environment (NAPE) will
radiology; pediatrics; internal medicine;
world should take note of what is happen-
hold its first national conference Febru-
physical medicine; emergency physicians;
ing in Sweden. There, doctors and farm-
ary 23 and 24, in Washington, using a
ob-gyns; preventive medicine; surgeons;
ers are working closely to come up with
grant from the Institute of Environmental
anesthesiologists and others. Vice Presi-
solutions to environmental problems.
Health Sciences, a branch of the National
dent-Elect Albert Gore and US Sen Tom
The next meeting of ISDE is scheduled
Institute of Health. The program is slated
Harkin have also been invited to speak.
to be held in Antwerp, Belgium, in Octo-
to include discussion of environmental
For more information about the agenda,
ber 1993. Meanwhile, Dr Scott and other
concerns by representatives of many
contact Dr John T. Grupenhoff, Suite 203,
ISDE leaders are preparing to launch a
medical specialty organizations, includ-
6410 Rockledge Dr, Bethesda, MD, 20817;
full-scale fight against pollution closer to
ing: otolaryngology; allergy and immu-
or telephone (310) 571-9790. 150th
home.
696
Wisconsin Medical Journal
December 1992
NOV-24-92 TUE 14:01
P.02
DRAFT
DRAFT FOR STATE MEDICAL SOCIETIES
November , 1992
Mr. William E. Madigan
Executive Director
Michigan State Medical Society
120 W. Saginaw
East Lansing, MI 48823
Dear Mr. Madigan,
Subject: REQUEST FOR YOU TO SEND TO YOUR ENVIRONMENT
COMMITTEE CHAIRPERSON INFORMATION ABOUT THE
NATIONAL CONFERENCE: PHYSICIANS AND THE
ENVIRONMENT, WASHINGTON, D.C., FEBRUARY 23-24,
1993
Our Academy is hosting a National Conference on Physicians
and the Environment, February 23-24, 1993, supported by a
grant from the National Institute of Environmental Health
Sciences (NIEHS).
Dr. John Kimball Scott, Chairman of the Long-Range Planning
Council of the AMA and a member of the governing board of the
National Association of Physicians for the Environment, has
urged us to make sure the appropriate state society officials
are invited to the conference.
Please forward the information contained in this letter to
the chairperson of your Society's Environment Committee, or
if you do not have such a committee, to the appropriate
person. There is no registration fee for the conference.
The purpose of the conference is to bring together medical
specialty and state and local society leaders and other
leaders in the medicine and environment fields to discuss
medical society activities currently underway, and planned,
that relate to the environment, and to determine how best
these activities can be organized and coordinated to improve
the health of our patients, and the public health generally.
We are hopeful that this first-ever national meeting of
physician organizations on the environment will serve to
organize and energize those organizations to become active,
if they are not already.
NOV-24-92 TUE 14:01
P.03
2
Along with the chairpersons of the Environment Committees of the state
societies, we are also inviting the president and chief executive of the 24
American Board of Medical Specialty (ABMS) recognized specialty societies to
attend (there is no registration fee) and to discuss current society
activities relative to the worldwide deterioration of the environment, and
especially how they relate to the patient population served by the
specialty; environmental research activities currently promoted by the
specialty, including those related to governmental or foundation granting
agencies; and professional and public education programs regarding
environmental health presently underway or planned.
We are also inviting the leaders of other selected organizations, as well as
leaders of various health professions, Federal agencies (including NIH
institutes), and interested Foundation officials.
The following issues will be discussed at the conference:
How to organize and educate physicians about environmental
pollution and how it impacts their patients and the public;
How to determine the current state of research and scientific
understanding in these matters and to develop research agendas:
How physicians can use their expertise to take a leadership role
in environmental protection and pollution prevention;
How to create environmental health education programs for the
public;
How the various physician specialties, national organizations, and
federal agencies can work together;
How to support health officials, environmental officials,
legislatures, and nonprofit organizations in their national,
state, and local environmental health efforts; and
How to develop public health recommendations to national, state,
and local policymakers in regard to environmental matters.
Included with this letter is an editorial, by John Grupenhoff, that appeared
some months ago in the Journal of Environmental Research which called for
the development of a National Association of Physicians for the Environment,
to be organized by medical specialty societies, which your chairperson may
find useful as background.
Also enclosed, for your information, is a copy of our Academy's pamphlet,
"The Environment: Our Mutual Concern," which describes our program. Also
included are copies of the brochure announcing the NIH conference held on
December 16, 1991, and the satellite teleconference held on May 8, 1992.
NOV. - 24-92 TUE 14:02
P.04
3
We are currently developing our meeting schedule, and a draft copy is
enclosed, but wanted to get this invitation in your hands early, for your
chairperson's consideration and planning purposes. We hope your chairperson
can accept our invitation to be a participant for the full conference.
As this is an invitation only conference, for 100 individuals maximum, we
look forward to hearing from you by December 15, 1992, so that we can
reserve 8 place for the person you indicate. Also. if no one will be coming
from your Society. we would like to know that also. Please phone or fax
response to Julie Jacobs of our office.
Sincerely,
Jerome C. Goldstein, MD, FACS
Executive Vice President
JCG/
OV-24-92 TUE 14:03
P.05
DRAFT - 11/20/92
Prellminary Program
NATIONAL CONFERENCE: PHYSICIANS AND THE ENVIRONMENT
WASHINGTON COURT HOTEL
WASHINGTON, D.C.
FEBRUARY 23 24, 1993
(Speakers noted are to be Invited; . = accepted)
Tuesday, February 23, 1993
Morning Moderator: Charles Cummings, MD
8:00 am - 8:30 am Muffins and Coffee Outside Meeting Hall
8:35 am - 8:45 am Introduction to Purpose of Conference
*Buddy Hicks, MD
Chairman, American Academy of Otolaryngology-Head and Neck
Surgery
*Charles Cummings, MD
President, American Academy of Otolaryngology-Head and Neck
Surgery
and/or
G. Richard Holt, MD
Immediate Past-President, American Academy of Otolaryngology-
Head and Neck Surgery
8:45 am - 9:05 am Physicians and the Environment-An Important Alliance
Jay Hair
President, National Wildlife Federation
9:05 am - 9:15 am Otolaryngology - The Environment: Our Mutual Concern
*Byron J. Balley, MD
Past President, American Academy of Otolaryngology-Head and
Neck Surgery
9:15 am - 9:25 am The Environment and the Skin-Our National Conference and Program
*Peyton Weary, MD
President-Elect, American Academy of Dermatology
9:25 am - 9:40 am Proposal: A National Association of Physicians for the Environment
*John Grupenhoff, Ph.D.
Executive Vice President, National Association of Physicians for
the Environment
9:40 am - 9:50 am The International Society of Doctors for the Environment
*John Kimball Scott, MD
9:50 am - 10:15 am BREAK
NOV-24-92 TUE 14:03
P.06
10:15 am - 10:35 am How Physicians Can Work on Environment Matters
*Robert Soderstrom, MD
Chairman, Medical Society of Gennesee County, Michigan
10:35 am - 12:00 n What Medical Specialties are Doing on Environmental Matters: Society
Presentations and Discussion
12:00 n - 12:25 pm Questions and Answers
12:25 pm - 1:30 pm Luncheon Moderator - Jerome C. Goldstein, MD
The Importance of Physician Organizations to the Environment and
Environmental Health
Senator Tom Harkin
.
US Senate
*Kenneth Olden, Ph.D.
Director, National Institute of Environmental Health Sciences
Afternoon Moderator: G. Richard Holt, MD
1:30 pm - 1:45 pm Our Experience In Environmental Health Education, Physicians, Patients,
Public
*Alfred Munzer, MD
President - Elect, American Lung Association
*Fran Du Melle
Director, American Lung Association, Washington D.C. Office
1:45 pm - 3:10 pm What Medical Specialties are Doing on Environmental Matters: Society
Presentations and Discussion
3:10 pm - 3:30 pm
BREAK
3:30
pm -
3:45 pm What Physicians Can Do About Threats to Our Environment
*Eric Chivian, MD or *Julla Moore, Executive Director, Physicians
for Social Responsibility
3:45 pm - 4:05 pm
General Discussion of Day's Topics
4:05 pm - 5:30 pm Breakout Sessions
Group discussions on potential physician organization
environmental activities
5:30 pm - 7:00 pm Cash Bar Reception
(Dinner on your own)
Wednesday, February 24, 1993
Morning Moderator: Nancy Snyderman, MD
TUE
14:04
P.07
8:00 am - 8:30 am Rolls and Coffee Outside Meeting Hall
8:30 am - 9:00 am Keynote Address: Physicians and the Health of Our Environment
Senator Albert Gore
9:00 am - 9:30 am NASA Environmental Mission to Planet Earth
9:30 am - 10:20 am Outreach Panel
Moderator: *John Grupenhoff, Ph.D., Executive Vice President,
National Association of Physicians for the Environment
Panellsts:
Horace Deets
Executive Director, American Association of Retired Persons
William R. Hendee, PhD
Senior Associate Dean
Medical College of Wisconsin
Don Lesh
Executive Director, Global Tomorrow Coalition
Physicians and the Environment: Views from Concerned
Foundations
J.P. Myers
Director, W. Alton Jones Foundation, Inc.
Virginia Trotter-Betts, RN
American Nurses Association
10:20 am . 10:40 am Biological Diversity: A Concern of Physicians
Thomas E. Lovejoy, PhD
Assistant Secretary, External Affairs, The Smithsonlan
10:40 am . 11:00 am BREAK
11:00 am - 11:40 am Medical Organizations Panel
*Moderator: Jerome C. Goldstein, MD
Executive Vice President, American Academy of Otolaryngology .
Head and Neck Surgery
Panellsts:
*James B. Snow, MD
Director, National Institute on Deafness and Other
Communication Disorders
*Alan Nelson, MD
American Society of Internal Medicine
*Mitchell Rhodes, MD
Council of Medical Specialty Societies
NOV- 24-92 TUE 14:05
P.08
*Jerod Loeb, MD
Vice President, Science and Technology
American Medical Association
*William H. McBeath, MD
Executive Director, American Public Health Association
11:40 am - 11:55 am Questions and Answers
11:55 am - 12:40 am Reports from Breakout Sessions followed by discussion
12:40 am - 12:55 n Summary of Conference
*Byron Balley, MD
ACCREDITATION STATEMENT
The American Academy of Otolaryngology-Head and Neck Surgery Foundation is accredited by
the Accreditation Council for Continuing Medical Education to sponsor continuing medical
education for physicians.
The American Academy of Otolaryngology-Head and Neck Surgery Foundation designates this
educational activity for
hours In category 1 of the Physician's Recognition Award of the
American Medical Association.
REPORT OF THE COUNCIL ON LONG RANGE PLANNING AND DEVELOPMENT
Report: D
(I-92)
Subject:
AMA Initiatives Regarding the Environment
Presented by: C. Burns Roehrig, MD, Chair
Referred to:
Reference Committee D
(B. J. Kennedy, MD, Chair)
1
BACKGROUND
2
3
The Council on Long Range Planning and Development believes that
4
environmental health is an important issue which deserves considerable
5
attention by the Association. This report was prepared to review
6
existing AMA policy on environmental issues, discuss continuing
7
environmental problems faced by the world population, provide
8
information on an important federal agency involved in environmental
9
issues, and provide specific recommendations in this area. This
10
report is not a scientific treatise on the subject, because the
11 Council on Scientific Affairs has undertaken significant activity on
12
this issue in the past.
13
14
American Medical Association (AMA) environmental analyses and policy
15
planning activities have resulted in the establishment of numerous
16
policies on a wide range of issues. The AMA Council on Scientific
17
Affairs has prepared two major overview reports on the issue of
18 environmental health in the recent past. The first, "Global Climate
19 Change: The Greenhouse Effect," Policy 135.977, AMA Policy
20 Compendium, detailed possible reasons for global warming and gave
21
suggestions for possible remediation. Following is Policy 135.977 as
22
adopted in 1989: The AMA: (1) endorses the need for additional
23
research on atmospheric monitoring and climate simulation models as a
24
means of reducing some of the present uncertainties in climate
25
forecasting; (2) urges Congress to adopt a comprehensive, integrated
26
natural resource and energy utilization policy that will promote more
27
efficient fuel use and energy production; (3) endorses increased
28
recognition of the importance of nuclear energy's role in the
29
production of electricity; (4) encourages research and development
30
programs for improving the utilization efficiency and reducing the
31
pollution of fossil fuels; and (5) encourages humanitarian measures to
32
limit the burgeoning increase in world population.
33
34
The second Policy, 135.973, was presented in a Council on Scientific
35
Affairs report entitled "Stewardship of the Environment" and was
36
adopted at the 1989 Interim Meeting. It provided a broad overview of
37
the environmental health challenges facing the profession and society,
CLRPD Rep. D - - page 2
1
and it was intended to serve as a framework for a cohesive,
2 proactive plan that would guide future AMA initiatives. The
3 recommendations in this report were that the AMA: (1) encourage
4 physicians to be spokespersons for environmental stewardship; (2)
5 encourage the medical community to cooperate in reducing or
6 recycling waste; (3) encourage physicians and the rest of the
7 medical community to dispose of its medical waste in a safe and
8 properly prescribed manner; (4) support enhancing the role of
9 physicians and other scientists in environmental education; (5)
10 endorse legislation such as the National Environmental Education Act
11 to increase public understanding of environmental degradation and
12 its prevention; (6) encourage research efforts at ascertaining the
13 physiological and psychological effects of abrupt as well as chronic
14 environmental changes; (7) encourage international exchange of
15 information relating to environmental degradation; (8) encourage and
16 help support physicians who participate actively in international
17 planning and development conventions associated with improving the
18 environment; (9) encourage educational programs for worldwide family
19 planning and control of population growth; (10) encourage research
20 and development programs for safer, more effective, and less
21 expensive means of preventing unwanted pregnancy; (11) encourage
22 programs that may facilitate human and environmental adaptation to
23 global climate changes or other elements of environmental
24 degradation; and (12) encourage economic development programs for
25 all nations that will be sustainable and yet nondestructive to the
26 environment.
27
28 This is an opportune time for the AMA to bring increased attention
29 to the issue of environmental health. This issue is a subject of
30 immense breadth and one that greatly affects the public's
31 well-being. This issue is particularly compelling to those
32 physicians who want their professional medical associations to be
33 both medically and socially relevant. In fact, surveys of
34 physicians have shown that a substantial proportion of respondents
35 identify improving the health status of the public as a major
36 concern. Reducing environmental risk factors are an important
37 component of achieving such a goal.
38
39 Further, environmental health issues have assumed increasing
40 importance to patients. For example, as indicated in the filed
41 portion of the Council report containing Policy 135.973,
42 approximately 80% of Americans responding to public opinion surveys
43
indicated that they are very concerned about the environment,
44
especially the quality of air and water.
45
46 CONTINUING PROBLEMS
47
48. Potential changes in the earth's climate is perhaps one of the more
49
important issues facing society today. Although controversy exists,
CLRPD Rep. D - - page 3
1
many believe three strategic air pollution threats may exist. Ozone
2
depletion is the first; the other two are diminished oxygen content
3
of the atmosphere and global warming. All three have the potential
4
to change the makeup of the entire global atmosphere and, in the
5
process, disrupt the atmosphere's crucial balancing role in
6
maintaining the global ecological system. Global environmental
7
change could result in deleterious health effects. Several of these
8
include:
9
10
(1) respiratory and pulmonary disease aggravated by air pollution
11
and exacerbated by elevated summertime temperatures. Air pollution
12 from industrial activities irritates the respiratory system and
13 contributes to problems such as bronchitis, bronchiectasis, asthma,
14
and chronic obstructive pulmonary disease. 1-3
15
16
(2) greater incidence of all skin cancers and immunosuppression
17
caused by destruction of stratospheric ozone and the resulting
18
increased exposure to ultraviolet-B radiation. Over the past seven
19
years in the U.S., the incidence of melanoma, the most deadly form
20
of skin cancer, has increased by 83%. 4 The Environmental
21
Protection Agency (EPA) estimates that further ozone depletion could
22
lead to an additional 31,000 to 126,000 cases of melanoma among U.S.
23 whites born before 2075 and an additional 7,000 to 30,000
24
fatalities. 5-8 In addition to causing skin cancer, excessive
25
exposure to summer sunlight can reduce the body's immune response,
26
leaving individuals more vulnerable to infectious diseases,
27
especially those in areas with poor sanitation.
28
29 (3) increased incidence of cataracts also caused by exposure to
30
ultraviolet-B radiation. The EPA's ozone depletion scenario
31
estimates an additional 550,000 to 2.8 million persons among
32
individuals born before 2075 will have cataracts, the third-largest
33
cause of preventable blindness in the U.S.5,9-10
34
35
(4) increased environmental stress on poor populations caused by
36
the long-term physical effects of ozone depletion and excessive
37
pollution; drought, increased numbers of pests, desertification, and
38 soil erosion, that disrupt food production and make certain areas
39
uninhabitable. For example, temperature increases are expected to
40
speed the evaporation of surface water in the western United States,
41
severely reducing the supply and quality of water. In addition,
42
declining summer precipitation, drought, and desertification of the
43
temperate United States midcontinental farm belt are predicted to
44
leave arable land only in the higher latitudes. Further, the sea
45
level could rise an estimated 0.2 to 1.5 meters due to thermal
46
expansion of the oceans and melting of glaciers and polar ice caps.
47
The rising oceans would threaten coastal cities, destroy sensitive
48
and food-critical tidal eco-systems, and contaminate ground water
49
supplies with salt. 11
CLRPD Rep. D - page 4
1
Deforestation and desertification, secondary to global warming, could
10
turn huge areas of arable land to dust with no assurance that it could
3
be recovered in other areas. 12 Without planned resettlements and
4
new agricultural and water systems, it seems likely that millions
5
could starve. 13, 14
6
7
Such dislocations will be additional causes of conflict, particularly
8
between "have" and "have-not" nations, thus making the breakdown of
9
the environment one of the most important international issues faced
10
by society and the public health community in the 21st century.
11
12
(5) continued environmental degradation caused by unabated
13
population growth rates. The population- continues to grow at rates
14
that outstrip resources in many parts of the world. In many areas of
15
the world, regionally grown food is already insufficient to sustain
16
growing populations. In 1980, 340 million persons in 87 developing
17
countries were not consuming enough calories to prevent stunted growth
18
and serious health risks 12 For the third year in a row, 1988 world
19
grain consumption exceeded production. 3
20
21
The effects of an increasing population raise an important and
22
difficult question for physicians. Environmental degradation can be
23
viewed as an ecologic problem, the result of an imbalance between the
24
earth's resources and the rapidly growing human population. In this
25
analysis, the planet can be viewed as overpopulated and, therefore,
26
reducing the rate of population growth could be an important and
27
practical way to reduce pollution.
15
28
29
To prevent further degradation of the environment, the AMA Council on
30
Long Range Planning and Development has concluded that a change in the
31
public's attitudes and behavior is required. The Council is convinced
32
that one of the best ways to bring about behavioral and policy changes
33
in this arena is to help the public fully comprehend the potential
34
risks to their health posed by environmental deterioration, and most
35
importantly, the threat to future generations.
36
37
As environmental issues become increasingly visible and important both
38
nationally and internationally, a clear need exists for physicians to
39
become leaders in the growing movement of scientists, policymakers.
40
and citizen activists working to avert a global environmental crisis.
41
The prevention of further environmental degradation will require an
42
enormous level of public education and advocacy activity.
43
44
NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES
45
46
In April 1992, the AMA Council on Long Range Planning and Development
47
met with Kenneth Olden, PhD, Director of the National Institute of
48
Environmental Health Sciences (NIEHS). Dr. Olden shared with the
49
Council the activities of the Institute and future research projects
50
and goals regarding the health of the public and environmental health.
CLRPD Rep. D - page 5
1
The NIEHS has a very important role to play both in the improvement
2
of public health and in the containment of national health costs.
3
NIEHS supports research on the etiology of most human diseases based
4
on their environmental association. The potential contribution of
5
NIEHS to the broad mission of the National Institutes of Health
6
(NIH) is significant. Environmental health science research
7
includes studies on the causes, prevention, and treatments of human
8
disease and dysfunction. For a variety of practical and historical
9
reasons, however, environmental health science research has been
10
primarily directed toward the identification and characterization of
11
physical and chemical factors that cause cancer. Approximately
12
one-third of current government appropriations to NIH supports
13
cancer-related research. This research has been critical to the
14
national cancer program and must be continued. However, NIEHS
15
research programs on other human diseases should be expanded in
16
order to foster the overall health of the American public. For
17
example, greater emphasis could be placed on studies to examine the
18
effect of the environment on reproductive health, neurological
19
disorders, immune disorders, respiratory problems, and aging.
20
21
The AMA would further the accomplishment of its mission by
22
strengthening its liaison efforts with the NIEHS. By enhancing this
23
liaison, the AMA could become involved in educating the public
24
through joint efforts with the NIEHS. This liaison could also
25
provide valuable physician insight into environmental research and
26
could be used as an avenue for the AMA to affect environmental
27
policy.
28
29
RECOMMENDATIONS
30
31
The Council on Long Range Planning and Development recommends that
32
Policy 135.973 (see page two) be amended as follows and that the
33
remainder of this report be filed:
34
35
1.
That part (1) of the policy be amended by addition to
36
read: "encourage physicians to be spokespersons for
37
environmental stewardship, including the discussion of
38
these issues when appropriate with patients; and
39
40
2.
That the following policy statements be added to Policy
41
135.973:
42
43
13.
encourage physicians and environmental scientists in
44
the United States to continue to incorporate concerns
45
for human health into current environmental research
46
and public policy initiatives;
47
48
14.
encourage physician educators in medical schools,
49
residency programs, and continuing medical education
50
sessions to devote more attention to environmental
51
health issues;
CLRPD Rep. D - page 6
1
15. strengthen the AMA's liaison with appropriate
2
environmental health agencies, including the National
3
Institute of Environmental Health Sciences (NIEHS); and
4
5
16. encourage expanded funding for environmental research by
6
the federal government.
Fiscal note: No significant impact
Resort to be environmental mecca
PLYMOUTH (AP) - The new
kinds of experiments
renewable
The site's existing facilities suit
owners of an eastern Wisconsin re-
energy, urban renewal," she said:
the institute's mission perfectly,
sort plan to transform the vacation
"We have a fairly detailed vision
Paulson said.
site into a mecca of environmental
statement."
The 34 trout ponds can be
thinking, helping create a plausible
The group bought the property,
to demonstrate bio-digestion, which
scenario for a "sustainable future."
from Larry Gentine of Plymouth,
uses fish waste for fish and plant
The Silver Springs Inn & Resort,
who agreed to provide a challenge
food. The 19 artesian wells can be
a 144-acre site about 5 miles south-
grant of $100,000 if the purchase
harnessed to provide enough hy-
west of Plymouth, was purchased
amount could be raised within a
droelectricity to power the entire
Wednesday by two founders of the
year. The price was not disclosed.
complex.
nearby High Wind ecological vil-
"We feel a little numb," Paulson
The resort's restaurant, trout
lage and six outside partners:
said. 'We've been meeting since
ponds and four chalets will retain
The group intends to expand the
last spring
but it all sort of
their staffs and remain opento the
resort into the home of The Plym-
came to a head very suddenly" on
public to help pay for the institute,
outh Institute, an educational cen-
Wednesday.
Paulson said.
ter for promoting sustainable
The group, which made a
"A lot of non-profit groups have
development. Several scientific and
$100,000 downpayment, plans to
to keep going to foundations for
business ventures are also planned.
build an energy-efficient confer-
money
and eventually the sup-
The idea is to create a center to
ence center to demonstrate the la-
ply runs dry. To be really sustain-
demonstrate sustainable develop-
test environmental technologies.
able you have to be part of the real
ment," High Wind spokeswoman
The center would house classes, lec-
world and maintain businesses.'
Lisa Paulson said. "Living in such a
tures and conferences about sus-
She said the purchase came at a
way that (society) is able to grow,
tainability and other ideas.
beneficial time politically.
but in a way that isn't destroying
The institute would also sponsor
"There's a great deal of interest
the future for the next civilization.'
youth programs; technical experi-
in this
with the new administra-
"We want to bring together and
ments to demonstrate sustainable
tion. All Al Gore talks about is sus-
integrate viable businesses with the
uses of natural resources; and
tainable development," she said,
kind of cutting-edge research that
courses for teachers, scientists,
referring to the vice president-
would attract scientists doing all
politicians and business leaders.
elect.
Milwaukee
THE JOURNAL
Tuesday, November 24, 1992 - Sunrise Edition
Doctors in the dark
Pollution ailments stump many physicians, survey says
By DON BEHM
international cooperation. The International Joint
Journal environment reporter
Commission, established in 1909, is a US and Canadi-
an panel responsible for resolving water quality and
More than half of Wisconsin's primary care physi-
quantity disputes along the shared border.
cians likely do not know the health effects caused by
"It's disturbing to see that neither physicians nor
exposure to mercury and chemicals known as PCBs.
their patients fully appreciate the health risks of envi-
although both are widespread environmental contami-
ronmental pollutants," said Julia Moore, executive
nants. a recent survey indicates.
director of the physicians group.
Also, few patients inquire about the pollutants. Only
Such lack of awareness also is alarming, the group
one-fifth of pediatricians, family practice physicians,
said, because state warnings to restrict consumption of
internal medicine specialists, obstetricians and gynecol-
large sport fish in hundreds of inland lakes and
ogists participating in the survey said that patients had
streams, as well as the Great Lakes, are prompted by
asked about possible illnesses caused by exposure to
tests showing high levels of mercury and PCBs in the
either of the contaminants.
fish.
The first-ever survey of physician perceptions of
"Our group sees the human health threats of these
environmental health risks was sponsored by Phy-
substances as a serious challenge facing the medical
sicians for Social Responsibility and the International
profession," Moore said. "It is essential for primary
Joint Commission.
care physicians to have more training in toxicology,
The physicians group was established in 1961 to
promote environmental protection, arms control and
Please see Toxins page 6
Toxins/Many doctors unaware of pollution ills
From page 1
population.
families son through studies on the
ing to: DNR Bureau of Water Re-
The most severe behavioral,
possible health effects caused; by
sources Management. PO Box
epidemiology and environmental
learning and reproductive prob-
exposure to contaminants in food,
7921, Madison, Wis. 53707.
nsk assessment."
lems show up in the second genera-
water and air. Hendee said.
The survey was conducted by
tion, the children born to adults
Mercury also is known to dam-
the Center for Survey Research at
exposed to toxins in their diet, rc-
GUIDE AVAILABLE FROM DNR
age the human nervous system.
the University of Massachusetts at
searchers said. One large source of
state environmental and health of-
A state Department of Natural
Boston. The center selected a sam-
the contaminants is fish.
Resources publication, "Health
ficials say. It can harm primary
ple of 174 practicing physicians
Scientists now know that PCBs,
Guide for People Who Eat Sport
senses and skills. such as our ability
and completed interviews with 94
mercury, DDT and other chemi-
to feel, see, taste and move.
Fish from Wisconsin Waters." lists
of them. The survey results could
cals and metals disrupt release of
rivers and lakes containing fish
PCBs. or polychlorinated biphe-
be related to all state primary care
estrogen and other hormones by
known to be contaminated with
nyls. also are suspected of causing
physicians with a margin of error
several glands. Consequently, they
mercury, PCBs and pesticides.
cancer. A small number of studies
of 10%. the center said.
can disrupt the thyroid. adrenal
Copies of the guide, which is re-
have found lower than average
and other glands that regulate body
vised each spring and fall, are avail-
birth weights in children born to
EDUCATION EFFORTS LAUNCHED
functions from brain growth to sex-
able at any DNR office or by writ-
fish-eating women.
More than 25% of primary care
ual development.
physicians in the survey did not
Other synthetic hormone dis-
know where they could obtain sci-
ruptors include: metais, such as
entific information on mercury.
cadmium and lead: alkyl phenols.
PCBs and their health effects. But
which are non-biodegradable deter-
fully 90% say they should be a
gents found in some plastics; tri-
source of reliable information for
azine weed killers; and some other
their patients.
industrial chemicals and pesticides
In the next year. Physicians for
such as dioxins. hexachloroben-
Social Responsibility and the Inter-
zene. keithane. kepone, lindane.
national Joint Commission intend
EBDC fungicides. methoxychlor
to schedule continuing medical
and pyrethroids.
education courses throughout the
US 10 provide information on the
SURVEY SUPPORTS LOCAL CONCERNS
known health effects caused by a
Survey findings also support the
variety of Great Lakes pollutants.
concern expressed by Medical Col-
The Medical College of Wisconsin
lege of Wisconsin officials at the
already held a two-day course in
October course. At that time. Wil-
October sponsored by the two
liam Hendee, senior associate dean
groups.
for research at the college, said
Researchers at that meeting
family doctors were not likely to
warned that dozens of industrial
consider whether a person's expo-
chemicals and pesticides that al-
sure to environmental pollutants
ready have spread throughout the
might be the possible cause of an
Great Lakes environment may be
illness.
damaging both the intellectual and
The reason is that doctors are
reproductive health of the region's
not adequately educated to help