Health and the environment

‘The environment is the key to better health’ (World Health Organisation, at the Ministerial Conference on ‘Health and the Environment’, London, June 1999). This quote defined the environment as a complex construct comprising both the physical parameters associated with the environment (e.g. atmosphere, water, soil) and the full range of human activities that disrupt these environments (e.g. outdoor and indoor air pollution, domestic accidents, economic activities, energy, industry, urban violence). The environment is now regarded as the totality of external pathogenic factors that impact health (e.g. chemicals), as opposed to internal, so-called genetic, factors. Consequently, when it comes to determining the causes of the main non-communicable diseases, ‘genetics loads the gun, the environment pulls the trigger’ (Francis Collins, 2006). The concept of the exposome, originally defined by Christopher Wild, allows for the integration of all risk factors that may affect health at different stages of life, including exposures during foetal development. Our course will focus on the adverse effects that the man-made chemical environment can have on human health. The pathophysiological mechanisms of environmental factors will be described. Methodologies for assessing health risks will be presented in both occupational (Occupational Exposure Limit) and environmental (Toxicological Reference Value, Indoor Air Guideline Value) contexts.