the U.S. Department of Energy, and EPA—asked IOM to conduct a study that would provide an independent assessment of three general issues:
- the specific medical and health issues that are raised by the concept of environmental justice and that require attention, for example, medical education, clinical practice and research, medical surveillance, and public health;
- the suitable roles of basic research and medicine in addressing these issues; and
- the appropriate priorities for medical research that would facilitate improvements in the current situation.
More specifically, IOM was asked to address the following:
- Characterization of the medical issues related to environmental health and justice. This would include a multiethnic focus with an emphasis on socioeconomic status, the diversity of potential environmental and occupational health hazards and conditions, and an assessment and evaluation of current health surveillance systems.
- Cost-benefit and risk-benefit analyses of environmental health and justice issues. For this aspect of the project, case studies or proposals for study methods could be reviewed to evaluate the different types of analyses with an accent on producing new research approaches and strategies.
- Role of emerging scientific research. An assessment of the status and development of biomarkers of susceptibility, exposure, and effect as they pertain to characterization of the health effects associated with environmental hazards. A target could be the development of new molecular biology-based technologies and tools. Ethical and legal issues related to clinical research would also be considered, as would epidemiologic research strategies.
- Opportunities for collaborative approaches leading to disease prevention. This would include some specific recommendations for implementation, including strategies for optimizing the conduct of basic and applied research. Collaborative interagency regulatory strategies would also be a focus of attention here.
Thus, in general, the committee's task was to assess the potential adverse human health effects caused by environmental hazards in communities of concern and to recommend how they should be addressed in terms of public health, biomedical research, education, and health policy perspectives. This report attempts to balance scientific opportunities with public needs and emphasizes the scientific approach in balance with the recognition that the community must play an increasingly active role in decisions about research and public health interventions. The committee felt that environmental justice issues do not lend themselves well to cost-benefit analyses and therefore approaching these issue from that perspective would not be helpful at this time. Environmental health sciences research can contribute to environmental justice most effectively by