Neo-Lamarckian medicine

Darwinian medicine is the treatment of disease based on evolution. The underlying assumption of Darwinian medicine is that traits are coded by genes, which are often assumed to be sequences of DNA nucleotides. The quantitative genetic ramification of this perspective is that traits, including disease susceptibility, are either caused by genes or by the environment, with genotype-by-environment interactions usually considered statistical artefacts. I emphasize also examining those epigenetic signals that can be altered by environmental perturbations and then transmitted to subsequent generations. Although seldom studied, environmentally-alterable meiotically-heritable epigenetic signals exist and provide a mechanism underlying genotype-by-environment interactions. Environment of a parent can affect its descendants by heritably altering epigenetic signals. Neo-Lamarckian medicine is the application of these evolutionary epigenetic notions to diseases and could have enormous public health and environmental policy implications. If industrial contaminants adversely affect organisms by meiotically-heritably altering their epigenetic signals, then cleaning up these contaminants will not remedy the problem. Once contaminants have adversely altered an individual's epigenetic signals, this harm will be transmitted to future generations even if they are not exposed to the contaminant. Exposure to environmental shocks such as free radicals or other carcinogens can alter cytosine methylation patterns on regulatory genes. This can cause cancer by up-regulating genes for cell division or by down-regulating tumour suppressor genes. Environmentally-alterable meiotically-heritable epigenetic signals could also underlie other diseases, such as diabetes, Prader-Willi syndrome, and many complex diseases. If environmentally-altered meiotically-heritable epigenetic effects are widespread - which is an important open empirical question - they have the potential to alter paradigmatic views of evolutionary medicine and the putative dichotomy of nature versus nurture. Neo-Lamarckian medicine would thereby shift emphasis from cure to prevention of diseases.

Risk communication and the Precautionary Principle

The perception of risks for environment and health deriving from globalization processes and an uncontrolled use of modern technologies is growing everywhere. The greater the capacity of controlling living conditions, the larger is the possibility of misusing this power. In environmental and occupational health research we tend to reduce the complexity of the observed phenomena in order to facilitate conclusions. In social and political sciences complexity is an essential element of the context, which needs to be continuously considered. The Precautionary Principle is a tool for facing complexity and uncertainty in health risk management. This paper is aimed at demonstrating that this is not only a problem of technical risk assessment. Great attention should also be paid to improve risk communication. Communication between the stakeholders (experts, decision makers, political and social leaders, media, groups of interest and people involved) is possibly the best condition to be successful in health risk management. Nevertheless, this process usually runs up against severe obstacles. These are not only caused by existing conflicts of interest. Differences in values, languages, perceptions, resources to have access to information, and to express one's own point of view are other key aspects.

[Efficiency of sanitary measures in oil-producing areas]

The paper presents the results of an analysis of the efficiency of sanitary and environment-protective measures relating the ambient atmosphere in the oil-producing areas of the Republic of Tatarstan. It characterizes the environment-protective activity of the PJSC "Tatneft", gives a sanitary evaluation of the quality of the ambient air in the oil-producing areas. It has been ascertained that the improvement of manufacturing technology and the construction of gas and dust catching units on the oil-producing facilities reduce atmospheric pollutant emissions. The levels of hydrocarbons, nitric oxide, and hydrogen sulfide have been substantially decreased. At present, the influence of oil-producing facilities on the quality of the ambient air is 17-19%; the main source of atmospheric pollution is motor transport (its influence on atmospheric pollution is 40-56%). At present versus 1989-1995, the degree of pollution and the mutagenic potential of the ambient air are reduced, which suggests the efficiency of sanitary and environment-protective measures implemented by the PJSC "Tatneft".

[Methodology in occupational and environmental epidemiology]

The close links between environment and health have long been known. The methodological bases for this study were especially developed in the occupational settings, and notably so in the study of occupational carcinogens. Many pollutants recently spread from the confined work places to the general environment (e.g., lead, benzene, PAHs, asbestos, noise) either as effluents of industrial sites or as exhausts of diverse environmental combustion sources (e.g., traffic, heating). The methodologies developed in the occupational settings proved extremely useful in addressing these new environmental problems. Main experiences in Italy include the study of a large residential population exposed to dioxin; the study of benzene and PHA's exposure in the city environment; the effect of point industrial pollution sources on the surrounding territory; the short and long term effect on respiratory and cardiovascular health outcomes and functions after exposure to PM10 and 2.5 in large cities.

[Molecular biological approaches for environmental medicine]

A revolution in biology and medicine is taking place as a direct consequence of rapid developments in the field of molecular biology. The tremendous advances in our knowledge of basic molecular genetics and cell biology have opened the door for new methods of diagnosis, assessment of individual susceptibility to disease, and elucidation of the pathogenesis of disease. These advances will have a profound impact on the practice of occupational and environmental medicine. In this review, we intend to summarize the approaches we have applied in order to deal with the environmental problems we have faced.

[From industrial hygiene and toxicology to environmental hygiene and toxicology: problems and prospects]

BACKGROUND

Low-dose exposures to mixtures of substances have received increasing interest and they involve many different occupational and environmental situations. The presence in the population (working and general) of groups of susceptible individuals is an important public health issue that poses new challenges to science and society.

OBJECTIVES

To discuss the evolution from traditional occupational hygiene and toxicology to the new environmental (general and occupational) hygiene and toxicology.

RESULTS

Environmental hygiene and toxicology have remarkably improved analytical tools available to solve most of the analytical issues posed by the present exposure scenario. Biomarkers of low-dose exposure, early effects and individual susceptibility are being intensively investigated.

CONCLUSIONS

The challenge in this field for the coming years appears to be not the analytical but the medical and ethical implications.