Interweaving Knowledge Resources to Address Complex Environmental Health Challenges

Greater than the sum of its parts: focusing SRP research through a systems approach lens

The National Institute of Environmental Health Sciences Superfund Research Program (SRP) funds diverse transdisciplinary research to understand how hazardous substances contribute to disease. SRP research focuses on how to prevent these exposures by promoting problem-based, solution-oriented research. SRP's mandate areas encompasses broad biomedical and environmental science and engineering research efforts and, when combined with research translation, community engagement, training, and data science, offers broad expertise and unique perspectives directed at a specific big picture question. The purpose of this commentary is to adapt a systems approach concept to SRP research to accommodate the complexity of a scientific problem. The SRP believes a systems approach offers a framework to understand how scientists can work together to integrate diverse fields of research to prevent or understand environmentally-influenced human disease by addressing specific questions that are part of a larger perspective. Specifically, within the context of the SRP, a systems approach can elucidate the complex interactions between factors that contribute to or protect against environmental insults. Leveraging a systems approach can continue to advance SRP science while building the foundation for researchers to address difficult emerging environmental health problems.

Alleviating Environmental Health Disparities Through Community Science and Data Integration

Environmental contamination is a fundamental determinant of health and well-being, and when the environment is compromised, vulnerabilities are generated. The complex challenges associated with environmental health and food security are influenced by current and emerging political, social, economic, and environmental contexts. To solve these “wicked” dilemmas, disparate public health surveillance efforts are conducted by local, state, and federal agencies. More recently, citizen/community science (CS) monitoring efforts are providing site-specific data. One of the biggest challenges in using these government datasets, let alone incorporating CS data, for a holistic assessment of environmental exposure is data management and interoperability. To facilitate a more holistic perspective and approach to solution generation, we have developed a method to provide a common data model that will allow environmental health researchers working at different scales and research domains to exchange data and ask new questions. We anticipate that this method will help to address environmental health disparities, which are unjust and avoidable, while ensuring CS datasets are ethically integrated to achieve environmental justice. Specifically, we used a transdisciplinary research framework to develop a methodology to integrate CS data with existing governmental environmental monitoring and social attribute data (vulnerability and resilience variables) that span across 10 different federal and state agencies. A key challenge in integrating such different datasets is the lack of widely adopted ontologies for vulnerability and resiliency factors. In addition to following the best practice of submitting new term requests to existing ontologies to fill gaps, we have also created an application ontology, the Superfund Research Project Data Interface Ontology (SRPDIO).

Knowledge and behavioural interventions to reduce human health risk from private groundwater systems: A global review and pooled analysis based on development status

Groundwater contamination constitutes a significant health risk for private well users residing in rural areas. As the responsibility to safeguard rural private domestic groundwater typically rests with non-expert homeowners, interventions promoting risk mitigation and awareness represent the most viable means of preventing supply contamination. However, no global review or pooled analyses of these interventions has been undertaken to date. The current study sought to identify and quantify the performance of private well interventions from 1990 to 2018 via a global systematised review and pooled analysis. The PICO (Population-Intervention-Comparison-Outcome) approach was employed for literature identification. Relevant studies were statistically analysed across two quantitative outcome (performance) types, namely knowledge and behaviour, controlling for intervention characteristics and country development status. Mean behavioural and knowledge attainment across interventions was 53% and 48%, respectively, with interventions in economically developed regions exhibiting higher behavioural outcomes (56% vs. 45%) than those in developing regions. Geographically, interventions were located in southern or southeast Asia (n = 23), North America (n = 15), Central America (n = 1) and Africa (n = 1), with none identified in Australia/Oceania, Europe, or South America. Behavioural outcomes were significantly associated with presence of educational/research coordinator (p = 0.023), with these interventions attaining higher levels of efficacy (+74%) than those implemented by other coordinator types. Findings indicate that instructor-led, practical interventions allied with both large- and local-scale awareness-raising campaigns represent an optimum approach for future private well risk interventions. Subsequent adoption of such interventions may lead to increased levels of private well maintenance and provide a point of reference for myriad water and health communication contexts.

Institutional insights on integrating social and environmental science for solutions-driven research

Solving complex environmental problems requires interdisciplinary research involving the social and environmental sciences. The U.S. Environmental Protection Agency is working toward solutions-driven research and interdisciplinary integration within its Office of Research and Development. This article details the history of this process and discusses lessons learned from other federal agencies seeking to integrate social and biophysical research: finding the right combination of top down and bottom up approaches; balancing objectives of advancing science and/or supporting programmatic operations; using social science methods to inform the process; and engaging multiple stakeholders. Attention to the social context of scientific practice, including research processes and research use, fosters success. Three strategies for integrating social sciences to support solutions-driven environmental research are: weaving social science throughout the research process, strengthening social networks, and fostering interdisciplinary hubs. Integration into planning and carrying out research has greater transformative potential than integration into product development and distribution. This article provides insights into institutional considerations for advancing interdisciplinarity and the social context of scientific practice in government agencies. It illustrates the multiple decision contexts and inclusion of social science at the science-policy interface.

Advancing Environmental Health Literacy: Validated Scales of General Environmental Health and Environmental Media-Specific Knowledge, Attitudes and Behaviors

Environmental health literacy (EHL) involves understanding and using environmental information to make decisions about health. This study developed a validated survey instrument with four scales for assessing media-specific (i.e., air, food, water) and general EHL. The four scales were created as follows: 1) item generation: environmental health scientists and statisticians developed an initial set of items in three domains: knowledge, attitudes, and behaviors; 2) item review: items were reviewed for face validity; 3) validation: 174 public health students, the exploratory sample, and 98 community members, the test sample, validated the scales. The scales’ factor structure was based on exploratory factor analysis (EFA) and model fit was assessed through confirmatory factor analysis (CFA). For each scale, the final EFA resulted in an independent three-factor solution for knowledge, attitudes, and behaviors. Good fit for the three-factor structure was observed. Model fit for CFA was generally confirmed with fit indices. The scales showed internal consistency with Cronbach’s alpha from 0.63 to 0.70. The 42-item instrument represents an important contribution towards assessing EHL and is designed to enable meaningful engagement between researchers and community members about environmental health. The intended outcome is sustained community–academic partnerships benefiting research design, implementation, translation, dissemination, and community action.

Advancing science in rapidly changing environments: opportunities for the Central and Eastern European Conference on Health and the Environment to connect to other networks

The Central and Eastern Europe region is faced with longstanding environmental health problems as well as emerging health threats from pollution caused by the region's recent period of rapid industrialization. As researchers in the region continue to work to address these problems, they could find unique approaches by increasing collaborations between biomedical and non-biomedical scientists and by more closely following the Superfund Research Program model of pursuing basic research, then connecting with stakeholders in the region to share and apply new knowledge. To build upon and leverage research in the region, researchers and stakeholders should work to formalize the bi-annual meeting of the Central and Eastern European Conference on Health and the Environment into a more cohesive organization and make efforts to connect to broader global networks that aim to spread research results and applications around the world. By taking these steps to connect to the broader world of environmental health research, the CEE region stakeholders can reduce pollution-related disease, minimize costs of hazardous waste remediation, and help grow the economy in their region.

Combining Social Science and Environmental Health Research for Community Engagement

Social science-environmental health (SS-EH) research takes many structural forms and contributes to a wide variety of topical areas. In this article we discuss the general nature of SS-EH contributions and offer a new typology of SS-EH practice that situates this type of research in a larger transdisciplinary sensibility: (1) environmental health science influenced by social science; (2) social science studies of environmental health; and (3) social science-environmental health collaborations. We describe examples from our own and others' work and we discuss the central role that research centers, training programs, and conferences play in furthering SS-EH research. We argue that the third form of SS-EH research, SS-EH collaborations, offers the greatest potential for improving public and environmental health, though such collaborations come with important challenges and demand constant reflexivity on the part of researchers.

When Data Justice and Environmental Justice Meet: Formulating a Response to Extractive Logic through Environmental Data Justice

Environmental data justice (EDJ) emerges from conversations between data justice and environmental justice while identifying the limits and tensions of these lenses. Through a reflexive process of querying our entanglement in non-innocent relations, this paper develops and engages EDJ by examining how it informs the work of the Environmental Data & Governance Initiative (EDGI), a distributed, consensus-based organization that formed in response to the 2016 US presidential election. Through grassroots archiving of data sets, monitoring federal environmental and energy agency websites, and writing rapid-response reports about how federal agencies are being undermined, EDGI mobilises EDJ to challenge the 'extractive logic' of current federal environmental policy and data infrastructures. 'Extractive logic' disconnects data from provenance, privileges the matrix of domination, and whitewashes data to generate uncertainty. We use the dynamic EDJ framework to reflect on EDGI's public comment advising against the US Environmental Protection Agency's proposed rule for Transparent Science. Through EDJ, EDGI aspires to create new environmental data infrastructures and practices that are participatory and embody equitable, transparent data care.

Implementation Science for the Environment

The establishment of the field of implementation science was motivated by the understanding that medical and health research alone is insufficient to generate better health outcomes. With strong support from funding agencies for medical research, implementation science promotes the application of a structured framework or model in the implementation of research-based results, specifically evidence-based practices (EBPs). Furthermore, explicit consideration is given to the context of EBP implementation (i.e., socio-economic, political, cultural, and institutional factors that could affect the implementation process). Finally, implementation is monitored in a robust and rigorous way. Today, the field of implementation science supports conferences and professional societies as well as one dedicated journal and numerous others with related content. The goal of these various activities is to reduce the estimated, average "bench to bedside" time lag of 17 years for uptake of EBPs from health research into routine practice. Despite similar time lags and impediments to uptake in the environmental domain, a parallel field of implementation science for the environment has not (yet) emerged. Although some parallels in needs and opportunities can easily be drawn between the health and environmental domains, a detailed mapping exercise is needed to understand which aspects of implementation science could be applied in the environmental domain either directly or in a modified form. This would allow an accelerated development of implementation science for the environment.

The National Institute of Environmental Health Sciences Superfund Research Program: a model for multidisciplinary training of the next generation of environmental health scientists

The National Institute of Environmental Health Sciences (NIEHS) Superfund Research Program (SRP) funds university-based, multidisciplinary research on human health and environmental science and engineering with the central goals to understand how hazardous substances contribute to disease and how to prevent exposures to these environmental chemicals. This multi-disciplinary approach allows early career scientists (e.g. graduate students and postdoctoral researchers) to gain experience in problem-based, solution-oriented research and to conduct research in a highly collaborative environment. Training the next generation of environmental health scientists has been an important part of the SRP since its inception. In addition to basic research, the SRP has grown to include support of broader training experiences such as those in research translation and community engagement activities that provide opportunities to give new scientists many of the skills they will need to be successful in their field of research. Looking to the future, the SRP will continue to evolve its training component by tracking and analyzing outcomes from its trainees by using tools such as the NIEHS CareerTrac database system, by increasing opportunities for trainees interested in research that goes beyond US boundaries, and in the areas of bioinformatics and data integration. These opportunities will give them the skills needed to be competitive and successful no matter which employment sector they choose to enter after they have completed their training experience.

Community Engaged Cumulative Risk Assessment of Exposure to Inorganic Well Water Contaminants, Crow Reservation, Montana

An estimated 11 million people in the US have home wells with unsafe levels of hazardous metals and nitrate. The national scope of the health risk from consuming this water has not been assessed as home wells are largely unregulated and data on well water treatment and consumption are lacking. Here, we assessed health risks from consumption of contaminated well water on the Crow Reservation by conducting a community-engaged, cumulative risk assessment. Well water testing, surveys and interviews were used to collect data on contaminant concentrations, water treatment methods, well water consumption, and well and septic system protection and maintenance practices. Additive Hazard Index calculations show that the water in more than 39% of wells is unsafe due to uranium, manganese, nitrate, zinc and/or arsenic. Most families' financial resources are limited, and 95% of participants do not employ water treatment technologies. Despite widespread high total dissolved solids, poor taste and odor, 80% of families consume their well water. Lack of environmental health literacy about well water safety, pre-existing health conditions and limited environmental enforcement also contribute to vulnerability. Ensuring access to safe drinking water and providing accompanying education are urgent public health priorities for Crow and other rural US families with low environmental health literacy and limited financial resources.

Incorporating ToxCast and Tox21 datasets to rank biological activity of chemicals at Superfund sites in North Carolina

BACKGROUND

The Superfund program of the Environmental Protection Agency (EPA) was established in 1980 to address public health concerns posed by toxic substances released into the environment in the United States. Forty-two of the 1328 hazardous waste sites that remain on the Superfund National Priority List are located in the state of North Carolina.

METHODS

We set out to develop a database that contained information on both the prevalence and biological activity of chemicals present at Superfund sites in North Carolina. A chemical characterization tool, the Toxicological Priority Index (ToxPi), was used to rank the biological activity of these chemicals based on their predicted bioavailability, documented associations with biological pathways, and activity in in vitro assays of the ToxCast and Tox21 programs.

RESULTS

The ten most prevalent chemicals found at North Carolina Superfund sites were chromium, trichloroethene, lead, tetrachloroethene, arsenic, benzene, manganese, 1,2-dichloroethane, nickel, and barium. For all chemicals found at North Carolina Superfund sites, ToxPi analysis was used to rank their biological activity. Through this data integration, residual pesticides and organic solvents were identified to be some of the most highly-ranking predicted bioactive chemicals. This study provides a novel methodology for creating state or regional databases of biological activity of contaminants at Superfund sites.

CONCLUSIONS

These data represent a novel integrated profile of the most prevalent chemicals at North Carolina Superfund sites. This information, and the associated methodology, is useful to toxicologists, risk assessors, and the communities living in close proximity to these sites.

Future of environmental research in the age of epigenomics and exposomics

Environmental research and public health in the 21st century face serious challenges such as increased air pollution and global warming, widespread use of potentially harmful chemicals including pesticides, plasticizers, and other endocrine disruptors, and radical changes in nutrition and lifestyle typical of modern societies. In particular, exposure to environmental and occupational toxicants may contribute to the occurrence of adverse birth outcomes, neurodevelopmental deficits, and increased risk of cancer and other multifactorial diseases such as diabetes and asthma. Rapidly evolving methodologies of exposure assessment and the conceptual framework of the Exposome, first introduced in 2005, are new frontiers of environmental research. Metabolomics and adductomics provide remarkable opportunities for a better understanding of exposure and prediction of potential adverse health outcomes. Metabolomics, the study of metabolism at whole-body level, involves assessment of the total repertoire of small molecules present in a biological sample, shedding light on interactions between gene expression, protein expression, and the environment. Advances in genomics, transcriptomics, and epigenomics are generating multidimensional structures of biomarkers of effect and susceptibility, increasingly important for the understanding of molecular mechanisms and the emergence of personalized medicine. Epigenetic mechanisms, particularly DNA methylation and miRNA expression, attract increasing attention as potential links between the genetic and environmental determinants of health and disease. Unlike genetics, epigenetic mechanisms could be reversible and an understanding of their role may lead to better protection of susceptible populations and improved public health.

Community Engagement and Research Translation in Puerto Rico's Northern Karst Region: The PROTECT Superfund Research Program

We describe here the social science-environmental health collaboration in PROTECT, the Puerto Rico Testsite for Exploring Contamination Threats, which is one of eighteen Superfund Research Program centers funded by the National Institute of Environmental Health Sciences. This collaboration has multiple facets: (1) create a holistic, unified research program that addresses the complexity of environmental contamination, (2) offer research participants an engaged and respectful interaction with the research team, (3) provide cross-training, in which the team's social scientists learn environmental health and the environmental health scientists learn social science, and (4) provide training for graduate students and post-docs in multiple disciplines in this burgeoning form of collaboration.

Communicating Results of a Dietary Exposure Study Following Consumption of Traditionally Smoked Salmon

One expectation of community-based participatory research (CBPR) is participant access to study results. However, reporting experimental data produced by studies involving biological measurements in the absence of clinical relevance can be challenging to scientists and participants. We applied best practices in data sharing to report the results of a study designed to explore polycyclic aromatic hydrocarbons absorption, metabolism, and excretion following consumption of traditionally smoked salmon by members of the Confederated Tribes of the Umatilla Indian Reservation (CTUIR). A dietary exposure study was developed, in which nine Tribal members consumed 50 g of traditionally smoked salmon and provided repeated urine samples over 24 hours. During recruitment, participants requested access to their data following analysis. Disclosing data is an important element of CBPR and must be treated with the same rigor as that given to the data analysis. The field of data disclosure is relatively new, but when handled correctly can improve education within the community, reduce distrust, and enhance environmental health literacy. Using the results from this study, we suggest mechanisms for sharing data with a Tribal community.