?port or the Committee on

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0155 O'll
Report of the Committee on
to the Surgeon General
*
*
U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
Public Health Service
1962

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PUBLIC HEALTH SERVICE PUBLICATION NO. 908
UNITED STATES GOVERNMENT PRINTING OFFICE
WASHINGTON : 1962
For sale by the Superintendent of Documents, U.S. Government Printing Office
Washington 25, D.C. - Price $1.00

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Letter of Transmittal
Honorable Luther Terry
Surgeon General
U.S. Public Health Service
Dear Dr. Terry :
The Committee on Environmental Health Problems, established by
you during August 1,1961, was asked to develop long-range objectives
for the environmental health program of the Public Health Service.
To be given special attention were the problems of manpower, intra-
mural vs. extramural research, and relationships with other Federal
agencies.
The Committee completed its review in time to submit a report by the
requested date, November 1, 1961. Herewith is the report. A sum-
mary of the conclusions and recommendations developed by the Com-
mittee is presented at the start of the report.
The Committee found the charge to be challenging and worthy of the
most serious consideration. They will be pleased if their report
communicates effectively their feeling for the magnitude and impor-
tance of the problems encountered in environmental health, and
equally for the magnitude and importance of the steps which the
Committee feels are involved in meeting these problems.
The Committee expressed its appreciation for the freedom of action
given to it, for the willing and effective cooperation shown by the
Public Health Service and its Bureau of State Services (Environ-
mental Health), and for the services of the staff "resource represent-
atives" selected from the personnel of the Bureau.
Respectfully submitted.
Paul M. Gross, Chairman
November 1,1961
in

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Foreword
A Committee on Environmental Health Problems was set up by the
Surgeon General, U.S. Public Health Service, during August 1961
and met for the first time on August 23, 1961, in Washington. The
charge to the Committee was based upon background developed within
the Service and within other parts of the Government,1 and was in
summary as follows:
The Committee is to develop long-range objectives for the environmental
health program of the Public Health Service, including consideration of re-
search and of the operating surveillance and control programs, giving special
consideration to—
(1) Manpower requirements.
(Li) The roles of intramural and extramural research efforts.
(ili) The relationships of the current and any proposed Public Health
Service programs and facilities to those of other Federal agencies.
The Committee Is to deliver its final report by November 1,1961.
After discussing its terms of reference at its first meeting, the Com-
mittee, acutely aware of the limited time for completing a large task,
organized itself into a series of working Subcommittees. One group
of Subcommittees was asked to study the current and projected pro-
grams of the Bureau of State Services (Environmental Health) and
to provide an appraisal of the extent to which these programs are
commensurate with the national need, and, should they appear inade-
quate, to make appropriate recommendations,
From its own prior understanding of the problems of environmental
health, the Committee furthermore appointed a group of Subcommit-
tees especially charged with a study of certain broader aspects of
environmental health, not specifically identified with existing pro-
grams, as these related to the broad mission of the Public Health
Service as a whole with respect to environmental health.
These Subcommittees were given wide latitude to engage the services
of supplementary consultants with specialized competence in the
relevant areas.2 The reports of these Subcommittees appear as part
of this volume.
* See Appendix for the minutes of a meeting of the President'* Science Advisory Com-
mittee ad hoc Panel on Environmental Health, May 18, 1961, and for a letter to the Sec-
retary of Health, Education, and Welfare from the Deputy Director of the Budget, July
5, 1901.
¦A listing of membership of Subcommittee* and names of consultant* appeare In the
Appendix.
V

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VI
FOREWORD
The full Committee met on five occasions. It early determined that
it could best fulfill its task by providing an analysis-review of the
ongoing programs, an appraisal of the national needs in environmental
health, an evaluation of the role of the Public Health Service in meet-
ing these needs and of mechanisms by which these needs might be
met, and a projection of broad but firm guidelines within which the
future program of the Public Health Service might be developed.
The Subcommittee reports were extremely useful to the full Committee
as background against which this broad evaluation and projection were
developed, but the Committee did not discuss all of the many and de-
tailed proposals of the Subcommittees for purposes of their endorse-
ment, modification, or rejection. Thus, the Subcommittee reports are
presented as originally submitted to the Committee.
Included in the membership of the Committee3 were persons who
were also members of the standing advisory committees for each Divi-
sion of the Bureau of Environmental Health. The Public Health
Service itself provided much source information; furthermore, the
staff of the Bureau, Division chiefs, and certain persons designated
as resource representatives attended the meetings (other than execu-
tive sessions) of the Committee and Subcommittees.
* Designated on Committee membership list In the Appendix.

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Contents
Fin
Letter of Transmittal					hi
Foreword						v
Conclusions and Recommendations					1
The Committee's Review of Environmental Health
Problems			5
General Background: The Effort Needed in Environ-
mental Health				7
Resources Required for the Needed Effort in Environ-
mental Health						13
Problems in Environmental Health—Some Examples		17
Reports of Subcommittees.				_ -			37
Manpower Resources and Training	—		39
Applied Mathematics and Statistics		45
Pharmacology, Toxicology, Physiology, and Biochemistry.	49
Analytical Methods and Instrumentation		59
Air Pollution					65
Environmental Engineering		97
Milk and Food			133
Occupational Health		—	165
Radiological Health							205
Water Supply and Pollution Control		215
Appendix										263
A.	Committee					265
B.	Subcommittees					267
C.	Consultants to Subcommittees				269
D.	PHS Organization for Environmental Health		270
E.	Minutes, Ad Hoc Panel on Environmental Health		271
F.	Bureau of the Budget, Letter fco the Secretary, HEW.	275
Index..						279
711

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Report of the Committee on
ENVIRONMENTAL HEALTH PROBLEMS
Conclusions and Recommendations
The Committee has reviewed the problems which face this nation in
the field of environmental health, particularly as they relate to the
mission of the Public Health Service. The Service has established
programs dealing with certain aspects of environmental health. How-
ever, the growth of our technology and the urbanization of American
society have proceeded at a pace with which the Service's current pro-
grams are not prepared to cope. From its total evaluation of the
problem, the Committee concludes—
That a national need exists for establishment and maintenance of a
vigorous and integrated effort to maintain controls over the human
environment compatible with projections of change in both population
and the environment itself.
That the current "categorical" approaches represented by Public Health
Service divisional programs are incapable of providing either (a) the
necessary cognizance of combined multiple effects of environmental
impacts or (6) the depth of effort required by individual divisional
programs.
That accommodation to the national needs in environmental health
will require the establishment of a strong focal center adequately staffed
and equipped to prosecute an effective and integrated program within
the Public Health Service and to manage and coordinate a strong extra-
mural research, training, and technical support program utilizing the
available institutional resources of the nation.
That an adequate legislative basis for a sufficient national program is
environmental health does not exist at present.
One of the factors missing in the current efforts of the Service is a
place at which primary responsibility for the control of environmental
hazards comes to a focus. The Committee believes that immediate
action should be taken to establish a center where the operational,
research, and training programs of the Service in environmental health
can be brought together. This is not to say that all of these functions
of the Service should be centralized. On the contrary, many must re-
main close to the place where environmental hazards exist. However,
the complexity of the problem requires that the Service's programs
be designed with a total perspective toward the environmental health
1

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0	ENVIRONMENTAL HEALTH PROBLEMS
needs of the nation. This perspective can best be gained by a concen-
tration of primary effort at a Center.
Therefore, the Committee makes the recommendations given in the
following paragraphs:
1. PUBLIC HEALTH SERVICE RESPONSIBILITY IN ENVIRONMENTAL
HEALTH
a.	A major national effort, both governmental and nongovern-
mental, must be started if the environmental health problems resulting
from the rapid growth of our highly technological civilization are to
be adequately understood and if measures for their control and ulti-
mate prevention are to be developed.
b.	It is essential that the Federal Government assume leadership
in the research and development effort required to supply knowledge
and techniques to the discrete State and local agencies of all types
engaged in prevention and control activities for alleviation of threats
to health from the environment.
o. The focus of this national effort should be centered in the U.S.
Public Health Service.
d. The leadership of the Public Health Service in the prosecution
of a national environmental health program should utilize to the
fullest possible extent existing university, industrial, governmental,
and other research and technological capabilities through grants and
contracts for research, demonstrations, and educational and training
facilities. Extramural extensions of the Federal activity should com-
prise a major fraction of the total annual effort.
2. MANPOWER NEEDS
~.	In undertaking a national program in environmental health, high
priority should be given to the early initiation of adequate training
programs for a wide range of personnel in the physical, biological,
and social sciences. These efforts should include the strengthening of
the divisional training programs, the creation of a new program of
institutional grants for comprehensive environmental health training,
and the continued support of the Service's short-term, internal pro-
grams. Funds in excess of $25 million are urgently needed to place
these programs in full operation. Training effort of this magnitude
will not create an imbalance with other scientific needs of the "United
States.
~.	Strong efforts are needed to improve the status and income levels
of environmental health scientists to permit Federal, State, and local
health agencies to recruit needed personnel.
3. NEED FOR A NATIONAL ENVIRONMENTAL HEALTH CENTER
To implement effectively the development of a focal point within
the U.S. Public Health Service for an enhanced and major national

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Conclusions and Recommendations
3
effort in environmental health, the Committee recommends the es-
tablishment of a Center for Environmental Health, which should in-
clude the following elements:
a.	The headquarters activities of the present operational programs,
including their administration, fundamental and applied research,
and the national pool of resource personnel who supply information
and assistance relating to control activities to the dispersed regional
laboratories and instrumentalities operating wherever preventive
and control measures are required.
b.	The administrative headquarters of a unified environmental
health grants program in support of fellowships, university training
programs, university-related research projects, and demonstration
grants to properly constituted agencies.
o. Appropriate facilities for the conduct of special training pro-
grams.
d. A new "Office of Environmental Health Sciences," independent
of the divisional structure and with separate budgetary provision,
consisting of scientific groups reporting to the scientist who is Director
of the Office of Environmental Health Sciences. These groups, which
would include biological, physical, and social scientists as well as
mathematicians, would study basic problems in environmental health,
undertake research on problems of common interest to the several
divisions where desirable, provide central services in mathematics,
statistics, data processing, information storage and retrieval, instru-
mentation and analytical laboratory procedures, etc., and provide
advice and consultation to the Bureau of Environmental Health with
respect to the overall direction of research. Beyond these functions,
these groups would be specifically charged with the continuing re-
sponsibility for an overall purview of the entire field of environmental
health.
4. LOCATION OF THE ENVIRONMENTAL HEALTH CENTER
The Committee recommends that the Environmental Health Center,
including the Office of Environmental Health Sciences, be located in
the Washington area.
5. PROGRAMS IN ENVIRONMENTAL HEALTH
a.	The Bureau of State Services (Environmental Health) is pres-
ently organized into five working divisions, a structure which evolved
as needs were recognized. It is recommended that, as soon as possible,
each of the operating programs be strengthened materially with re-
spect to staff and facilities, so as to accomplish their specific missions
more effectively.
b.	In view of the growing environmental health hazards resulting
from rapidly changing technology and increasing population the
country over, the Committee recommends the continuing development

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4	ENVIRONMENTAL HEALTH PROBLEMS
of regional facilities, supplementary to the Center, with adequate
staff and facilities to conduct applications research, training and con-
trol activities appropriate to the regions involved.
o. The Committee recommends that as the Public Health Service
moves toward the broader and more comprehensive effort here pro-
posed, every effort be made to conserve the real strengths of the present
program during the transition period and that intensive study be
given to an optimal organization pattern for environmental health
activities within the U.S. Public Health Service.
6. RELATIONSHIP OF PROGRAMS OF BUREAU OF ENVIRONMENTAL
HEALTH TO THOSE OF OTHER FEDERAL AGENCIES
The broad scope of the problem of environmental health relates to
virtually all of man's activities. It is to be expected, therefore, that
the specific programs of the Bureau of State Services (Environmental
Health) will frequently be contiguous with those of other agencies.
It is imperative therefore that continuing effective liaison be main-
tained between the Bureau and other national, State, and local agen-
cies so as to maximize the effectiveness of each while avoiding
unnecessary duplication of effort.
7. NEED FOR LEGISLATION
a.	The Committee recommends that the Public Health Service seek
such legislation as may be required to establish a Bureau of Environ-
mental Health with necessary authorization to conduct research, train-
ing and technical support activities, and to administer a broad
program of extramural training, research, demonstration, and insti-
tutional support grants and contracts. Such authorization should be
in addition to existing legislation governing operation of the divisional
programs. It should be designed to supplement, rather than limit,
the existing authority for divisional operation.
b.	The Committee recommends that a statutory Advisory Council
on Environmental Health be established to advise the Surgeon Gen-
eral on matters concerning policy, operations, research and training
in the field of Environmental Health. This council would also serve
as an advisory group for the Environmental Health Center, including
the Office of Environmental Health Sciences.
Additional conclusions and recommendations, appropriate to the
more detailed consideration of subject matter, appear in the Subcom-
mittee reports.

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The Committee's Review of
Environmental Health Problems
General Background: The Effort Needed in Environmental
Health
Resources Required for the Needed Effort in Environmental
Health
Problems in Enviromental Health : Some Examples
S

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General Background : The Effort Needed in
Environmental Health
It has been stated that "the history of Public Health is . . . the
story of man's endeavors to protect himself and his community against
disease."1 Its role today must be enlarged to include provision for the
positive protection of the healthy against the adverse influences of a
highly complex technological society which operates in evermore
crowded communities.
"The past 50 years have witnessed an unprecedented overall trend
toward the improvement of community health. Yet, this advance
has not been uniform either within communities or between various
parts of the world. A large group of countries generally under-
developed in an economic and technological sense, and often new as
independent nations, still have problems of preventable disease like
those with which the countries of western Europe and the United
States had to cope 75 to 50 years ago. . . . However, in economically
more fortunate countries, such as the United States, Great Britain,
and a number of others in Western Europe, the actual problems of
community health are very different. ... a whole set of newer prob-
lems has appeared, and it is with these that the community health
program of the next 50 years will have to be concerned.
*•**«•*
"... as the problems of communicable disease have declined in
urgency, the community health program has broadened to include,
wherever feasible, other elements and situations that may adversely
affect the physical and mental well-being of people in the community.
The widening horizons of public health have in recent years come
to include such problems as accident prevention and mental health,
as well as renewed emphasis on the control of the physical environ-
ment. With our expanding and changing industrial technology have
come environmental alterations of increasing complexity. The once
dominant problems of bacterially contaminated air, water, and food
have now been replaced in considerable degree by chemical pollution,
and the possible relation of this condition to the induction of cancer.
Recent years have also brought about an increasing amount of dis-
cussion of the social and economic changes accompanying our expand-
ing industrialism.
**~#*»»
i George Rosen, A Hittory of Public Health (New York: 11D Publications, X»e* 1058,
P. 14).
7

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8	ENVIRONMENTAL HEALTH PROBLEMS
"Recent years have brought an increasing awareness of the problem
of atmospheric pollution. ... In the same category is the new and
important field of radiological health. . . . Then there is the problem
of housing."2
As the nature of public health problems has changed over the years,
local, State, and Federal governmental relationships with respect to
meeting these problems have also been evolving to the present pattern,
A former Surgeon General of the U.S. Public Health Service has noted
that the Public Health Service is unique in the number and scope
of its responsibilities, within the Federal Government and in the
Nation, for environmental health.8 He also portrayed in greater detail
the scope of environmental health and the nature of the problems
faced. Major program areas around which the Public Health Service
is organized4 are water supply and pollution control, air pollution,
radiological health, milk and food protection, occupational health,
and environmental engineering, including accident prevention and
protection against solid wastes. The scope and details of these current
problems are reviewed in the reports of the Divisional Subcommittees.
What factors will determine the nature and magnitude of an ade-
quate national environmental health program in the future? Pro-
jections and predictions abound which purport to describe the growth
of the American population in the remainder of this century, and
the increasing fraction of older individuals in the population; the
ever-increasing complexity of our technology; the development of
new industries; and increasing reliance on nuclear power; the mag-
nitude of the gross national product; the magnitude of the national
agricultural effort; the introduction of new chemicals into our food,
water, air, clothing, tools, and toys; the coalescence of huge metro-
politan areas; altered means of communication and transportation;
new modes of dress; increased leisure time and the demand for recre-
ational facilities. The exact magnitude of any one of these projections
may be open to question, but their trend is all too apparent. And from
these technological, agricultural, economic, and social changes must,
inevitably, arise a panoply of diverse problems in environmental
health which must be solved before they are permitted to become acute.
Many of these problems have been identified and are presented
in detail, in the Subcommittee reports. It is from consideration of
the nature and magnitude of these problems that the broad guidelines
of the necessary national effort in environmental health emerge. A
few examples illustrating this principle are presented later in this
report.
»Ibid., p. 486-489.
*	"Environmental Health." The Surgeon General'* Report to the House Committee on
Appropriations. U.S. Public Health Service, Department of Health, Education, and Wel-
fare, January 1860.
*	See Appendix for statement of present organisation.

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General Background
9
It is apparent from these examples, and from many others cited in
the Subcommittee reports, that there are numerous functions, such as
epidemiology and biostatistics, which are common to environmental
health programs. Some of these functions are even now ongoing
in current programs, albeit at an inadequate level. One approach to
a strengthened national environmental health program would be
simply to expand each of the ongoing programs and staff each so as
to permit apparently adequate performance in all desirable functions.
Indeed, this has been the history of the U.S. Public Health Service
program based upon specific "categorical" legislation. But the Com-
mittee is strongly of the opinion that this is not a sound basis of an
adequate long-range national program in environmental health. Ulti-
mately, this must result in unnecessary duplication of effort while
completely failing to provide an integrative synthesis of those facets
of the various environmental health problems which are held in com-
mon. In consequence, the Committee recommends the creation of a
comprehensive Environmental Health Center.
As presently envisioned, the Center would contain the following:
1.	The headquarters activities of the present operational programs, including
their administration, fundamental and applied research, and the national pool of
resource personnel who supply information and assistance relating to control
activities to the dispersed regional laboratories and instrumentalities operating
wherever preventive and control measure are required.
2.	The administrative headquarters of a unified environmental health grants
program in support of fellowships, university training programs, university-
related research projects and demonstration grants to properly constituted
agencies.
3.	Appropriate facilities for the conduct of special training programs.
4.	A new "Office of Environmental Health Sciences," independent of the Di-
visional structure and with separate budgetary provision, consisting of scientific
groups reporting to the scientist who Is Director of the Office of Environmental
Health Sciences. These groups which would be specifically charged with the
continuing responsibility for an overall purview of the entire field of environ-
mental health, would include biological, physical, and social scientists as well
as mathematicians, free to study basic problems in environmental health and
undertake research on problems of common Interest to the several operating
units where desirable, while providing central services In mathematics, statistics,
data processing, Information storage and retrieval, instrumentation and analyti-
cal laboratory procedures, etc., and providing advice and consultation to the
Bureau of Environmental Health, with respect to the overall direction of
research.
It is the Office of Environmental Health Sciences, in particular,
which will make possible an integrated national environmental health
program while avoiding unnecessary duplication of effort. It offers
a new method of attacking those facets of environmental health prob-
lems which are common to many of the operational programs. By its
integrated approach it can identify and appraise environmental health
problems which are not under consideration. At the same time it can
627408—62	3

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10 ENVIRONMENTAL HEALTH PROBLEMS
develop protection criteria which are based on ail aspects of the
environment.
The Committee considers that one of the strongest arguments for
the Center is that it provides a focal point for the entire national en-
vironmental health program. By locating the operational programs
contiguous to each other and to the Office of Environmental Health
Sciences, the following advantages accrue:
1.	There will be available to all units central facilities and personnel for
such functions as toxicology, epidemiology, applied mathematics, instrumenta-
tion, systems analysis, data processing and information storage and retrieval.
2.	Each operational unit will have available to it a large pool of scientific
specialists and experts for advice and consultation. By the same token it
provides an effective device for cross-fertilization both as between operational
programs and between disciplines.
8. Clearly such a Center provides a sounder and more comprehensive struc-
ture for the conduct of both intramural and extramural training programs.
4.	It will minimize unnecessary duplication of effort in both fundamental and
applied research programs.
5.	It will make possible within the Center a coordination of the efforts of
the individual operating programs and will provide a base for more effective
relations with other related institutions both within and without the government.
Clearly, the success of the Center is entirely contingent upon the
caliber of its scientific personnel. It may well be necessary to take
extraordinary measures with respect to salary structures, working
conditions, etc., in order to recruit and hold top-level scientists.
The total environmental health program of the Public Health Serv-
ice should be so designed and funded as to provide for fullest possible
utilization of the Nation's existing scientific manpower, research capa-
bilities, and regulatory agencies. The Committee believes that this
objective can be achieved through a well-planned system of grants
and contracts for research, demonstration, training and program
operations, managed from a national Center.
While a substantial proportion of the entire program should be
developed extramurally, the effective employment of such dispersed
national resources will require the existence of an intramural activity
in depth and breadth sufficient to evaluate, review, and maintain in-
telligent working relationships with the external programs. Compe-
tence and facilities for such management, and for translation of the
resulting findings into control practice, will best be developed within
a unified Environmental Health Center.
With the need for and development of a Center identified as the
major focal point for environmental health within the Public Health
Service, the role of regional and field stations and facilities must be
considered.
It is the Committee's opinion that such field stations and laboratories
can best serve a particular environmental health program and obtain

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General Background
11
fundamental and applied data relating to some specific limited proj-
ects (such as shellfish or saline water problems).
If a Center of the type recommended is developed, considerations
arise as to choice of location for such a center. In addition to the
present operational programs, it is essential to have top-level person-
nel available drawn from the natural and social sciences and mathe-
matics under the Office of Environmental Health Sciences. This
group would perform functions of the types delineated in the first
four Subcommittee reports.
Beyond the performance of such functions, this group would
provide a necessary internal core of scientific leadership whose re-
sponsibility would be to provide overall guidance and direction to the
major effort necessary in relation to environmental health problems.
No present program of governmental health activity exceeds in scope
and complexity that which will be involved in environmental health.
Cogent arguments relating to the shortage of and competition for
top-level scientific talent can be made,® which appear to have consid-
erable validity and which point to a more segmented development of
strong scientific leadership groups located near and working with
major university centers.
The Committee carefully weighed and discussed the import of these
arguments as they related to their concept of the 5- to 10-year needs
for manpower, facilities, and resources, reasonably commensurate
with the level which would be required for a major effort in solving
environmental health problems. There is a need for central focus and
leadership in a Public Health Service environmental health program
of the type envisaged. This program must be related to other Public
Health Service activities as well as government agency programs
related to environmental problems.
Immediate planning must be undertaken for the staffing, organiza-
tion, and facilities of central environmental health groups within the
Public Health Service. Even if such planning proceeds rapidly, the
benefits that the Committee envisages from focal centralization of this
type will probably not be realized in less than 4 years.
After examining all the operational, regulatory, and research
aspects of the proposed and existing programs in environmental
health, the Committee recommends that the Environmental Health
Center, including the Office of Environmental Health Sciences, should
be located in the Washington area. Our reasons for this are based
on the necessity for the regulatory and operational aspects of the
environmental health program to be contiguous. Similarly, the oper-
ational and research programs in environmental health can function
much more effectively if they are in close contact with one another.
• see the mtnutea of a meeting of the Presidents Science Advisory Committee ad boo
Panel on Environmental Health, In the Appendix to this report.

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12 ENVIRONMENTAL HEALTH PROBLEMS
Similarly, there are many Public Health Service interdepartmental
problems which arise that call for frequent and interdisciplinary
review. Proximity to the National Institutes of Health with the
Clinical Center and the National Library of Medicine is essential for
research and access to clinics and patients. Another cogent reason is
the need for contact with many other Government agencies and de-
partments working in ancillary fields in environmental health such
as the Defense Department, Interior Department (Bureau of Mines),
Commerce Department (Bureau of Standards and Weather Bureau),
and the Atomic Energy Commission.
An example concerns the relationship of the Division of Radiologi-
cal Health to the Atomic Energy Commission. The Subcommittee
considering the radiological health program believes that this problem
should be dealt with, as soon as possible, by the creation of a Radiation
Hazards Research Liaison Committee composed of the Chief of the
Division of Radiological Health, Public Health Service, an appro-
priate representative of the Atomic Energy Commission, and such
other personnel from the two agencies as may be needed. This com-
mittee would meet at frequent intervals to review Public Health Serv-
ice and Atomic Energy Commission radiation research programs and
to plan and devise ways and means whereby the resources of one
agency may be used to advance fully the programs of the other. This
committee would review budgetary proposals in all areas of common
interest before annual budgets are submitted for consideration to
the Bureau of the Budget. Although a Radiation Hazards Research
Liaison Committee of the type set forth here may not resolve all of the
questions of program duplication, it should go a long way to resolve
misunderstandings concerning the content of Atomic Energy Com-
mission and Public Health Service programs in radiological health
and will assure Congress that the full resources of both agencies are
being brought to bear on the radiological problems of the Nation.

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Resources Required for the Needed Effort m
Environmental Health
It is self-evident from the above discussion that the character and
magnitude of the effort required, not only in the natural and social
sciences but in medical, public health, and engineering practice, de-
mands new resources and application of these resources in new ways.
While the Committee, as a result of studies and discussion, felt that
it had achieved comprehension of the broad nature and magnitude of
the effort and resources which will be needed in the next 5- to 10-year
period, it did not feel that these needs could be projected in any great
detail with much real validity. Obvious reasons for this were the
severely limited timespan of the Committee's operation (about 2
months), and the important fact that the conditions encountered in
the environment which affect health are changing rapidly and all too
often unpredictably, An excellent example of this unpredictability
is found in the almost overnight change in the dimensions of the fall-
out problem because of the recent long series of Russian bomb tests.
With these reservations as to delineation in any detail of a future
program, the Committee in the following summation gives its best
estimates of the nature, order of magnitude, and priorities in time
which it believes will be required to develop soundly the major na-
tional effort in environmental health which should be carried forward.
Development of the program outlined in this report will require
a high-quality central scientific staff and the provision of facilities and
supporting resources. In view of the present large deficiency of
resources in relation to environmental problems, a more rapid buildup
of scientific staff in the immediate years ahead than in the ensuing
years is considered necessary. For the central scientific staff a
growth from the present core of 125 to approximately 300 by 1965
is recommended. By 1970 the central scientific staff needed is esti-
mated at 450.
Based on these projections for scientific personnel, and applying
ratios and costs for supporting staff and resources from Government
and industrial experience, the annual operating cost of the Environ-
mental Health Center is expected to be $50 million in 1970.
For all field operations, including regional laboratories and stations,
field studies, decentralized training, basic data collection and analysis,
regulatory and technical assistance activities, a like cost is foreseen.
Thus, total intramural operations by the Public Health Service for
environmental health activities is projected at $100 million by 1970^

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u ENVIRONMENTAL HEALTH PROBLEMS
Research and training are expected to account for at least 50 percent,
$50 million, of this total.
The extramural program of grant support for training and re-
search, demonstrations, and State and local program development
should be much larger than the intramural operations in order to
provide the required scientific and technical manpower and for the
necessary acceleration of the total national effort. A ratio of extra-
mural support to intramural research and training operations of 5 to 1
is recommended for the period to 1970. This would amount to $250
million and place the total requirement by 1970 at $350 million.1 The
Committee believes these estimates to be reasonable and the program
goals to be achieved with these resources attainable.
Resource needs are in terms of manpower, facilities, and budgetary
support, and those relating to scientific manpower for the program
are the most important. Obviously without the availability of a suffi-
cient number of natural and social scientists of the varied levels of
ability and experience and the much larger numbers of technically
trained ancillary groups needed for the research implementation, sur-
vey and control aspects of a large and broad effort in environmental
health such a program cannot be effective.
The future manpower requirements of a national environmental
health program can be broadly classified into subprofessional and
professional categories:
1.	Subprofessional.—The need for large numbers of individuals with varying
levels of experience, ability, and specialized training who will man the opera-
tional, control, and surveillance units concerned with environmental health of
county, city, State, and industrial health departments and groups.
By and large, the training techniques needed for this subprofessional type
of training are known and effectively carried out through a variety of short-
term courses and seminars and inservice types of activity presently largely
centered in the U.S. Public Health Service. As is pointed out in the report of
the Subcommittee on Manpower Resources and Training (table III), an average
of some 2800 individuals were trained per year in this way in the period 1956-
61. The estimate of the annual training needs in this category by 1963 is for
the training of some 10,000 such individuals and several times this number an-
nually by 1970.
Thus training of this type will be limited by the availability of ln-house in-
structional manpower for such short-term ln-house activities, by space and
facilities, and by budgetary support. This is a large and somewhat difficult task
In the Committee's view, but one which can be accomplished if there is proper
appreciation of the need for adequate staffing, facilities and funds commensu-
rate with numbers of trainees to be handled.
2.	Professional.—In the area of scientific and professional manpower avail-
ability and training for environmental health needs, the problem Is quite differ-
ent. This is in large measure a segment of the overall national problem of
providing an adequate supply of highly trained scientists, engineers, physicians,
and allied professionals sufficient to meet the country's growing demands.
1 Excluding grants for construction of public works such as those for municipal waste
treatment.

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Resources Required
15
Studies of the professional scientific manpower problem with which the
Nation is faced have been made by many groups so that discussion of this prob-
lem in any detail will not be entered into here, except to the extent that it is
relevant to the environmental health problems.
For this purpose, reference is made to one of the most recent of these studies
made by the National Science Foundation.'
Some data from this report will give a background perspective against which
to appraise the environmental health manpower problems at the scientific and
professional level. This report (pp. 18-19) estimated that there were 1,400,000
scientists, engineers, and teachers of science in the United States in 1960-61,
this number Included 12,000 M.D.'s doing research, but not all M.D.'s. Of this
total but not including any M.D.'s, there were 87,000 scientists and engineers
who were Ph. D.'s or Sc. D.'s. By 1970, according to the National Science Foun-
dation estimate {p. 14), this figure of 87,000 should reach 168,000 Ph. D.'s and
Sc. D.'s, or just about double.
With this background it is of interest to look at the figures for man-
power in this scientific and professional category estimated to be en-
gaged in environmental health activities in the Public Health Service
in 1962 (Subcommittee on Manpower Resources and Training Report,
Table I). For 1962 the estimate is 125 which is probably a reasonably
reliable figure. If allowance is made for the differences between
1960-61 and 1962, it would seem fair to say the environmental health
program needs in the Public Health Service in 1960-61 accounted
for about 0.15 percent of the total national pool of 87,000 individuals
in this category in 1960-61.
If the projections of Table I (Report of Subcommittee on Man-
power Resources and Training) are reasonably valid, the Public
Health Service requirements for professional scientific Ph. D.- and
Sc. D.-trained manpower would rise to about 0.24 percent of the na-
tional pool in 1965, and to about 0.27 percent of the total national pool
of 168,000 estimated to be available by 1970. These increases in with-
drawal from the national pool for the Public Health Service staffing
and their rate of increase in the next 10 years do not appear to the
Committee to be too difficult of achievement nor alarming in their
potential effect on nationally available manpower resources of this
type. It should be pointed out, however, that there are some individ-
ual disciplines vital to the environmental health program in which
marked expansion of training efforts will be necessary to fulfill the
manpower needs. (See, for example, the Report of the Subcommittee
on Pharmacology, Toxicology, etc.)
The total national scientific manpower requirement is much more
difficult to estimate or project to the future. As noted above, the total
scientific manpower pool for the Nation was estimated to be about
1,400,000 in 1960-61 (National Science Foundation report). Of this
• National Science Foundation, "Investing In Scientific Progress 1961-70," Washington,
D.C.. 1061. (Report NSF fll-27.)

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16 ENVIRONMENTAL HEALTH PROBLEMS
total, approximately 2 percent were engaged in environmental health
activities8 in 1961. The best projection of this percentage engaged
nationally in environmental health activities in 1970 available to the
committee is about 2.6 percent.
If this situation is broadly as stated, it has important implications
for training needs at the graduate and engineering school levels, for
the types of personnel needed:
1.	The Department of Health, Education, and Welfare through the Public
Health Service should actively support moves of other agencies (especially the
National Science Foundation) to increase the national pool of scientists and
engineers at the Ph. D. or equivalent level.
2.	Through suitable conferences, seminars, and educational campaigns aimed
at the graduate and engineering schools, the Public Health Service should point
out the need, career opportunities, and intellectual challenge that the developing
program in environmental health presents to Ph. D.'s and engineers in the
wide range of contributing disciplines from mathematics, physics, and chemistry
through biology, the premedical sciences, the earth sciences, and the relevant
social sciences.
3.	The research grants programs, especially those with graduate and engineer-
ing student training components, should be liberalized and broadened so as to
actively involve more university investigators in the broad range of disciplines
mentioned. Such wider involvement will prove one of the most important ways
of orienting the thinking in the average engineering or graduate school toward
the existing and emerging problems of environmental health and their challenge
to students interested in careers in basic or applied research.
1 This Includes Individuals In water and sewage works fields, in State and local health
departments, teaching, research, public works, and In private and consulting practice.

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Problems in Environmental Health: Some Examples
Example 1
THE PROBLEM OP AIR POLLUTION
Polluted air is a product of industrialization, urbanization, and
human mobility, all of which will continue to increase rapidly in the
years ahead. The concern with air pollution in urban areas relates
to the emission of a variety of gases and particles, often followed by
secondary reactions in the air. Recent evidence has made clear that
all metropolitan areas have limited air resources. Even in areas where
the meteorological conditions are favorable, air resources are being
heavily utilized, and in some cases acceptable concentration limits
have been exceeded. Basically, the total potential quantity of pol-
lutants discharged to the atmosphere relates to two factors—the
size of the population, and the per capita use of energy and materials.
That air pollutants can affect health has been demonstrated conclu-
sively in several disasters in which many people were made ill and
human deaths occurred. Among the more dramatic are the episodes in
Donora, Pa., where 20 people died; and in London in 1952, when the
normal mortality rate was exceeded by 4,000 additional deaths in a
single week. A growing body of circumstantial evidence testifies that
long-term low-level air pollution exposures can contribute to and
aggravate chronic diseases which affect large numbers of our popula-
tion. Economic damages to crops, animals, and structures are mani-
fest—totaling billions of dollars annually.
The national application of what we now know about controlling air
pollutants is unsatisfactory.
Procedures for the identification of specific compounds contributing
to air pollution are largely tedious and expensive, and few laboratories
are equipped to undertake such determinations. The chemical com-
position and physical state in which air pollutants occur are of in-
creasing importance; for example, particle size as it relates to the
physiology of the pulmonary system. For only a small number of the
simpler gases such as sulfur dioxide, hydrogen sulfide, and carbon
monoxide are analytic methods available and for these, simpler and
less expensive procedures are desirable. There is need to measure
at frequent intervals such substances as aldehydes, olefins, polynuclear
aromatic compounds, and others, the number of which will be multi-
plied many times over in the years ahead.
The history of technology indicates that the patterns and the types
of these emissions and sources will change in the future. However,
17

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18 ENVIRONMENTAL HEALTH PROBLEMS
the precise direction in which these changes will occur cannot be
predicted.
In all urban areas motor vehicle emissions are in varying degrees
already a significant source of pollution. The interrelationship be-
tween hydrocarbons and oxides of nitrogen when photochemical air
pollution (smog) is produced in the presence of sunlight needs futher
elucidation. The role of particulates in the formation of smog and
the mechanism by which smog irritates the eyes and causes damage to
vegetation will require further research.
The formation of ozone and other oxidants, associated with unde-
sirable biologic effects and characteristic of photochemical smog, is
known to result from reactions among gases at concentrations of a
very low order at which they are relatively innocuous. Control of
such secondary reactions requires identification of the participating
primary pollutants and determination of the relative importance of
each in the photochemical processes. Changing technology neces-
sitates fundamental studies in photochemistry. The identification
of primary reactants associated with secondary toxicants will facili-
tate the development of more effective and less costly controls. Ade-
quate knowledge of the intermediate and secondary products must
be acquired before their biologic effects can be fully assayed and
understood.
A fundamental scientific problem is that of establishing relation-
ships between meteorological parameters and dispersive capacities.
Objective determination of reasonable emission rates and the degree
of control required for single sources in a given community are de-
pendent to a considerable extent on research in this area.
Studies are required that will provide a sound basis for future
estimates of national losses from (1) damage to crops and livestock,
horticultural products, and other types of vegetation; (2) corrosion
of materials and soiling of surfaces; and (3) interference with ground
and air transportation. Economic losses due to the expenses of illness
and diminished productivity resulting from air pollution are unknown,
as are the effects of air pollution upon the general well-being of healthy
individuals.
It is already recognized that mortality surveys, by themselves, are
not sensitive enough to reflect the subtle influence of minute concentra-
tions of toxins in the atmosphere. The use of morbidity data for this
purpose has been hampered by the fact that concurrent air sampling
and usable morbidity data have been almost nonexistent. Any leads
that indicate differences in morbidity—or less probably, in mortality—
must be followed in an attempt to relate health effects to a specific
pollutant or class of pollutants. To complicate the problem, tradi-
tional statistical methodology requires improvement by incorporation
of better methods for analyzing the vast quantities of data that accrue

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Examples
19
from long-term observations. Too, the problems of measuring mor-
bidity have required development of new techniques. Assessment of
illness due to air pollution requires more, generally, than the usual
medical questionnaire or routine physical examination. Some ob-
jective measures of physiological processes and their changes have
been developed and more are required.
Since the respiratory tract is the portal of entry for inhaled sub-
stances, an intensive effort has been directed toward pulmonary func-
tion testing as an indicator of the physiologic effects of air pollutants.
Procedures that had previously seemed adequate for day-to-day fol-
lowup of patients responding to treatment, for single observations in
the routine diagnostic workup of the clinic, and for the measurement
of gross functional aberrations, have not proved suitable for use in
the field.
Until pulmonary function testing is standardized, epidemiologic
studies that rely on such measurements as an index of physiologic
changes will have little comparability. Studies, now underway, to
assess methods and evaluate techniques must be intensified. Research
on health effects has been mainly an attempt to associate individual
pollutants with a group of diseases. Research must also be directed
toward tissues other than those with which pollutants make first
contact.
We know that human panels exposed to irradiated mixtures of indi-
vidual hydrocarbons and nitrogen dioxide experience eye irritation.
The problem of what constituents in smog are actually responsible
for this biologic manifestation will probably not be resolved until an
objective test—perhaps an electrophysiologic technique—can be de-
vised, that will permit precise measurements, reflect sensory compo-
nents, and eliminate psychic influences. Apparently a number of
factors in the original mixture determine the occurrence and the
degree of eye irritation. The reaction products mainly responsible
are thought to be formaldehyde, acrolein, and peroxyacyl nitrate.
Because a number of statistical studies have indicated a higher
incidence of lung cancer in urban than in rural areas and because
such well-known experimental carcinogens as benzpyrene have been
found in community air, the finger of suspicion has been pointing for
some time to atmospheric benzpyrene and related aromatic polycyclic
hydrocarbons as at least contributory etiologic agents in lung cancer.
Certainly it does not seem possible to attribute the alarming increase
in lung cancer incidence to smoking alone. A growing body of ex-
perimental evidence incriminates atmospheric hydrocarbons.
All organic fractions of airborne particulate matter from U.S. cities
are capable of producing local skin tumors after subcutaneous injec-
tion in mice, and chronic low-level exposure seems to be more injurious
than brief heavy exposure. Animals exposed to both the virus of

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20 ENVIRONMENTAL HEALTH PROBLEMS
influenza and inhalation of ozonized gasoline develop true epidermoid
cancers in the lung. The applicability of such evidence to human
disease is as yet uncertain, but the research leads now developed
should be followed up intensively.
A causal relationship between air pollution and the group of chronic
obstructive ventilatory diseases that appear to be increasing in inci-
dence in this country has not been definitely established. But isolated
research findings that asthmatic attacks occur more frequently on days
with smog damage to plants, that emphysema patients improve on
breathing filtered air after several days' exposure to smog, and that
the daily course of patients with chronic obstructive respiratory dis-
ease fluctuates with certain pollutant levels strengthen the conviction
held by many experts in the field that these indicated relationships
may be important leads to definitive knowledge—leads that should
be vigorously pursued.
An integrated research effort, utilizing laboratory techniques, statis-
tical methods, and the epidemiologic approach, along with intensified
chemical, meteorological, physical, and engineering studies, provides
the hope for a solution to these problems. Alone, no one method
can hope to accomplish this aim.
Example 2
THE PROBLEM OF WATER POLLUTION BY INDUSTRIAL WASTES,
INCLUDING RADIOACTIVITY
Organic Industrial, Wastes
Studies and surveys by the Public Health Service in recent years
indicate that the amount of organic industrial wastes (treated and
untreated) now going into the Nation's watercourses is about double
the amount of municipal wastes; that is, a "population equivalent" of
150 million persons.
The increase in organic industrial wastes since 1900 and estimated
amounts in 1970 and 1980 are shown in the following table:
Increase (n Organic Industrial WasUt
Year
Index of i
Industrial
produotion
Population
equivalent
discharged
(In millions)
1900	
20
40
06
113
m
*240
•887
ia
49
78
100
190
*210
<50
'310
<80
1020	
1940	
1950				
1959	
1970		
1980	

> Bawd on J8*7-19 -100; (mm Fad oral Bmrn Board	• Ammo* (athnatad percent rata o( Industrial waata
Ind«s of Produotion, X9OO-10M.	tnatment wmtruction will continue.
• Estimated by National Planning Board, "National	* Xtaumaa 80 paraaat removal of popqlaUoa aquUmlant
Economis Proiaatlons," from annual growth rat* ot 4.1	by traatmant will be obtained,
paraaat.

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Examples
U
By 1975, industry is expected to more than double the production
attained in 1950. This would indicate a possible doubling of present
organic wastes by 1980 which may be tempered by certain technologi-
cal and engineering developments, and the extent to which industry
met its responsibilities for satisfactorily treating its own wastes.
These data show that substantial reductions in industrial organic
pollution loads can be effected by waste treatment if industry can
attain 80 percent removal of "population equivalents." Such reduc-
tions will require a greatly accelerated construction program and the
development of new treatment processes, because fully effective meas-
ures have not yet been developed for many organic industrial wastes.
The table also indicates the pollution situation that will exist if the
present rate of treatment construction continues or if treatment proc-
esses are not found which can approach 80 percent removals.
Inorganic Industrial Wastes
There have been large increases also in the discharge of the "com-
mon" inorganic industrial wastes (principally of mineral and chem-
ical origin). These wastes have polluting effects different from
organic wastes and cannot be measured in terms equivalent to sewage.
Inorganic wastes originate from metal pickling, acid mine drainage,
metal finishing, chrome tanning, and from the mining, processing, and
manufacture of a wide variety of metal and chemical products. Also
organic wastes often contain substantial amounts of inorganic con-
stituents. Production figures for the industries discharging inorganic
wastes show that the amounts are very large and the index of indus-
trial production indicates they are increasing rapidly. Fully effec-
tive treatment processes have not yet been developed for many inor-
ganic industrial wastes.
New Chemical Wastes
The chemical industry is the fastest-growing segment of American
industry and some of its growth is reflected in the following table:
Leaders In Synthetic Organic Chemical Growth i
[Production In million pounds]
1028
1088
1040
Plasties	
Synthetlo robbers	
Synthetic detergents and otber surface-active agents.
Nylon and otber non-celluloaic fibers	
Insecticides and otber agricultural chemicals	
Medlctaals	
30
0
180
8
18
0
8
18
1,488
1,178
875
68
07
48
I Source: Th$ Chtmicai Industry Fad* Book 1090-61 Edition.

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M ENVIRONMENTAL HEALTH PROBLEMS
Synthetic dyes, adhesives, surface coatings, solvents, and many
other industrial, agricultural, and commercial products have also
registered substantial production growth.
A major new water pollution problem has emerged with the growth
of the synthetic chemical industry. Wastes from this industry are
reaching watercourses in increasing numbers and amounts each year,
both from the use of the manufactured products and from wastes
produced during their manufacture. These chemicals reach the
stream by way of municipal and industrial sewers, land drainage, or
indirect application of chemicals to the stream, lake, or impoundment.
Wastes and products originating with the synthetic chemical indus-
try are extremely complex in their composition and behavior. Some
cause tastes and odors and a large number are highly toxic to fish
and aquatic life. Many do not respond to biological treatment and
persist in streams for long distances. We do not know how to detect
most of these compounds in water, or how to treat them in waste
effluents or remove them from water. Most important, we do not
know the long-range toxic effects of these new synthetics on man.
The new synthetic wastes are present in low concentrations in most
waters for the moment, but the industry is continuing its rapid growth.
Each year we are finding increasing amounts of these wastes at our
water supply intakes, and since neither our sewage nor our water
treatment plants remove them, they are reaching the consumer in
increasing amounts.
Radioactive Wastes
Still another new water pollution problem of serious potential has
emerged in recent years from the growth of nuclear technology. The
presence of radioactive materials in our streams is adding another
new contaminant to the Nation's water supply that has serious health
implications if not controlled.
Pollution by radioactive materials from nuclear weapons testing is
well known. Waste products from mining and refining radioactive
minerals, such as uranium or thorium, may be discharged into streams.
Waste products from refined radioactive substances used in power
reactors or for industrial, medical, or research purposes require ade-
quate control measure to prevent dangerous concentrations from
escaping to streams.
Radioactive materials are characteristic of a newly developing
class of water pollutants that are subtle in effect and not detected by
the usual stream pollution analyses. Even so, their control is a
problem in principle no different than the control of the more common
types of wastes, and in this instance the only practical means of
protection against human exposure to radioactive wastes in water is
treatment and control of such wastes at their source. Since radio-

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Examples
activity exposure effects are cumulative, these controls must be effected
in light of total human exposure in the environment.
Heat
"Heat pollution" is becoming an increasing matter of concern to
water pollution control administrators and conservationists. Since
1900, electric power production has approximately doubled every 10
years and is expected to double again in 1970. Unless controls are
effected, this could mean an increase in "heat pollution" of more than
100 percent in the next 10 years. This does not even take into account
the increase in water temperatures that will accompany the increase
in impoundments for hydropower, irrigation, navigation, flood con-
trol, and water-supply purposes.
In areas of population and industrial concentration, such an increase
in "heat pollution" in lakes and streams could have a profound effect
on the ability of the waters to assimilate even well-treated wastes, or
to serve increasing demands for recreational and fishing opportunities.
The following example illustrates the potential of heat as a pol-
lutant. In the Illinois River near Chicago, the effect of thermal
pollution from steam-electric plants is reported to be equivalent to
doubling the organic waste load from the Chicago area, that is, from
the present "population equivalent" of more than 1 million to more
than 2 million.
Evaluating the Pollijtional Effects of Wastes
"With increasing frequency, control agencies are faced with water-
pollution problems that involve new types of wastes whose impact on
water uses and on human health cannot now be fully evaluated.
Toxicological and epidemiological studies are essential to assessment
of the public health importance of new wastes, and a protocol of
effective research must be established.
Predicting Toxic Efleet of a Waste on Aquatic Life: Data on which
to base the environmental requirements of aquatic life are needed and
must be developed through research. These requirements, which
include such items as temperature, dissolved oxygen, carbon dioxide,
and pH, should be based on scientific fact so that reliable criteria can
be developed for managing water quality to restore and maintain a
suitable aquatic environment. These criteria may also prove valuable
in managing water quality for other uses.
Predicting Impairment of Water Treatment Processes by a Waste:
A waste may impair water treatment processes by retarding floccula-
tion, increasing chlorine demand, or through other effects. Reliable
predictive methodology for such effects should be developed to guide
water purification practices.
Predicting Effect of a Waste on Palatability: Objectionable taste
and odor of drinking water is the most common manifestation of

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u
ENVIRONMENTAL HEALTH PROBLEMS
industrial pollution which is difficult to identify and trace. Develop-
ment of effective methods for predicting a waste's taste and odor
potential, and for identifying and tracing the substance responsible
is needed.
Epidemiological Studies: Current methods of disease reporting
seem to indicate that waterborne infection is infrequent and not a
major route of disease dissemination; yet there remain troublesome
endemic occurrences of diarrheal diseases, infectious hepatitis, and
poliomyelitis not explained by "contact" spread. More refined tech-
niques must be developed to reveal the less obvious cause and effect
relationships.
Few systematic appraisals of the health effects of pollutants have
been made other than traditional investigations of infectious diseases.
We need to know much more of the effects of mineral salts, organic
compounds, domestic and industrial waste components, as well as
the etiological agents of infectious disease; also, we need to know the
effects of deficient trace elements, molybdenum, selenium, vanadium,
nickel, zinc, and copper.
Evaluating Toxic Effect of a Waste on Humans: Many of the waste
substances now entering water supplies are known to be toxic in
sufficient concentrations, but there are many others of unknown tox-
icity. Detailed studies of the toxicologic effects of individual chemi-
cals and mixtures of chemicals are time consuming and costly, and it
is hazardous to predict toxicity potentials of mixtures on the basis of
individual components, especially if they vary in specific biological,
physical, and chemical properties. Increased attention must be di-
rected to the development of rapid screening tests for waste materials
which may carry toxicity hazards in the area of water supply. Th©
fundamental studies in toxicology and the related sciences required
by the development of such tests can probably be best conducted in
concert with other programs having similar interests and competency.
Treatment of Wastes
The important need for the development of new methods for treat-
ing wastes more effectively and cheaply is not being adequately met.
Also, since conventional treatment methods remove only 40-60 percent
of pollutants in wastes, there is a real need to develop entirely new
processes which will approach actual purification. This is becoming
a particular requirement for large cities and in areas of population
and industrial concentration where treated effluents are too great a
burden on receiving streams, and where the same water must be used
several times to meet needs.
Improvement of Biological Systems of Waste Treatment: Improve-
ment of methods for selecting and rapidly adapting micro-organism®
to metabolize new organic compounds will increase the effectiveness of

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Examples

present biological treatment systems. Whether organisms can metab-
olize a given compound or not will provide regulatory bodies and
industry with information to determine whether a waste is acceptable
in a waste treatment system and the receiving water.
Treatment of Wastes in Stabilization Ponds: The waste stabiliza-
tion pond is a recent important low-cost treatment development.
Pond design presently is on an empirical basis and understanding of
the natural factors (solar energy, respiration, wind, etc.) involved in
the stabilization processes is too fragmentary to properly evaluate
their effect on design criteria. Additional knowledge is needed on
effects of hydraulic loading and of waste character on pond efficiencies
in removing pathogenic organisms.
The Application of Physical-Chemical Principles to Separation of
Soluble Solids: In the face of a naturally fixed water supply, the
growing needs of expanding population and industry are requiring
that a given water supply be used more and more intensively. Eventu-
ally reuse will become an accepted and necessary practice in most
densely populated areas. The development of satisfactory w7aste
treatment techniques which will provide for repeated reuse of the
receiving stream represents a major, challenging research problem.
Because present methods of waste treatment, stream sanitation, and
water purification cannot remove many of the new pollutants and only
a fraction of the older ones, a major research program has been under-
taken to evaluate physical-chemical principles applicable to much
more complete removal of contaminants from water. Some of the re-
search areas of interest are: Adsorption, extraction, foam fractiona-
tion, freezing, ion exchange, oxidation, and various membrane proc-
esses. The major question will revolve about the eventual economic
feasibility of such operations. Participation in this program by uni-
versities, research institutions, and industry is highly desirable.
Disposal of Waste Effluents
In disposal of waste effluents, the receiving water is seldom used
effectively for maximum dilution. This raises pertinent questions
regarding the adequacy of outfall design techniques. Effective tech-
niques need to be developed to assure optimum use of all available
receiving water, whether this be in a stream, the Great Lakes, or
coastal marine waters.
The discharge into top soil of the liquid wastes from millions of
homes and many industrial plants represents a potential, and often
actual, nuisance and public health hazard. Discharging liquid in-
dustrial and radioactive wastes into very deep porous strata em-
phasizes the need for more information on this method of final
disposal.
627408—
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m ENVIRONMENTAL HEALTH PROBLEMS
Quality Surveillance
Until recently, few programs of water quality intelligence could
present a realistic picture of changing quality conditions in a stream.
The minimum criteria for effective quality surveillance are clear. An
acceptable program must be based on stream data that accurately
reflect the stream's condition. Sampling and analytical procedures
must be dependable and inexpensive.
With increasing demands for water of good quality for all water
uses, the demand for dependable and economical sampling and analyti-
cal techniques becomes more acute. Even the application of our most
advanced laboratory methods would presently provide only a partial
picture of water quality conditions. Because of the importance of
such data in water quality management programs, considerable em-
phasis must be given to research directed to satisfying this need.
Improvement in Bacterial Indices of Fecal Contamination; The
major research goal of sanitary microbiology is to develop simpler,
more rapid and more specific procedures for identifying contamina-
tion by human wastes. Such procedures are important in health pro-
tection and are needed where questions of important regulatory action
are involved.
Recovery, Identification, and Evaluation of Viruses: During the
last 15 years more than 70 viruses have been detected in human feces.
All may be present in sewage. Viruses pass through the sewage treat-
ment plant, persist in contaminated waters, and may penetrate the
water treatment plant. Numerous outbreaks of infectious hepatitis
have been traced to contaminated drinking water. The occurrence of
such incidents appears to be increasing.
An assessment of the significance of water in transmitting viruses
will depend on the development of improved techniques. The de-
velopment of an effective method of culturing the virus of infectious
hepatitis represents the single most important task for research on
waterbome viruses.
Use of Biota in Water Quality Surveillance: Changes in aquatic
population reflect changes in water quality. A number of attempts
have been made to employ aquatic life in water quality surveillance.
No system has, however, been generally accepted as satisfactory by
aquatic biologists. The potential value of employing aquatic biota
in water quality surveillance should be determined by research.
Recovery and Identification of Chemical Contaminants: Increased
production and widespread use of organic chemicals are introducing
more new and highly complex chemicals into the water resource for
which no methodology for detection and measurement exists.
The development of more effective methods for capturing, concen-
trating, identifying, and measuring organic contaminants represents
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Examples
an important need in water quality surveillance, and in development
of controls. Improved, highly refined instrumentation for micro-
chemical analysis must be developed for this purpose. It is clear that
this will require evaluation and adaptation of the most advanced
techniques of chemical separation and analysis.
Example 3
SOCIAL AND ECONOMIC ASPECTS OF ENVIRONMENTAL ENGINEERING
Environmental engineering concerns itself with the establishment
and maintenance of a healthful environment, particularly in urban
areas where the problems are most acute. This requires bringing
together the social, biological, and physical sciences in dealing with
the problems of the health and welfare aspects of man's relationship
with his environment. These have been delineated by an American
Public Health Association committee as follows:
1.	Insuring the elements of simple survival.
2.	Prevention of disease and poisoning.
3.	Maintaining an environment suited to man's efficient performance.
4.	Preservation of comfort and the enjoyment of living.
Environmental engineering, therefore, deals with safeguarding
man's water, air, food, conveyances, structures for habitation and
employment, and his recreational and work environments. It in-
volves not only the control of the quality and quantity of basic neces-
sities, but also, importantly, the control of the waste byproducts,
whether solid, liquid, or gaseous. These byproducts, if uncontrolled
or allowed to accumulate, would not only stifle existence but lead to
widespread disease and physical impairment.
Increasing population and increasing concentrations of people into
the urban areas of the United States have accentuated environmental
problems in two important, related ways: (1) as our air, water, and
land resources are fixed, increasing populations decrease the quantity
of each of these basic necessities available to the individual; (2) with
increasing amounts of waste products concentrated in areas with
growing populations, the relative effects of these wastes on man are
increasing at an ever-increasing rate. These threats are of an insidious
nature, a form of creeping paralysis which, if not recognized and
corrected, can lead to urban stagnation and death as surely as the most
violent epidemic.
The solution of environmental engineering problems is viewed as
dependent upon a recognition of these two factors and upon finding
the ways for applying, successfully, technological advances already
achieved. It is of course, also dependent upon the continuing search
for new ways and means of controlling the environment.
The modern practice of environmental engineering, from the public
health viewpoint, consists of obtaining cooperation between numerous,
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28 ENVIRONMENTAL HEALTH PROBLEMS
contiguous municipalities and this presents complex economic and
social problems. It is, therefore, at this point that the engineering
and social science professions become interdependent. Each has a
vital contribution to make and it is doubtful if progress can be made
without an attack on the problem by these combined forces. Some
illustrations of these points are the following.
Socioeconomic Implications
Although engineers have traditionally endeavored to design the most
economical as well as the most workable solution to a problem, eco-
nomics in our context has a larger meaning. Involved is the need
for evaluating the overall economic picture of a metropolitan complex
for, say, the provision of an adequate water supply. In large metro-
politan areas the provision of enlarged water supply facilities is some-
times hampered because of irrational rate structures. Solving such
problems requires thorough economic studies of the water rates and
instituting an equitable system overall. The importance of social
factors is illustrated by the location of arterial highways without
regard to social, economic, and health implications of these decisions.
When this does occur, the completed road may create severe problems
of neighborhood decay, inaccessibility to industrial complexes, or other
undesirable "direction" of city growth.1
Metropolitan Approach to Planning
The metropolitan factor appears strongly to be the common denomi-
nator to most environmental engineering problems. The technical
literature of the past 10 years abounds with references to the recog-
nition of this fact. There are now 210 Standard Metropolitan Statis-
tical Areas, and the number is growing each year. Of these, 27 are
interstate. Still another pertinent statistic is that 70 percent of the
U.S. population lives in urban areas. The growing interest in com-
prehensive metropolitan health planning is well illustrated by the
recent appearance of an Environmental Health Planning Guide pub-
lished by the Public Health Service. Designed for use by either
technical or lay people, the guide emphasizes the evaluation of health
related utilities and services which readily lend themselves to long-
range planning.
Metropolitan Cooperation and Health
A study of an unsuccessful effort to create a county health depart-
ment, and a more recent study of the social forces blocking State
efforts to create county wide health departments, are examples of rele-
vant social science research. The similar failures to secure public
1A pertinent discussion of social factors la appended to the Report of the Subcominltt*®
on Environmental Engineering, q.v.
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Examples
29
action on water fluoridation suggests the need for social science re-
search into public attitudes as a basis for health action.
Most threats to environmental health cover geographic areas which
are larger than the traditional political boundaries which constitute
the basic State and local governmental system of this country. The
problem of fragmented government is particularly acute in metropol-
itan areas, and it is in these areas that the problems of environmental
health are most serious. Further, these health problems are no re-
specters of the boundaries which divide these areas into literally
hundreds of semi-independent principalities. Air and water pollu-
tion, and radiation are hardly controllable unless the attack can be
made on an areawide basis. The possibility of such areawide coopera-
tion is a field which has been extensively researched by political scien-
tists during the last decade. Most practical advances have been made
through the use of the areawide functional special district. The em-
ployment of this and other governmental innovations may well fit
the need of the public health function. Different problems are being
created, hoAvever, by the mushrooming of these special districts. Some
central function is going to play a coordinating role; health may be
the logical function for this purpose.
Closely related in subject matter would be the study of interstate
cooperation in health matters. Particularly in metropolitan areas,
interstate cooperation has become an essential to an effective attack
upon common problems. Today air pollution and water pollution are
of special interest in this connection, but these are only two aspects
of the problem. Recent social and legal research has produced an
accumulation of knowledge in the field of interstate cooperation,
and in the use and limits of the interstate compact which needs to
be related to public health. What is suggested is studies of metropoli-
tan health problems that would be comparable to those conducted in
the mass transit field by the Transportation Center at Northwestern.
These examples are intended to indicate that the traditional areas
of study in environmental health have underlying social causes to
which social scientists can contribute insight.
Still another broad area of environmental engineering where social
sciences play a part is that of standards formulation. In drafting
criteria of performance in the environmental health field, it is im-
portant that the social factors of standards applications be carefully
considered.
After three decades of increasing interest and work in the health
aspects of housing, there is still little or no information on the effects
on health of room size, noise, air conditioning, lighting, and other
environmental factors.
In the area of metropolitan development, health-oriented standards
are either nonexistent or empirical. Attempts have been made by
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SO ENVIRONMENTAL HEALTH PROBLEMS
some zoning authorities to set criteria. For example, New York and
Chicago zoning authorities have set arbitrary limits on noise and
vibrations from industrial sectors, but the problem of permissible noise
levels in business and residential areas is not dealt with.
The setting of health standards for urban development is compli-
cated by the subjective nature of the problem. Modern health con-
cepts include mental health aspects. Much of how persons or large
groups of people react to noise, vibration, light, and temperature is
governed by attitudes. To research this area, the combined skills
of social, psychological, physical, and medical scientists will be
required.
Example 4
THE PROBLEM OF FOOD CONTAMINANTS
Microbiological Contaminants or Foods
The notable successes of the past 50 years in controlling botulism,
typhoid fever, and other severe foodborne diseases, have tended to
create an impression that technical knowledge in this area is adequate
to prevent all infections and intoxications of microbial origin. How-
ever, the facts are that gastroenteric episodes continue to occur at
a rate second only to respiratory infections, among the short-term
illnesses suffered by middle-class American families. Current food
sanitation practices have failed to reduce the high incidence of food-
borne diseases during the past 8 years. Although the majority of
outbreaks either go unrecognized by health authorities or are of
undetermined etiology, a growing body of evidence indicates that
hitherto unsuspected fungi, bacteria, viruses, rickettsiae, and protozoa
may be partially responsible. For example, infectious hepatitis has
been traced to consumption of polluted shellfish, first in Sweden, and
on two more recent occasions in the United States. Clostridium per-
fringens, which has long been associated with foodborne gastro-
enteritis in Great Britain, is only now beginning to receive serious
consideration in U.S. health departments. The first official reports
of such outbreaks were received by the Public Health Service less
than 2 years ago.
Well-known types of food poisoning organisms occur frequently
in a variety of foods. Eaw market milk supplies nearly always con-
tain Staphylococcus aureus. Dried or frozen egg products are notable
sources of Salmonella organisms. When these products are used for
manufacturing purposes, they may cause serious contamination of
the finished product, as happened in the case of commercially marketed
hollandaise sauce. Outbreaks of Salmonella typhwmrivm were re-
ported from Los Angeles, Calif., and St. Paul, Minn., in mid-June
1961. The hollandaise sauce withdrawn from the market was found
to contain S. typhimurium in lots obtained in San Antonio, Tex., San
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Examples
31
Francisco, Calif., Washington, D.C., and St. Paul, Minn. The product
was manufactured in New York State.
There are in excess of 600 serotypes of Salmonella which may cause
illness in man. A sharp increase in cases in the United States due to
one, S. reading, rarely identified among Salmonella isolates from
human or animal infections, began in September 1956. During the
12-month period following, 325 acute sporadic cases and 3 outbreaks
due to S. reading were reported in widely scattered States from Alaska
to New York. Obviously this widespread illness, due to a specific
micro-organism, does not follow patterns of water or milk borne
outbreaks but would be applicable to a processed contaminated food
product in national distribution.
An example of spread of Salmonella infections from contaminated
egg albumin was reported in England. Widely scattered cases were
traced to certain bakeries where dust from American egg-albumin
powder contaminated the finished bakery products.
From the above examples it may be seen that foodborne disease-
producing micro-organisms are widely distributed in foods in national
and international distribution, for which no protection of the public
is afforded.
Recent field studies in a metropolitan area have shown (a) that
Salmonellae were present in 17 percent of the raw market poultry, and
(5) that staphylococci were found in 21 percent of the market Cheddar
cheese. Direct evidence regarding possible effects of these contami-
nated foods on the health of consumers is not available, but similarly
contaminated products have, on other occasions, been implicated in
gastroenteric outbreaks.
The foregoing examples illustrate the complexity and magnitude of
the microbiological problems of food protection, which require much
increased research effort by the Public Health Service, in concert
with other governmental agencies and industry. Potentially useful
approaches to these problems include:
1.	Methodological studies to improve techniques for the quantitative detection
and identification of pathogenic foodborne micro-organisms and their toxic
products.
2.	Bacteriological, virologlcal, mycological, and parasitological Investigations
to determine the kinds, prevalence, persistence, and public health significance
of potential pathogens in specific foods. For example, the production of safe
shellfish depends on a thorough knowledge of the microbiological condition of
estuarial growing areas, as well as commercial harvesting, shucking, and pack-
ing operations, which are subject to contamination with various toxic dlno-
flagellates, enteric bacteria, and viruses.
3.	Veterinary public health studies on epizootic diseases of food animals, which
may be transmitted to man..
4.	Ecological studies on the interrelated physical, chemical, and biological
factors that affect the growth and survival of pathogenic micro-organisms in
food.
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ENVIRONMENTAL HEALTH PROBLEMS
5. Coordinated epidemiological, clinical, and laboratory investigations of
foodborne diseases to establish cause-and-effect relationships, modes of con-
tamination and transmission, extent and severity of illness, techniques for finding
and reporting natural outbreaks, and means for prevention and control.
0.	Consideration of the public health significance of alterations in the micro-
flora of foods, which may be brought about by the newer methods of processing
and marketing; e.g., freeze drying of products which may be reconstituted and
sold at delicatessen counters or from vending machines.
7. Field studies in the community setting on practical approaches to the control
of microbiological contamination of foods.
Foreign Chemicals in Foods
Increasing contact between foods and foreign chemicals is unavoid-
able in our technologically oriented economy. Without use of agri-
cultural chemicals, food additives, sanitizing agents, chemically
treated water, and synthetic packaging materials, the United States
could not feed the urban population. It has been estimated that elimi-
nation of agricultural chemicals alone would reduce farm yields by
10 to 90 percent.
There is also growing concern about the radionuclide contamination
of milk and other foods by fallout from nuclear explosions, by-
products of atomic reactors, and residues of radioactive wastes.
About five-sixths of the strontium 90 taken into the human body is
estimated to come from foods, especially dairy products. Accidental
release of short half-lived radionuclides, such as iodine 131, from a
reactor in another country has, on at least one occasion, necessitated
withholding milk from the market until the level of radioactivity
declined. Extensive studies, in close cooperation with radiological
health and atomic energy experts, will be necessary to understand
the progression of radionuclides through the food chain and their
long-term effects on man.
As is brought out in the report of the Subcommittee on Milk and
Food, "there are no harmless substances; there are only harmless ways
of using substances." The determination of how and when chemicals
may be used safely in relation to food is already a major public health
problem, and it will become even more important in the future.
Some of the avenues by which the health implications of foreign
chemicals in foods may be approached are as follows:
1.	Methodological studies to develop and simplify analytical procedures for
both the presumptive qualitative and quantitative determination of herbicide,
insecticide, rodenticide, germicide, and other potentially harmful residues in
foods. There are many new tools now available which should be studied with
respect to their application in this field.
2.	Toxicological and pharmacological investigation of animal and human
responses to repeated low-level dietary exposures, using chemicals singly or in
combinations which are typical of their occurrence in food.
3.	Exploration of the correlations between long-term, chronic-toxicity testing
and more rapid presumptive procedures, based on reactions of enzyme systems,
tissue cultures, or micro-organisms, to chemical agents.
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Examples
S3
4. Radiochemical studies on the occurrence, measurement, intake, retention,
and biological effects of radionuclides from foods and other environmental
sources, including dietary means of minimizing human exposure and damage.
Example 5
PROBLEMS IN OCCUPATIONAL HEALTH
Occupational health is that portion of the total health effort which
is closely associated with the individual's occupation. The occu-
pational environment presents many special risks as well as oppor-
tunities for improving health, but effective programs must be based
upon adequate and simultaneous attention to both the man. and his
environment.
The traditional emphasis in the study of occupational disease has
been on specific, dramatic, and killing diseases apparently caused by
single or small groups of environmental factors. The recognition and
conquest of lead poisoning, mercury poisoning, tar cancer, phosphorus
poisoning, radium poisoning, and silicosis are classical stories.
Occupational health today, however, must not only continue the
application of conventional methods for the detection of new toxic
agents, but must also extend its traditional concept in new dimensions.
The problem confronting us today contains many elements that are
new, but our methods of attack have been slow to adapt to the new
challenges. The health of the worker is still far from optimal, and
frank occupational disease also persists. Residual or slowly develop-
ing disease or dysfunction may not be detected by conventional clinical
examinations or by conventional reports of death or disease. Some
occupationally induced disease can easily be confounded with "normal"
causes of progressive deterioration such as aging. The involvement
of each individual may be less, but many more persons are involved.
It has been estimated that of the more than 70 million members of the
civilian labor force, probably more than half have some degree of
physiological impairment which could be greatly reduced if adequate
knowledge were available.
There is increasing evidence that impairments now being en-
countered are not produced by single, isolatable, and easily incrimi-
nated factors; rather that many are the result of multiple factors
working together, each adding its own insult and helping others to
add theirs. Only tentative beginnings have been made to answering
such questions as the effects of high atmospheric pressures or thermal
stress on the tolerable limits of toxic chemicals. Attempted solutions
of some problems lead to new questions. For example, we may point
to the paradox that has developed in the South African mines—dust,
as it was known, has been largely suppressed and with it has dis-
appeared the gross silicosis of old, but pneumoconiosis remains and
resultant deterioration of pulmonary and cardiac functions continues.
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A* ENVIRONMENTAL HEALTH PROBLEMS
This pneumoconiosis may at times even show a negative correlation
with the environmental dust count as conventionally estimated.
Again, with the decrease in heavy physical labor and the introduction
of automation, the incidence of physical strain in industry can be
expected to decrease, but the psychological stresses are obviously in-
creasing at least in proportion and probably absolutely as well. For
example, the problem of handling and interpreting masses of incoming
information under pressure, in split-second fashion and often with
very critical consequences, so dramatically seen in airport control
rooms, is developing with increasing frequency in communication
centers across the Nation, in plant control room and in emergency
installations. In less intensive fashion the psychological and social
concomitants of the job affect every worker, his relations with others,
his productivity, his anxieties, and his health.
Recognition of the interrelationship of various environmental fac-
tors has perhaps been most evident in the heightened awareness of
the effects of the growing chemical world surrounding us and of the
consequences of exposures to radiation and other agents of technologic
prowess. There is a widening gap between the new materials being
created and an understanding of their effects on living systems. It
should become axiomatic that these materials must be as well under-
stood for their biological potentialities as well as for their physical
and mechanical properties. It is in the in-plant environment where
many of the toxic pollutants now threatening the air and water of
communities throughout the Nation are first spawned. The indus-
trial worker is first exposed to the chemicals that find their way into
home use. Industry is the incubator for problems of more far-
reaching consequence, and alert, scientifically sound, and unbiased
investigations of occupational health problems can provide bases for
later communitywide investigations. Also, without adequate knowl-
edge and coordination of activities the elimination of a contaminant
from a plant may well result in a community air- or water-pollution
problem.
Over one-half of the industrial plants in this country lack basic
industrial hygiene control measures. The most serious deficiency is
in the provision of adequate preventive measures for workers in the
small plants of less than 500 employees, which accounts for over
two-thirds of the work force.
In several States the provision for the control of occupational
environments is below the level considered adequate. Of the 584
persons employed full or part time in occupational health in State
and local units in February 1961, 58 percent were in 6 States; the
remaining States had either no programs or inadequate ones. Al-
ready serious, the manpower shortage in occupational health is
expected to worsen.
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Examples
36
Great benefits have come from advances in science and technology
and from their application by our industries. These have not been
gained, however, without certain costs in terms of human values. If
we are to enjoy to the fullest extent the benefits from our modern
industrial society, these costs have to be better recognized, evaluated,
and reduced. The national effort in occupational health must be
directed to this end. Accordingly, an occupational health program
must have as its basic objectives:
1.	Recognition of the influences and risks associated with occupations;
2.	Evaluation of their effect upon human health and efficiency;
3.	Development of preventive measures; and
4.	Effective application of the knowledge so gained to industrial practice.
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REPORTS OF SUBCOMMITTEES
Manpower Resources and Training
Applied Mathematics and Statistics
Pharmacology, Toxicology, Physiology, and Biochemistry
Analytical Methods and Instrumentation
Air Pollution
Environmental Engineering
Milk and Food
Occupational Health
Radiological Health
Water Supply and Pollution Control
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Report of the Subcommittee on
MANPOWER RESOURCES AND TRAINING
RECOMMENDATIONS
1.	The divisional training program providing fellowships and
traineeships to students and training grants to universities should
be strengthened and augmented. In those instances where authority
to undertake these programs does not exist, such authority should be
sought by appropriate legislation.
2.	A substantial program of environmental health institutional
grants to support those universities engaged in programs of graduate
education should be instituted.
3.	Support for the training grant programs outlined in the fore-
going two recommendations should be increased as quickly as possible
to a level of $25 million.
4.	There should be established, in the office of the Bureau Chief, a
unit responsible for the formulation of overall policy and adminis-
tration of the several training grants programs. This unit is essential
to assure an orderly development of the total program.
5.	Other Federal agencies engaged in training activities should
take cognizance of the manpower demands which will be imposed
upon them by the rapidly expanding field of environmental health
and should adjust their programs to meet these new burdens.
MANPOWER REQUIREMENTS
The success of any human endeavor is closely related to the quality
of the manpower which can be brought to bear therein. The effective-
ness of the Public Health Service's programs in environmental health
depends in no small measure on the availability of competent person-
nel in sufficient numbers to meet the tasks faced by the Service in this
field.
Review of the several subcommittee reports which deal with the
divisional programs of the Service's Bureau of Environmental Health
indicate clearly that substantial deficiencies in manpower exist even
now and that this situation will be aggravated in the years immediately
ahead unless the training of additional personnel is vigorously pro-
moted and prosecuted.
The types of personnel needed for a comprehensive attack on the
problems of environmental health are delineated in the divisional sub-
committee reports. They include a broad range of individuals with
backgrounds in the physical and biomedical sciences, in mathematics,
39
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J+0 ENVIRONMENTAL HEALTH PROBLEMS
and in the social sciences. In the physical sciences, representation ex-
tends from classical physics and chemistry through meteorology, geo-
physics, and radiation physics to hydrology, oceanography, and sani-
tary engineering; in the biomedical sciences the personnel requirements
extend from molecular biology, botany, and microbiology through
biochemistry, pharmacology, and radiobiology to epidemiology, toxi-
cology, and the several medical disciplines. In mathematics, represen-
tation is required from classical mathematics through biomathematics
and statistics. And the very nature of the problems encountered in
environmental health makes essential the availability of personnel with
backgrounds in sociology, political science, anthropology, and
psychology.
The intellectual resources upon which environmental health may be
expected to draw are obviously extremely broad and extend well be-
yond those usually required in public health. Indeed, a large propor-
tion of the personnel needed by the Bureau of Environmental Health
in the years ahead must be sought outside of regular public health
channels. Particular emphasis must be placed on this point because
added burdens on the training programs of such agencies as the Na-
tional Science Foundation and the National Institutes of Health may
be expected in the near future. Hence, these agencies should prepare
now to meet the extra demands which a rapidly expanding environ-
mental health program will place upon them.
In table I are listed the current numbers of professional personnel
in each of several scientific categories working in the field of en-
vironmental health in the Service and in the Nation at large. It is
expected that, by 1970, more than twice these numbers will be required
in most categories and triple in some.
Table I
Professional discipline >
Public Health
Service
Nation
Physics .....	-			-				
80
80
145
ss
420
140
3,400
7,000
2,000
1,000
8,600
6,000
Chemistry

Medical-..		----	-		

Allied sciences ..........	......			
Total 		,	
830
26,800

1 These are professional disciplines of all levels of training.
It is noteworthy that, at the present time, the total national pool of
environmental health scientists is less than 2 percent of the sum of all
scientists, engineers, and teachers of science in the United States. It
may therefore be said that current environmental health programs
place little drain on the scientific personnel resources of the Nation.
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Manpower Resources and Training
The requirements for additional environmental health personnel in
the future do not change this picture substantially. Indeed, the
growth of the total scientific manpower, projected by NSF,1 in the
next decade is similar to that outlined above for the field of environ-
mental health.
To meet the substantial demands for trained personnel expected over
the next decade, the subcommittee believes that the Public Health
Service should take courageous leadership in the development of an
extensive range of training programs which provide not only for the
immediate technical needs of the Bureau of Environmental Health but
for its broad requirements as well. It is recommended that the divi-
sional training programs be augmented and strengthened as suggested
in the divisional subcommittee reports. In addition, however, the Sub-
committee strongly urges the Service to undertake a program of in-
stitutional grants in which support is given to universities to provide
comprehensive training in environmental health. In such programs,
each university would be expected to call upon its total resources in
many departments to train a broad range of students for environmental
health carriers.
The current training grant programs of the Public Health Service
are tabulated in table II. The institutional grant program just re-
ferred to would be an important additional component of this series
of programs.
Table ir
Grants program
Public Health Tralneeship Program	
Project Grants for Graduate Training In Public
Health.
Formula Orants to Schools of Public Health	
Air Pollution Tralneeships			
Air Pollution Awards to Educational and Training
Institutions.
Grants for Training to Radiological Health	
Water Supply and Pollution Control Training
Grants.
Graduate Training Grants	
Regular Research Fellowships	
Health Research Facilities Grants	
i BSS, Bureau of State Services.
NIH, National Institutes of Health.
Where administered in PHS, presently1
Division of Community Health Practice, BSS.
Division of Community Health Practice, BSS.
Division of Community Health Practice, BSS.
Division of Community Health Practice, and Divi-
sion of Air Pollution, BSS.
^Division of Community Health Practice and Divi-
sion of Air Pollution, BSS.
Division of Radiological Health, BSS.
Division of Water Supply and Pollution Control,
BSS.
Division of General Medical Sciences (all 7 Institutes,
NIH).
Division of General Medical Sciences (all 7 Institutes,
NIH).
Division of Research Grants, NIH.
Presently the Public Health Service is spending approximately
$8.5 million for training grants activities, including facilities, in
environmental health. This support should be increased as rapidly
as possible to a level of $27.5 million if the manpower requirements of
1 Investing In Scientific Progress. National Science Foundation Report, NSF fll-27.
62T408-—&2	1
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1$ ENVIRONMENTAL HEALTH PROBLEMS
the next 10 years are to be fulfilled. These funds should be expended
in the form of institutional and departmental training grants and as
stipends to students to assist them to defray tuition and living costs.
At present, the various training grant programs are administered
differently and through a variety of organizational units. This has
sometimes resulted in an imbalance in one program relative to another.
It seems clear that coordinating mechanisms should be established to
assure an orderly development of the total program, composed as it
is of many interrelated parts.
When these mechanisms are set up, cognizance should be taken of
the close relationships which exist between the various divisional
programs and the types of personnel needed to be trained. These
mechanisms should therefore strengthen the divisional training pro-
grams as well as promote their coordination. An example of one way,
in which an orderly development of total program could be achieved,
is the establishment of a training grant unit composed of the directors
of the training grant operations in the Bureau and in each of the
divisions to formulate overall policy on the administration of training
grants in environmental health.
This unit could then intelligently take into account the relationships
of these programs with outside professional and technical societies,
the universities, and the scientific community in general. The various
grant programs should not be in competition with one another.
Therefore, overall coordination and administration of these programs
is essential to achieve maximum impact with the money being spent.
SHORT-TERM TRAINING
In addition to the academic training at professional levels of special-
ists for work in environmental health, there is great need for updating
those individuals already on the job. This is being accomplished by
a variety of inservice training programs, with special emphasis on
technical seminars and short courses ranging from 8 to 10 days to 12
weeks. Such updating and refinement of skills and competencies are
essential for all who work in this field—in the Public Health Service,
in State and local government, in industry, and in research.
Table III indicates present and estimated costs for inservice train-
ing of all types of environmental health personnel by the Public
Health Service.
Table III

1066-61
(inclusive)
1666
(estimated)

14,200
$2,280,000
10,000
$2,600,000


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Manpower Resources and Training
GRADUATE TRAINING OF STAFF
In addition to the short-term inservice training activities, the
Bureau should accelerate the formal academic outside-PHS graduate
training of its personnel. This is necessary as part of career develop-
ment and to further the professional competency of the staff. The
graduate training of 185 employees (to the M.S. and doctorate level)
over the last 7 years is noteworthy considering program levels. How-
ever, this effort must be increased to at least 3 to 5 percent (on a sliding
scale) of operating budgets. This type of program will not only
serve as a necessary training device but will attract new scientific
disciplines into the field.
In table IV are listed the immediate requirements to fund the several
training programs set forth above. As indicated heretofore, it is
hoped that these programs may be vigorously promoted and prose-
cuted. Unless this is done, the Service will be in serious danger of
failing to meet its responsibilities in environmental health.
Table IV
Program
Immediate need
Institutional grants	
$5,000,000.
Training grants (faculty, facilities, and student support)	
$20,000,000.
Short-term inservice training for all types environmental health per-
$2,600,000.
sonnel.

Graduate training (Public Health Service environmental health per-
3 percent of operating budget.
sonnel).

PERSONNEL RECRUITMENT
Although the training programs discussed in the foregoing para-
graphs will go a long way to solve the manpower problems in en-
vironmental health, recruitment of these personnel into governmental
public health programs, particularly at the State and local levels,
may not be easy unless efforts are made to provide a better working
climate for environmental health scientists. This involves (a) the
development of an improved status for such scientists by greater
recognition of their importance by society and (6) the provision of
incomes more commensurate with their value to the health of the
nation. The surgeon general should make every possible effort to
promote those conditions which will bring about a better status and
improved income levels for scientists working in environmental health.
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Report op the Subcommittee on
APPLIED MATHEMATICS AND STATISTICS
RECOMMENDATIONS
1.	There should be a central facility to attack the problems of en-
vironmental health and to provide for services and activities needed
in this area.
2.	This central facility should include staff and research facilities
to handle basic problems in environmental health and should provide
for research activities designed to unify divisional interests where
desirable, provide central services in the field of mathematics, sta-
tistics, and electronic data processing, and advise the Bureau chief
and the Director of the Environmental Health Center with respect
to the overall direction of research in environmental health.
3.	This central facility should include:
a.	An analysis group to review and conduct both laboratory and field studies
of interdivisional concern and to advise the Bureau chief in long range program
planning, priorities, and management. This analysis group should be provided
with funding independent of divisional research budgets and should have both
long and short range objectives and projects. It should report directly to an
Environmental Health Center research director.
b.	A consulting and research design group in the area of mathematics and
statistics to provide guidance to categorical programs for the wide range of
problems to be encountered and to insure that each of the Bureau programs
receives the maximum possible benefit from activities in other parts of the
Bureau and in other governmental units. Functions of this group should Include
the refinement and standardization of morbidity and other data relevant to
environmental health so as to enable the identification of environmental health
problems.
c.	An electronic data processing group to service the Bureau and the Divisions
and to insure that the most modern and efficient data processing procedures
are followed throughout the Bureau.
4.	There should be established an information storage and retrieval
activity as part of a library and information center at the Bureau
level. This information storage and retrieval facility should provide
a service to environmental health activities in air, water, food, occupa-
tional health, etc., and should utilize consulting services and data-
processing capabilities of the electronic data processing group and
the staff of mathematicians and statisticians at the Bureau level.
INTRODUCTION
This subcommittee felt that its recommendations should cover an
area described in the report of the Study Group on the Mission and
Organization of the Public Health Service (June I960) as Ecology
V
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46 ENVIRONMENTAL HEALTH PROBLEMS
and Systems Analysis. This activity involves the recognition of the
multiple causation of disease and the fact that there are many environ-
ments which may interact to affect the health of man. As was stated
in the reorganization report:
"Potentially toxic substances reach the population in intermittent,
minute exposures from many sources. One division of BEH may
assess the import of a given substance through one medium, another
through another medium. A combination of skills in ecology, epi-
demiology, toxicology, biometrics, and electronic and other analytic
systems is required to establish comprehensive, baseline data as a foun-
dation for specific assessments."
Three groups are recommended for the Environmental Health
Center. Their responsibilities will be as follows.
ANALYSIS GROUP
The primary purpose of this group is to engage in and develop
studies designed to clarify the relationship between the environment
and health and to explain the ecologic processes which affect the
quality of man's environment. To define more clearly the broad
nature of the environmental health research in which the members of
this group will engage, the following examples are suggested:
1.	Epidemiological study of the physiologic, economic, and social
effects on urban population of multiple and simultaneous, low-level
environmental exposures (e.g., oxidants in the air, industrial wastes
in water supply, radioactivity in foods), including study of the way
in which demographic and population factors either moderate or
heighten the effect of environmental hazards.
2.	Consideration of the criteria and systems which should be recog-
nized by regional and metropolitan planning groups as necessary in
the control of air, water, food, radiological and industrial environ-
ments within a metropolitan regional or topographic area to provide
adequate utilization of natural and economic resources while safe-
guarding man's health.
3.	Determination of the relationships between such variables as (a)
the air transport of radioactivity to cattle forage or food growing
areas, (6) the microclimate and general ecology of pastureland or
cropland, (c) the accumulation of radionuclides in the milk of cattle
or other foods, (d) the mechanism and effects of subsequent uptake
and storage of such nuclides by man.
This group may also undertake, on request from the divisions, cer-
tain broad or theoretical research studies within the jurisdiction of a
single division. An example of such a study might be quantitative
and preferably mathematical definition of the importance of such
factors as: (1) Domestic and industrial water quality requirements,
(2) stream self-purification, (3) water treatment, (4) algal effects on
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Applied Mathematics and Statistics
47
dissolved oxygen, and (5) multiple use and reuse on the proper man-
agement of water resources. Similar studies might occur in occu-
pational health, environmental engineering, and in other areas.
The analysis group will also include long-range planning of en-
vironmental health research and advising the Bureau chief with
respect to the overall direction of research and field operations in the
light of Bureau objectives and functions.
Although not the primary mission for this group, its members
should be available on request for consultation with division represent-
atives and with members of the Environmental Health Center consult-
ing and research design group described below. It is important that
the analysis group not be charged with day-today operating responsi-
bilities and that it be allowed to view environmental health in the
broadest possible perspective. To insure this and to insure continuity
of studies and activities this group should be financed as a separate and
distinct activity and not be dependent upon divisional research
budgets. It should report directly to a Bureau level research director.
CONSULTING AND RESEARCH DESIGN GROUP
The basic effort for this group will be to provide consulting services
to statisticians and other research workers in the various divisions.
They will supply assistance and consultation with respect to the statis-
tical design of laboratory and field studies and the effective use of
electronic data processing equipment in statistical analysis. This
group will also engage in mathematical statistical research, and deal
with unsolved problems of the divisions. In addition, the members
of this group may engage in such primarily mathematical research as,
for example, the development of realistic mathematical representa-
tion of the processes of turbulent dispersion of pollutants in air,
water, and body fluids.
The Consulting and Research Design Group must have responsi-
bility for leadership in the development of uniform standards and
criteria for the adequate reporting of sickness patterns related to en-
vironmental hazards by local, State, and Federal agencies. It will
engage in the construction of morbidity indices, particularly those
which would take advantage of existing hospital, industrial, and other
records, to measure more accurately the effects of environmental
hazards on man's health. This group must also assume responsibility
for insuring the usability of environmental health data produced by
other Federal agencies (e.g., Bureau of the Census, Bureau of Old Age
and Survivors Insurance).
ELECTRONIC COMPUTING AND DATA PROCESSING FACILITY
This should be a large-scale facility to serve the data processing
needs of divisional and Bureau activities. It will, in addition, keep
abreast of latest developments in electronic computing equipment and
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48 ENVIRONMENTAL HEALTH PROBLEMS
programing, including the development of automatic recording instru-
ments for laboratory and field investigations. This group will also
maintain liaison with the information retrieval activities of the library
and information center mentioned in Recommendation 4 of the
Subcommittee.
The establishment of this facility should not preclude the mainte-
nance at divisional level of mechanical data handling resources (e.g.,
keypunch, sorting, and tabulating equipment—commonly called EAM
equipment) to meet small-scale immediate needs of the Division.
PROPOSED STAFFING AND BUDGET
Analysis Group
This group will require experienced competent professional investi-
gators and adequate supporting staff in such areas as epidemiology,
industrial medicine, industrial hygiene, toxicology, ecology, social
sciences, mathematics and mathematical statistics, operations research
and systems analysis, sanitary engineering, and physical chemistry.
It should operate as several groups with project leaders in specific
areas. Approximate initial staff requirements: 30 persons.
Consulting and Research Design Group
Staff for this group will include highly qualified individuals and
supporting staff in the areas of mathematics, applied mathematics,
mathematical statistics, biostatistics, records analysis and the social
sciences, including demography and population analysis. Approxi-
mate initial staff: 10 persons.
Computing and Data Processing Facility
This group will include a director, assistant director and staff for
overall supervision of the facility and particular responsibility in the
areas of computer equipment and program development. The group
will also include systems analysts in the areas of computer systems,
information retrieval systems, statistical systems, and mathematical
systems. To each of these systems, analysts and computer programers
will be assigned as needed. In addition, adequate tabulating and sup-
porting staff will be needed. Approximate initial staff: 45 persons.
Total Annual Budgetary Requirements
Personnel 	$1, 275, 000
EDP and other equipment	 900,000
Total
2,175,000
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Report of the Subcommittee on
PHARMACOLOGY, TOXICOLOGY,
PHYSIOLOGY, AND BIOCHEMISTRY
RECOMMENDATIONS
1.	Expansion of intramural and extramural research efforts uti-
lizing the basic science disciplines of biochemistry, pharmacology,
physiology, and toxicology is recommended because of the increasing
importance of chemical agents and radiation as causative factors in
environmental health problems.
2.	A common denominator exists with respect to the basic science
approach to environmental health problems arising from any type of
exposure to chemical agents and radiation. It is, therefore, concluded
that future progress in the solution of many of the environmental
health problems can be made most efficiently and economically by con-
solidation of the major research activities within an environmental
health center. It is recommended that each of the major divisions of
the environmental health center contain the appropriate numbers of
toxicologists, biochemists, pharmacologists, and physiologists attached
to each division that are required for solution of immediate practical
problems. In addition to strong representation of disciplines within
each division or problem area, the personnel of individual disciplines
should be brought together less formally but firmly on an interdivi-
sional basis. It would then be possible to take full advantage, for
example, of the contributions that a toxicologist or biochemist in air
pollution can make toward problems in water pollution, occupational
health, and radiobiology.
3.	It is recommended that the environmental health center make
provisions for basic research in toxicology and other basic science
disciplines without reference to particular immediate problem areas.
The center should strive for national leadership in environmental
health, and to accomplish this objective it is essential that provisions
be made for personnel and facilities beyond those required for service
activities connected with the solution of specific immediate problems.
4.	It is recommended that the environmental health center contain
a centralized group for storage and retrieval of toxicological informa-
tion as a service to the center itself, other public health laboratories,
and the entire nation.
5.	It is recommended that in consideration of any new field stations
or regional laboratories for environmental health activities attempts
should be made to locate them in close affiliation with universities to
49
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60 ENVIRONMENTAL HEALTH PROBLEMS
facilitate acquisition of personnel and to enhance the training oppor-
tunities in this field.
6. The proposed expansion of Public Health Service facilities and
activities in environmental health, together with the certain marked
expansion of toxicological work in industry and other Government
agencies as a result of existing and new legislation, makes it imperative
that the training of professional personnel in the basic biological
sciences be expanded. In connection with satisfying the increased
personnel requirements in the aspects of environmental health that
utilize the basic biological sciences during the next decade, the follow-
ing recommendations are made:
~.	Expansion of training grant programs in departments of biochemistry,
pharmacology, and physiology in medical schools, schools of public health, and
(schools of veterinary medicine, particularly in those departments containing
staff members who are competent and interested in some aspect of environ-
mental health research.
~.	Encouragement of selected schools of public health, medicine, and veterinary
medicine to establish departments of toxicology as a direct method of increasing
the output of professional toxicologists, Substantial Public Health Service
support would be needed initially for facilities and staff and the support of
predoctoral and postdoctoral students.
o. Expansion of research grant programs with long-term support for broad
programs on the basic aspects of toxicity measurements, mode of action and
treatment of poisoning. Research * grant support to existing departments of
biochemistry, pharmacology, physiology, entomology, and food technology in
medical, public health and schools of agriculture will build effective research
groups within universities and contribute substantially to the total environ-
mental health research program and the training of scientists for careers in this
field.
d. Maintenance of a substantial inservice training program in the environ-
mental health center and regional laboratories for the training of postdoctorates
and preprofessional personnel.
INTRODUCTION
During recent years marked changes have occurred in the nature of
environmental health problems. In the past, communicable diseases
were of principal concern, but a concentrated effort directed toward
acquisition of knowledge about their cause and the development of
effective control measures has led to a solution of most of these
problems.
During the past few years unprecedented technological advances in
the development and practical use of new chemical agents for a variety
of purposes, and expansion of atomic energy developments, have neces-
sitated radical changes in the approach to environmental health
problems.
Progress in the control of communicable diseases required intensive
efforts on the part of clinical investigators, with the supporting pre-
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Toxicology and Related Sciences
51
clinical research contributed principally by the disciplines of microbi-
ology, pharmacology, and biochemistry.
The different nature of present and future environmental health
problems, which deal mainly with toxic chemical and physical agents,
places heavier responsibilities on the preclinical biological sciences
of toxicology, biochemistry, physiology, and pharmacology than at
any time in the past.
The development of plans for progress in solving future problems
in environmental health must take into account (a) an increasingly
greater dependence upon basic biological sciences, (b) the inadequate
supply of professionally trained personnel available for environmental
health activities, and (
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6% ENVIRONMENTAL HEALTH PROBLEMS
In the area of food protection, toxicological studies on pesticides,
herbicides and other agricultural chemicals, on chemicals intentionally
added to food, endogenous toxicants and natural poisons are needed.
In the field of radiological health, the long-term effects of low levels
of radiation need much additional intensive study. Protective meas-
ures against radiation injury must be developed.
These examples represent only a few of the present and future
problems in which the basic science disciplines of biology must assume
an important role, and in which similar approaches at the laboratory
level are equally applicable to the problems regardless of their en-
vironmental origin. Environmental health problems concerned with
toxic chemical agents require laboratory investigations on experi-
mental animals. Laboratory investigations together with clinical
observations are essential for establishing the recommended conditions
for elimination of health hazards. An interdisciplinary approach by
the basic biological sciences is highly desirable for optimum progress.
TOXICOLOGY
Regardless of the source of the exposure or the type of toxic agent
under study, the modern toxicological approach includes identification
and analysis of chemical agents, detailed studies on the acute and
chronic toxicity in laboratory animals and attempts to develop anti-
dotal agents. The assistance of the toxicologists is also required in
the interpretation of experimental findings in terms of hazards to man
and in the establishment of tolerance levels. The present standard
procedures for measuring the toxicity of chemicals are costly and
laborious, and they require extensive facilities. However, there are
no known substitutes for these tests with sufficient reliability to re-
place the conventional procedures.
The rapid development of new chemicals to the stage of practical
application greatly outpaces the rate at which their toxicology can
be investigated by all organizations engaged in this activity, and this
trend is expected to continue. It is, therefore, essential to plan for
intramural and extramural efforts in toxicology for at least the next
decade. The plans for toxicology must also include basic research not
necessarily related to immediate environmental health problems.
The development of new methods, instruments, and approaches to
toxicological problems will require research, personnel, and facilities
far in excess of the needs for immediate practical problems. Ade-
quate provisions must be made for basic intramural and extramural
research in toxicology. Planning for the future in this manner will
result in developments of ultimate value to practical problems and,
if conducted under appropriate leadership, the basic research program
will contribute greatly toward stimulating the interest of competent
scientists to enter this field.
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Toxicology and Related Sciences
63
BIOCHEMISTRY
An understanding of the deleterious actions of chemical agents and
radiation hazards requires the knowledge and skills of the biochemist.
Assessment of the potential health hazards of toxic agents to man is
aided significantly by the availability of information on their stor-
age, excretion, and metabolic fate. As part of an interdisciplinary
approach to environmental health problems the potential contributions
of biochemistry cannot be overemphasized.
Basic research on the precise mode of action of toxic agents can be
expected to provide the soundest foundation for assessment of health
hazards and for the development of specific methods of treatment.
Biochemistry has already accomplished a great deal in explaining
the mode of action of toxic agents on the basis of their interference
with enzymatic reactions. Adequate provisions should be made for
the use of this discipline in both intramural and extramural research
activities because of its importance in solving practical problems and
its great potential value for attracting personnel into training and
careers in environmental health research,
PHYSIOLOGY AND PHARMACOLOGY
The nature of exposure of man to some chemical agents such as air
pollutants, skin irritants and industrial airborne poisons demands the
use of experimental methods of physiology and pharmacology for
the assessment of health hazards.
Measurements of the actions of environmental chemicals on the
function of intact organs and the general physiological functions of
the intact animal constitute an essential step in the development of
required information on toxic agents. Measurements that employ
physiological and pharmacological techniques are essential to bridge
the gap in information that sometimes occurs in understanding toxi-
cological and biochemical findings as they relate to functional activity
of the intact organism.
There are numerous environmental health problems that do not
involve exposure to toxic chemical agents in which the techniques of
physiology are required to properly assess the degree of hazard. Phys-
iology plays an important role in gaining an understanding of the
stressful effects of physical factors such as heat, light, noise, and
work. A tremendous amount of additional effort is needed utilizing
the techniques of experimental physiology to study the influence of
these physical factors alone and in combination with one another
and in combination with chemical agents on health and work
performance.
The role which these disciplines have played in the training of per-
sonnel for careers in environmental health must also be considered in
the long range plans. Provisions must, therefore, be made for siz-
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64 ENVIRONMENTAL HEALTH PROBLEMS
able efforts in both of these disciplines in future plans for both intra-
mural and extramural environmental health research activities.
FACILITIES AND TRAINING NEEDS
Satisfactory progress with the numerous problems in environmental
health that involve the discipline of toxicology, biochemistry, phar-
macology, and physiology requires a marked expansion and full coor-
dination of facilities and manpower within the Public Health Service
and development and material expansion of research and training
in universities through strong extramural support.
The development of coordinated efforts in overlapping divisions of
environmental health must be accomplished to utilize the basic bio-
logical sciences advantageously within the Public Health Service and
in universities. Such developments could be accomplished by the fol-
lowing organizations and programs:
Public Health Service Environmental Health Center
As indicated above the problems of environmental health involving
exposure to toxic chemicals have many similarities with respect to
application of the disciplines of the basic biological sciences. Estab-
lishment of an environmental health center would bring together the
problems and disciplines in such a manner that accelerated progress
could be expected in all phases of environmental health. Toxicology,
biochemistry, physiology, and pharmacology should all be appropri-
ately recognized and represented in the center.
Provisions should be made for a strong toxicology unit to engage
in toxicological examination of chemical compounds, and to perform
analytical work and other services directly related to the immediate
problems of each division. Development of a strong research com-
ponent in toxicology is essential for new ideas and approachs to toxi-
cological problems. If the center strives for national leadership in
this field, its stature will be enhanced; an outstanding effort in toxi-
cology would serve as a strong stimulus to outside institutions and
attraction of competent personnel into the center for training and
experience would be assured.
The organizational structure for toxicology within the center should
involve attachment of toxicologists to each division for designation
of their primary responsibilities. In addition, however, there should
be some interdivisional organization of all personnel within the center
into disciplinary groups for mutual benefit to the entire program and
to the members of each discipline.
The center should have a toxicology information group for the
storage and retrieval of data not only for the benefit of the center but
also for use by other Public Health laboratories and institutions
throughout the Nation.
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Toxicology and Belated Sciences
55
The discipline of biochemistry should be represented in each major
subdivision of the center. The solution of problems involving chem-
ical analysis, and the tissue storage and fate of toxic agents will be
greatly aided by appropriate activity of a biochemical nature.
Furthermore, a strong biochemical research component will permit
application of advances in biochemistry to investigations of the mode
of action of toxic chemicals and to rational development of antidotal
procedures. Basic research of this type will serve an important na-
tional need and will stimulate interest in problems of environmental
health outside the center.
Physiology and pharmacology must also be considered as important
disciplines for inclusion in all major units of the environmental health
center. Adequate representation of these fields is essential to insure
thorough studies on the influence of toxic agents and injurious phys-
ical factors on the physiological functions of intact animals. Basic re-
search aimed at methods for elucidating toxic effects in intact animals
and organ systems should be included in the plans for these disciplines.
Regional Environmental Health Laboratories
The environmental health center should maintain sufficient flexi-
bility in its program and structure to permit a change in emphasis
toward important new problems when they arise in order to exert a
stimulating influence on environmental health activities throughout
the Nation. It is anticipated that changes in emphasis will have to
take place from time to time even though other problems are not yet
completely solved.
The center should be supplemented by the creation of regional
laboratories placed in geographical locations with special consideration
for sites with longstanding environmental health problems. For ex-
ample, in geographical areas where air or water pollution is a continu-
ing problem, service functions such as analyses and some localized
research activities could be transferred to the regional laboratory and
thus free the staff and facilities of the center to undertake new
problems of national importance.
In regional laboratories it would be expected that disciplines provid-
ing analytical chemists and toxicologists would generally be required,
but the facilities and personnel requirements might vary considerably
depending upon the particular problems under consideration and the
amount of research to be included in the programs of these labora-
tories. Affiliation of these laboratories with, or in close juxtaposition
to, universities should be considered whenever possible because of the
value of such an arrangement in the recruiting of personnel, the possi-
bility of attracting students into environmental health research, and
the availability of consultation services.
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56 ENVIRONMENTAL HEALTH PROBLEMS
University Research and Training Programs in
Environmental Health
The present demand for professional personnel trained in the basic
biological sciences with orientation toward careers in environmental
health activities greatly exceeds the supply. This situation will con-
tinue to exist and to become more acute unless new mechanisms are
instituted for increasing entrance of students into this field.
At the present time toxicologists are trained within the facilities
and by the staff of other disciplines, usually in departments of pharma-
cology. However, a sizable number of departments of pharma-
cology in medical and veterinary schools have no graduate training
programs of any type. In those departments which do have graduate
programs the training and interests of the staff members are diversi-
fied and are often centered on activities quite far removed from en-
vironmental health research. As a result, relatively little space of
effort is devoted to toxicology in the majority of the departments of
pharmacology.
The output of trained toxicologists by other disciplines is sporadic
and small in comparison with the needs. New mechanisms for the
training of toxicologists are, therefore, urgently needed. Progress in
this connection could be achieved by encouraging schools of medicine,
public health, and veterinary medicine to recognize toxicology as an
independent scientific discipline and, with the aid of extramural
Public Health Service support, to provide facilities and staff for train-
ing and research programs in this field. Initially, the staffing of these
departments would necessitate drawing upon the resources of bio-
chemistry, physiology, and pharmacology until toxicology becomes
self-sustaining.
A second mechanism for increasing the supply of toxicologists and
personnel for the biochemical, physiological, and pharmacological
aspects of environmental health could be the establishment of environ-
mental health research and training programs or centers in univer-
sities. The centers should be organized in such a manner as to draw
upon specialists from the various disciplines who would direct their
efforts toward an integrated approach to environmental health re-
search programs. They would contribute not only to the solution of
important public health problems but also to the training of inves-
tigators for this field. They could readily be located in medical,
veterinary, and schools of public health with financial support being
provided by the Public Health Service to selected institutions.
Research Grants in Environmental Health
Continuous expansion of research grant programs in various aspects
of environmental health is necessary. The encouragement of individ-
uals in existing departments of pharmacology, biochemistry, phyBi-
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Toxicology and Related Sciences
57
ology, food technology, and entomology to undertake research in the
area of environmental health must be continued. The value of the
efforts of individual scientists in furthering knowledge of toxic sub-
stances, developing improved methods of experimentation, and in the
training of students in this field has been well established. Expansion
of these efforts should be encouraged particularly when research of
a basic nature is being conducted.
627408—62	5
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Report of the Subcommittee on
ANALYTICAL METHODS AND
INSTRUMENTATION
RECOMMENDATIONS
The subcommittee recommends:
1.	That the needs of the several categorical programs would best
be served by the provision of a center within which the common
analytical requirements could be housed and the associated operational
staffs maintained. Not only would the individual divisional efforts
be facilitated by assurance of maximal use-efficiency and maintenance
of highly qualified operating staff, but the wise management of such
a focal point would assure the interdivisional contact essential to
effective consideration of the integrated environment on human health
and welfare.
2.	That the center be staffed with scientists and engineers of the
best available competence to design analytical equipment and methods
to meet the research and operational needs of the program, and to
test, modify, and standardize the use of advanced instruments and
methods evolved by others. The magnitude of such activity should be
restricted, however, to that which is required to supplement and main-
tain close contact with, instrumentation development by industry, and
to plan and direct intelligently a strong extramural contract program.
To conduct the indicated operations well equipped instrument design
and model shops, and machine, electronic, glassworking, and other
fabrication facilities will be required. Such central capability would
supplement, and in no sense limit, the development of divisonal capa-
bilities for prosecuting assigned activities.
3.	That the Center facilities be so organized and managed as to
provide working tools for study of the integrated effects of simul-
taneous, or consecutive, multiple environmental impacts on health
and welfare.
4.	That the central environmental health facility be so designed as
to provide for prompt and economical adjustment of analytical rou-
tines to the fluctuating requirements of research and program opera-
tions.
5.	That field laboratories or operational centers be similarly de-
signed for ease of adaptation to changing analytical technology.
While the advantages of consolidation of instrumental and analytical
facilities for the several programs in field stations are the same as those
applicable to the national center, it seems likely that these advantages
69
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60 ENVIRONMENTAL HEALTH PROBLEMS
will have to be compromised because appropriate locales for one type
of activity will not always be appropriate to another; e.g., field opera-
tions in air pollution will not usually be geographically related to
those required by water pollution.
6.	That surveillance networks be developed to maintain knowledge
of quality levels for air, water, and radiation. The emphasis should
be on rugged, dependable automatic monitors reporting through nor-
mal communications circuits to field centers and to a national data
processing and analysis center.
7.	That a central training facility and appropriate regional centers
for training be equipped with basic analytical instruments and labora-
tories necessary to provide instruction in the changing procedures of
environmental health measurement and control operations.
8.	That provision be made for the development and maintenance
of a central bank of analytical reference standards pertinent to the
several categorical programs of the Public Health Service, and that
these standards be available to State and local agencies.
9.	That procedures are needed for recognizing early biological
damage resulting from single or multiple environmental exposure.
10.	That the instrumental aspects and analytical facilities of the
national center be developed progressively, first to strengthen and
make more effective the respective divisional programs and subse-
quently to emphasize the concern with simultaneous multiple environ-
mental impacts.
11.	That the analytical and instrumental capability of the Service
be strengthened by reliance on and close program coordination with
other Federal agencies engaged in method standardization and the
design and development of instrumentation, such as the National
Bureau of Standards, the Department of Agriculture, and the Atomic
Energy Commission.
INTRODUCTION
The effectiveness of research, surveillance, and preventive actions
in all parts of the Environmental Health Program will be related
to the adequacy, reliability, and speed of methods for measurement of
environmental variables and biological responses thereto, and on the
skill with which they are used. While such a conclusion is too obvious
to require defense, its implications with respect to an integrated ap-
proach to environmental health are worthy of careful consideration.
The analytical needs of the several divisional programs differ sub-
stantially, yet have common elements which suggest the economy and
efficiency of a unified, or closely coordinated, geographically central-
ized facility for methods development, evaluation, standardization,
and demonstration, and for joint utilization of certain costly research
implements. On the other hand, no consolidation of methods re-
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Analytical Methods and Instrumentation
61
search, and no transfer of responsibility for such work should be so
complete as to limit the fundamental responsibility of those concerned
with the environmental problem. Such actions should supplement
and facilitate the work of the problem oriented divisions; they should
be available on demand but have no overriding functions.
FACILITY REQUIREMENTS OF THE PROGRAMS
Water Resources
Within the scope of current legislative authorizations, the Water
Pollution and Water Supply Program of the Public Health Service
has several identifiable functions involving analytical and instru-
mental needs:
a.	Research and development.
b.	Surveillance (the gathering and processing of basic data on water
quality and water supply).
c.	Field demonstrations.
d.	Training.
This program involves emphasis on field facilities for decentralized
research on problems unique to specified geographical areas and for
regional surveillance, demonstration, and training activities. It also
includes research of general applicability, training functions best per-
formed at a central location, and technological support to headquar-
ters operations including enforcement. The need for continuous
surveillance of water qualities and quantities in relation to variable
waste discharge and other factors requires a monitoring system cap-
able of supplying measured values to a central data processing and
analytical center. Similar or additional data developed by local,
State, or other Federal agencies should also be transmitted to the
central facility to provide the basis for interpretation and preventive
action.
Air Pollution
In distinct contrast with the needs of the Water Supply and Pollu-
tion Control Program, the Air Pollution Program of the Public
Health Service can best be prosecuted from a strongly centralized re-
search, training, and technical support facility. Field functions will
probably be served largely by contract or grant to academic and other
non-Public Health Service agencies. Monitoring of air quality will
require operation of a network of sampling and analytical facilities;
some fraction of this should be the direct responsibility of the Public
Health Service and be national in scope, although it is expected that
detailed local reconnaissance will continue to be the responsibility of
State and local governments. The latter will rely on the Service for
guidance in choice of methods and instruments. Data from all sources
will need to be processed promptly and meaningfully by a centralized
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62 ENVIRONMENTAL HEALTH PROBLEMS
facility in the interest of effective control action by responsible
agencies.
Radiological, Health
The Radiological Health Program of the Public Health Service is
so intimately related to concurrent programs of the Atomic Energy
Commission and other Federal agencies that a research training and
program operating facility in close geographic and administrative
relationship to these activities is indicated. In addition to a strong
focal center, the program requires field facilities related to decen-
tralized operations of the related agencies. These will not, in most
cases, be located in proximity to field sites utilized by other divisions
of the Environmental Health Program. Certain monitoring require-
ments may be met by sampling and measurement in coordination with
similar air and water monitoring activities, but the program will have
additional and quite independent needs for surveillance. Analytical
and instrumental needs for radiological health training will differ
substantially from those required by most other categorical programs.
Even so, centralization with other elements of the Environmental
Health Program could result in economies of manpower and money
at least in the provision of basic maintenance and modification of
services. Surveillance data should be reported to some central facility
for interpretation and evaluation in terms of other environmental
parameters and effects.
Milk and Food
This program will require a complete facility for the evaluation of
the effects of technological processing on foodstuffs, from production
to consumption, and for the development of quality analyses, deter-
mination of the physiological impact of food variables, epidemiologi-
cal analyses, development and standardization of microbiological
procedures, and for both basic and applied research aimed toward
understanding and control of foodborne disease. The variety and
temporal variability of the problems requires a well-equipped and
flexible facility for attaching them as they occur, and provision for
fluidity in surveillance rather than fixed or "regional" locations. In
general, field laboratories should be of an ad hoc nature, e.g., for
local study of shellfish pollution, or evaluation of local agricultural
practices as related to foodborne toxic substances. Their best loca-
tion will usually not coincide with the field facilities required by other
Environmental Health Programs.
Occupational Health
This program differs in philosophical orientation from that of
other divisional interests, in that it is concerned primarily with the
health of workers and is therefore more dependent on facilities for
the prosecution of work in the medical sciences. Its relationship to
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Analytical Methods amd Instrumentation
63
environmental health is, nevertheless, natural since the working
environment is implicitly the etiological system with which the pro-
gram is concerned.
Requirements for analytical and instrumental facilities will be
closely parallel with those of other programs concerned with air,
food, radiation exposure, sanitation, and other aspects of the occupa-
tional milieu. Beyond this there is a need for facilities usually asso-
ciated with medical research, including provision for clinical studies.
The in-house functions of this program are well adapted to close
coordination with cognate portions of the Environmental Health
Program and would be benefited by close association in a National
Center. Field functions, on the other hand, must be related to the
existence of worker groups and epidemiological and clinical facilities,
and will not normally be well served by integration into regional
environmental health units.
Environmental Engineering
This program is responsible for several highly important areas of
environmental health not yet assigned to divisional programs. As
presently constituted, these activities will be served best by a cen-
tralized research, service, and training center providing close and
comprehensive coordination with the categorical activities. Field
operational bases may well be associated with field centers of other
environmental health programs.
TYPES OF ANALYTICAL METHODS AND INSTRUMENTATION
REQUIREMENTS
It is evident that each of the divisional programs has need for a
focal facility for its own use, whether directly associated with the
others or not. It is also apparent that the needs for analytical capa-
bility and instrumentation, while by no means identical, have large
elements in common:
1.	Organic and inorganic analysis, Including a capability for determination
of trace quantities, and for the analysis of large numbers of samples in a
short time.
2.	Radiation analysis, including a capability for low-level measurements and
for determination of specific radionuclides rapidly and in large numbers.
3.	Toxicologic and pharmacologic analyses; capability for tissue analyses,
physiological measurements, biochemical analyses, behavioral analysis, and
pathologic examinations including the structure analysis.
4.	Data reception, processing and analysis; each national program will depend
for its guidance on a capability for gathering, receiving, processing and analysis
of information as to changes occurring in the environment.
5.	Methods Development: each area requires a capability for development
and standardisation of analytical procedures to be used in its own program,
and In the programs of State and local agencies.
0. Instrument Development and Maintenance: each program will have increas-
ing need of a capability for in-bouse development, adaptation, and maintenance
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64 ENVIRONMENTAL HEALTH PROBLEMS
of analytical instrumentation, including both research and field monitoring
devices. Substantial competence and well-equipped shops will be required even
though primary reliance for instrument development should be delegated to the
scientific instrument industry. Effective coordination with the latter requires
adequate in-house capability.
7. Supporting shops, drafting, art, printing and reproduction, and other
technical services.
The many major areas of common need suggest immediately the
establishment of a center for joint use to avoid duplication and to
insure maximal efficiency in operation. Unquestionably such central-
ized supporting facility could yield substantial benefits in scope and
quality of service rendered. The success of the aggregate would,
however, depend more on the administrative skill with which it is
managed than on the assemblage itself. If handled judiciously it
could serve well the needs of the Nation; if permitted to function
as a "center" not strictly subservient to the categorical programs, it
could become just another ineffectual splinter related to the total
effort.
Apart from the analytical and instrumentation needs common, in
principle, to the divisions, there is an enormous diversity of require-
ment not directly relatable to the Center concept. Outstanding in
this category are the following:
1.	The research and development instrumentation required to prosecute indi-
vidual study projects within each of the divisional areas of responsibility.
These may be located within a Center, or at regional or field centers. fThey
will be of great variety and will become obsolete and replaceable as related
technology advances. Apart from the fact that their geographical juxtaposition
would facilitate informational transfer among their operators, the location of
the equipment would be of little consequence.
2.	Monitoring Instrumentation: At least three of the divisional programs
(water, air, radiological health) have a growing need for surveillance networks
based on automatic or semiautomatic sampling, analytical, and recording de-
vices. A reasonable expectation is that such monitors be telemetered to a
central data processing facility.
The instruments themselves will, for the most part, have to be developed
to a degree of dependability, service life, compactness, and low cost not now
available. Wherever possible the design should contemplate multiple function
units. Current technological trends suggest miniaturization, and the employ-
ment of solid state circuit components for prolonged reliability.
Radiation monitoring is a more advanced art than is the monitoring of
material pollutants; in consequence a proportionately greater developmental
capability will be required to place air pollution and water pollution monitors
into field operation. Until they are developed and tested, data on these pollut-
ants will have to be obtained less efficiently and at much greater cost by
manual sampling and analysis.
3.	Analytical Facilities and Instrumentation for Training: Instruction in
analytical techniques and Instrumentation, employed in environmental control
programs, will require separate and distinctly different equipment for each
categorical program whether the training is conducted centrally or at field sites.
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Report of the Subcommittee on
AIR POLLUTION
CONCLUSIONS AND RECOMMENDATIONS
Foreword
The need for a dynamic program in air pollution as a component
part of a National Environmental Health Center is evident from a
study of the magnitude and complexity of this problem. Develop-
ment of a strong centralized program is believed to be a necessary
prerequisite to the effective utilization of regional or local field stations
by the Federal Government.
Air pollution affects the health and well-being, the productive effort,
the convenience and happiness of millions of citizens in hundreds of
communities throughout the country. Air pollution is not confined
by political boundaries—and its chemical, medical, and physical com-
plexities are as yet poorly defined. It is a problem involving gaseous
emissions and mixtures of gases and particles of many kinds from
many sources. Enough is known concerning the nature and serious-
ness of the problem in some urban centers to cause concern that it
may be more important than is generally recognized and that it may
be expected to become more serious with urban growth and the de-
velopment of new technology. The urgency of this matter is further
highlighted by the fact that the air-pollution problems of the next
25 to 50 years are being created by present urban construction and
planning, by product development, and by present sociological trends.
A national network of observers and investigators, coordinated and
directed from a highly specialized air-pollution research and opera-
tions center, is needed to detect and develop methods of controlling
air pollution at its source, or, lacking preventive measures, to develop
protective devices and systems for the protection of exposed popula-
tions. Research, surveillance, and training programs of the highest
order and technical assistance to State and local governmental agen-
cies are needed. Also needed is the development of strong research
and training centers in universities.
The Subcommittee, in carrying out its responsibilities, discussed
fully its findings and recommendations with the National Advisory
Committee on Community Air Pollution. In addition, the Sub-
committee reviewed the policies and proposals made by several national
groups representing the public and governmental officials, including
the Council of State Governments, the U.S. Conference of Mayors,
65
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66 ENVIRONMENTAL HEALTH PROBLEMS
the American Municipal Association, and the National Association
of County Officials. These groups have formally proposed a centrally
integrated air-pollution program by the Federal Government capable
of exerting leadership and providing technical assistance and material
and financial support to local governments in the solution of their
air-pollution problems.
In the light of these considerations, and in order to meet the needs,
the recommendations of the Subcommittee contemplate a central,
integrated air-pollution program, equipped with adequate facilities
of its own and utilizing, as required, existing supplemental resources
throughout the country. This program should be capable of provid-
ing national leadership through the mechanism of research grants,
contracts, and direct Public Health Service operations. These
include:
a.	The use of existing and the development of new university-based research
and training resources assisted by research grants and contracts.
b.	The use of other qualified public and private organizations through the
same mechanism; and
c.	The use of existing or future Public Health Service field stations for specific
studies and operations where other solutions to the problems are not available.
The Subcommittee concludes that the Public Health Service, in
order to fulfill its obligation of providing national leadership in the
field of air pollution, requires a national air-pollution research, train-
ing, and operations center, located geographically close to the central
administrative offices of the Service. It further concludes, since there
are many elements scientifically and operationally common to the con-
trol of air pollution and other environmental health programs, that
a National Environmental Health Center in which the various pro-
grams are closely associated geographically, scientifically, and ad-
ministratively is an urgent necessity.
Specific Conclusions and Recommendations
1. The Subcommittee on Air Pollution takes cognizance of the re-
search recommendations contained in the 1960 report of the Surgeon
General's Task Group entitled "National Goals in Air Pollution Re-
search" and concludes that this provides the basic plan of needed
research and time phasing. The Subcommittee believes, however,
that the level of support recommended in each of the areas outlined
in that report is minimal, and concludes that among areas currently
needing particular emphasis by the Public Health Service are the
following:
~.	Intensified studies of time and Bpace variability of urban pollution levels
under various source, topographic, and meteorologic conditions.
~.	The specific Interrelationships of air pollution and the social and economic
development of communities in urban areas.
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Air Pollution
67
o. Increased emphasis on development of adequnte automatic instrumentation
and procedures for identification and measurement of air pollutants by the
Public Health Service.
d.	Extension and intensification of the studies of interreactions of pollutants
in the atmosphere.
e.	Increased studies on synergistic effects of pollutants on physical and biologi-
cal systems.
2.	The Subcommittee has inquired'into the current facilities avail-
able to the Public Health Service for the conduct of its intramural
research program in air pollution as outlined in "National Goals in
Air Pollution Research" and supplemented above, and concludes that
these are grossly inadequate to carry out the research program rec-
ommended. It further concludes that the present geographic separa-
tion of the central core research program from the operations and
administrative elements is a handicap to the fulfillment of the mis-
sion of the Service in air-pollution control.
3.	The Subcommittee concludes that there is a lack of sufficient
numbers of trained personnel to carry on adequate air-pollution pro-
grams nationally and recommends that the Public Health Service
devote increased attention to the training of research, technical, and
administrative personnel. It is recommended that such training as-
sistance continue to be both intramural and through training grants
to universities and other qualified institutions. The Committee con-
cludes that the existing intramural training program also suffers
from inadequate facilities and from geographical separation from the
administrative and operations parts of the program. It further con-
cludes that the program could be made more effective by fuller asso-
ciation with the intramural training programs in other fields of
environmental health. .This association could be best achieved in the
recommended National Environmental Health Center.
4.	The Subcommittee has examined, in addition to the research
and training functions, the present operational functions, including
technical assistance, of the Public Health Service air-pollution pro-
gram, and concludes that it is soundly conceived and, within the re-
sources available, effectively executed. It concludes, however, that
the program is handicapped by the lack of adequate physical facili-
ties in which to operate and by the separation of the administrative
and intramural research parts of the program.
5.	The Subcommittee concludes that the attainment of the objec-
tive would be better assured by centralized interdisciplinary technical
efforts as recommended for the National Environmental Health Cen-
ter. The Subcommittee further concludes that greater emphasis
should be placed on the application of existing knowledge in thd
control of air pollution and recommends that for this purpose the
Public Health Service provide increased stimulation and assistance
to State and local governments.
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68 ENVIRONMENTAL HEALTH PROBLEMS
Among the areas in which the Public Health Service must provide
leadership and technical and financial assistance are:
~.	Appraisal of present and potential air-pollution levels in specific localities
and their probable effects.
~.	Stimulation of local participation in air-pollution abatement from the
administrative, legal, and sociological points of view.
c.	Provision of improved methods and instruments for recording emissions,
atmospheric levels of pollutants, and effects of pollution.
d.	Administrative procedures useful in combating interjurisdictional problems
due to large-scale dispersion of pollutants.
e.	Analysis of meteorological conditions in specific areas and relationships to
border regions.
One of the means for the attainment of these objectives is grants
for specific projects to stimulate the development, improvement, and
extension of local air-pollution-control programs by State and com-
munity agencies.
6.	The Subcommittee recommends that the Public Health Service
assume the responsibility for the development of recommended air
quality standards based on scientific information, to guide communi-
ties in the establishment and conduct of control programs.
7.	The Subcommittee recommends that the Public Health Service
assume the leadership in the development of standardized methods
for sampling, analysis, and recording of air pollutants.
8.	The Subcommittee concludes that the funds available to the
Public Health Service in the past have been distributed so as to obtain
a reasonable balance among research, training, and operations activi-
ties in the air-pollution program. In the Subcommittee's considered
judgment, the further needed development of the air-pollution pro-
gram will require the progressive increases in research, training, and
operations, including technical assistance, as heretofore outlined and
as tabulated below:
Million) of Dollan
Year
1966
1660
1962
19631
1966)
1970>
Research..	
1.62
4.66
7.82
12.0
16.0
16.0
Training'	
.04
.26
.37
1.5
5.0
5.0
Operations	
.17
.39
.61
•4.0
•12.0
•16,0
Total	
1.73
6.20
8.80
17.5
33.0
86.0
1 Levela of expenditure recommended by the Subcommittee, with appropriate recognition of the recommendation* of
the Burgeon General's Committee on National Go all In Air Pollution Reiieareh."
> Eetimatee of expenditures for training in 1963 and thereafter include opat* for apeolaliaed training of research worker*
and teacher!, for graduate training of pereon* in epeclflo diaoiplinea in control operation*, and ahort-term training of Add
and teohnioal personnel. The Subcommittee ennaidera It Important that the lohedullng of the varlou* type* of training
be coordinated with eonaideratlon of needa for various oategorle*. las time for ourriculura development, and other faetora.
I The inoreaee* refleot additional fundi for grants-in-aid for the purpose of providing aaalatanee in development, im-
provement, and extension of local air-pollution program*.
The Subcommittee feels strongly that there has been a marked im-
balance in regard to facilities for this rapidly expanding program
which has been faced with so many demands. No funds have been
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Air Pollution
69
appropriated to the Service for air-pollution facilities, and such ex-
pansion as has been accomplished, through rental of quarters and
temporary construction, has of necessity been at the expense of pro-
gram operations and research activities. The advantages of such a
facility are covered in greater detail hereafter.
9.	The Subcommittee has examined the research, training, and op-
erations programs of the Division of Air Pollution in relation to other
environmental health programs of the Public Health Service and
concludes that the coordination and integration of these various
programs will:
a.	Effect savings, promote the prevention of undesirable duplication, facilitate
the sharing of knowledge and the exchange of ideas, and achieve a broader
coverage of studies;
b.	Make for a more productive research program and provide a more stimu-
lating and effective training program; and
o. Provide for more efficient operations, all of which are designed to reduce
the effect on humans and on the community of a wide variety of environmental
pollutants in air, water, and food. The Committee concludes that among the
additional beneflts to the air-pollution program of such an association are the
following:
(1)	Increase la the likelihood of attracting and retaining personnel of outstanding
ability who would be capable of evaluating all available Information on air pollution and
of acting as a focal point for the total national effort.
(2)	Among the facets of environmental health related to air pollution now relatively
underdeveloped that would be attacked more effectively by close association of the various
programs are blocllmatology. meteorological factors in relation to air pollution, relationship
of indoor to outdoor atroospheretc environment, and the role of natural resource use such as
agriculture and forestry In relation to air pollution.
(3)	Provision of centralized services and resources that would be beyond the reach of
any single Division, such as centralized instrumentation and analysis functions, computer
operations and data processing, public Information services, graphic arts services, experi-
mental animal supplies, and central administrative services.
The contemplated Center should be funded and staffed to permit the
maximum stimulation and utilization of the total national resources
for research, training, and operations in the solution of environmental
health problems. The Center should be staffed with a core group of
topflight personnel in the various disciplines, which would be engaged
in activities of planning, stimulation, coordination, evaluation, pro-
vision of scientific leadership, and conduct of research, training, and
operations programs of national relevance. The Subcommittee, at
the same time, is cognizant that certain highly specialized functions
and services would of necessity have to continue to be specific-
program-oriented and directly associated with such programs.
10.	The Subcommittee recommends that, in order to meet the grow-
ing need for Federal action to achieve the above objectives in the field
of air-pollution control, there be established at the earliest possible
time an air-pollution facility for research, training, and operations.
Ideally, this facility would be part of a National Environmental
Health Center provided this does not result in undue delay.
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70 ENVIRONMENTAL HEALTH PROBLEMS
INTRODUCTION
Authority for Program
As an entity, the air-pollution program of the Public Health Service
dates only from 1955. In that year, Public Law 159 was enacted by
the 84th Congress. It directs the Public Health Service to engage in
a program of research, technical assistance, and training in relation to
air pollution. The Act authorizes direct activities by the Service and
their support through grants and contracts; it directs the Service to
cooperate with and assist public and private organizations and to col-
lect and disseminate information relating to air pollution and its
control.
A second Act passed by the Congress in 1960, Public Law 86-493,
directs the Public Health Service to conduct a thorough study to de-
termine the amounts and kinds of substances which, from the stand-
point of human health, it is safe for motor vehicles to discharge to the
atmosphere and to report thereon to the Congress not later than
June 1962.
In addition to these two specific laws, there is authority for the con-
duct of air-pollution-program activity in the basic Public Health Serv-
ice Act, particularly Section 301, which authorizes the conduct and
support of research concerned with the diseases and impairments of
man.
For reasons which will appear later, the Subcommittee believes that
present authority is inadequate.
Scope, Philosophy, and Objectives or the Program
The Public Health Service air-pollution program to date has been
based on the philosophy that the basic responsibility for the regula-
tory control of air pollution rests with the States and local govern-
ments, and that the Federal role should be a supporting one of research
technical assistance to public and private organizations, and training
of technical personnel.
The basic objectives of the program are threefold: (1) to improve
the status of knowledge about the causes and effects of air pollution and
about the means of controlling it within acceptable limits; (2) to apply
our present and future knowledge to the actual control of air pol-
lutants through technical assistance to States, communities, and in-
dustry; and (3) to stimulate all levels of government, industry, and
the general public to devote increased attention and greater resources
to the prevention and control of air pollution.
If present needs to cope with this problem are to be met, a signifi-
cant expansion in the scope of the air-pollution program is urgently
required.
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Air Pollution
11
NATURE AND EXTENT OF THE AIR POLLUTION PROBLEM
Air as a Natubal Resource
The pollution of one of our most important natural resources—the
air we breathe—has become a matter of national concern. Except
for natural causes, polluted air is a product of industrialization, ur-
banization, and human mobility, all of which will continue to increase
rapidly in the years ahead. The concern with air pollution in urban
areas relates to the emission of a variety of gases and particles, often
followed by secondary reactions in the air. The pollutants come from
the fuels we burn in home and factory and in transporting ourselves
and our goods, from the production and processing of materials in
mine and factory, from our consumption of products, and from our
disposal of unwanted waste materials.
The concentration of pollutants in the air at any time depends upon
the interplay of many factors, such as the quantity being emitted, the
vertical and horizontal dispersion of the pollutants from the sources,
and the chemical and physical reactions that pollutants undergo be-
fore and after dispersion. Recent evidence has made clear that all
metropolitan areas have limited air resources. Even in areas where
the meteorological conditions are favorable, air resources are being
heavily utilized, and in many cases acceptable concentration limits
have been exceeded. The only recourse is source control. A combi-
nation of atmospheric capacity and the economic feasibility of control
therefore will limit the air utilization and even the maximum size of
a community.
In any specific area, the atmosphere has only limited capacity to
dilute and disperse contaminants discharged to it before they can cause
undesirable effects. Thus, the air must be regarded as an important
and limited natural resource, whose quality must be conserved in the
common interest.
Air Pollution and Health
That air pollutants can affect health has been demonstrated dramat-
ically in several disasters in which many people were made ill and
human deaths occurred. A growing body of circumstantial evidence
testifies that long-term, low-level air pollution can contribute to and
aggravate certain chronic diseases. Any evidence which points to
differences in morbidity or mortality due to air pollution must be
followed up in order, if possible, to relate specific health effects to
specific pollutants or classes of pollutants.
The long-term effects of air pollution on man and other biologic
systems must be quantitated accurately in order to establish the neces-
sity, feasibility, and economic practicability of control measures de-
signed to abate these effects. Research is still sorely handicapped by
the lack of technics sensitive enough to detect minimal changes. To
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n ENVIRONMENTAL HEALTH PROBLEMS
determine the levels of air pollutants above which, biologic effects can
be expected, extensive toxicologic, pharmacologic, and physiologic in-
vestigations will be needed.
Since the respiratory tract is the portal of entry for inhaled sub-
stances, an intense effort has been directed toward pulmonary function
testing as an indicator of the physiologic status of exposed subjects.
However, until pulmonary function testing is standardized, epidemio-
logic studies which rely on such measurements as an index of physio-
logic changes have little comparability.
The industrial threshold limits which have been set up for many of
the individual compounds present in the outside air are probably in
most cases too high for community residents, who include the most
sensitive persons and who endure more or less constant exposure over
a lifetime. Information is required about the toxicity, either acute or
chronic, and the synergistic effects of pollutants in the various combi-
nations in which they may occur in community air.
We know the acute lethal dose of ozone and the morbid pathology of
chronic inhalation in various laboratory animals. But no one has
studied human populations long exposed to small amounts of ozone.
In most cases earlier studies on air pollutants have been carried out
on realistically high concentrations and have been concerned chiefly
with lethal effects or extremely crude measurements on physiologic
or psychologic consequences. This approach is of relatively little
value and it is most urgent to extend laboratory studies of air pollu-
tion to meaningful levels using much more systematic and informative
techniques for the evaluation of their effects. In many cases these
diagnostic techniques themselves will need development.
Many air pollutants require such study in respect to the nitrogen
oxides, for example. Little if anything has been ascertained about
time-dose relationships or about the systemic changes from long ex-
posures to low concentrations of nitrogen oxides, even in laboratory
animals. Nitrogen oxide is said to have an affinity 300,000 times
greater than oxygen and 1,000 times greater than carbon monoxide for
hemoglobin; the significance of this for actual exposure needs study.
Decreased production of specific antibodies and decreased resistance
to infectious disease were described many years ago in animals ex-
posed to nitrogen oxides for prolonged periods, but such experiments
need to be repeated with lower doses over longer periods, with an eye
not to such gross changes as survival time and mortality rate, but to
more elusive immunologic phenomena. Additive and even synergistic
effects between nitrogen dioxide and carbon monoxide were shown
more than a quarter of a century ago.
A well-established biologic effect of smog is eye irritation. We
know that human panels exposed to irradiated mixtures of individual
hydrocarbons and nitrogen dioxide experience eye irritation. Appar-
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Air Pollution
73
ently a number of factors in the original mixture determine the
occurrence and the degree of eye irritation, and the reaction products
considered to be mainly responsible are formaldehyde, acrolein, and
peroxyacyl nitrate.
Because a number of statistical studies have indicated a higher inci-
dence of lung cancer in urban than in rural areas and because such well
known experimental carcinogens as benzpyrene have been found in
community air, the finger of suspicion has been pointing for some time
to atmospheric benzpyrene and related aromatic polycyclic hydro-
carbons as at least contributory etiologic agents in lung cancer. Cer-
tainly, it does not seem possible to attribute the alarming increase in
its incidence to smoking alone. Besides the controversial statistical
association, a growing body of experimental evidence incriminates
atmospheric hydrocarbons. Benzpyrene, detected in significant quan-
tities in the air of U.S. cities, is sufficiently stable in air to permit its
being inhaled by community residents. In animals exposed to smog
and then to soot, particles are precipitated and retained on the injured
bronchial epithelium, allowing a high local concentration of hydro-
carbons carried on soot. Although carcinogens are biologically in-
effective while absorbed on soot, oxidants and human plasma are
capable of eluting them from soot-laden lungs. All organic fractions
of airborne particulate matter from U.S. cities are capable of pro-
ducing local skin tumors after subcutaneous injection in mice, and
chronic low-level exposures seems to be more injurious than brief
lieayy exposure. Animals exposed to both the virus of influenza and
inhalation of ozonized gasoline develop true epidermoid cancers in
the lung.
A causal relationship has also been suggested between air pollution
and the group of chronic obstructive ventilatory diseases which appear
to be increasing in incidence in this country as industrialization in-
creases. Isolated research findings—that asthmatic attacks occur
more frequently on days with smog damage to plants; that emphysema
patients improve on breathing filtered air after severals days' exposure
to smog; and that the daily course of patients with chronic obstructive
respiratory disease fluctuates with certain pollutant levels—strengthen
the conviction held by many experts in the field that these indicated
relationships may be important, leads to definitive knowledge, leads
that should be vigorously pursued.
Current Status of
Air Pollution Control
Our present knowledge about the health effects of air pollution and
some of the steps needed to expand that knowledge were reviewed in
the preceding section. In addition, air pollution's economic effects—
damage to crops, animals, and structures—are manifest and we need
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74- ENVIRONMENTAL HEALTH PROBLEMS
to learn much more about these and to measure them much more ac-
curately than we have so far attempted to do.
We can also greatly expand our knowledge of effective control
methods. Nevertheless, the national application of what we now
know about controlling air pollutants is unsatisfactory. Engineering
procedures are known that can be used to control or prevent the emis-
sion of most pollutants, with some notable and important exceptions.
The application of these procedures has been primarily pragmatic—
based on judgments of what is technically and economically feasible.
National expenditures for such controls, including of oration and
maintenance, are estimated to total $300-$400 million annually—a
figure to be compared with the estimated annual economic damage of
$7.5 billion, plus the unknown costs of effects upon health. Our sur-
veys indicate that local government or regional regulatory control
programs provide service to approximately 45 percent of the popula-
tion resident in urban areas which have air-pollution problems. In
many of these, however, the program is minimal. The average annual
expenditure for these official programs amounts to about 10 cents per
capita as compared to perhaps 40 cents for a reasonably comprehensive
program.
Areas Needing Further Research
Identification and measurement of pollutants: Although some prog-
ress has been made in identifying and measuring general classes of
pollutants, there is real need for intensive research into methods for
identifying and measuring general classes of pollutants; there is real
need for intensive research into methods for identifying and meas-
uring the individual substances that make up these classes. Simpler
and less expensive procedures are needed for this purpose.
Our knowledge is far from complete regarding air pollutants: their
identity and quantity; the specific sources from which they derive;
factors governing their dispersion and chemical and physical changes
in the atmosphere; their effects, singly and in combination. Methods
of measuring the physical state as well as the chemical composition
of pollutants are needed.
Continuing source appraisals: TVe are concerned with pollution
arising from domestic, municipal, and industrial sources. These pol-
lutants in general are the end products of combustion, the products
of incomplete combustion, and the emissions from various types of
process industries. Technological development continually alters the
types of emissions from chemical processing and from manufacturing
and other industrial sources. The precise direction in which these
changes will occur cannot be predicted, but the fact that they will
occur is certain, emphasizing the need for continuing source appraisals.
The role of motor vehicles: One ubiquitous source of air pollution
is the motor vehicle. In all urban areas, motor-vehicle emissions are
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Air Pollution
75
in varying degrees already a significant source of pollution. Current
trends in their use suggest that motor vehicles may become an even
more significant source of pollution. The interrelationship between
hydrocarbons and oxides of nitrogen when photochemical air pollution
(smog) is produced in the presence of sunlight needs further elucida-
tion. The role of particulates in the formation of smog and the
mechanism by which smog irritates the eyes and causes damage to
vegetation will require further research.
Photochemical smog: The formation of ozone and other oxidants
characteristic of photochemical smog is known to result from reactions
among gases at concentrations of a very low order, at which they are
relatively innocuous. Control of such secondary reactions requires
identification of the participating primary pollutants and determi-
nation of the relative importance of each in the photochemical proc-
esses. Changing technology necessitates fundamental studies in photo-
chemistry. The identification of primary reactants associated with
secondary toxicants will facilitate the development of more effective
and less costly controls. Adequate knowledge of the intermediate
and secondary products must be acquired before their biologic effects
can be determined.
Meteorology: A fundamental scientific problem is that of establish-
ing suitable relationships between meteorological parameters and dis-
persive capacities. These relationships are necessary to predict the
three-dimensional distribution of airborne material, under a wide
variety of weather conditions, emitted from sources of known charac-
teristics. Objective determination of reasonable emission rates and
the degree of control required for single sources in a given community
are dependent to a considerable extent on this research.
Economic losses: Estimates of losses due to air pollution to date have
been largely guesses, and studies are required that will provide a sound
basis for future estimates of national losses from (1) damage to crops
and livestock, horticultural products, and other types of vegetation;
(2) corrosion of materials and soiling of surfaces; and (3) interference
with ground and air transportation. Economic losses due to the
expenses of illness and diminished productivity resulting from air
pollution are completely unknown, as are the effects of pollution upon
the general well-being of healthy individuals.
Studies are also required to identify specific causative agents of
economic damage, their mechanisms and rates of action, their effective
concentrations, and the costs of control, as a further basis for the
development of adequate control measures and acceptable levels of
pollutants in community air.
Control 'procedures: There are control methods available today for
many of the known sources of pollution. In many cases, however,
effective control methods are not yet economically feasible, either by
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76 ENVIRONMENTAL HEALTH PROBLEMS
process design and modification or through the installation of specific
equipment. Considerable expansion of research on the fundamental
aspects of control is needed, as well as on the development of appli-
cable devices, so that the use of control methods will be more wide-
spread and acceptable from an economic viewpoint.
Application op Existing Knowledge
Greater emphasis must be placed on the application of existing
knowledge—and of new knowledge as it is developed—if research is
to bear fruit in the form of control or abatement of air pollution.
Toward this end, it has now become quite clear that the Federal pro-
gram should provide greater stimulation and assistance to States and
local governments in (1) appraising their air-pollution problem;
(2) initiating or further developing their legislative authority; (3)
organizing effective air-pollution-control agencies; and (4) develop-
ing "tailored" control programs to meet special needs. Plans have
been developed for possible future Federal financial assistance to States
and communities through a program of matching grants and ex-
panded technical assistance activities to stimulate increased applica-
tion of knowledge at the State and local levels.
If Federal stimulation of States and communities to control air
pollution through regulation at the local level should fail to achieve
the desired results, it may become necessary at a future date to seek
some measure of direct Federal regulation.
Lastly, an expanded national research and application program
will depend upon the availability of trained personnel to staff it. The
numbers of such personnel are now woefully inadequate, and this
lack will be accentuated as expansion occurs.
Technical Assistance Role or the Public Health Service
In a large majority of the jurisdictions which need control activity,
State and local programs are nonexistent at present, or are grossly
inadequate. Technical work in the field directed toward appraisal
of problems and development of solutions is at a level far below that
required for maintenance of an acceptable level of air quality. Over
the next few years, the broad objectives of the technical assistance
activity will be to assist States and communities in appraising overall
problems and in developing "tailored" control programs, and to pro-
vide technical consultation on specialized problems. Cooperative
Federal-State-local demonstration projects will be used to foster and
facilitate program development and to provide some of the informa-
tion upon which to base program design. In general, the Public
Health Service activity will be directed toward helping initiate pro-
grams and toward providing tools and techniques in a form useful in
attaining this end. Also, in order to provide a stimulus for this
needed State and local control activity and render initial support in
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77
surveying problems arid in operating control programs, provision
would be made for Federal grants to State and local agencies for these
purposes.
In the more distant future, as Statp and local programs develop,
greater emphasis can be given to assistance in the more technical
aspects of air pollution control.
Social Aspects
Among the areas which currently need special emphasis by the
Public Health Service are the specific interrelationships of air pollu-
tion and the social and economic development of communities in urban
areas.
In the structure of the American federal system of government,
problems of intergovernmental relations are most marked, varied, and
difficult in the large metropolitan areas, where the activities of all
levels of government function in close proximity. Within such areas,
Federal, State, county and municipal agencies, often supplemented by
a host of special-purpose units of local government, must carry on
their functions in close juxtaposition, subject to an extremely com-
plicated framework of Federal, State, and local laws and administra-
tive regulations. Obviously, it is the responsibility of government at
all levels collectively to deal effectively with the problem of air pol-
lution, which, unfortunately, does not respect lines of political
jurisdiction.
We have a continuing concentration of population and economic
activity in the metropolitan areas. As an example, it should be noted
that the 1960 Census of Population found nearly two-thirds of the
entire population of the United States residing within metropolitan
areas—112.9 million persons of the nationwide total of 179.5 million.
The 212 areas recognized as "metropolitan" in 1960 accounted for 84
percent of all the increase in the Nation's population during the 1950-
60 decade. For these areas, the growth was 23.6 million persons, or
26 percent, while the population of the remainder of the country
changed only from 62 to 66.4 million, an increase of 7 percent.
It is also in these growing metropolitan areas, of course, that most
of the more serious air pollution problems arise. A question of some
sociological importance is why many of these areas fail to provide
adequate funds for the control of air pollution. It is doubtful that
the citizens of our metropolitan areas have accepted air pollution as a
desirable attribute of a high-density society. The desire for "clean
air" is universal,, but it is necessary to provide a focus for action to
meet the problem. In this connection, the Division of Air Pollution
now has on its staff a sociologist who, among other things, will attempt
to determine the views of the citizens of various communities and the
best mechanism to translate the individual latent wishes into desirable
action for the general welfare.
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78 ENVIRONMENTAL HEALTH PROBLEMS
Economic Aspects
The metropolitan areas of the United States account for the major
portion of the country's economic activity. As of June 1960, metro-
politan areas accounted for 78.6 percent of all bank deposits in the
United States. In 1958, metropolitan areas accounted for more than
three-fourths (76.8 percent) of the value added by manufacture, con-
tained 67.2 percent of the country's manufacturing establishments, and
accounted for 73.8 percent of the total number of industrial employees
and 78.5 percent of all manufacturing payrolls. Of the total amount
of value added by manufacture in that year, 55.2 percent was attribut-
able to 40 major metropolitan areas, in which 52 percent of all indus-
trial establishments were located, with 62.8 percent of industrial em-
ployees and 57.1 percent of the payrolls. Furthermore, a major portion
of building activity in the Nation takes place in metropolitan areas.
In 1959 and again in 1960, 69 percent of all "housing starts" occurred
in these areas.
The Division of Air Pollution, recognizing the economic damage,
estimated in excess of $7.5 billion annually, is interested in the devel-
opment of technics and methodology to more accurately assess such
costs. To meet this need, interest has been engendered in some
academic institutions to undertake such investigations by applying
for a research grant. Studies of the problem on a short-term basis
to evaluate the nature and scope of the economic aspects of air pollu-
tion have been completed. There remains the need for further inves-
tigation of this aspect by employing the services of a full-time
economist.
Legislative Aspects
For a variety of reasons, the Division of Air Pollution must devote
considerable attention to the consideration of the legal basis for local
control problems. In many cases the existing legislation is antiquated
and fails to provide for sound administration. Compounding this
problem, many metropolitan territories are not within the limits of
any one political unit of government. Many cross State boundary
lines—and their polluted air, of course, crosses even more freely—so
that adequate control requires interstate action.
Moreover, the problem may be simply too large for individual com-
munities. Photochemical smog, for example, which results largely
from motor vehicle emissions, is obviously a problem of nationwide
importance. It is a present Federal responsibility to provide informa-
tion which will enable communities to deal with this and other sources
of pollutants, but this one cannot be dealt with in any one community.
Ultimately, this is a problem of control and at present no Federal
authority exists to take care of it.
The Division of Air Pollution has prepared and distributed digests
of State laws and guiding principles for new legislation. There are
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Air Pollution
79
many legislative needs to be met. Effective local action requires that
the State governments permit greater flexibility and freedom of action
for local units of government and provide for modification of re-
sponsibilities among such units in the best interests of the area as a
whole. Most significant action by States would be legislation which
provided, at least within the confines of metropolitan areas, for the
joint exercise of common powers or for entering into contractual
arrangements. In some cases the creation of functional authorities
would be desirable.
Of considerable significance are the problems of financing and staff-
ing local control agencies. Although about one-half of the core cities
of metropolitan areas have specific air pollution legislation, repeated
surveys have demonstrated that more than half of all funds now being
expended by local governments on this account are within the single
State of California.
On the national level, it appears essential that the State and local
agencies of government receive financial as well as technical assist-
ance to initiate or strengthen existing air pollution control programs.
This would furnish an opportunity to provide Federal leadership
at all levels of government. Legislation of this type has been under
consideration and is now awaiting introductory and legislative actions.
The effective exercise of the various activities indicated here should
be performed by the Division of Air Pollution. However, there are
circumstances, particularly in relationships with outside organiza-
tions, where a coordinated approach would be desirable.
ROLES OF PUBLIC AGENCIES AND PRIVATE INSTITUTIONS AND
ORGANIZATIONS
The respective roles of the Federal Government, the States and
communities, and industry were clearly set forth by the Surgeon
General's Ad Hoc Task Group on Air Pollution Research Goals as
follows:
As to the nature and extent of the research to be funded, the Federal Govern*
ment should be largely responsible for research of a broad nature and of general
applicability throughout the country. and for the training of specialized personnel.
In addition, the Federal Government should have primary responsibility for
development of information required to establish air quality standards, and for
the collection and distribution of information.
The States and communities have a responsibility to support research on prob-
lems of primary interest to them, and to survey and evaluate continuously or
Intermittently the air pollution problems within their respective jurisdictions.
Although industry's responsibility for research in air pollution extends In
varying degree to all the goals, the major contribution to be expected of industry
relates primarily to the development of adequate and economical control equip-
ment and procedures. As used in this Report, industry is intended to Include
business, commercial, manufacturing, and other activities involved in the produc-
tion and the exchange of goods. This definition would include agricultural, real
estate (e.g., apartment houses), and Government agencies when these are sources
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80 ENVIRONMENTAL HEALTH PROBLEMS
of air pollution. The control of contaminants at industrial sources is solely
the responsibility of the Industry concerned. It is reasonable to assume, there-
fore, that the cost of research involved in the development of control processes
and equipment is largely the responsibility of industry. To realize the maximum
return on industry's investment in air pollution research, perhaps even to qualify
it as a contribution to the national effort, requires that the information obtained
by industry be available for integration with the general fund of knowledge.
Funds from private sources such as research foundations and philanthropic
organizations may also be available. A number of voluntary organizations,
particularly those concerned with health research, have a real stake in this
matter and should be encouraged to participate fully. The role of the universi-
ties and nonprofit research institutes will largely be confined to the conduct of
research, the education and training of personnel, and the provision of con-
sulting services. With the exception of some State-supported universities, these
organizations cannot be expected to provide significant support for research on
air pollution problems with their own funds.
Although this Report is concerned only with responsibilities for research, the
committee is not unmindful that the full costs of enforcement will fall on the
States and communities and that the entire cost of control of industrial sources
must be borne by industry. On the other hand it must be realized that all such
costs are ultimately borne by the public, so that in the final analysis it becomes
a matter of how much society is willing to pay for research, control, and en-
forcement to maintain a clean and healthful environment.
PHS Research
As a result of increasing concern over air pollution and its effects on
health, the Public Health Service recently conferred added strength
and recognition upon its two existing Air Pollution Programs by
combining them into a single unit with Division status. On Septem-
ber 1,1960, the Air Pollution Medical Program and the Air Pollution
Engineering Program were consolidated in a new Division of Air
Pollution, consisting of five Branches: (1) Laboratory of Engineer-
ing and Physical Sciences, (2) Laboratory of Medical and Biological
Sciences, (3) Field Studies Branch, (4) Technical Assistance Branch,
and (5) Research and Training Grants Branch. Creation of this
Division provides a sharp focus for activities both within and outside
the Public Health Service and a more comprehensive, interdisciplinary
approach in research, technical assistance, and training.
The nature and range of research projects conducted or sponsored
by the Public Health Service can best be indicated by a brief review
of some typical studies which were actually underway during fiscal
year 1961,
Motor vehicle emissions: Following the approval, late in fiscal year
1960, of Public Law 86-493—which directs the Public Health Service
to make a thorough study and report to Congress by June 1962 on
the health effects of motor vehicle emissions—the Division of Air Pol-
lution has sharply accelerated its research in this area.
In one group of studies, colonies of experimental animals are being
exposed in the laboratory to irradiated and nonirradiated motor ve-
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Air Pollution
81
hicle exhaust and to concentrations of auto exhaust pollutants as they
occur in the ambient air on city streets.
In large cities, arrangements were completed for continuous meas-
urement of exhaust-related gaseous pollutants to determine their
ranges of concentration. In three cities, lead in the ambient air, and
blood and urine levels of selected population groups, are being meas-
ured for correlation with traffic density and other parameters.
To help determine the pollutant contributions of gasoline- and
diesel-powered trucks and buses, their operating modes are being sur-
veyed in several cities. The particulate fraction of gasoline and diesel
engine exhaust is also being analyzed for a variety of polynuclear
hydrocarbons and oxygenates for correlation with analyses of potential
carcinogens in emissions from other combustion sources. A coopera-
tive survey is under way in Los Angeles to determine exhaust con-
centrations of hydrocarbons, carbon monoxides, carbon dioxide, and
nitrogen oxides in a representative sample of registered motor vehicles
under prescribed operating conditions.
Other research activities: In 50 stations of the National Air Sam-
pling Network, gaseous pollutants such as sulfur dioxide and oxides of
nitrogen are now being sampled. Formerly, only particulates were
sampled.
Further advances were made in designing and improving instru-
ments for sampling pollutants or assessing their effects; for example,
a portable transistorized particle counter and size analyzer. For
industrial-type installations, improved filter devices were developed.
Chemical research was oriented toward analytic methods for aromatic
and aliphatic hydrocarbons and inorganic gases.
A forecasting network throughout 36 States east of the Rockies was
developed and research is in progress to provide a basis for extending
the service to the Western States. A nationwide network has been
set up to determine atmospheric turbidity. A program has been
initiated whereby tetroons can be tracked by radar to indicate the
trajectory of pollutant material. Further work was done on the
chemical analysis of precipitation and on pollen sampling.
Special sampling for assay of potential cancer agents was conducted
in six cities. The previously developed analytic technic for measur-
ing certain potential carcinogens, particularly 3,4-benzpyrene, was
applied to air samples of 103 cities and 28 nonurban sites; city levels
averaged 16 times those found in nonurban areas. To further gage
the potential carcinogenicity of polluted atmosphere, the geographic
distribution of lung cancer according to the histological type of tumor
is being studied to test the theory that the different cell types may
result from different causative agents.
The following are typical of many field studies of air pollution's
health effects. Tests in a large industrial firm indicated a relation-
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82 ENVIRONMENTAL HEALTH PROBLEMS
ship between absenteeism due to certain respiratory diseases and total
sulfate pollution in the air. Further study of Nashville survey results
disclosed a similar association between asthmatic attacks and air-
borne sulfates. In studies of two small towns, which differed only
in the degree of air pollution prevalent, preliminary analysis of data
suggests corresponding differences in the residents' lung function and
breathing capacity.
Laboratory studies on health effects were also expanded. In further
animal studies, conjugated nitroolefins were found to be potent irri-
tants, with not only eyes and respiratory tracts affected but also cir-
culatory and nervous systems. An especially significant study revealed
that the resistance of mice to respiratory infection was markedly
decreased after exposure to ozone, as demonstrated by increased mor-
tality rate and lowered survival time. Pulmonary function tests re-
vealed that human beings exposed under laboratory conditions to
certain inhaled substances experienced reactions similar to those de-
scribed in animals.
Research Grants
Nature and scope of current grants: Research grants which were
supported during fiscal year 1961 can be grouped as to subject matter
and cost, as follows:
Subject
Epidemiological and Other Studies Involving Human BelngB	
Studies Involving Laboratory Animals, Protozoa, and Tissue Cultures
Studies Involving Plants, Including Algae and Fungi	
Meteorology	
Basle and Applied Chemistry ol Air Pollution	-	
Analysis and Identification of Air Pollutants	
Control Devices	
Totals	
10
(405,169
13
241,904
8
288,107
4
64,839
18
426,640
IS
277,761
6
84,388
73
1,788,793
The present research grant program appears to be fairly well bal-
anced and broad enough in scope to support research in the biomedical
and physical sciences related to the physical environment. In the
above areas, a stepped-up effort is indicated.
Other areas of research requiring grant support: The total needs
of an adequate air pollution control program also include research
activities in the social sciences (economics, sociology, and community
planning) and the humanities (law). A general research grants pro-
gram in these areas should be initiated consistent with program needs.
There are in addition two general areas of need in the field of research
grants which are of primary importance. The first is for a substantial
increase and acceleration of program-oriented research, research di-
rected toward solving specific practical problems. The second is for
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83
more basic research in areas which may provide fundamental informa-
tion useful in the resolution of air pollution research problems.
The respective roles of the Bureau of Environmental Health and
the National Institutes of Health: As long as the Division of Research
Grants acts as the initial receipt and assignment office for Public
Health Service research grant proposals, there should be a minimal
overlap in the support of programs of the several Bureau of Environ-
mental Health divisions and the National Institutes of Health insti-
tutes and divisions. Criteria of referral for research grant applica-
tions have been developed to delineate the program interests of these
several organizations. Those related to environmental health are out-
lined in Public Health Service publication No. 870 entitled "Research
Grants in Environmental Health." In those cases where a given grant
may be supported by more than one program, it receives the ultimate
program assignment after negotiations between program representa-
tives concerned. This system should be continued as it appears to be
most successful. In the environmental health programs, there should
be constant communication between the Divisions and the Bureau
office to determine areas of most needed emphasis.
Research Supported by Others
Other Federal agencies: Federal agencies other than the Public
Health Service which have sponsored air pollution investigations in
cooperation with the Service include the Atomic Energy Commission,
the Bureau of Mines, the Bureau of Standards, the Department of
Agriculture, the Library of Congress, the Department of Defense, and
the Department of the Air Force.
States: Outside the Federal Government the State of California
has been the largest supporter of medical research, with projects
totaling approximately $250,000. These include population surveys
in California, studies of lung function, and research relative to the
setting of air quality standards. Cooperatively with the Service,
medical research studies are under way with partial support from
Erie County and New York State in the Buffalo area and from the
State of New Jersey in Jersey City.
In general, activities engaged in by States and localities are more
directly concerned with air sampling technics and control devices
aimed at ameliorating local problems, although the effects upon
agriculture are also being studied through State-supported research
stations. If additional Research Grants and Contract funds become
available there would undoubtedly be greater participation on the
part of the States.
Industry: With a few exceptions research by industry has been
primarily on control measures. A few industrial groups or individual
companies have from time to time sponsored specific projects at a
number of universities, institutes of technology, and research institutes,
concerned largely with determining the smog-forming potential of
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84 ENVIRONMENTAL HEALTH PROBLEMS
their own operations and with developing economical methods of re-
ducing emissions from these operations.
According to available information, the total research expenditures
for the automobile industry have approximated $1 million annually,
with the greater part devoted to research on auto exhaust control
devices as a consequence of the acute problem in California.
Expenditures for the study of agricultural problems resulting from
air pollution have been contributed by several directly interested in-
dustrial groups but, as far as can be ascertained, these appear to have
been mainly for field monitoring in the vicinity of various plants
rather than for fundamental research.
The American Petroleum Institute and the Automobile Manufac-
turers Association, through the Coordinating Research Council, under-
took studies of automobile exhaust gases. The combined expenditures
of API, Western Oil & Gas Association, and numerous individual com-
panies for fundamental research are said to exceed $1 million annually.
In 1960 the petroleum industry announced a program for 1961 in re-
search on new equipment aimed at the better combustion of fuel oil and
distillates. Research projects supported by the petroleum industry
include development of new tools and technics; air analysis programs;
characterization of chemicals present in gasoline; research in photo-
chemistry at the Franklin Institute; studies on the effect in photo-
atmospheric materials upon vegetation at the University of California,
Riverside; and the development of specific devices for control of re-
finery emissions.
Very recently two manufacturers of lead additives for gasoline
indicated their desire to support a cooperative project on the relation
between atmospheric lead and auto exhaust to be conducted by the
Kettering Laboratory in Cincinnati.
The fourth edition of "Guide to Research in Air Pollution," pub-
lished recently by the American Society of Mechanical Engineers and
developed jointly with the Division of Air Pollution is the most up
to date (calendar year 1959) tabulation of Air Pollution research
throughout the United States.
Training
Intrwrrmral training: The Air Pollution Training Activities Section
of the Division of Air Pollution participates in the overall training
program at the Robert A. Taft Sanitary Engineering Center, Cin-
cinnati, Ohio. This Section designs and presents short-term technical
courses based on the needs of professional people at the point of
practical application. In scope these courses cover the analytical,
survey, control, medical, and meteorological aspects of air pollution.
Field courses are given throughout the country to professional persons
in the field of air pollution and to technical and nontechnical personnel
from organizations which have need for a broad understanding of the
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Air Pollution
85
current problems of community air pollution. This Section also offers
consultation services to university staffs on the design and conduct of
air pollution courses.
Current 'program: In fiscal year 1962, 13 residence courses are
scheduled for presentation, with an expected enrollment of 260 pro-
fessional personnel. The broad 2-week course, "Community Air Pollu-
tion," will be presented twice during the year. Other 2-week courses
which will be offered include such highly specialized courses as
"Atmospheric Survey," "Microscopic Analysis of Atmospheric
Particulates," "Analysis of Atmospheric Organics," "Control of
Particulate and Gaseous Pollutants," and "Particulate Pollutant Con-
trol." Courses of shorter duration will include "Sampling and
Identification of Aeroallergens," "Medical and Biological Aspects of
Air Pollution," "Radioactive Pollutants in Air," "Analysis of Atmos-
pheric Inorganics," "Meteorological Aspects of Air Pollution," and
"Source Sampling for Atmospheric Pollutants."
Also scheduled for fiscal year 1962 are two Summer Training In-
stitutes : one on "Atmospheric Particulate Sampling" to be given at
Rutgers, the second on "Control of Particulate Emissions" to be given
at the California Institute of Technology, Also, an "Orientation in
Air Pollution" is to be presented in Denver, Colo.
Additional needs: The number of short courses offered by the Public
Health Service and the number of persons enrolled in the courses have
shown a steady increase over the past several years. There is a need,
however, for further amplification of this centralized training. This
type of training also should be expanded on a decentralized, regional
basis by the Public Health Service, and should be offered by universities
in the form of extension-type curricula.
The existing intramural training program also suffers from inade-
quate facilities and from geographical separation from the administra-
tive and operations parts of the program. The program could be made
more effective by fuller association with the intramural training pro-
grams in other fields of Environmental Health, This association could
be best achieved in the recommended National Environmental Health
Center.
Training grants: Assuming satisfactory progress, the estimated
needs for air pollution personnel by 1970 may be summarized as
follows:
Activity
Total Specially
trained
Industry.
Research.
Teaching
Control agencies,
7,500
7,800
9,000
100
2,000
2,000
l.WO
100
Total.
18,100
8,600
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86 ENVIRONMENTAL HEALTH PROBLEMS
The above estimate of 1970 needs calls for the addition of approxi-
mately 4,000 specially-trained individuals to the number currently
working in this field.
Personnel working in the fields of air pollution research and control
must be drawn from a wide variety of disciplines. In some cases, in-
dividuals may enter air pollution activities with little specialized
training in air pollution or merely an orientation to air pollution
problems. In other cases, formal training in the methodology and
techniques peculiar to air pollution activities will be required above
and beyond initial disciplinary preparation.
Some 40 professional disciplines are currently represented—or
listed among the needs—in air pollution research and control. They
include 7 specialized areas in engineering, 4 in medicine, 6 in chemistry,
and 2 in nursing, plus at least 20 more ranging from toxicology and
genetics to economics and community planning. In the majority of
these disciplines, additional specific training in air pollution appli-
cations is needed.
Current activities: In fiscal year 1962, $79,208 is being expended by
the Division to provide training grants to 8 schools of engineering and
public health for the support of graduate teaching to cover physical
and engineering problems of air pollution. Approximately $25,000
more is being used to support trainees in some of these institutions.
This training grant program falls far short of the needs for personnel
outlined above. The entire biomedical and social science needs have
been so far neglected.
General needs: In meeting these needs, it would be preferable for
the Bureau to support training grant programs in the fundamental
disciplines related to environmental health as a whole. To name a
few, this could very well be done in toxicology, epidemiology, and the
basis engineering disciplines. On the other hand, categorical training
programs could be used to provide the formal training in methodology
and techniques peculiar to air pollution activities which must be ob-
tained above and beyond initial disciplinary preparation, or to pro-
vide specialized training for certain special purposes.
Speoial needs: In view of the many types of trained personnel
needed to pursue air pollution research and control activities in the
United States, it is evident that no one particular kind of grant pro-
gram is completely suited to all these needs. It is, therefore, pro-
posed that extramural support of training activities in universities
and other institutions be developed toward four objectives: (1) train-
ing for research, (2) training for program needs, (3) individual
traineeships, and (4) special training for top-level administrators.
(1) Training programs to meet special research needs would best be patterned
after that currently in effect at the National Institutes of Health. There would
be established in the Division three training committees: (o) for air pollution
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Air Pollution
87
biomedical sciences research training, (b) for air pollution engineering and
physical sciences research training, and (c) for air pollution social sciences re-
search training, Bach committee would review for merit the applications as-
signed to it and make recommendations to be acted upon by the National
Advisory Health Council.
(2)	Training for program needs would be established in the Division under
three training committees: (a) for air pollution biomedical sciences service
training, (6) for air pollution engineering and physical sciences service train-
ing, and (c) for air pollution social sciences service training. Each committee
would review for merit the applications assigned to it and make recommendations
to the Division Chief. These recommendations could then be reviewed by the
Bureau Chief and acted upon by the Surgeon General.
(3)	As authorized by Public Law 84-159, the Division would establish a
traineeship program for study at all academic levels. A standing advisory re-
view committee would receive applications from candidates who wanted to
study in any of the fields related to air pollution activities. Committee recom-
mendations would be acted upon by the Division Chief.
(4)	Special training for top-level air pollution control administrators would
be instituted on only a very few university campuses. The chief control officer of
a large air pollution control program must, above all, be a good public ad-
ministrator. In order to arrive at intelligent decisions, he must have a knowl-
edge of the needs of his program and an acquaintance with the relative con-
tributions the several disciplines can make to it. He may have for his back-
ground training skills In one or more of some two-score professional disciplines.
It Is necessary therefore, that a training program for such an individual be
tailored to his specific needs, in order to fill the gaps in his background and
provide him with the skills of public administration.
The first requirement for such a program would be its establishment
in a university center which contains departments and colleges which
deal with all the background disciplines. There would have to be
close cooperation between the departments under the general direction
of the student's mentor to provide suitable training. There would
probably be few, if any, formal course requirements but rather semi-
nar and discussion sessions. The student who could best take ad-
vantage of this program would be a trained expert in his own field,
and in addition would have senior level working experience in some
phase of environmental health.
A single institution might be able to train two to nve chief control
officers per year. The training grant to such an institution should
provide for the full support of one faculty member, who would or-
ganize and guide this program and maintain the necessary cooperative
interdepartmental relationships.
Such a training grant program might be funded in the range of
$75,000-$100,000 per year.
Operations
Introduction: Public Law 159 specifically states that control of air
pollution sources is a State and local responsibility. At present,
therefore, the "operations" portion of Federal activity encompasses no
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88 ENVIRONMENTAL HEALTH PROBLEMS
control activity as such. However, there are several problem areas
in which the concept of control at the local level is less than realistic.
Among these are the problems of automotive vehicle exhaust and in-
terstate pollution. It is a reasonable prognostication that the opera-
tions portion of the Federal program eventually will include some
control activity and will require development laboratories and testing
facilities in support of such activity.
The operations portion of the Division of Air Pollution Program
is not synonymous with Technical Assistance, but is much more in-
clusive, involving as it does Public Information, Monitoring, Fore-
casting, Standardization, Development, and Evaluation activities, in
addition to those more specifically classified as Technical Assistance
to State and local agencies.
If one defines as "operations" all phases of a national air pollution
program other than research and training, then operations includes
the entire area of the application of our accumulated know-how to the
problem of air pollution control. Since control operates essentially
at the local level, this phase must also encompass the communications
channels to funnel information and assistance to the thousands of
localities throughout the Nation. Let us therefore first examine these
channels as to both their adequacy and their content.
Two sets of channels are needed: one carrying technical information
and aid to the professional workers in the field, the other transmitting
information to the lay public. The technical channel is closely re-
lated to the research and training functions of the program in that it
is the means by which the results of the research are put to use and
incorporated in training program curricula. It is obvious that dis-
semination of information does not, by itself, insure its application.
Therefore a complete operations program includes not only the means
for disseminating information but also the means for encouraging its
application.
Technical assistance: A large part of the operations program of the
Division of Air Pollution falls in the category of Technical Assistance
to State and local agencies. These activities are characterized by the
fact that in practically all cases the Division is required to work in
a local community, with and for the local agency, and to provide
services to support the local activity. Studies have indicated that
all communities in the United States having a population greater
than 50,000 and about 40 percent of the communities in the 2,500-
50,000 bracket have air pollution problems. Thus about 6,000 com-
munities are potential clients for some form of technical assistance.
The Division of Air Pollution has Air Pollution Program repre-
sentatives in the New York, Chicago, and San Francisco regional
offices to provide personal attention to local problems. More such
representatives are needed in the several regions to which none are
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89
as yet assigned and in any particular State or city where the demands
are very great.
There is a continuing demand for assistance to communities in the
drafting of control legislation and of rules and regulations. To meet
this need, the Division of Air Pollution has expended considerable
effort in the assembly, codification, analysis, and publication of exist-
ing and proposed forms of legislation and regulations. As time goes
by, increasing sophistication is being required in these matters; deci-
sions are being faced such as whether or not to incorporate regulatory
concepts based upon considerations of toxic levels, meteorological
factors, topography, control technology, etc.
The survey has been the most common form of technical assistance
provided by the Division to State and local agencies during the past
6 years. Many jurisdictions have as yet not been surveyed to deline-
ate the extent of their air pollution problem and point out the means
of its control. The newer, more sophisticated survey techniques yield
more information than earlier surveys, but require more manpower
and equipment per survey. Local agencies are in frequent need of
assistance also in dealing with specific problems. Until each State
agency is capable of handling these problems, many of them will be
referred to the Division of Air Pollution.
The more deeply State and local agencies get involved in monitoring
ambient air and air pollution sources, the more frequent will be the
situation where the local agency lacks certain pieces of unique or
costly laboratory or field equipment. In the former case, a solution
is to send the sample to a fully equipped PHS laboratory for analyses;
in the latter case, it makes sense to lend the needed field equipment
from an equipment pool maintained by PHS for the purpose. The
Division of Air Pollution presently provides both these types of
service on a moderate scale, with indications that the scale will increase
in the future.
Project and program grants: A tremendous buildup of State and
local agency facilities and staff is needed if the desired decentraliza-
tion of technical assistance is to be ultimately achieved. The surest
way to reach this objective is to provide funds to State and local
agencies through project and program grants. For the initial survey
in a State or community, it is proposed that project grants cover the
entire cost. For subsequent support of a State or local program
after the completion of the survey and appraisal, it is proposed that
the grants be on a matching basis on the order of $1 of Federal
grant funds to $3 of State or local funds.
Investigation of interstate problems and intrastate problems of
national significance: Under the present legislation the Division of
Air Pollution lacks authority to gain access, on its own recognizance,
to municipal, industrial, and commercial sources of air pollution for
827408—82	17
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90 ENVIRONMENTAL HEALTH PROBLEMS
the purpose of assessing the nature and extent of emissions to the
atmosphere and studying the means for their control. This makes
it difficult to properly assist local agencies. The solution is legislative
authority to PHS to investigate on its own initiative air pollution
problems of national significance, with such authority spelled out to
mean appropriate access to emission sources.
The identical problem arises where air pollution from one State
adversely affects a neighboring State. Where the offending State
has neither a compact on interstate air pollution with its neighbor
nor a State control agency willing to intervene in behalf of its sister
State, there should be authority vested in the Surgeon General of
PHS to conduct an appropriate investigation on his own initiative,
with rights of access to responsible or suspected sources assured by
the enabling legislation.
Forecasting: Since August I960, the Division of Air Pollution has
operated an Air Pollution Potential Forecasting Service for the States
east of the Rockies and is currently pilot testing a similar service for
the western United States. The ultimate development of a really
satisfactory local air pollution forecast system will have to await
the establishment of a national network of stations to take vertical
soundings of gradients between the ground and 5,000 feet.
Implicit in air pollution potential forecasting is the ability to spot
the stagnation that lingers longer than expected, since this is the situa-
tion with disaster potential. A start is being made toward the devel-
opment of procedures for Federal, State, or local action in the event
the disaster potential situation should occur.
Monitoring: Most present air quality monitoring activity is to
establish baseline data against which high values may be detected.
More and more future monitoring will be for the purpose of com-
parison with baseline data to detect dangerous situations. Presently
the Division of Air Pollution operates the National Air Sampling
Network as the basic national air quality monitoring scheme. This
network is not adequate to the air quality monitoring needs of the
Nation. For instance, it provides continuous monitoring in only six
cities and for only a limited number of pollutants. Permanent con-
tinuous monitoring stations need to be established in many more
cities and in a few nonurban locations as control stations.
A number of State and local agencies operate local networks. An
expansion of these and the stimulation of others would be in the
national interest and would seem to be a proper use for air pollution
project grant funds to States and cities.
Process and equipment development and evaluation: Since instru-
ment development, control equipment application, and related activ-
ities are primarily undertaken by private industry, this area is one
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91
requiring extensive cooperation with industry, and one for which the
Division needs appropriate laboratories, test facilities, and staff.
Standardization and certification: One important need of both
control agencies and industry is in the general area of standardiza-
tion—of equipment and process test procedures and of analytical
methods. In American practice, professional and trade associations
spearhead standardization activities. However, Federal agencies par-
ticipate in such activities and frequently provide valuable supporting
services. Standardization activities in the air polluton field are in
their infancy. The future should see more participation on the part
of the Division of Air Pollution with professional and trade associ-
ations in these activities. The Division should plan to provide the
laboratory facilities and staff for carrying on such activities.
Dissemination of technical information: A national air pollution
agency has a major responsibility of providing a source of technical
information for State and local use. However, even before satisfying
the extramural need, a firm intramural technical information base
must be provided to meet the needs of the technical staff of the Divi-
sion of Air Pollution. Thus, the library, abstracting, translating,
and other services discussed need to be readily accessible and available
to the Division's staff.
A wide dissemination of abstracts of the pertinent technical liter-
ature is an essential need of the professional worker in the air pollution
field. At present the Division of Air Pollution is supporting some
abstracting service, but there is need for further extension and coordi-
n ation of abstracting services.
Additional translating services, both from English to foreign lan-
guage and from foreign languages to English, would be desirable.
To a larger extent than at present, the Division of Air Pollution
should provide reprints of important air pollution literature which
appears in reports of very limited initial distribution.
It would be desirable to publish and make available for wide distri-
bution the series of course manuals already compiled by the Division
of Air Pollution, and to prepare manuals in additional areas.
The professional air pollution worker in all except a few major
cities lacks access to a comprehensive air pollution library. The Divi-
sion of Air Pollution has a national responsibility to provide a
National Air Pollution Library and Reference Service so that these
workers may thereby have easier access to the technical literature in
their field.
Dissemination of information to the general public: Although cer-
tain information activities do lend themselves to centralization, an
effective public information program is important to the success of
this Division's functional program and, for the reasons noted below,
should be planned and carried out as an integral part of that program.
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92 ENVIRONMENTAL HEALTH PROBLEMS
The objectives of the Federal program are not yet generally under-
stood by the public nor accepted by the many groups which affect and
are affected by the air pollution problem. Air pollution is far from
being adequately controlled now. A long-continued public education
program will be needed to bring about adequate control. Air pollution
has major social and economic ramifications beyond those traditionally
dealt with by the health professions. Since control depends upon
cooperation among all levels of government and industry, its achieve-
ment depends to a high degree upon understanding on the part of all
interest groups as well as the public. These groups include State and
local governments, most industries, unions, schools, women's and civic
clubs, professional associations, voluntary health organizations, and
many more. Many of these have interests in conflict with the objec-
tives of the Division and with each other, yet many can and do make
concrete contributions toward better control of air pollution, provided
they are kept well enough informed to be properly motivated.
The Division not only must continue its public relations program
with magazines, newspapers, radio and television now largely geared
to the Federal program—but should also provide professional guid-
ance to State and local air pollution agencies and other local groups
which seek to inform their local publics on local situations. There
is also a need for development and publication of short informational
brochures of the kind needed to explain aspects of the problem and
program to the public. National conferences and regional demon-
strations offer another means by which current problems and progress
may be brought to public attention.
Strictly from the information viewpoint—apart from possible gains
in economy or efficiency—the Division's activities could in many
instances be expanded or its public impact be strengthened by coopera-
tive action with other divisions concerned with environmental health.
Some worthwhile activities can be better carried out jointly. For
example, the Museum of Science and Industry in Chicago has offered
an entire room for a permanent display on environmental health, but
would not be interested in air pollution alone. A motion picture
intended for lay audiences would have more impact, if it covered
water pollution and radiological fallout, for example, rather than air
pollution alone. The support of many organizations would be easier
to enlist for the entire field of environmental health than for any one
area of that field. A recruiting booklet for the environmental health
field might be more appealing than one limited to air pollution—
and more selective than one which covered the entire Public Health
Service. In addition, there would be advantages in the location of all
environmental activities in a centralized location for easier access by
reporters, writers, and other visitors with information potentials.
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Air Pollution
93
There would be "overflow" from one division to another, from which
all benefit.
INTEGRATION OF AIR POLLUTION WITH OTHER ENVIRONMENTAL
HEALTH PROGRAMS
The proposed reorganization of the Public Health Service now
presents all divisions of the proposed Bureau of Environmental
Health with a timely opportunity to coordinate and integrate opera-
tions, to effect savings, to prevent undesirable duplication, to share
knowledge, and to achieve broader coverage in studies of the total
insult inflicted on humans by a wide variety of ubiquitous environ-
mental pollutants in the air we breathe, the water we drink, and the
food we eat.
Perhaps the most important benefit to be derived from the inte-
gration of the Division of Air Pollution with the other environmental
health programs at a National Environmental Health Center would
be the greater likelihood of attracting men of outstanding ability and
national reputation, men capable of pulling together all available
information on air pollution and of acting as a focal point for the
total national effort. The cooperative efforts of recognized authorities
in each of the programs, under the stimulation and guidance of a few
topflight scientists acting as coordinators at the Bureau level, could
bring about general recognition of the importance of environmental
health problems and develop a reputation for the Center which would
attract personnel to these programs.
Division Functions and Centralized Activities
There are certain functions presently carried out by the Division
of Air Pollution which in the general interest of all environmental
health programs could be performed as a centralized activity of the
Bureau of Environmental Health. There are also some functions
which could be carried out profitably either as a Bureau activity or
as a cooperative activity by two or more program divisions. The
Division of Air Pollution, however, should retain primary responsi-
bility, in whole or in part, for much of the program in this field, due
largely to the nature of its activities.
For example, research projects and technical assistance and train-
ing activities in the Division of Air Pollution are characterized by a
high degree of interdisciplinary effort. One example of the need for
close collaboration among many disciplines is the study of auto ex-
haust emissions and their effects on health. This study requires
several research teams, each consisting of: Mechanical, chemical,
electrical, and electronic engineers and instrumentation specialists to
design and operate the unique facilities required; chemists and physi-
cists to characterize the exhaust prior to and following complex photo-
chemical reactions, and to identify a wide spectrum of organic and
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91* ENVIRONMENTAL HEALTH PROBLEMS
inorganic compounds, sometimes in the parts-per-billion range; toxi-
cologists, physiologists, pathologists, veterinarians, microbiologists,
biochemists, geneticists, and statisticians to conduct studies of effects
on animals; and a similar variety of specialists to study the response
of plants to auto exhaust.
Centralized bureau support of this interdisciplinary attack on pro-
gram-related projects could provide comprehensive toxicological
information services and such services as the care of animals, and could
stimulate the exchange of information among scientists of the same
or related disciplines in each of the divisions.
Special functions of an interdisciplinary nature at the bureau level
might include: (1) Recognition of new environmental health prob-
lems not related to a specific program and initiation of action, by
assignment of responsibility to one of the divisions or by other appro-
priate means; and (2) direction of broad investigations involving
multiple environmental factors.
Specific program-related methodology and instrumentation re-
quired to carry out program functions also should remain the pri-
mary responsibility of the Division. Examples in the air pollution
program include: (1) The development of equipment to measure
respiratory function in humans and laboratory animals, and (2) the
development of technics and instrumentation for laboratory and field
sampling of air pollutants.
Centralized instrumentation and analysis functions, on the other
hand, would be desirable in connection with the operation of a com-
bined system of networks for the routine sampling of air, water, and
food. Specialized networks required for short periods of time by the
operating programs should remain the responsibility of the respective
programs.
Computer operations and data processing should be centralized
or pooled but not to the extent that it would discourage individual
investigation. For example, programing should be a function of the
organizational unit charged with responsibility for conducting a
project.
Intramural training consisting of short, intensive courses for re-
search, enforcement, and administrative personnel should be the re-
sponsibility of the operating program in so far as course content and
staffing are concerned. Administrative coordination and operation of
training facilities, on the other hand, should be part of a centralized
activity.
Neglect or Undekdevelopment Within this Fxbld
Within the field of environmental health there are several areas
which have not received much attention, due primarily to a lack of
clear responsibility for division effort in these areas. Bioclimatology
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Air Pollution
9ri
is an example of an area of relative neglect. The well-being of indi-
viduals, particularly those already suffering from physical impair-
ment, is known to be affected by weather. Meteorological factors also
have a significant effect on the frequency and severity of air pollution.
The combined effects of weather and air pollution on human health
and well-being need intensive study.
The relationship of air ions to air pollution and to public health
also should be explored. The Division of Air Pollution has interest
in this field.
The Division of Air Pollution is almost exclusively concerned with
the outdoor environment, while the indoor environment, except for
occupational problems, remains essentially neglected as an area of
interest in environmental health. The inquiries concerning heating,
cooling, cleaning, and deodorizing air in public and private buildings
which this Division receives from occupants and representatives of
industries engaged in various aspects of air treatment, seem to indi-
cate an expectancy that the Public Health Service would be actively
engaged in this area of environmental health.
RELATIVE EMPHASIS TO ACHIEVE BALANCED PROGRAM
Among Program Elements
The program elements—research, training, and technical assistance
(operations)—are interrelated. Operational needs largely deter-
mine the nature and scope of the research program and the relative
effort to be devoted to the various problems from time to time. The
need to acquire new knowledge regarding air pollution has placed
the greatest emphasis on research. Approximately 80 to 90 percent
of program funds have been spent annually on research, and the re-
mainder has been used to initiate token efforts in technical assistance
and training. As additional funds become available, greater empha-
sis can be placed on technical assistance and training. The level of
effort by the Federal program on research recommended in "National
Goals in Air Pollution Research" will serve as a general guide in the
allocation of funds to achieve a balanced program.
Just as the research program must be designed to meet the needs of
control programs, so the training activities must be designed to meet
the long-range and short-term requirements of the research and oper-
ating programs on a national scale. Thus a program attuned to the
needs in air pollution includes what might be considered a built-in
mechanism to achieve and maintain a balanced program, namely: (1)
Federal, State and local, and industry operations; (2) research to
meet the needs in (1); and (3) training to meet needs in (1) and (2).
The application of existing and new knowledge must be stimulated
throughout the Nation in State and local agencies. The Public Health
Service should provide the national stimulus and leadership in effect-
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96 ENVIRONMENTAL HEALTH PROBLEMS
ing this application. A mechanism which has proven successful in
other public health fields has been the awarding of grants to State
and local agencies to assist them in initiating or reinforcing their con-
trol programs. The Public Health Service now has authorization
for the awarding of grants to State and local agencies for the appraisal
of air pollution problems. Additional legislative authorization would
have to be sought to permit the awarding of grants for control opera-
tions at the State and local levels. The Public Health Service should
seek this additional authorization and should seek the funds to carry
out the legislative provisions. If such authority and funding are
realized, the relative emphasis of the various elements of a balanced
program necessarily will be altered, with additional emphasis on the
operations aspect of the total Division activity.
Intramural and Extramural
Intramural activities include the "in house" efforts of the Public
Health Service and other Federal agencies, efforts supported by the
award of contracts to private individuals or organizations, and such
Federal efforts as the law permits in support of State and community
activities. Extramural activities are those supported by grants to
universities.
It does not seem feasible to arrive at a precise ratio of intramural
and extramural activities. Certainly a strong central program is
urgently needed to serve as a focus for the national effort. Beyond
this it is considered highly desirable to expand the extramural effort
at universities within the next 5 to 10 years to about five times the
current level.
It is the opinion of this Committee that a proper balance between
intramural and extramural activities and among the various elements
of the air pollution program will be assured through recommenda-
tions and reviews by the National Advisory Committee on Community
Air Pollution, and that the normal budgetary and legislative proc-
esses will further tend to ensure a program balanced in accordance
with the needs.
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Report op the Subcommittee on
ENVIRONMENTAL ENGINEERING
RECOMMENDATIONS
The Subcommittee on Environmental Engineering at meetings lield
on August 31, September 21, and October 13, 1961, considered its
responsibilities in the field of its subject. In accordance with the
charge from the parent Committee, this Subcommittee has defined
long-range research objectives in environmental engineering. It has
also discussed the field of environmental engineering per se and has
delineated relationships to that field of the Public Health Service,
Division of Environmental Engineering and Food Protection, herein-
after often referred to as DEE&FP or as the Division.
The Subcommittee visualized the need for a greatly expanded
research program in environmental engineering as defined herein.
However, the difficulties of staffing led the Subcommittee to make con-
servative estimates of the magnitude of expenditures required. The
Subcommittee presents the following recommendations.
1.	It is recommended that there be developed, under the leadership
of the Public Health Service, a more comprehensive program in en-
vironmental engineering, as discussed in this report, utilizing the com-
bined and separate skills of physical, biological, and social scientists,
at a level of expenditure which will assure the resources commensurate
with the task.
2.	That an Environmental Health Center be provided wherein a
part of the environmental engineering program may be conducted by
the Public Health Service.
3.	That the research goals outlined in this report be used to guide
the development of the environmental engineering research program.
In addition to urgent research needs in established program areas the
Subcommittee particularly recommends action to initiate investigation
into new and unexplored phases of environmental engineering such
as community noise, vibration, lighting, and open space requirements.
4.	In establishing the Environmental Health Center that provision
be made for centerwide programs as well as divisional programs and
that separate funding be provided for each.
5.	That research funds be apportioned on an extramural to intra-
mural ratio of the order of 5 to 1. It is further recommended that
basic research be largely done on an extramural basis.
6.	That the levels of research grants and contract research in en-
vironmental engineering be increased from their present level of about
$700,000 to a level at least of $10 million per year in 5 years.
97
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98 ENVIRONMENTAL HEALTH PROBLEMS
7.	That there be provided to DEE&FP resources which will permit
it to meet its intramural research responsibilities in environmental
engineering. It is recommended that funds to a level of $2 million per
year in 5 years be appropriated.
8.	That substantially greater emphasis be placed on research and
development in the field of public water supply treatment and dis-
tribution, particularly from the standpoint of water quality, and that
provisions be made for an identifiable, organizational unit within
the DEE&FP to deal with these critical water supply problems.
9.	The Committee recognized the importance of field studies and
demonstration projects in the environmental engineering field es-
pecially pertaining to regional and metropolitan problems. It recom-
ments that funds be made available to DEE&FP to support this work
at a level of at least $3 million per year by the end of a 5-year period.
10.	The Subcommittee recognized the metropolitan and regionwide
character of most environmental engineering problems and recom-
mends that the Public Health Service utilize its field study and re-
search grants in such a way that this concept is observed.
11.	That the level of research and nonresearch training grants be
increased for environmental engineering. Future requirements for
manpower are incorporated in the overall figures prescribed by the
Subcommittee on Manpower Resources and Training.
12.	That the Public Health Service take the lead in promulgating
the criteria required by communities in the engineering area of en-
vironmental health.
13.	That a review be made of the inadequacies of legislation where-
under the Division operates and that new legislation be promulgated
to provide the Division an adequate framework to discharge its obli-
gations in—
~.	The control of noninfectious disease agents In relation to interstate car-
riers and interstate disease problems; and
~.	Research and development pertaining to solid wastes; and
c.	Research and development regarding health problems in intrastate metro-
politan areas; and
d.	Research and development regarding the health problems of housing.
14.	That early steps be taken to establish high-level liaison and
operating relationships between HEW-PHS and other appropriate
Federal agencies (such as, but not limited to HHFA and the Depart-
ment of Commerce, Bureau of Public Roads) in the area of urban
development and metropolitan planning so as to promote the interests
of environmental health.
15.	The Subcommittee recognized that in order to carry out the pro-
grams recommended above, an expansion, proportionate to the new
workload, of existing DEE&FP central, technical, and administrative
staffs, will be required. It is recommended that provisions be made for
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Environmental Engineering
99
this. It is estimated that an increase of at least $500,000 per year at the
end of 6 years will be required for this purpose.
NATURE OF THE PROBLEM
Environmental Engineering concerns itself with the establishment
and maintenance of a healthful environment, particularly in urban
areas where the problems are most acute. This requires bringing to-
gether the social, biological, and physical sciences in dealing with the
problems of the health1 aspects of man's relationships with his en-
vironment. This involves safeguarding man's water, air, food, con-
veyances, structures for habitation and employment, and his recrea-
tional and work environments. It involves not only the control of the
quality and quantity of basic necessities, but also, importantly, the
control of the waste byproducts, whether solid, liquid, or gaseous.
These byproducts, if uncontrolled or allowed to accumulate, would not
only stifle existence, but lead to widespread disease and physical
impairment.
Increasing population and increasing concentrations of people into
the urban areas of the United States have accentuated environmental
problems in two important, related ways: (1) As our air, water, and
land resources are fixed, increasing populations decrease the quantity
of each of these basic necessities available to the individual; (2) with
increasing amounts of waste products concentrated in areas with grow-
ing populations the relative effects of these wastes on man is increasing
at an ever increasing rate. These threats are of an insidious nature,
a form of creeping paralysis which, if not recognized and corrected,
can lead to urban stagnation and death as surely as the most violent
epidemic.
It is for this latter reason that the environmental health concept
and an environmental health research center are of particular sig-
nificance to the environmental engineering field—the recognition of
the problem and the development of effective measures for correction
and control depend more on a calm scientific appraisal of the overall
problem than on public demand.
The Subcommittee recognized the importance of accidents and their
relation to environmental engineering. We believe that there are
many factors in the environment which contribute to accidents. These
should not be disregarded but made the subject of research. The
Subcommittee understands that accidents of all types are the concern
of the PHS Division of Accident Prevention in which there is con-
1 There are four basic levels of public health concern with the environment, aa enon-
ciated by the American Public Health Association (1):
1.	Inanrlng the element* of atmple annival;
2.	Prevention of dlaeaae and potaonlng;
8. Maintaining an environment anlted to man'a efficient performance;
4. Preieiration of comfort and the enjoyment of living.
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100 ENVIRONMENTAL HEALTH PROBLEMS
ducted a research program at the present level of about $2 million
per year. As accidents fall within the purview of this Subcommittee
in connection with metropolitan planning, housing and recreational
areas, there should be coordinated efforts and funding between
DEE&FP and the Division of Accident Prevention.
In order that the Public Health Service can take immediate steps to
assure the quality of our urban environment, priority must be given
to the following:
1.	The application of the technical "know-how" that we already possess
through more effective administration and organization, including metro-
politan planning.
2.	Research into all phases of the environmental engineering problem,
including a more fundamental knowledge of the effect of wastes on man
(both physically and sociologically) ; more economic methods of water
supply collection, treatment, and distribution; more efficient and effective
methods of sewage treatment (including onsite disposal), drainage, and
the collection and disposal of garbage and refuse.
3.	The development of health criteria or guidelines for use in planning and
conducting programs involving water supply and sewage disposal, drainage,
the disposal of garbage and refuse, bousing, urban renewal, zoning, open
space, and accident prevention.
TRENDS IN ENVIRONMENTAL ENGINEERING
The term environmental engineering is itself rather new. However,
a close study of the definition given above shows that environmental
engineering is the growth, or possible the sophistication, of what
is known as sanitary engineering. To the fields of water supply,
sewage, air pollution, and others, has been added a new dimension.
It pertains to the practice of the profession, from the public health
viewpoint, under urbanization. It is the large dimension of gaining
acceptance of proposed environmental control projects by contiguous,
diverse political groups. It is at this point that the engineering and
social science professions became interdependent. Among the trends
noted in "environmental engineering" the following are important.
Social and Economic Implications
Although engineers have traditionally endeavored to design the
most economical as well as the most workable solution to a problem,
economics in our context has a larger meaning. Involved is the need
for evaluating the overall economic picture of a metropolitan complex
for, say, the provision of an adequate water supply. In large metro-
politan areas the provision of enlarged water supply facilities is some-
times hampered because of irrational rate structures. Solving such
problems requires thorough economic studies of the water rates and
instituting an equitable system overall. The importance of social
factors is illustrated by the location of arterial highways without
regard to social, economic, and health implications of these decisions,
When this does occur, the completed road may create severe problems
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Environmental Engineering
101
of neighborhood decay, inaccessibility to industrial complexes, or other
undesirable "direction" of city growth. Appendix E of this report
contains a pertinent discussion of social factors.
Metropolitan Approach to Planning
The Subcommittee is convinced that the metropolitan factor is the
common denominator to most environmental engineering problems.
The technical literature of the past 10 years abounds with references
to the recognition of this fact. There are now 210 Standard Met-
ropolitan Statistical Areas (2) and the number is growing each year.
Of these, 27 are interstate. Still another pertinent statistic is that
70 percent of the U.S. population lives in urban areas. The growing
interest in comprehensive metropolitan health planning is well illus-
trated by the recent appearance of an Environmental Health Plan-
ning Guide (3) published by the Public Health Service. Designed
for use by either technical or lay people, the guide emphasizes the
evaluation of health related utilities and services which readily lend
themselves to long-range planning.
New Environmental Hazards
Until a few years ago the principal cleansing agent used in the
U.S. was soap which when discharged in waste waters was changed
by biological action to innocuous substances which disappeared. By
1958 the people of this country were consuming 3.8 billion pounds
(4) of detergent which after use was discharged to the environment
usually by way of drainage to surface or ground waters. Detergents
resist biological decomposition and travel nearly unchanged for long
distances to be picked up in municipal and individual water supplies.
They pass readily through usual water treatment processes. What
the long-range effects of detergents on health may be is not known.
Other chemical contaminants (5) found in drinking waters in recent
years include DDT, aldrin, orthonitrochlorobenzene, diphenyl ether,
tetrftlin, and acetophenone. The concern of the Public Health Service
over these agents is expressed by the fact that the National Cancer
Institute has begun studies of the carcinogenic properties of organic
extracts from finished water supplies of several cities.
National Government and Metropolitan Relationships
From the cities themselves has come increasing pressure upon the
Federal Government to provide direct assistance in solving their prob-
lems, many of which fall in the environmental field. The Council of
Mayors at their annual Convention held in 1958 in Miami, Fla., re-
quested Senator, now President, Kennedy (6) to speak on the subject,
which he called "Time for an Urban Magna Carta." In the past few
years several bills have been introduced in Congress providing for
the establishment of a Department of Urban Affairs. Although this
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102 ENVIRONMENTA L HEALTH PROBLEMS
has not yet occurred, it is clear that direct relationships between the
Federal Government and urban centers will grow. From the health
viewpoint, an increasing demand by local government for environ-
mental engineering standards is anticipated.
Synergistic Effects
Synergism is defined as the "Cooperative action of discrete agencies
such that the total effect is greater than the sum of the . . . effects
taken independently." Little is known about the total effect of com-
bined insults to man by his environment and major research should
be directed toward this field as soon as possible. It is also here that
the value of a central research center, where all facets of the environ-
ment are being simultaneously investigated, would be most apparent.
RESEARCH OBJECTIVES
This Subcommittee considered its scope of interest according to the
broad definition given under Nature of the Problem. Although the
term environmental engineering embraces air pollution, water pollu-
tion, milk and food, radiological and occupational health, these inter-
ests were excluded from consideration as other subcommittees were
dealing with them. There remained a large area embracing the major
part of the environment. The Subcommittee defined the major divi-
sions of this area as given in Table I.
Tablb i
Major Divisions of Environmental Engineering
Housing and Occupied Space
Urban and Recreational Areas
Water Supply
Solid WasteB
In terms of program interests of the Public Health Service, Division
of Environmental Engineering and Food Protection, various seg-
ments of the environment with which the Subcommittee concerned
itself are listed in Table II.
Tablb II
Segment* of the Environment of Interest to the Division of
Environmental Engineering and food Protection
Water Supply *
Metropolitan Development
Solid Waste#
Housing
Inter*tate Carriers
Plumbing
Emergency Sanitation
Individual Sewage Disposal
Individual Water Supply
Swimming Pools
Recreational Areas
Noise and Vibration
Air Conditioning
Environmental Aspects of Accident Control
* Public water supplies from water works Intake to con-
sumers tap.
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Environmental Engineering
10S
An inspection of Table I shows that each element of the environment
listed in Table II may be placed under one or more of the headings of
Table I. The Subcommittee delineated three categories of research:
Basic, operational (applied), and administrative. Research objec-
tives 2 were then developed for each division of interest shown in Table
I. The degree of priority as to when these projects should be initiated
has been shown in terms of (I) immediate; (II) 2 to 5 years; (III)
5-10 years. A review of these is convincing as to the vast amount and
scope of research which is required if environmental health is to keep
pace with changing world conditions.
NEED FOR CRITERIA OR GUIDELINES
Environmental engineering guidelines, or criteria of performance,
are viewed as an outstanding need by both professional workers and
government officials at local, State, and National levels. Authoritative
criteria require years of research and observation to develop, and when
developed, must be reviewed at suitable, periodic intervals, changed
and updated. Some problems of standards formulation are illustrated
by the Public Health Service Drinking Water Standards. First is-
sued in a very elemental form in 1914, they were revised in 1925,1942,
and lastly in 1961. In the latter work the Advisory Committee was
unable to set firm requirements for limits on several important items,
including viruses, because of the lack of basic research data.
Another example where much basic research is required is in the
area of housing hygiene criteria. After three decades of increasing
interest and work in the health aspects of housing there is still little
or no information on the effects on health of room size, noise, air
conditioning, lighting, and other environmental factors.
In the area of metropolitan development, health oriented standards
are either nonexistent or empirical. Attempts have been made by some
zoning authorities to set criteria. For example, New York and Chi-
cago zoning authorities have set arbitrary limits on noise and vibra-
tions from industrial sectors but the problem of permissible noise
levels in business and residential areas is not dealt with.
The setting of health standards for urban development is compli-
cated by the subjective nature of the problem. Modern health concepts
include mental health aspects. Much of how persons or large groups
of people react to noise, vibration, light, and temperature is gov-
erned by attitudes. To research this area the combined skills of social,
psychological, physical, and medical scientists will be required. In
summary, the following table lists selected, environmental engineering
areas where, in the opinion of this Subcommittee, sound standards are
required.
* These ore liatad In Supplement* A through D.
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10k ENVIRONMENTAL HEALTH PROBLEMS
Table III
Areas in Which Environmental Engineering Criteria Are
Needed
Housing and Occupied Space:
Itoom Size
Noise
Vibration
Lighting
Vent II nt ion
Plumbing
Mobile Homes
Accident Prevention
Urban and Recreational Areas:
Building Lot Size
Population Density Standards for—
Water
Sewage
Waste Disposal
Noise and Vibration by Type of Area
Mobile Home Parks
Accident Prevention
Water Supply:
Drinking Water Standards
Bathing Water Standards
Recreational—Other Than Bathing
Solid Wastes:
Collection
Disposal
On Site
Community
LONG-RANGE OBJECTIVES
The Subcommittee reviewed long-range objectives in terms of the
administrative, legislative, and financial arrangements required to ac-
complish research objectives in environmental engineering. An anal-
ysis of the Division's work indicates the need for strengthening in
fiscal resources, manpower, and legislative authority some parts of its
organization. Legal authority for the Division's activities is con-
tained in the broad terms of the Public Health Service Act and amend-
ments. The provisions of the Act should be carefully reviewed and
further amended to provide a modern, legal framework within which
the Division can operate to meet the problems of today's changing
environment.
The Division is now staffed with a Research Grants Branch which
administers the distribution of PIIS research grants for projects re-
lated to its work. A review was made of the level and distribution of
research grants of interest to the Division. In force, as of March 1,
1961 (7), there were 135 research grants of which only 25, or 18.5 per-
cent, were in environmental engineering. The rest pertained to milk
and food. Dollarwise, these projects were distributed $655,700 for
environmental engineering and $2,214,600 for milk and food. The
Subcommittee interprets these statistics to show two deficiencies.
(1) Research grants, in terms of dollars, in the area of environ-
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Environmental Engineering
106
mental engineering are grossly inadequate; and (2) the small num-
ber of applications shows a lack of interest or awareness on the
part of investigators in universities and other research organizations
as to requirements and opportunities for study in the environmental
engineering field. The Subcommittee strongly urges that steps be
taken to remedy both defects.
During the next 5 years the Research Grants Program should be
expanded both in scope and funds. In addition to the present proj-
ect grants, provision should be made for more broadly based support
to institutions for programs of research, research facilities, and sup-
port for large-equipment items which may be used by more than one
project or research program. Amounts of money required for this
purpose are estimated to require progressive annual increases of
$2 million so that in 5 years there will be an expansion of the pro-
gram to the level of $10 million per year.
In addition, the Division, which currently has virtually no com-
prehensive organized research program, should be provided with re-
sources to permit it to do research work both in its own facilities and
by contract. It is estimated that an annual expenditure to the level
of $2 million per year at the end of 5 years will be required.
Long-range planning to meet the research and operational goals
must face the questions of manpower and training. The diverse dis-
ciplines required for conducting the work are well described by
DEEFP in its "Areas of Specialization Required To Attain Long-
Range Program Goals," a copy of which is appended to this report.
The Subcommittee is in agreement with statements made therein.
Estimates,pf the required numbers in the specific disciplines will be
furnished by another subcommittee. It is clear, however, that envi-
ronmental engineering must compete with other sciences and engineer-
ing professions, for young, technically minded persons. It is also clear
that in the past the field of environmental engineering (sanitary engi-
neering) has not been successful in attracting adequate numbers of
young men to its practice. Part of this deficiency can be met by pro-
viding graduate-level training to engineers and scientists who were
basically trained in related fields. This effort must be encouraged
and research and traineeship grant programs by the PHS should be
augmented.
LEVELS OF RESPONSIBILITY
The foregoing discussions have shown that any program of environ-
mental engineering commensurate with the Nation's needs involves
responsibilities at many levels.
Among the agencies and professional groups sharing the burden of
providing a continuously healthful environment for U.S. citizens are
the following: universities, foundations, health agencies, State and
627408—93	8
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106 ENVIRONMENTAL HEALTH PROBLEMS
local governments, women's organizations, and medical and engi-
neering and professional societies. Pertinent especially to this report,
with its emphasis on research, is the role to be played by the university
and the health agencies, particularly the Public Health Service.
In keeping with their traditions, it is expected that the universities
will continue to have the responsibility for professional education and
a major share of the responsibility for conducting much of the funda-
mental research.
The Public Health Service, with its long tradition of protecting the
Nation's health, is in an established position where it may furnish
leadership in aiding the States and localities in solving their environ-
mental health problems. It should accomplish this by technical
assistance, certain types of training, demonstration projects, and in-
creased research activities, both intramural and extramural. The
Subcommittee believes that the major part of the research program
should continue to be extramural. It is also convinced that the Divi-
sion of Environmental Engineering and Food Protection, having at
present, no organized, intramural research effort in environmental
engineering, should institute such a program. The Subcommittee is
convinced that adequate funds and facilities should be provided to
enable DEEFP to discharge these responsibilities.
The Subcommittee also considered levels of responsibility or activity
of other Federal agencies in the four areas of environmental engineer-
ing listed in table I. In the field of housing, the HHFA is the major
Federal agency involved, but it does not presently conduct or sponsor
major undertakings in health-oriented housing research. The area of
urban or metropolitan development is a new identified entity. The
Subcommittee noted little or no health-related research being done in
this area at the present time. In the water-supply field extensive
research is going on at the Engineer Research and Development
Laboratory, Corps of Engineers, Fort Belvoir, Va. However, the
thrust of this work is toward military and not civilian applications.
Also, within the Department of the Interior, the Office of Saline Water
has an extensive research program, but the prime objective is the aug-
mentation of water resources through treatment of saline water.
Within the PHS the Division of Water Supply and Pollution Control
conducts water-supply research mainly related to raw water up to the
waterworks intake. This Subcommittee has coordinated with theirs
in the development of this area. No other Federal agency than the
PHS undertakes solid-waste research and virtually none is being con-
ducted at the present time.
REFERENCES
1.	"Lev«ls in Environmental Health," Frank M. Stead, JAPHA, Vol. CO, No. 8,
March 1960.
2.	Bureau of the Census, U.S. Department of Commerce, Washington, D.O.
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Environmental Engineering
107
8. "Environmental Health Planning Guide," Public Health Service Publication
No. 823, Washington, D.O.
4.	"Effects of Synthetic Detergents on Water Treatment and Quality of Water,"
Jesse M. Cohen, Sanitary Engineering Center, Cincinnati, Ohio, 1959.
5.	"Newer Chemical Contaminants Affecting Water Quality," F. M. Middleton,
Sanitary Engineering Center, Cincinnati, Ohio. 1961.
0. "Time for an Urban Magna Carta," U.S. Senator John F. Kennedy, speech
delivered September 11, 1958, to the annual conference of the U.S. Confer-
ence of Mayors.
7. "Public Health Research Grants in Milk, Food, Interstate and Community
Sanitation, March 1,1961," Office of Research Grants, Division of Engineer-
ing Services, Bureau of State Services, PHS.
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Supplement
RESEARCH GOALS IN ENVIRONMENTAL ENGINEERING
A.	Housing and Occupied Space
B.	Urban and Recreational Areas
C.	Water Supply
D.	Solid Wastes
E.	Social Science and Environmental
Health
F.	Areas of Specialization Required: To
Attain Long-Range Program Goals
A. HOUSING AND OCCUPIED SPACE
Not®.—Occupied space includes, but is not limited toT institutional buildings, suck as nurseriee day-cure center*,
school*, coUtffea. and hospitals. offices, place* of assembly, vessels, ami aircraft,
Description of Retmrch Area	Category * Priority1
To formulate minimum standards for residences and oc- B	I
cupied structures to satisfy the physical, physiological,
and psychological needs of man, and to formulate de-
sirable standards for residences and occupied structures
to fulfill the desires of man and to provide efficiency and
comfort of living; such minimum and desirable stand-
ards to include, but not limited to—
(~)	Room sizes:
(1)	Floor area.
(2)	Room volume.
(3)	Limiting dimensions; e.g., ceiling heights.
(~)	Thermal factors; including air temperature, radi-
ant temperature, air movement and relative
humidity:
(1)	For warmth.
(2)	For cooling.
CODE:
> Category of Research:
B—Basic.
0—Operational.
A—Administrative,
> Recommendtd Priority?
I—Undertake as soon as possible.
II—2 to S years.
Ill—fi to 10 years.
108
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Environmental Engineering
109
Description oj Retearch Area	Cfotegory* Priority*
(c)	Ventilation:
(1)	Air cleanliness.
(2)	Removal of odors.
(d)	Illumination; quantity and quality standards:
(1)	Natural lighting.
(2)	Artificial lighting.
(e)	Noise; including that from internal and external
sources:
(1)	Relationship to hearing.
(2)	As a disturbing factor of sleep.
(/) Vibration; including that from internal and
external sources.
To formulate criteria for the design of neighborhoods for
planners, developers, etc., to provide a healthful resi-
dential enviornment including, but not limited to	 AO	II
(~)	Basic requirements for site selection:
(1)	Physical characteristics of the site.
(2)	Proximity to hazards and nuisances.
(3)	Essential community facilities.
(~)	Utilities and services:
(1)	Water supply.
(2)	Sewage disposal.
(3)	Refuse and garbage disposal.
(4)	Telephone, electricity, and fuel.
(c)	Land use:
(1)	Housing and population densities.
(2)	Development of open space.
(d)	Vehicular and pedestrian facilities:
(1)	Roads and streets.
(2)	Vehicle parking.
(3)	Walkways.
To evaluate the adequacy of present governmental con-
trols to create and maintain a healthful residential
environment and to propose amendments and/or sup-
plements as necessary, including	 AO	II
(a)	Building codes.
(b)	Housing codes.
(c)	Fire and safety codes.
(d)	Zoning codes.
(e)	Subdivision regulations
(/) Other administrative legal instruments.
To determine the relationship of housing to health and to
health and to identify the causative and contributing
factors:
(a)	communicable disease					B	I
(b)	mental illness			B	I
(c)	chronic disease..		B	1
(d)	well-being		-				B	III
CODE:
i Caltgorv ofReuarek:	* Ricommmdtd Priority:
B—Basic.	I— Undertake as soon as possible.
O—Operational.	11—3 to A years.
A—Administrative.	Ill—6 to 10 years.
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110 ENVIRONMENTAL HEALTH PROBLEMS
Description 0} Tteiearch Area	Category» Priority1
To determine the role of the following in causing or con-
tributing to home accidents:
(~)	Design	 B	I
(1)	Of the dwelling unit and structure.
(2)	Of the installed equipment and facilities.
(3)	Of furniture and household utensils.
(4)	Of the neighborhood.
(~)	Illumination	 B	II
(c)	Noise and vibration	 B	II
(d)	Toxic or irritating gaBes, dust and fumes	 B	I
To determine the mechanism of the transmission of air-
borne disease organisms in dwellings and structures
heated or cooled by circulating air	 B	II
To evaluate the public health significance of exposure
over long periods of time to low concentrations of toxic
or irritant gases, fumes, dust, etc	 B	I
(~)	In the residential environment.
(~)	In other occupied space.
To revise the American Public Health Association's Ap-
praisal Method to Evaluate the Quality of Housing	 AO	I
(~)	To provide a technique for epidemiologists and
others to use in studying housing and health.
(~)	To provide an instrument for redevelopment
officials, planners, and others to determine
areas of communities which need corrective
action to provide a healthful environment and
indicate the type of corrective action that is
needed.
(c) To develop a precise index of the hygiene quality
of an individual dwelling unit or structure.
To evaluate the role of housing in the transmission of
virus diseases to man..			 BO	II
To determine if a relationship exists between juvenile
delinquency and housing quality.			 B	II
To develop more effective and efficient methods of treat-
ing solid and liquid wastes on-site in residential areas,
particularly in the suburbs and urban fringe areas	 B	III
To develop effective meanB of protecting inhabitants of
residences fTom radioactive substances including fallout. B	I
To develop criteria for the elderly and the handicapped to
provide a healthful residential environment for them
living independently to the maximum practical degree. BO	I
To determine adequacy of mobile homes as places of
prolonged residence of families with and without
children		 _			 O	III
To formulate design standards for mobile home parks to
create a healthful residential environment	 0	III
To define housing standards for itinerant workers	... AO	III
CODE:
1 Category of JUttarch:	' Recommended Priority:
B—Basic.	I—Undertake as soon as possible,
O—Operational.	11—2 to 6 yean.
A—Administrative,	III—6 to 10 years.
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Environmental Engineering
111
B. URBAN AND RECREATIONAL AREAS
Ducription 0/ Raearch Area Category1 Priority1
To assess health problems related directly to metropoli-
tanism	 B	I
(a)	To compare chronic disease rates in urban and
rural populations.-	 B	I
(b)	To compare communicable disease rates in
orowded urban areas versus sparsely populated
areas			 B	I
(c)	To determine the effects on health of levels of
community noise	 B	I
(d)	To evaluate health values of open spaces-—.,. B	I
To determine effects of environmental facilities on metro-
politan development patterns, and vice versa; relation-
ships to changing forms of metropolitan areas and
patterns of land use				 B, O, A I, II, III
(~)	To determine capacities, costs, operational char-
acteristics, and space requirements of various
typeB of sanitation facilities and services as
related to the planning function	 OA	II
(~)	To determine the role and limitations of various
types of sanitation systems and residential
development, by general classification, in serv-
ing future land UBe plans and urban area	 OA	II
(c)	To determine the effects of change in form of
sanitation services and facilities on urban de-
velopment	 B	II
(d)	To determine the effects of land use patterns on
sanitation and environmental health services
(various patterns and levels of service)..	 B	II
(e)	To determine the effects of various levels of user
charges on operation and utilization of public
and private sanitation and environmental
health service and facilities; also the effects of
different levels of charge on land use as well as
on all utilization of systems	 AB	I
(/) To determine theoretical limitations of possible
degrees of substitutions for various types of
services and facilities	.				 AB	I
(g) To determine zones of influence of major trunk-
lines of water and sewer facilities in terms of
residential and industrial development	 AB	II
(A) To develop concepts of points of diminishing
returns and break-even points for sanitation
1 and environmental health facilities, in relation
to unit components...				 B	I
(t) To develop methods for projecting the range of
possible future facility patterns within which
we have choice									... B	III
OODB:
1 Category of Rutarch:	t Rtcommtrubd Priority;
B—Bute.	I—Undertake as soon as possible,
0—Operational.	II—3 to 6 years.
A—Administrative.	in—i to 10 yean.
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m ENVIRONMENTAL HEALTH PROBLEMS
Deicription of Peiearch Area	Category' Priority *
(j) To assess forces shaping urban areas	 AB	I
(k) To determine restraints on change due to insti-
tutional, physical, or financial factors	 AB	II
(Z) To determine the relation of national, industrial,
and population changes to urban environ-
mental health projections	 B	III
Criteria development—
(o) To identify fundamental criteria for use in en-
vironmental health planning	 B	I
(6) To develop methods for use of mathematical
models, systems analysis, and computers for
evaluation of interaction and effect of various
cri teria	 B	I
(c) To research the methodology of sampling tech-
niques, survey techniques, and other tools
needed for studies	 OB	I
Social values related to environmental health—
(a)	To determine the effects of various types and lev-
els of environmental and sanitation services on
individual and family life; also neighborhood
relations	 AB	II
(b)	To assess the effects of open areas and recrea-
tional areas in relation to planning of residen-
tial development	 O	III
(c)	To determine the effects of social customs and
ethnic tendencies on the use and effectiveness
of environmental health measures	 B	III
(d)	To evaluate greater population mobility—short
term and long term—in relation to environ-
mental health planning	 OB	II
(e)	To identify and refine social criteria for decision
making in environmental health planning	 B	II
Economic development—industrial, commercial, trans-
portation—
(~)	To determine the effect of industrial growth and
development on planning for environmental
health and sanitation requirements	 A	III
(~)	To determine the effect of changes, such as shift
of commercial activity from central core to
fringe areas, on environmental health facilities
and services			 A	III
(c) To measure and analyze costs and benefits of al-
ternative interurban systems and services and
their effects on location and growth of indus-
trial and commercial areas	 AB	II
• Recommended Priority:
I—Undertake as soon as possible.
II—2 to a years.
Ill—6 to lo years.
CODE:
> Category of Reteareh:
B—Basic,
0—Operational.
A—Administrative.
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Environmental Engineering
113
Detcription of Research Area	Category J Priority1
Interrelationship between environmental health facilities
and services and other programs such as urban renewal,
urban highway, and airport programs—
{a) To develop methods of collaboration among
planners and program operators in different
fields of activity	 A	I
(b)	To study the impacts of urban renewal, highway,
and airport programs on environmental health
and sanitation facilities and service programs. 0	II
(c)	To determine the effect of changing modes of
transportation (i.e., to mass transit) on de-
velopment of metropolitan sanitation services. O	II
Intergovernmental relationships, financing, and admin-
istration—
(a)	To evaluate various systems of laws and regula-
tion to their effectiveness as environmental
health controls	 A	I
(b)	To define conflicting governmental programs of
public works or regulations as they affect envi-
ronmental health			._ A	III
(c)	To identify and evaluate trends in forms of gov-
ernment as they relate to environmental health. A	III
(<2) To determine the effectiveness of various forms
of financing sanitation facilities and services. A	II
(e) To determine the effect of different levels of gov-
ernment on administration and financing of
environmental sanitation facilities and services. AO	I
(/) To evaluate the effectiveness of communication
between government and citizenry on environ-
v menta) ,health problems			 AO	II
(g) To identify and analyze the decisionmaking pro-
cess						 B	II
C. WATER SUPPLY
To determine the future water supply needs—particularly
of urban areas	 AO	II
(~)	Relationship of concentration of population in
metro areas and availability of surface and
underground water resources to those areas... AO	II
(~)	Metro and municipal water supply planning and
evaluation related to development of adequate
water supplies	 AO	II
(c) Alternate water supply sources for emergency
needs	 AO	I
{d) Water resources management	 AO	III
CODE:
> Category of Research:	i Recommended Priority:
B—Basio.	I—Undertake as soon as possible.
0—Operational.	n—2 to 4 years.
f|| A—Administrative.	Ill—5 to 10 years.
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1U ENVIRONMENTAL HEALTH PROBLEMS
Description of Reiearck Area Category * Priority *
To determine efficient methods for water supply utiliza-
tion, augmentation, and development	 AO	I
(a)	Conservation of surface waters	 AO	I
(1)	Better utilization of wasted flood waters.
(2)	Control of evaporation.
(3)	High rate recharge aquifers.
(4)	Prevention of silting of reservoirs and
reclamation of silted reservoirs.
(b)	Conservation of ground waters	 BOA I
(1)	Self-purification of ground waters and
persistence of ground water contami-
nation.
(2)	Depletion and recharge of underground
reservoirs.
(c)	Water wastage control			 AO	I
(1)	Resources.
(2)	Plumbing design and installation.
(3)	Sociological factors.
(d)	Augmentation of water resources		BOA I
(1)	Development of marginal sources.
(2)	Conversion of sea water.
(3)	Extraction from atmosphere.
(4)	Reclamation of polluted water.
To determine the relationship of water quality—for drink-
ing, recreational, domestio, and food processing uses—
to the health of man	 BO	1
(a)	Communicable and chronic diseases incidence re-
lated to water quality		 BO	I
(b)	Optimum and minimum physical, chemical, and
biological standards for various water uses	 B	II
(c)	Standards for raw water quality related to in-
tended usage and treatment available	 B	II
(d)	Beneficial effects of constituents in or added to
water supplies—fluorides, etc	 BO	II
(«) Criteria for public acceptability and economic
factors of water supplies—taste, odor, color,
hardness, etc	 BO	II
(J) Effects of algae and other organisms on water
quality			 B	II
(g)	Effects of gross and trace quantities of chemicals
in water on humans			 B	I
(h)	Effects of viruses in water supplies on humans.. BO	I
(0 Toxicological significance of organio chemicals in
water fertilizers, insecticides, weedicides, and
other agricultural poisons. What is the effect
of ohronio toxicity when combined with other
environmental conditions?	- BO	I
(J) Effect of antibiotics in water supplies	 BO	I
(&) Effects of detergents in water supplies	 B	I
CODE:
i Cattgwy of Rttearch:	* Rtammtniei Priority:
B—Baalo.	I—Undertake as soon as possible.
O—Operational.	II—2 to 6 years.
A—Administrative.	Ill—J to 10 years.
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Environmental Engineering
116
Description of Research Area	Category	Priority >
(I) Standards for temporary emergency supplies	 B	I
(to) Relationship between risk of infection and bao-
terial standards—particularly tracer organ-
isms—for drinking and swimming water	 BO	I
(n) Effects of metals and salts of metals on humans
(also organic compounds)	 B	I
To develop, improve, and standardize laboratory quality
control					-	- B	I—II
(o) Methods for recovery, identification, and enumer-
ation of viruses such as infectious hepatitis,
etc	 B	I
(6) Methods for accurate and rapid detection and
determination of toxic chemicals in trace
quantities, such as endrin, etc	 B	I
(c)	Methods for accurate and rapid determination
of biological organisms		 B	I
(d)	Methods for determining specific radionuclides.. B	II
(ie) Automated quality determination and control.. BO II
To develop and improve systems for water treatment	 BO	II
(~)	Development of equipment and operational
system design for more effective removal of
harmful substances or less costly operation.
(~)	Particulate removal	 B	I
(e)	Removal of chemicals in solutions (heavy metals
and salts of heavy metals) and synthetic chem-
icals (detergents, insecticides, antibiotics, etc.)- B	II
(d)	Removal of viruses			 B	II
(e)	Coagulant aids		 BO II
(f)	Automated treatment			 O	III
(g)	Hardness removal—central vs. individual and
home treatment		 AO	II
(A) Mechanisms for the removal or inactivation of
sulfates, nitrates, and phosphates in waste
waters used for ground water recharge		 B	II
To determine and control water quality deterioration In
distribution systems	 0	II
(a)	Decontamination of reservoirs and systems	 0	II
(b)	Control organisms and pests in water distribution
systems and in reservoirs on the system		 O	III
(c)	Effectiveness of devices to prevent baokflow or
introduction of contamination into distribu-
tion system.				 0	I
(d)	Programs for detection and control of distribution
system hazards..		 A	I
(e)	Topological determination of piping materials
and other contact surfaces, Buoh as plastic pipe
or coatings	 BO	II
(f)	Performance of plumbing systems and devices
and appliances	„	 0	II
CODE:
' Oategors of Retearch:	»Recommended Priority:
B—Basic.	I—Undertake as soon as possible.
0—Operational.	II—2 to 8 years.
A—Administrative.	m—t to 10 years.
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116 ENVIRONMENTAL HEALTH PROBLEMS
Description of Research Area	Category1 Priority *
(:g) Pressure and flow problems in distribution system
and plumbing	 O	III
(A) Disinfection procedures	 BO	II
(i) Corrosion control	 BO	III
To determine related factors influencing water supply
programs	 A	I
(a)	Develop health information	 A	I
(b)	Manpower requirements	 A	I
(c)	Training of operational personnel—especially the
smaller plants	 A	I
(d)	Political, social, and economic factors in devel-
opment-relationship between water supply and
subdivision development	 A	II
To determine health hazards associated with recreational
water use and effective measures to control any hazards. O	II
(a) Determination of topological and physiological
effects of such chemicals as iodine and isocya-
nine compounds	 B	I
(&) Operational problems of backyard swimming
pools	 0	II
(c)	Treatment and operation of swimming pools	 O	II
(d)	Effect of recreational use on water supply quality. O	II
(e)	Evaluating chemicals proposed for use in swim-
ming pool disinfection	 B	II
(/) Determination of optimum design criteria for ma-
terials, shapes, depths, and bathing load of
swimming pools for maximum safety and acci-
dent prevention	 B	III
(g) Determination of required bacteriological quality
standards for outdoor water sports and bathing
waters	 B	III
(A) Development of new practical and economical
methods of maintaining satisfactory water
quality for small backyard swimming pools	 BO	III
(z) Communicable disease transmission factors in
residential swimming pools	 BO	II
To develop systems for dispensing safe drinking water
from moving conveyances—ships, airplanes, trains,
vehicles, etc		 O	III
(~)	Water supply to conveyance	 O	III
(~)	Distribution system aboard conveyance	 0	III
(e) Closed systems		 O	III
CODE:
* Category of Research:	* Recommended Priority:
B—Basic.	I—Undertake as soon as possible.
O—Operational.	II—2 to 6 years.
A—Administrative,	III—6 to 10 yeaas.
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Environmental Engineering
117
D. AREAS OF NEEDED RESEARCH IN SOLID WASTES
Deteription of Retearch Area	Category1 Priority1
1.	To determine the relationship between property value,
or lot size, on the content and quantity of refuse
produced per capita		 B	III
2.	To determine the effects of different provisions of laws
and regulations governing refuse storage and collec-
tion practices; their effect on refuse production, on-
site disposal practices, sanitation, and total cost of
service	 A	III
3.	To develop "public education" measures which would
increase efficiency and effectiveness of refuse collec-
tion operations	 A	III
4.	To develop criteria or guidelines for refuse storage,
collection, and disposal to improve service, sanita-
tion, and efficiency	 A	II
5.	To determine the economic feasibility of compressing
and packaging refuse on the premises, or collection
trucks, and at sanitary landfill sites	 B	II
6.	To determine if controls can be developed to assure
the safe and satisfactory operation of home incinera-
tors with mixed refuse and with rubbish	 0	II
7.	To determine the economic feasibility of using home
incinerators instead of providing refuse collection
service	 0	II
8.	To determine the economic feasibility and sanitation
benefits of using disposable containers in refuse
collection operations	 O	II
9.	To determine the feasibility and sanitation benefits
of using chutes, moving belts, or other materials
handling methods in the collection of refuse from
apartment buildings and multiple family units	 O	II
10.	To determine the economic feasibility of using port-
able or truck-mounted incinerators for reducing the
volume of refuse and demolition debris	 0	III
11.	To determine the characteristics of the end products of
refuse disposal systems, their UBe, and market value,
such as finding methods or ways to utilize metals
found in incinerator residue	 B	I
12.	To determine the design criteria, and operation prac-
tices necessary to increase the efficiency of central
municipal incinerators	 B	III
13.	To determine the effects of the changing contents of
refuse on the various methods of disposal	 O	III
14.	To develop administrative and technical methods
that can be used to secure the optimum use of man-
power in refuse collection operations	 A	II
15.	To determine the rate of fly production of commonly
encountered solid wastes				 B	I
CODE:
i Cattgory of Rtuarch:	> Recommended Priority:
B—Bade.	I—Undertake as soon as possible,
O—Operational.	n—3 to 6 yean,
A—Administrative.	Ill—a to 10 years.
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118 ENVIRONMENTAL HEALTH PROBLEMS
DeecripHon of Rtsearch Area	Category i Priority1
16.	To develop a method of field testing to measure the
degree of soil compaction necessary to prevent the
emergence of flies from sanitary landfills. Specifi-
cally, the study should correlate instrumentation
to the emergence of adult flies from compacted soil. B	I
17.	To determine the economic feasibility of composting
as a method of solid waste disposal in communities
of varying size, i.e., establish the market for com-
post in agriculture, home gardening, and nursery
use as related to packaging and distribution costs.. A	I
18.	To determine the monetary value of compost to agri-
culture in terms of soil improvement or increases
in plant germination, growth, or yield	 B	I
19.	To determine criteria or guidelines for the handling
of demolition wastes	 B	I
(a)	Weight, volume, and character of wastes pro-
duced in metropolitan areas, based on popu-
lation served	 B	I
(b)	Cost of on-site burning...	 B	I
(c)	Cost of hauling and off-site burning—both
burning at a central site and in tepee
burners		 B	I
(d)	Cost of hauling and filling		 B	I
(e)	Cost of hauling and incineration	 B	I
(J) Measurement of weight and volume of demo-
lition wastes produced per square foot of
floorspace of buildings being razed	 B	I
20.	To determine the contribution to air pollution of open
burning of refuse	 B	I
(a) Open dumps	 B	I
(ft) Controlled burning dumps—ramp burning
or bank burning	 B	I
(c)	Backyard burning			 B	I
(d)	Agricultural burning	 B	I
(e)	Methods of laying fires to reduce air pollution.. B	I
21.	To determine the effects of refuse dumps and landfills
on ground water, Including operations receiving
mixed refuse and operations receiving rubbish only. B	I
22.	To develop a simple and reliable method 6f deter-
mining concentrations of particulate matter in
stack discharges from incinerators by using the
light refraction principle rather that the present
colormetric method of analysis	 B	I
23.	To determine the effect of the mass installation of
commercial and household garbage grinders on
water consumption and on sewage treatment
facilities	 B	II
OODB:
* Category of Rutaroh;	> Recommended Priority:
B—Ba«lo.	I—Undertake as soon aa poadbto.
O—Operational.	II—2 to fi years.
A—Administrative.	Ill—5 to 10 years.
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Environmental Engineering
119
Description of Raearch Area Categorv1 Priority *
24. To determine the most economic operating charac-
teristics of existing and commercially available
municipal incinerators. This would enable these
incinerators to be classified according to the range
of calorific value of the refuse for which they are
best suited			 O	I
CODE:
Categorv of Reuareht	1 Recommended Priority:
B—Basic.	I—Undertake as soon as possible.
O—Operational.	11—2 to 8 years.
A—Mdmlnifltrative.	in—6 to 10 years.
E. SOCIAL SCIENCE AND ENVIRONMENTAL HEALTH
COMMENTS ON SCOPE
The definition of environmental health which is suggested by the
Subcommittee structure of the Main Committee excludes much of the
environmental health area with which social scientists are concerned.
For example, mental health, apart from occupational health, seems to
be excluded. If so, the interests of the sociologist, anthropologist,
psychiatrist, and many medical people in the metropolitan area as an
environment for man in great measure are outside Committee con-
cern. The functions suggested for the proposed new Bureau of Com-
munity Health by the Study Group on Mission and Organization of
the Public Health Service, also include many of these aspects of health
services in the urban area which are of basic concern to the social
scientists. Thus the definition of environmental health with which
we are working excludes much of the area of direct interest to social
scientists.
The comments which follow assume these limitations on the defini-
tion of the field of environmental health.
PARTICIPATION BY SOCIAL SCIENCES IN ENVIRONMENTAL
HEALTH RESEARCH
There is probably no aspect of environmental health, however nar-
rowly or broadly defined, to which the social sciences cannot make a
contribution. The environment in which man meets health chal-
lenges is inevitably social as well as physical.
Experience suggests that if social scientists are to make their maxi-
mum contribution, they should participate in at least two ways in
program formulation and conduct.
The first grows out of exposure of social scientists to the engineers
and natural scientists that are engaged in research in such program
areas as water pollution, air pollution, radiological health, housing,
food supply, etc. One or more social scientists participating in the
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120 ENVIRONMENTAL HEALTH PROBLEMS
deliverations of such groups can, at minimum, point out the existence
of economic, social, and administrative considerations that influence
the parameters of the physical problems under examination. For ex-
ample, the newest health hazards come from radiation but the degree
and nature of atomic energy and fissionable materials employed in
industrial production are both technical and economic questions. The
economist should, therefore, be a part of the team effort directed at
understanding and eventually controlling the threat to environmental
health caused by radiation. Similar technological changes lie behind
the new or enlarged areas of environmental and occupational health
and social scientists have a contribution to make to this understanding.
Also directly related to environmental health is urbanization and
suburbanization of American society. The nature and trend of popu-
lation concentration, the economic and social pattern of people living
in the areas, their cultural traditions, the public and private social
institutions in which they live and participate are a direct part of the
environmental health problem, especially so when corrective action is
the aim. For example, air pollution is related to commuting methods
and patterns as well as to industrial location. Commuting patterns
is an area where economists, political scientists, sociologists, and
geographers have been paying increasing attention and can contribute
significantly to research. The development of improved mass transit
systems or the ending of those now in operation have a significant
bearing on air pollution. The Los Angeles studies estimated that
69 percent of the hydrocarbons deposited in the air each day came
from automobiles, trucks, and buses. Thus, individual driving habits,
future trends, and their relationship to road patterns, industrial and
recreational locations, are aspects of the problem of air pollution which
can be usefully studied by economists, geographers, and other social
scientists.
These examples are intended to indicate that the traditional areas
of study in environmental health have underlying social causes to
which social scientists can contribute insight, especially when the ob-
jective is to develop standards for use in systems of social control.
The second kind of participation by social scientists in environ-
mental health studies may perhaps be best undertaken without con-
tinuous exposure to the work of the physical, life, and engineering
sciences directed at the more specific health problems. At least it is
suggested that a small group of social and other scientists could use-
fully be engaged in focusing on the complex administrative and inter-
governmental relation of the traditional program areas.
Such a group should also look at the multidimensional character of
the concepts of health and environment, and the complex behavior
patterns which compose the modern metropolitan area. This need is
also suggested by the fact that the Public Health Service shares its
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Environmental Engineering
121
concern with environmental problems with many other Federal de-
partments and agencies. The impact of the multiple Federal pro-
grams at the local government level, when not coordinated can be
devisive and not effective.
If Public Health Service programs are to be relevant and influential
at the metropolitan level, this condition needs to be reflected in Ad-
ministration in Washington, the State capitals, as well as at the local
level.
A multidisciplinary team set to work on the health environment as
a total system would perhaps open up new doors for health re-
searchers. For example, such a team might select one or a few
metropolitan communities as case studies for testing such techniques.
What is suggested here is an enlargement of the work proposed for
the Division of Environmental Economics and Organization, in the
report of the Study Group on Mission and Organization of the Public
Health Service.
An ideal setting for the work of such a group would be the pro-
posed environmental health center.
SOME EXAMPLES OF METROPOLITAN AREA PROBLEMS IMPORTANT
TO THE IMPROVING OF ENVIRONMENTAL HEALTH
Improvement in environmental health is possible only to the degree
that its hazards can be eliminated or mitigated or to the extent that
man's behavior can be altered in ways which will reduce his suscepti-
bility to the hazards. Again, staying within the usual fields included
in environmental health, the social scientist has a great deal to
contribute.
Most threats to environmental health cover geographic areas which
are larger than the traditional political boundaries which constitute
the basic State and local governmental system of this country. The
problem of fragmented government is particularly acute in metro-
politan areas and it is in these areas that the problems of environ-
mental health are most serious. Further, these health problems are
no respecters of the boundaries which divide these areas into literally
hundreds of semiindependent principalities. Air and water pollu-
tion, and radiation are hardly controllable unless the attach can be
made on an areawide basis. The possibility of such areawide co-
operation is a field which has been extensively researched by political
scientists during the last decade. Most practical advances have been
made through the use of the areawide functional special district. The
employment of this and other governmental innovations may well fit
the need of the public health function. Different problems are being
created, however, by the mushrooming of these special districts. Some
central function is going to play a coordinating role; health may be
the logical function for this purpose.
627408—62	9
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m ENVIRONMENTAL HEALTH PROBLEMS
There is also need for more specific research projects: looking to
ways and means of meeting area environmental health problems,
within the framework of the existing governmental structures.
Health programs also cost money—usually tax money. Can a local
community afford to conduct the kind of programs which may be
necessary to alleviate certain health hazards ? Measuring community
resources, particularly in metropolitan areas, is a complex problem.
A whole metropolitan area, for example, may have sufficient fiscal
capacity to carry out an extensive health improvement program; yet
many of the governmental units which constitute the area may lack
the necessary resources. Or a program may require interstate co-
operation—many metropolitan areas cross State lines—and such co-
operation may present legal and constitutional barriers that only
experts in law understand. A critical evaluation of interstate com-
pacts might prove valuable in this connection.
Health programs often involve extensive regulatory activity by
government. Programs in the environmental health field are likely to
require a type of regulation which reflects the highly scientific content
of the standards and their probable highly restrictive intent. Do local
and State governments possess the type of personnel which such pro-
grams will require ? If not, what kind of training will be needed to
produce them? The best designed program has no possibility of
success unless it is carried into the field by personnel capable of ap-
plying it. Further, the regulated publics will have to be educated
to a level of understanding in order to secure compliance, which is
required in few fields today.
Environmental health is also more closely related to overall physical
and social planning than any other part of the health field. How are
environmental health needs going to be integrated into the planning
process? Population density, for example, is inevitably related to
environmental health, yet densities are more often determined by
economic and political than by health considerations. Environmental
health programs dependent on particular population densities are not
likely to succeed unless coordinated with actual densities. The need
here is twofold. First, research in environmental health to be mean-
ingful must take into consideration the kind of densities likely and,
second, health considerations should in some way be integrated into
overall planning in order to provide the densities least harmful to
good environmental health. Further, many private economic de-
cisions uncontrolled by the public planning agency may adversely
affect the community health and should therefore be brought into the
planning purview. Here the planners need improved measurements
and standards to guide their decision, and these can best be derived by
the doctors, physical scientists, life scientists, and engineers working
together on these problems.
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Environmental Engineering
123
In all of these applied areas, the social and natural scientists work-
ing in environmental health complement each other. In order to
develop programs which are realistic and in order to understand better
what is necessary to get the programs adopted and correctly adminis-
tered requires a team effort.
A few more specific illustrations may serve to demonstrate the
viability of a metropolitan perspective in research on environmental
health problems.
Pollution Control
One field is the problem of administration of pollution regulat ions.
A significant part of the recent Delaware Valley Project dealt with
this subject and points to the need to view enforcement problems in
the context of a total river system and of the multipurpose use of its
water. Similar comprehensive studies need to be made of enforce-
ment practices and experience in air pollution and in the control of
food and milk moving in metropolitan areas. While many small
studies have been made, few have been directed toward a concern for
developing national enforcement standards and methods.
Metropolitan Cooperation and Health
A study of an unsuccessful effort to create a county health depart-
ment, and a more recent study of the social forces blocking State
efforts to create county wide health departments are examples of rele-
vant social science research. The similar failures to secure public
action on water fluoridation suggests the need for social science re-
search into public attitudes as a basis for health action.
Closely related in subject matter would be the study of interstate
cooperation in health matters. Particularly in metropolitan areas
interstate cooperation has become an essential to an effective attack
upon common problems. Today air pollution and water pollution are
of special interest in this connection, but these are only two aspects of
the problem. Recent social and legal research has produced an ac-
cumulation of knowledge in the field of interstate cooperation and in
the use and limits of the interstate compact which needs to be related
to public health. What is suggested is studies of metropolitan health
problems that would be comparable to those conducted in the mass
transit field by the Transportation Center at Northwestern.
Code Development and Enforcement
Research projects concerned with housing problems, with the Gov-
ernment's regulation of private housing, with zoning as a land planning
tool are all relevant to environmental health in cities. The use of
standards and their acceptability in the light of political, economic,
and cultural factors is of importance to gain acceptance for research
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m ENVIRONMENTAL HEALTH PROBLEMS
results. The fact that such standards are of local origin and use,
gives rise to economic and health problems of national concern by
imposing standards unrelated to the most up-to-date knowledge in the
public health fields.
Ethnic Minorities and Public Health
Increasingly society's contact with new groups of immigrants in
our metropolitan centers occurs through the five partners of the
minister, teacher, policeman, welfare official, and public health officer.
The first two have always been a part of the assimilation process in
the United States, but the latter two are relatively new on the scene
and partly have served to take the place of the professional machine
politician. This alternation in roles might be examined from any
one of a variety of angles: (1) The problems facing the public health
officer in enforcing regulations that are not understood by the minority
groups involved; (2) the development of a consistent policy toward
the minority group that can be used to provide directives for such
professional personnel. The New York City Puerto Rican popu-
lation would be an obvious subject of study in such an inquiry.
Suburban Schools and Gray Area Schools as Ilr-Ai/rn Problems
Among the problems produced by high density of population com-
bined with administrative separation from the central city are the
development of health programs and health standards for the sub-
urban and rural school systems. As the upper and middle income
group move from the central core of the city, the children who remain
also present a special health problem and a special opportunity for
effective health action programs addressed to improving living con-
ditions in general.
Local Finance and Public Health
Research in what is often described as the community power struc-
ture is currently extremely fashionable in social science. Numerous
attempts have been made to explicate the process by which decisions
are made in the local community and to classify the variations. One
of the questions still largely left unanswered is the extent to which the
local community leaders fire free to make decisions and the extent to
which decisions are forced upon them by circumstances inherent
in their environment. Thus, Robert Wood's study of the New York
metropolitan area governments has generated the suggestion that the
greater part of the variation in local government expenditures can be
explained by variations in population, tax resources, etc.; little leeway
is left in the form of unexplained variance for the operation of local
community decisionmaking. One of the first detailed explorations of
the subject is currently underway as part of the Carnegie program of
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Environmental Engineering
125
research in educational problems. Economists, sociologists, and polit-
ical scientists have joined in a statistical study of variations in local
government spending on schools. A comparable study of local gov-
ernment health expenditures might profit from the methodological
advances made, contribute to the knowledge of the public health pro-
fession as to its fiscal environment, and provide useful comparative
data for the student of local government finance.
Other aspects of the study of community power structure would
also be relevant to the overall research theme proposed. One of the
pioneer comparative studies in this area was Paul A. Miller's "Com-
munity Health Action," a study of initiation of hospital construction
applications under the Hill-Burton Act. Charles Wille has pub-
lished a similar study of the conflict surrounding a proposal to build
a community hospital in "Patients, Physicians, and Illness: A Source
Book in Behavioral Science and Medicine." The methods involved in
these studies are relevant to studies needed to secure action in areas
of environmental health.
Health Professionals and Community Decisionmaking
One of the principal methodological contributions of metropolitan
leadership studies has been the formulation of a procedure to deter-
mine the degree of overlap among the community participants in
decisionmaking in the various functional fields; e.g., do the same
men who determine who is nominated for the city council also appoint
school superintendents, etc. ? Research employing these same proce-
dures might be used to identify the character of public participation
in decisionmaking affecting health and to fix the position of the
health professionals in relation to them.
Metropolitan Reorganization and the Private Health Agencies
Usually the problem of metropolitan reorganization is presented
in terms of public instrumentalities; it exists, however, for private
agencies that are structured around separate communities as well.
What happens when a previously separate community is absorbed into
the metropolitan areas as a suburb; how freely do the suburban pri-
vate health agencies accept incorporation into metropolitan-level
organizations? These and related questions might also be explored.
Safety and the Automobile as a Public Health Problem
The car, the driver, the highway, the manufacturer, the police, and
the lawmakers represent a system. This is the system that produces
the automobile accident—4,888,000 injuries in 1957 reported by the
U.S. Public Health Service. This environmental health problem
cannot be left to the highway engineers, or even the automobile en-
gineers. It is a logical system for the epidemiologist to study together
with social scientists and engineers.
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126 ENVIRONMENTAL HEALTH PROBLEMS
F. AREAS OF SPECIALIZATION REQUIRED TO ATTAIN
LONG-RANGE PROGRAM GOALS
The Division's diverse responsibilities in providing protection and
improvement of public health ill the areas of environmental engineer-
ing and food protection require numerous areas of professional spe-
cialization. There are three basic objectives to be met for each
individual program goal:
1.	The identification, measure, and assessment of problems;
2.	The development of standards, criteria, and practices necessary to solve
these problems;
3.	The application of the most current standards and techniques toward the
solution of problem situations and the enforcement of regulations under legis-
lative responsibilities.
There is a need for expanding basic and applied research, technical
assistance competency, standards development, training activities, and
interstate control procedures.
The professional resources required to attain the Division objec-
tives are described below under four categorical headings reflecting
the overall development which each specialized area is expected to
attain within the coming 5 years. The status of these specialties will
change progressively as new problems appear and additional tech-
niques or pertinent knowledge becomes available. New specialties
will undoubtedly need to be added and the emphasis on existing areas
of competence will require adjustments to meet the changing problems
in environmental public health.
INDEPENDENT RESOURCES
The areas of specialization in this category form the core of the
professional resources required to meet the Division's research, tech-
nical consultation, training, and related responsibilities. Each area
will be developed in depth to serve the principal day-to-day needs of
the Division.
Engineers
Sanitary engineers with competence in water treatment, sewage dis-
posal, solid-waste methodology, and applied radiological health. Also
included are sanitary engineers with special orientation to metro-
politan planning and development problems and techniques. Sani-
tary engineers will be available for consultation and technical assist-
ance at the local levels or at the operational level as well as lending
their specialized knowledge in developing research information.
Chemical engineers with competence in research evaluation of food-
processing techniques, water purification, and swimming pool equip-
ment and operation.
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Environmental Engineering
m
Mechanical engineers equipped to investigate problems relative to
the design, construction, and operation of food equipment; control
of time-temperature operations; ultra-high-temperature pasteuriza-
tion ; dehydro-freezing; and hydraulics and pneumatics for application
to plumbing and water-supply systems.
Marine engineers for vessel construction and facility review at oper-
ational level; competence in nuclear powerplant installation and
shielding will supplement the basic marine engineering skills.
Physical Sciences
Chemists with competence in inorganic, organic, and biochemistry
for application to problems in enzymology, metabolism, nutrition, im-
munology, and other subspecialties related to the study of natural food
products. Strong support will be needed in physical, organic, in-
organic, and analytical chemistry to deal with the increasing problems
of hazardous chemical contamination of foods. Radiochemistry will
be essential component of this area, because of special significance of
foods as sources of environmental radioactivity and the importance of
tracer techniques in research. Special competence in water floccula-
tion and treatment, water-supply-quality evaluation, and sewage-
treatment techniques would also be required.
Physicists: The application of engineering physics to the research
areas in sound, light, vibration, and other preceptory phenomena will
be required. Physicists with special competence in health physics
will be utilized at the field level for problems involving radiation
hazards.
Life Sciences
Microbiology: Specialists in bacteriology, virology, mycology, and
parasitology will be required to investigate the causative agents of
food infection or intoxication and to develop control measures. Ori-
entation to microbial physiology, genetics, and serology, as well as to
medical, veterinary, sanitary, dairy, and marine microbiology, will
be necessary to investigate the public health implication of microbial
food contamination, develop sanitation standards, and devise pre-
ventive measure applicable to the preparation and serving of foods.
Special competence in water microbiology will supplement the chem-
ical and engineering skills also applied to this problem area.
Sanitarians and health service officers: Specialist in the applica-
tion of research information and techniques in the areas of microbi-
ology, entymology, and zoology in carrier sanitation and vector control
and for each class of highly perishable foods such as milk, shellfish,
meat, and poultry products will be required at the field level to conduct
studies and demonstration projects and perform surveillance
operations.
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128 ENVIRONMENTAL HEALTH PROBLEMS
Metropolitan Planning and Development Specialists
Political-economic disciplines; Political scientists, economists, and
attorneys with special orientation of their skills toward assessing and
solving metropolitan planning problems in such categories as local
and State political structures, public utility financing, community
economic base studies, enabling legislation at local, State, and regional
levels.
City planners to perform studies and demonstration projects and
furnish technical assistance to local, State, and regional units.
Health Educators and Technical Information Specialists
This group will have the prime responsibility of—
(~)	Enlisting community participation in study areas and demonstration
projects; and
(~)	Insuring that all research information submitted be available to the
scientific community for application to existing problems and to prevent duplica-
tion in research investigations and the application of research information to
operational programs.
DEPENDENT RESOURCES
Included in this category are areas of specialization for which the
Division must have the competence to meet its ordinary needs, but will
also require the support of other groups with respect to fundamental
or theoretical research and unusual equipment or professional talent.
Physical Sciences
Toxicologists: The Division will need the services of chemists,
pharmacologists, and pathologists to evaluate experimentally and
judgmentally the health hazards of foreign chemicals and natural
constituents found in foods. Recommendation of safe practices and
control measures will be a part of their responsibilities. Toxicologists
will be needed to evaluate materials proposed in construction of
equipment having public health significance and such special problems
as insecticide residues in food products and stored-water supplies.
This competence would be shared with such elements as the Division
of Water Supply and Pollution Control and the Division of Air
Pollution.
Physicists; Specialists capable of utilizing complex physical in-
strumentation and interpreting the results will be needed to charac-
terize foods and their significant components or contaminants. The
orientation of the work will be primarily to biophysics, but knowledge
of both radiation physics and the classical physics of heat and pressure
will also be required. In recognition of the very high degrees of
specialization within this area and the large investment required for
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Environmental Engineering
m
proper instrumentation, the Division will also need the support of
other groups with related competences. Quite probably a central
facility will best serve the needs for the most costly items which are
infrequently used by any division.
Statisticians: In this area, a distinction is made between statistical
design and analysis of data, on the one hand, and the broader areas
of systems analysis, data retrieval, and operations research which are
considered in the Category III, "Pooled Resources." The Division
will require a statistical staff and facilities sufficient to develop sound
protocols for research, evaluate technical data, and record information
in forms which can be subjected to more sophisticated statistical treat-
ment. Although the Division will need machines and staff for coding,
sorting, and collating statistical information, it will depend on others
for computer services and the development of mathematical statistics
to meet its needs.
Life Sciences
Hydrography: The special problems associated with production,
harvesting, and processing of raw shellfish and other seafoods re-
quires the attention of specialists in marine biology and oceanography
to complement the chemical and microbiological work on sanitation of
these products. Because of the allied interests of the Division of
Water Supply and Pollution Control, coordination of work in this
area is contemplated.
Medical Sciences
Physiologists will be required to evaluate physical effects of precep-
tory phenomena such as excessive levels of vibration, sound, tempera-
ture and related environmental factors encountered in the urban
environment.
Epidemiologists: Both "classical" and "experimental" epidemiolo-
gists will be needed to investigate the occurrence, causes, and circum-
stances associated with illness as attributed to foods. Field studies
with human populations, as well as experiments with animal popula-
tions, will be conducted in this area to examine critically and perhaps
extend the precepts of epidemiology with respect to the impact of both
food contaminants and food itself on health. Such specialists will
also determine sources and dissemination of communicable diseases
through food-service operations on interstate carriers, such recrea-
tional media as swimming pools and bathing places, and vector borne
disease problems stemming from faulty waste-disposal practices.
Behavioral Sciences
Psychologists 
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180 ENVIRONMENTAL HEALTH PROBLEMS
the individual, the family structure, and the overall community social
framework. The effects of changing environmental factors on the
populations of our urban centers must be evaluated in the sociological
and psychological aspects which will then be supplemented by what-
ever data of a physiological nature can be obtained. This total pic-
ture of deleterious effects of urban problems on our social structure
will provide positive guidelines not presently available for recom-
mending and implementing expanded community services and environ-
mental health measures.
Training
Training officers and specialists will insure that survey and evalua-
tion techniques, developed in the research area, are made available to
field personnel and that the latest and best techniques devised in the
research community are made available to the regional staffs. They
must be capable of recognizing, interpreting, and communicating
technical information of value in public health practice. They will
need the support of other professional staff members and consultants,
as well as certain training facilities available to the Center as a whole.
Administration and Management
In order to work effectively within the administrative framework
of the Bureau, DEEFP will need the full-time services of specialists
in personnel, fiscal management, procurement, management, and bibli-
ographic services, as well as skilled illustrators, draftsmen, shop-
workers, janitors, and emergency maintenance personnel. This group
will be heavily dependent on the central management and service
groups available to the Center as a whole.
POOLED RESOURCES
Areas of specilization in this category will be supported in common
with others using divisions at a single location. DEEFP will employ
ancillary specialists who have some knowledge of these fields, but will
depend on the central organization for facilities and additional talent.
Areas included here differ from those in category II with respect to
the degree of internal development required to meet the needs of the
Division.
ADPS Unit
Systems amtysis: As noted above, DEEFP has need for sup-
porting resources which will bring to bear advanced mathematical
theory and data processing equipment on the public health surveillance
of the environment. These resources will supplement the internal
statistical competence of the Division if a central facility is provided*
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Environmental Engineering
131
Physical Sciences
Mathematieicma to develop mathematical models for solving aspects
of environmental programs in community development and planning
on a predictive basis wherever possible.
Olimatologists: Rainfall, temperature, day length, and other cli-
matic factors are well known to affect the composition of food crops.
In order to assess the role of these factors in the uptake of radionu-
clides, agricultural chemicals, and soil constituents, climatologic
studies will be required. Studies may also be needed on the rela-
tion of climate to human nutrition.
Life Sciences
Ecologiats: Understanding of the health problems associated with
foods requires knowledge of food chains and the factors that determine
the dietary habits of man. These important components of human
ecology can best be investigated in broad studies, but are of special
interest to DEEFP.
Radiation and Reactor Technology
These specialists will represent a very high degree of competence
in the specialized aspects of radiological health and nuclear reactor
technology. DEEFP has direct interests in (a) the possible contri-
bution of reactors to radionuclide contamination of foodst and (6)
the utilization of high-energy sources as tools for research on radia-
tion sterilization and neutron activation analysis. Because of tile
high costs involved, the Division would prefer to utilize a central
facility which might be constructed and operated by the Division of
Radiological Health. In addition, such projects as the evaluation of
radiochemical constituents in water supplies and specialized prob-
lems in nuclear powerplanfc units on ships would be investigated by
these specialists.
UNDEVELOPED RESOURCES
This includes categories to be drawn upon intermittently for special
projects or problem application and will consist primarily in profes-
sional competencies retained under contract or by consultant appoint-
ments. Other elements of the Service are also included which would
not be found within the projected Bureau structure.
Clinical and Medical Disciplines
Specialists in such fields as geriatrics, pediatrics, radiology, allergy,
dentistry, and internal medicine may be needed to undertake specific
studies or provide advice on responses of man and animals to food
constituents and dietary regimens.
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m ENVIRONMENTAL HEALTH PROBLEMS
Other Areas
Even within the areas where the Division has considerable com-
petence, situations will almost certainly arise which require the help
of additional specialists in such fields as spectroscopy, organic syn-
thesis, chemotherapy, electron microscopy, and the like. The full
range of possibilities cannot be clearly defined in advance, but ample
provision should be made for the temporary employment of such in-
dividuals on a basis that will be mutually acceptable to them and to
the Government.
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Report of the Subcommittee ok
MILK AND FOOD
CONCLUSIONS AND RECOMMENDATIONS
The principal conclusions and recommendations of the Milk and
Food Subcommittee, regarding the food-protection aspects of environ-
mental health, are summarized below.
Conclusions
1.	Food is a major component of man's environment, which exerts
important multiple effects on human physiology and psychology.
Food may also serve as a carrier of chemical and biological contami-
nants acquired from soil, air, water, food handlers, equipment, and
many other sources. Much useful information is at hand concerning
the impact of diet and food contaminants on health, but the more
subtle relationships are not yet clearly understood. Enough is known,
however, to suggest that food, alone or in concert with other factors,
may affect man's response to nearly all environmental stresses.
2.	There is an enormous and rapidly increasing disparity between
the rate at which new public health problems are arising, due to
growth and technological changes in the food field and the level of
effort being directed toward their solution. The food industries and
governmental enforcement agencies are actively engaged in the com-
mercial application of new processes and in determining compliance
of finished products with existing standards. They urgently need
the active participation and leadership of the Public Health Service
in a national program to develop additional information, methods,
and criteria applicable to new products which may be used to protect
the health and welfare of the consumer.
3.	It is necessary that the Public Health Service program in food
protection include aspects of the problem not now being studied. In
areas of common interest, collaboration with other governmental
agencies will be required. Among the major problems of public
health concern are the following:
a. Prevention and control of foodborne-disease outbreaks caused by micro-
organisms or their toxic products, which represent one of the more common
categories of nonfatal illness In the United States.
& Determination of the health effects of foreign chemicals occurring In food as
residues, additives, or fallout.
a Assessment of the physiological significance of the complex chemical and
physical changes resulting from novel methods of processing, packaging, storing,
and marketing convenience foods.
d. Development of criteria and methods for determining food safety.
ffl
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m ENVIRONMENTAL HEALTH PROBLEMS
e.	Surveillance of the consumer food supply with respect to sanitary quality.
f.	Evaluation of food equipment and processes from the public health view-
point.
g.	Improvement of control techniques used by health agencies in the field of
food protection.
4.	The current Milk and Food Program of the Public Health Serv-
ice is making valuable contributions in the areas of milk, shellfish,
and food service sanitation, which fortify, rather than duplicate, the
work of industry and other governmental agencies in these areas. The
intramural and extramural phases of its research, training, and tech-
nical assistance activities are severely handicapped by inadequate
funds, manpower, facilities, legislative authority, and organizational
status. The Program cannot be expected to cope with the rapid
changes occurring in our $80 billion food industry, or to be an effec-
tive participant in a comprehensive environmental health program,
unless its support is increased substantially over the $5 million appro-
priated in fiscal year 1962 for grants, laboratory construction, and
internal operations.
5.	Inclusion of a Food Protection Program in the proposed environ-
mental health center is essential to its effective development and for
the ultimate solution of problems involving multiple environmental
stresses on man. Among the specific advantages are:
a. "Cross-fertilization" of the research staff by association with professional
counterparts in other fields.
ft. Common use of special equipment, such as high-energy radiation sources
and climatological facilities, which may be accessible in other parts of the
Center.
c.	Capitalization of talent by creating a community of scientific culture which
will attract, hold, and develop capable people.
d.	Participation in a program to determine the total impact on health of sub-
stances acquired, not only from food, but other environmental sources, including
air, water, and occupational exposure.
e.	Exploration of the part played by environmental factors in determining
the varied responses of man to ingestion of certain bacteria and other potential
causes of foodborne illness.
/. Guidance of research studies involving health hazards of foods so that the
results will be more readily useful to industry and community health agencies.
Recommendations
1. The Public Health Service is recommended as the focal point for
research, surveillance, and standards necessary to maintain and im-
prove the quality of the food supply as it affects the health and welfare
of the consumer and for the stimulation of research application. The
Service has worked for many years with States and localities as well
as other Federal agencies and industry, and is in a key position to
integrate the interests of the producers, processors, distributors, and
consumers of food. Such preventive action is essential to the main-
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Milk and Food
185
tenance of our high health status in the face of revolutionary changes
in food technology and eating habits of the population. The proposed
overall mission is to improve and protect the public health and welfare
as they may be affected by foods and beverages, alone, or in combina-
tion with other environmental stresses.. The primary objectives
include:
a.	Detection, assessment, and control of microbiological, chemical and nu-
tritional health hazards which have been and will continue to be introduced as
the result of changes in food production, procurement, processing, packaging,
marketing, and serving.
b.	Reappraisal of food protection measures now in use, as they are affected
by changes in technology and food handling practices.
o. Surveillance of developments in science and technology as they may potenti-
ally affect food protection.
d.	Development and maintenance of a basic-data program on trends of public
health hazards associated with food production, processing, and distribution.
e.	Investigation and development of methods to prevent or reduce health-
hazard problems confronting the food industries.
f.	Application of the accumulated knowledge to Improve public health
practice.
2.	The pressing need for competent manpower, to staff both food
research and operational programs, warrants a major expansion of
training activities, including the following :
a.	Development of interest among potential candidates for employment by
offering career inducements, beginning at the high school level.
b.	Creation of greater opportunities for basic scientific training, at both the
undergraduate and graduate levels, by means of grants to colleges and univer-
sities as well as fellowships for the support of individual students.
o. Reinforcement of technical knowledge among industry, State, and municipal
health workers concerned with foods, by organizing and presenting Intensive
specialized courses in the various phases of food protection.
3.	The increasing occurrence of foodborne illnesses, and the dearth
of information about potential health hazards associated with recent
technological developments in the food field, are compelling reasons
for fostering a broad program of research on food protection,
including:
a. Rapid expansion of the research grants program in scope and funds during
thenextCyears.
Establishment of a central research and technical-service facility, supported
by regional laboratories designed to deal with the special problems of each area.
o. Utilization of the existing PHS Milk and Food Program as a nucleus around
which to build a multidiscipiine organization that has greatly increased capacity
and resources for experimental work, technical leadership, and conversion ot
research to practical food protection programs.
d. Development of contractural relations and interagency agreements for
projects of mutual interest to the Public Health Service and other governmental
or private organizations.
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136 ENVIRONMENTAL HEALTH PROBLEMS
4.	The Committee notes that the Public Health Service Act,
as amended, does not refer explicitly to food protection, but covers this
area only by implication. The Service is, therefore, urged to seek
legislation that will specifically authorize and support a national pro-
gram in the food field along the lines recommended above. Enactment
of such legislation would serve to delineate Service responsibilities,
generate public awareness, and establish a basis for the working re-
lationships with other organizations, on which the program depends
for its continued development. In this connection, the Committee be-
lieves that planned improvements in the Milk and Food Program,
including the construction and operation of two new shellfish research
laboratories, are so much needed that they should proceed independ-
ently of further legislative proposals or administrative determinations
relating to longer range developments in the field of environmental
health.
5.	A five- to six-fold increase in the scope and intensity of both the
intramural and extramural food-protection activities of the Public
Health Service is recommended during the next 5 years, in order to
overcome the evident deficiencies and to keep pace with new develop-
ments in the food field. The Service should plan to acquire an addi-
tional 250 professional staff members,1 about 500 more supporting
personnel, a new central research facility, and an annual operating
budget of approximately $8 to $10 million by fiscal year 1967. It is
estimated that an additional $15 to $20 million will be needed to pro-
vide support for extramural research, training and facilities grants,
contracts, and interagency agreements, thus bringing the total sup-
port for the Program to roughly $25 to $30 million within 5 years.
A further three- or four-fold expansion should be anticipated by
fiscal year 1972.
INTRODUCTION
Food protection is defined, for the purposes of this report, to include:
(a) The prevention and control of contamination with biological,
chemical, or physical agents which, alone or in combination with other
environmental insults, adversely affect man's health; and (6) the
maintenance or improvement of those dietary, sensory, and other
qualities which contribute to human welfare. The important multiple
effects of foods on health and welfare and influenced, in large measure,
by the environmental conditions under which the foods are produced,
processed, packaged, and made available to the consumer. They, in
turn, affect man's physical and mental responses to other stresses, which
together make up the complex termed environmetal health. (1)
When foods come into contact with air, water, soil, and the byprod-
ucts of civilization, they acquire a variety of microbial and chemical
1 See Supplement for types of professional specialists required.
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Milk and Food
187
contaminants which may be passed on to the consumer. Food process-
ing may remove or destroy some agents, but it may also allow further
exposure to environmental contamination. The complexities arising
from multiple ingredients, processes, and types of contamination,
make food protection a peculiarly difficult area of public health. Much
of the needed research in this area requires an interdisciplinary team
approach.
In contrast to air and water, for which availability and purity are
the principal considerations, food, even when plentiful and uncon-
taminated, exerts profound physiological effects on the consumer. Al-
though man's basic nutritional requirements have been defined (18),
much remains to be learned about the more elusive, yet important,
sensory properties of foods, and the more subtle dietary relationships
to physical vigor, mental alertness, longevity, resistance to infection,
and the onset of degenerative diseases. In any event, enough is al-
ready known to suggest that man's response to almost any environ-
ment stress may be affected by the food he eats.
Food also differs from air and water in being the private property
of individuals and business enterprises, whose economic interests do
not necessarily coincide with the needs of public health. Public pres-
sure has led to a profusion of laws related to food (27), which some-
times result in the misuse of public health regulations to erect
economic barriers.
Trends
The store of Abraham Lincoln's day sold less than a hundred food
items, consisting mainly of dried staples and produce from nearby
farms (37). Meals were generally eaten at home, where they were
prepared daily from the basic ingredients. Perishable foods, such
as milk and meat, were used as quickly as possible or were converted
to butter, cheese, sausage, etc., which would keep longer. Neither
the causes of foodborne diseases nor the means of preventing them
were clearly understood, and the quality of food products was deter-
mined largely by the odors, tastes, and appearances associated with
spoilage.
About the turn of the century, notable changes began to appear in
the traditional pattern, based on the development of farm machinery,
commercial canning, long distance transportation by railroads, and
mechanical refrigeration of storage warehouses, Concurrently scien-
tific studies were begun which, over the years, have led to a succession
of remarkable advances in the production, manufacturing, distribu-
tion, and serving of foods. For example, bacteriological and epidem-
iological studies on the role of milk and other foods in the spread of
infectious diseases, such as typhoid fever, dysentery, tuberculosis, and
687408 62 ¦ 10
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138 ENVIRONMENTAL HEALTH PROBLEMS
septic sore throat, led to the establishment of sanitation programs
involving pasteurization of milk, veterinary examination of dairy and
food animals, inspection of restaurants, and education of food han-
dlers in hygienic practices. Botulism was found to be caused by the
toxins of spore-forming bacteria that could grow in foods without
air. As a result, commercial canning practices were radically revised
to incorporate adequate heat-processing for the destruction of these
spores.
Biochemical research laid the foundation for modern concepts of
human nutrition and toxicology. Prevention of deficiency diseases
was made possible by supplementation with vitamins and minerals.
Addition of vitamin D to milk, thiamine to flour, and iodine to table
salt are well-known examples. Possible carcinogenic and other harm-
ful effects resulting from improper use of certain food additives were
considered, and legislation has been promulgated to control the com-
mercial application of chemical preservatives, artificial colors, and the
like, in order to prevent a potential problem from actually occurring
(IT).
In the agricultural field, tremendous strides have been made in the
development and application of chemicals, such as fertilizers, weed-
killers, insecticides, fungicides, and feed supplements; these have re-
sulted in an increased food output per acre. Selection and hybridiza-
tion have also increased the productivity of crop plants and domestic
animals. With the aid of power-driven machinery, the American
farmer now produces 10 times as much food per acre with less man-
hours than his Indian or African counterparts (32).
The technology of food processing, packaging, and distribution
has also undergone dramatic changes since World War II. The ma-
jor trend is toward centralized processing and widespread distribution
of commercially prepared convenience foods which minimize or elim-
inate culinary work in the preparation of meals. Among these foods
are dried, precooked, and frozen products which are not sterile. The
consequences of improper storage, shipment, or marketing are obvious.
Because of the consumer demand for convenience products, modern
foods are no longer simple commodities; they are compounds and
blends of products, obtained from worldwide sources and subjected
to multiple processes, which may introduce unrecognized health
hazards.
Food processing is becoming increasingly complex and often in-
volves elaborate electronic control of high-speed continuous opera-
tions. In some instances, momentary temperature fluctuations may
result in failure to protect large amounts of the product, without the
knowledge of the operator. High-temperature short-time processing,
freezing, vacuum dehydration, and radiation sterilization may be
applied singly or in combination to those products. Certain of these
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MUk and Food
139
new methods involve increased handling after cooking or other treat-
ment ; therefore, the skin and fecal microflora, including bacteria, vi-
ruses, fungi, and parasites, may contaminate the final product.
Continuing changes in processing techniques may be expected to intro-
duce a variety of new problems in the future.
In addition to the usual glass and metal containers, foods are now
being packed in treated papers, plastics, laminated foils, flexible tubes
and pressurized cans. The time-honored method of canning involved
heat sterilisation, but today packaged foods may be only partially
sterilized and held in the refrigerated or fro?>en state until marketed.
Certain packaging techniques, for example, by excluding oxygen may
prevent molds from developing; however, at the same time, such tech-
niques may contribute to the less apparent, though more important,
health hazards involving the growth of toxigenic bacteria.
More than 8,000 food items are available for sale in supermarkets,
and new products are being offered to the consumer at the rate of
about 2 dozen per day (11). Further evidence of the rapid rate
of change in this field is provided by the fact that two-thirds of
these convenience items either did not exist in 1946 or have been
radically changed since that time.
Comparable developments have occurred in the food service indus-
tries. Today practically all urban wage earners and students eat
at least one meal a day away from home. In addition to spending
about $1 billion per month in restaurants, the American public is
giving ever increasing patronage to commercial catering and delicates-
sen operations. The development of automatic vending machines,
which deliver individual hot or cold foods and even complete meals,
is also progressing rapidly. The automatic food dispensing business
has increased from $10 million in 1954 to move than $200 million in
1960 (5). In the future it may be expected to receive an even greater
share of business now going to restaurants and grocery stores.
The retail value of the U.S. food supply now stands at approxi-
mately $80 billion per year (11), and it will continue to expand as
the population grows (26). At present, industry is spending more
than $100 million per year on new product developments, all of which,
a priori, involve a wide assortment of food safety problems (21). Too
often such technological changes are equated with improvements in
quality, without discriminating between changes which actually re-
duce health hazards and those introduced primarily for reasons of
convenience or economic advantage, Unquestionably many improve-
ments have been made in both directions, but public health agencies
have been unable to keep pace with the overwhelming number of new
problems that continue to arise as the technological revolution in the
food industry progresses (88,47) .
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IJfi ENVIRONMENTAL HEALTH PROBLEMS

320

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240
to
200
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160
CO

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120

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_ fRCW OAUEfl, ft AL , PUBLIC HEALTH REPORTS 1953 -1960
FOOD
(OTHER THAN MILK PRODUCTS)
_ WATER
	
MILK a DAIRY
PRODUCTS
»¦¦ »—»—f— ¦—»
1952
1953
1954
1955	1956
YEARS
1957
1958
(959
FOOD,MILK, AND WATERBORNE DISEASE
OUTBREAKS REPORTED IN U.S.A. 1952-59
Fig. 1
An estimated 1 million cases of food poisoning occur annually in
the United States (14). This estimate is probably too low because
scarcely any individual escapes an occasional intestinal upset. The
number of reported outbreaks has approximately doubled since 1952
(see Figs. 1 and 2) and the majority of these outbreaks are of undeter-
mined etiology and scope. Staphylococcal food poisoning and
salmonella infections are among the most commonly reported forms
of gastroenteritis, but investigation and reporting of foodborne illness
are so grossly inadequate that a real evaluation of the impact of con-
taminated food on health cannot be made at the present time (see
Figs. 3 and 4).
210
180
160
tn
< 120
liJ
£E
00
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60
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S SALMONELLA & SHIGELLA
-•"'ALL OTHERS
1952
1963
1954
1955	1956
YEARS
I9ST
1958
1959
TYPES OF FOODBORNE MEASE OUTBREAKS
RETORTED IN US,A,1932-59
Fro. 2
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Milk and Food
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4
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2
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4 6 8 10 12 14
NUMBER OF STATES REPORTING
16
CASES IN
OUTBREAKS
POPULATION
(MILLIONS)
3,818
13.9
74?
16.1
425
4.8
818
4.5
17
1.9
526
12 4
833
13 3
1,779
32.9
1.250
16.1
207
23.5
0

I0.4&0 TOTAL 169.3
DISPARITY BETWEEN REPORTED FOODBORNE D/SEASE AND
POPULATION Or REPORTING AREAS - 1958
Fro. 3
Acute illnesses represent but one facet of the total problem. To
this should be added other difficulties introduced through direct
and indirect addition of chemicals which may have long-term effects
on health (41). These may be introduced at different stages; e.g.,
during production (residues of insecticides, growth regulators in
plants, hormones in animals, etc.) during processing (detergents or
>0)
CASES iN
OUTBREAKS
POPULATION
(MILLIONS)
, 1.709
15.3
196
2.8
1,223
16.6
1,502
9.5
494
10.1
ns
1.7
309
1,0
342
4.9
769
7.2
It6
4,0
696
25.6
2,1 IB
20.4
795
34.9
0

10,594 TOTAL 178,2
2 4 6 6 10 12
NUMBER OF STATESSDGREPORTING
PlStAWY BETWEEN REPORTSP fOOPBOKHE PISEASE
AftP 70PULAT10N OF RET0R7/M0 AREAS ~/9 39
Fig. 4
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U2 ENVIRONMENTAL HEALTH PROBLEMS
other contaminants of the water supply, dust and fumes from the
air, and additives used in formulation), during storage (via leaching
from containers) and during preparation for serving (contact with
faulty utensils, and residues of cleaners or sanitizing agents). In
addition, the human body may suffer other stresses of a psychological
or physical nature, which should be integrated with those of food
origin.
Study of the cumulative effects from repeated exposures to small
amounts of food contaminants has only begun, and knowledge of the
interrelationships between dietary factors and other elements of the
environment is essentially lacking. Recent research has begun to
indicate that the main nutrition problems of the future may well be
concerned with the sensory properties of foods, such as flavor, odor,
texture, etc.—how these are affected by processing, and their mediation
via the central nervous system (42). All of this must be integrated
with the above cited physical, chemical, and microbiological problems
in respect to the whole human being.
Positive action is needed to stem the trend toward obsolescence of
the food protection program in public health agencies, and thus keep
pace with the developments in food science and technology. In con-
trast to the notable progress made in food sanitation during the first
half of the 20th century, this area of Government activity has now
become the weakest link in the protection of the Nation's food supply.
Current Responsibilities of the Public Health Service and
Its Relationships With Other Governmental Agencies
The Milk and Food Program derives its statutory authority from
the Public Health Service Act of 1944, as amended, particularly Sec-
tions 301, 311, 314, and 361 of Public Law 410 (42 U.S.C. 241, 243,
246, 264). This broad authorization provides for the Public Health
Service to assist states and localities and to carry out interstate quar-
antine activities, primarily directed at the control of communicable
diseases. Public Law 410 does not specifically direct the Service to
conduct programs related to food protection in relation to infectious
disease control nor does it address itself to the problems of nonliving
disease-producing agents. Under its mandate, the Service is now
engaged in milk, shellfish, and food service activities designed to assist
the States and local authorities in the development, operation, and
maintenance of programs for the prevention and control of food-
borne diseases. To implement this role and to provide national leader-
ship in this area, the Milk and Food Program (a) conducts research
and field investigations, (6) evaluates the public health significance
of new processes, techniques, and equipment, (c) develops recom-
mended sanitation standards, technical procedures, and program
guides for State and municipal adoption, {d) provides technical and
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Milk and Food
143
advisory assistance to governmental agencies and food industries on
food sanitation, (e) conducts specialized training courses for public
health workers and industry personnel engaged in sanitary control
of milk, shellfish, and food service operations, and (/) participates
with the States in cooperative programs for the certification of inter-
state milk shippers and interstate shellfish shippers.
In this program, working relationships and agreements are main-
tained not only with the States, but with elements of the Public Health
Service, other Federal agencies, and various domestic and foreign
organizations having responsibilities for the U.S. food supply. A
review of these numerous relationships indicates that they are mutually
beneficial, and do not lead to duplication of effort. At present, the
Milk and Food Program is heavily dependent on the Communicable
Disease Center at Atlanta for epidemiological investigation of disease
outbreaks, and when these occur on interstate carrier^, both groups
frequently assist the Interstate Carrier Program with studies neces-
sary to enforce the Interstate Quarantine Regulations. Research and
surveillance related to radionuclides in milk and other foods are co-
ordinated closely with the Division of Radiological Health, which, in
fact, provides fiscal support for the activities of the Milk and Food
Program in this field.
In 1959, a document, entitled Shellfish, Milk and Food Service
Sanitation Activities of the Public Health Service and the Food and
Drug Administration, was developed jointly by the two agencies and
Che Office of the Secretary of the Department of Health, Education,
and Welfare (44). It identifies and compares the activities of these
agencies, and in addition, summarizes the cooperative agreements,
understandings, and working relationships between PHS and FDA
in the areas of milk, food, and shellfish sanitation. A similar docu-
ment was developed in 1961, Public Health Service and Food and
Drug Administration Activities Concerned with Pesticide Hamrds
(88). These analyses indicate that the enforcement efforts of FDA
against adulteration and misbranding of foods in interstate commerce
are, in fact, strengthened by the collateral efforts of PHS to support
intrastate and local food protection programs (25). The differences
in responsibilities and objectives of the two agencies are effective deter*
rents to duplication, even in research, where both frequently work on
different facets of the same problem to the mutual advantage of all
concerned. Additional work is necessary (a) to make these relation-
ships more effective in areas of food safety above and beyond the
present scope of the Milk and Food Program, (6) to keep pace with
the rapid developments in food science and technology which have
been and are continuing to be made, and (9) to keep abreast of the
needs, requirements, and desires of the American people.
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1U ENVIRONMENTAL HEALTH PROBLEMS
The Public Health Service also has a memorandum of agreement
(2) with the Fish and Wildlife Service of the Department of Interior
relative to the certification of interstate shellfish shippers, as well as
a bilateral agreement with Canada (15) on the sanitary control of
shellfish. These are supplemented by informal liaison and collabora-
tive research efforts. All of this is cited to illustrate the cooperative
and integrated effort undertaken for the protection of the American
people in this portion of their food supply. It is an extremely im-
portant one from the food protection point of view, since so much of
our shellfish is consumed raw.
Working relationships with the U.S. Department of Agriculture are
concerned principally with protection of dairy and poultry products.
Currently the Service is a participant with the U.S. Atomic Energy
Commission and the U.S. Department of Agriculture in cooperative
research on the development of a feasible process for the removal of
radioactive contamination from milk (39). The present successful
method of treatment with ion-exchange resins to remove radionuclides
was devised by the Milk and Food Research staff of the Public Health
Service (34), and pilot plant operations are in progress at the Belts-
ville laboratories of the Agricultural Research Service.
A variety of relationships is maintained with the Department of
Defense, which range from individual consultation to formal agree-
ments. For example, Milk and Food Research receives support for
investigation of properties of paralytic shellfish poison under an inter-
agency agreement with the U.S. Army Chemical Corps. These two
agencies are also cooperating informally with several other groups,
including the Food and Drug Administration and the Food Research
Institute of the University of Chicago, to study staphylococcal entero-
toxin, which is the most commonly reported cause of food poisoning
in the United States. Rather intermittent and casual relationships
are maintained with other components of the Department of Defense,
including the Armed Forces Food and Container Institute of the
Quartermaster Corps.
Industry Contributions to Food Protection
In addition to the development of new products and processes, the
food industry is making noteworthy contributions to public health,
particularly in those areas which directly affect sales or where govern-
mental agencies have taken the initiative. The competitive nature of
private enterprise is a barrier to acceptance by industry of full re-
sponsibility for food protection, but it willingly cooperates with health
agencies to protect the consumer from any foreseeable hazard.
For example, industry participates with public health agencies in
the 3A Sanitary Standards organization for the design of dairy equip-
ment. Similar voluntary standards are being developed by industrial
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Milk and Food
groups concerned with bakery equipment, restaurant equipment, vend-
ing machines, pickles, olives, mayonnaise, confections, and the like.
These and other groups may also provide engineering and micro-
biological data for common use in the development of new processes.
The food industry frequently supports projects in universities and
privately owned laboratories on problems relating to health and wel-
fare, such as sanitary requirements, foodborne diseases, nutrition, engi-
neering performance of processes, chemical composition, microbiologi-
cal content, toxicology of additives, and consumer acceptance of new
products. The findings are generally published in the technical
periodicals of professional and trade associations, which industry also
assists in supporting.
Most firms recognize the importance of inhouse sanitation and
quality control programs; however, the smaller manufacturers, in
particular, frequently lack the technical knowledge and resources to
determine their needs in this area. It is, therefore, essential for pro-
tection of the consumer to provide reliable sources of such information.
At present, many local health agencies are unable to render this service,
and the industry is, understandably, reluctant to reveal its difficulties
to enforcement agencies. The manufacturer often depends on advice
from the technical representatives of other firms which sell sanitizing
agents or equipment. Although the contributions of the latter groups
to food protection are invaluable, experience has shown that they
cannot cope with the total problem. This situation presents a challeng-
ing opportunity for collaboration between industry and government,
in which the Public Health Service is well suited to extend its leader-
ship along the lines already developed with the dairy and shellfish
industries.
Examples of work which needs to be done in this area are:
1.	Development of standards of sanitary quality for procurement, processing,
and distribution of foods comparable to those contained In the various PHS
recommended ordinances, codes, and guides dealing with milk, shellfish, and
restaurant sanitation.
2.	Reevaluation of existing standards in terms of (a) their application to
products produced by new procedures or processes and (6) possible simplification
or improvement on the basis of new scientific knowledge.
3.	Evaluation of engineering limits to performance precision of food process
equipment as It relates to («) control of microbiological contaminants, (6)
maintenance of desired temperatures, pressures, flow-rates, and other physical
conditions.
4.	Formulation of requirements for the quality of air and water used in food
processing.
5.	Establishment of design and construction criteria for food equipment which
minimize handling of the product, opportunity for contamination, growth of
micro-organisms, and difficulty of cleaning.
6.	Development of precise simple methods for examination of foods with re-
spect to their sanitary quality, which may be applied uniformly by both Industry
and health agencies.
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W ENVIRONMENTAL HEALTH PROBLEMS
PROBLEM AREAS AND GOALS
Industry, enforcement agencies, and the public need the assistance of
a national organization primarily concerned with health problems,
which can work and be the focal point of leadership in a lattice of other
governmental and private organizations to provide the inspiration,
information, guidelines and resources necessary for food protection
(27). The Public Health Service has an obligation to meet this need
in such a way that it will engender the confidence and cooperation of
all concerned. It must avoid, on the one hand, a fragmentary approach
which cannot give adequate and timely answers to new problems being
evolved or, on the other hand, an overly comprehensive program that
tends to duplicate and infringe on the primary responsibilities of other
organizations. Particular attention should be given to health-related
problems which require the participation of a public agency for the
protection of the consumer's interest and to those areas of environ-
mental health where food indirectly may play a decisive role in human
welfare.
The proposed overall mission is to improve and protect the public
health and welfare as they may be affected by foods and beverages,
alone or in combination with other environmental stresses. The
primary objectives include:
1.	Detection of microbiological, chemical, and nutritional health hazards which
have been and will continue to be introduced as the result of changes in food
production, procurement, processing, packaging, marketing, and serving.
2.	Reappraisal of food-protection measures now in use as they are affected by
changes in technology and food-handling practices.
3.	Surveillance of developments in science and technology as they may
potentially affect food protection.
4.	Development and maintenance of a basic-data program on trends of public
health hazards associated with food production, processing, and distribution.
5.	Investigation and development of methods to prevent or reduce health-
hazard problems confronting the food industries.
6.	Application of the accumulated knowledge to improve public health practice.
Major problem areas, which are expected to be of continuing im-
portance during the next decade or longer, are noted below, together
with comments on their significance and some suggested approaches to
their solution.
Microbiological Contaminants of Foods
The notable successes of the past 50 years in controlling botulism,
typhoid fever, and other severe foodborne diseases, have tended to
create an impression that technical knowledge in this area is adequate
to prevent all infections and intoxications of microbial origin. How-
ever, the facts are that gastroenteric episodes continue to occur at a
rate second only to respiratory infections, among the short-term ill-
nesses suffered by middle-class American families. Current food sani-
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Milk and Food
147
tatioii practices have failed to reduce the high incidence of foodborne
diseases during the past 8 years (14). Although the majority of out-
breaks either go unrecognized by health authorities or are of un-
determined etiology, a growing body of evidence indicates that hitherto
unsuspected fungi, bacteria, viruses, rickettsiae, and protozoa may be
partially responsible (20). For example, infectious hepatitis has been
traced to consumption of polluted shellfish, first in Sweden (40), and
on two more recent occasions in the United States (29, 30). Clostri-
dium perfring ens, which has long been associated with foodborne
gastroenteritis in Great Britain (24), is only now beginning to receive
serious consideration in U.S. health departments. The first official re-
ports of such outbreaks were received by the Public Health Service less
than 2 years ago (14).
Well-known types of food-poisoning organisms occur frequently in
a variety of foods. Raw market milk supplies nearly always contain
Staphylococcus aureus. Dried or frozen egg products are notable
sources of Salmonella organisms (12). When these products are used
for manufacturing purposes, they may cause serious contamination
of the finished product, as happened in the case of commercially mar-
keted hollandaise sauce. Outbreaks of Salmonella typhim/u/rium were
reported from Los Angeles, Calif., and St. Paul, Minn., in mid-June
1961 (31). The hollandaise sauce withdrawn from the market was
found to contain S. typhimimum in lots obtained in San Antonio, Tex.,
San Francisco, Calif., Washington, D.C., and St. Paul, Minn. The
product was manufactured in New York State.
There are in excess of 600 serotypes of Salmonella which may cause
illness in man. A sharp increase in cases in the United States due to
one, S. reading, rarely identified among Salmonella isolates from
human or animal infections, began in September 1956 (28). During
the 12-month period following, 325 acute sporadic cases and 3 out-
breaks due to S, reading were reported in widely scattered states from
Alaska to New York. Obviously, this widespread illness, due to a
specific micro-organism, does not follow patterns of water- or milk-
borne outbreaks but would be applicable to a processed contaminated
food product in national distribution.
An example of spread of Salmonella infections from contaminated
egg albumin was reported in England (45). Widely scattered cases
were traced to certain bakeries where dust from American egg-albumin
powder contaminated the finished bakery products.
From the above examples it may be seen that foodborne disease-
producing micro-organisms are widely distributed in foods in national
and international distribution, for which no protection of the public
is afforded.
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J48 ENVIRONMENTAL HEALTH PROBLEMS
Recent field studies in a metropolitan area have shown (a) that
Salmonellae were present in 17 percent of the raw market poultry (48),
and (5) that Staphylococci were found in 21 percent of the market
Cheddar cheese (16). Direct evidence regarding possible effects of
these contaminated foods on the health of consumers is not available,
but similarly contaminated products have, on other occasions, been
implicated in gastroenteric outbreaks (3, 23, 46).
The foregoing examples illustrate the complexity and magnitude
of the microbiological problems of food protection, which require
much increased research efforts by the Public Health Service, in con-
cert with other governmental agencies and industry. Potentially
useful approaches to these problems include:
a. Methodological studies to improve techniques for the quantitative detection
and identification of pathogenic foodborne micro-organisms and their toxic
products.
&. Bacteriological, virological, mycological, and parasitological investigations
to determine the kinds, prevalance, persistence, and public health significance
of potential pathogens in specific foods. For example, the production of safe
shellfish depends on a thorough knowledge of the microbiological condition of
estuarial growing areas, as well as commercial harvesting, shucking, and pack-
ing operations, which are subject to contamination with various toxic dino-
flagellates, enteric bacteria, and viruses.
c.	Veterinary public health studies on epizootic diseases of food animals,
which maybe transmitted to man.
d.	Ecological studies on the interrelated physical, chemical, and biological
factors that affect the growth and survival of pathogenic micro-organisms in
foods.
e.	Coordinated epidemiological, clinical, and laboratory investigations of food-
borne diseases to establish cause-and-effect relationships, modes of contamination
and transmission, extent and severity of illness, techniques for finding and
reporting natural outbreaks, and means for prevention and control.
f.	Consideration of the public health significance of alterations in the micro-
flora of foods, which may be brought about by the newer methods of processing
and marketing; e.g., freeze-drying of products which may be reconstituted and
sold at delicatessen counters or from vending machines.
g.	Field studies in the community setting on practical approaches to the control
of microbiological contamination of foods.
Foreign Chemicals in Foods
Increasing contact between foods and foreign chemicals is unavoid-
able in our technologically oriented economy. Without use of agri-
cultural chemicals, food additives, sanitizing agents, chemically
treated water, and synthetic packaging materials, the United States
could not feed the urban population (17,19,36). It has been estimated
that elimination of agricultural chemicals alone would reduce farm
yields by 10 to 90 precent (32).
There is also growing concern about the radionuclide contamination
of milk and other foods by fallout from nuclear explosions, byproducts
of atomic reactors, and residues of radioactive wastes. Campbell
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Milk and Food
et al. (7) have estimated that about five-sixths of the strontium 90
taken into the human body comes from foods, especially dairy products.
Accidental release of short half-lived radionuclide, such as iodine 131,
from a reactor in another country has, on at least one occasion, neces-
sitated withholding milk from the market until the level of radio-
activity declined (43). Extensive studies, in close cooperation with
radiological health and atomic energy experts, will be necessary to
understand the progression of radionuclides through the food chain
and their long-term effects on man.
In a recent address, "Foods, History and Problems," Mrak (32) has
noted that "there are no harmless substances; there are only harmless
ways of using substances." The determination of how and when
chemicals may be used safely in relation to food is already a major
public health problem, and it will become even more important in
the future (9).
Some of the avenues by which the health implications of foreign
chemicals in foods may be approached are as follows:
~.	Methodological studies to develop and simplify analytical procedures for both
the presumptive qualitative and quantitative determination of herbicide, insec-
ticide, rodenticide, germicide, and other potentially harmful residues in food.
There are many new tools now available which should be studied with respect to
their application in this field.
~.	Toxicological and pharmacological investigation of animal and human re-
sponses to repeated low-level dietary exposures, using chemicals singly or in
combinations which are typical of their occurrence in food.
o. Exploration of the correlations between long-term, chronic-toxicity testing
and more rapid presumptive procedures, based on reactions of enzyme systems,
tissue cultures, or micro-organisms, to chemical agents.
d. Radiochemical studies on the occurrence, measurement, intake, retention,
and biological effects of radionuclides from foods and other environmental
sources, including dietary means of minimizing human exposure and damage.
Nutritional Quality op Market Foods
The newer types of food processing, packaging, and storage provide
many opportunities for the addition, removal, modification, and inter-
action of substances which are physiologically important (4, 22). For
example, high temperatures may destroy heat-labile vitamins and
amino acids, and they may also affect the availability of calcium or
other mineral components. Efforts to compensate for such losses by
supplementation may lead to imbalances and excesses in the total diet.
Blending and reprocessing of products may bring about changes of
possible health significance which would not otherwise be encountered.
Undigestible materials, such as alginate, pectin, or modified cellu-
lose, are often substituted for normal food ingredients in an effort to
improve texture and keeping qualities or to Jower calorie value and
cost. If carried to excess, such modifications may have serious
nutritional consequences to certain segments of the population. There
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150 ENVIRONMENTAL HEALTH PROBLEMS
are, in fact, hundreds of other artificial substances being used in the
manufacture of foods to improve texture, flavor, color, and stability
(17, 19). Apart from their intended uses, these substances have
physiological potentials which are, in many instances, incompletely
explored at the present time.
In addition to recognizing and avoiding undesirable changes in food,
there is the problem of learning how to promote good health by dietary
means. The potential for increased resistance to infection, lengthened
life, greater vigor, and retardation of degenerative diseases is now
recognized, but not enough is yet known in these areas to take advan-
tage of the possibilities in public health practice.
In assessing the physiological significance of the complex changes
which occur in foods as they move from farm to factory and thence
to the family dinner table, the following approaches may be useful:
a. Comparisons of the dietary effects of different processing methods as ap-
plied to a common food, such as raw, pasteurized, evaporated, and dried milk.
&. Assessment of nutritional changes resulting from new processes such as
ion-exchange treatment of milk, ultra-high-temperature pasteurization, freeze-
drying, dehydro-freezing, microwave cooking, or radiation sterilization.
c.	Evaluation of safety with respect to unusual levels and combinations of
food ingredients.
d.	Biochemical investigation of reactions among food ingredients, with special
reference to the formation of compounds which may Influence the metabolism
of mammals.
e.	Controlled long-term studies on animal and human populations to Identify
and investigate the interrelationships between diet and other environmental
factors such as temperature, exercise, radiation, or the pollutants of air and
water.
Criteria and Methods of Determining Food Safety
Public confidence in commercially distributed foods depends on
the maintenance of high sanitary quality. The buyer, whether he
realizes it or not, depends entirely on the industry's awareness of
food-hazard problems and the integrity of industrial and governmental
controls to insure the safety and wholesomeness of food items pur-
chased in retail markets or public eating places (6). When these
foods are produced and/or processed at locations remote from con-
sumer areas, local health agencies cannot inspect the sanitary condi-
tions to which these products may have been exposed prior to their
arrival in the local market. The trend toward centralized manufac- 4
turing and widespread distribution of refrigerated, nonsterile, con-
venience foods has created a need for the development of standard
methods and uniform criteria by which the sanitary quality of these
products may be determined (8,13). Even more, there is vital need
to identify the nature and extent of the potential public health hazards.
A substantial beginning has already been made in this area with
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Milk and Food
161
respect to the interstate shipment of milk and shellfish. The volun-
tary programs between the States and the Public Health Service in
these areas are based on:
1.	Employment of sanitation, administration, and evaluation standards rec-
ommended by the Public Health Service.
2.	Utilization of laboratory methods recommended by the American Public
Health Association and the Association of Official Agricultural Chemists.
8. Uniform application of these methods and criteria by the responsible gov-
ernment agencies in both producing and receiving areas; and
4. Self-imposed compliance of the dairy and shellfish industries with the
established criteria of sanitary quality.
On the basis of the experience gained in these programs, the Public
Health Service is not only in an excellent position to accept leader-
ship in the extension of these concepts to other foods, but must do
so at the earliest possible time, since technological progress in the food
industries is expanding rapidly. Acceptance of this responsibility
will require a continuing effort on each type of food for which the
potential public health hazard has been carefully studied, proper
practices established, and enforcible sanitary standards adopted.
Present knowledge does not permit the use of identical procedures
and criteria for different categories of foods. Because of the diffi-
culties in detecting and identifying specific etiological agents, devel-
opment of feasible sanitary standards will depend upon the application
of indirect tests for indicator organisms and chemicals, which reflect
the past history and present quality of the product in question. Ac-
tivities which will contribute to the development of this area include
the following:
0. Study of the microflora, typical of selected foods, and the changes it may
undergo during various stages of production, processing, storage, distribution,
and preparation for serving.
b. Develop analytical schema for determining chemicals in foods of unknown
composition.
o. Develop and evaluate biological, chemical, and physical tests, which may
be routinely applied to the examination of foods.
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m ENVIRONMENTAL HEALTH PROBLEMS
become the focal point of comparative data on the microbiological,
chemical, nutritional, toxicological, and related qualities of key food
items. Such information will serve to identify potentially hazardous
products, provide leads for research, and guide both public and private
agencies in planning effective control programs.
Because of the magnitude and complexity of the surveillance pro-
gram, gradual development over the next 5 years is suggested along
the following lines:
a. Establish surveillance programs on milk, shellfish, and the food services
of interstate carriers, with ¦which the Service already has much experience
and numerous contacts in both control agencies and Industry.
ib. Determine the variety and utility of information obtainable about additional
foods from other sources.
,o. Formulate plans for regular collection and analyses of samples from key
stations located in different areas and, if possible, at sites being used by other
networks.
d.	Devise methods for coding, statistical analysis, and reporting.
e.	Develop techniques for utilization of reported findings by industry and
government.
Evaluation of Foon Equipment and Processes from the Public
Health Viewpoint
The design, construction, and operation of milk and food equip-
ment determines, to a large extent, the sanitary condition of finished
products. Study of the operational characteristics, reliability of
control devices, feasibility of cleaning and sanitizing, resistance to
corrosion, and protection against product contamination are essential
to the development of sound public health performance criteria.
For competitive reasons, the food-equipment industry cannot as-
sume full responsibility in this area, but it has willingly cooperated
with public health agencies to the extent that the latter could specify
commercially feasible sanitary requirements. The 3-A Sanitary
Standards for dairy equipment represent a notable example of such
cooperation.
A substantial increase in public health activity in this area is needed
to cope with the wide variety of new equipment being applied to the
mechanical processing, packaging, and serving of foods (10.35). For
example, ultra-high-temperature pasteurization of milk involves com-
plex problems of heat transfer, vapor pressure, fluid flow, and elec-
tronic control on which the success and reliability of the process
depends. Intimate knowledge of these problems is essential to the
definition of the public health requirements, and can only be obtained
by use of experimental devices and testing of commercial-scale equip-
ment. The service is now constructing temporary facilities in which
to conduct engineering and microbiological studies along these lines.
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Milk cmd Food
158
Other important areas in which evaluative studies are needed
include:
a.	Purification of shellfish taken from substandard growing waters.
b.	In-transit food services of airlines, trains, buses, and ships.
c.	Automatic vending of meals.
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m ENVIRONMENTAL HEALTH PROBLEMS
IMPLEMENTATION
Substantial expansion of extramural research grants and contracts,
as well as intramural research, surveillance, training, and technical
assistance activities, is needed to meet the Public Health Service's
responsibilities for food protection outlined above. The Milk and
Food Program has a nucleus of professional staff around whom these
activities can be increased rapidly, but it lacks many of the specific
competencies and facilities which will be required for the enlarged
program. Its research and training staff are presently composed
mainly of bacteriologists, biochemists, and food technologists, about
half of whom are housed in temporary laboratories at Cincinnati,
Ohio, and Purdy, Wash. The headquarters and regional office staffs
are largely sanitary engineers and sanitarians, whose workload is so
heavy that a consistent effort cannot be placed on any facet of the
technical assistance activities. The program has supplemented its
budget with funds from outside sources, such as the Division of Radio-
logical Health and the Army Chemical Corps, in an effort to broaden
its operations. Dependence on such funds tends to create an air of
instability, especially in research, which now receives about one-third
of its support from outside sources.
Several NTH Study Sections have approved research grants re-
lated to food protection, but coverage of the major problem areas is
uneven, and the total effort is inadequate to develop the basic informa-
tion needed by public health agencies. There is no program of insti-
tutional grants for research or training purposes specifically associated
with food protection.
In the light of the disparity between the existing program and the
present-day need for food protection, an order-of-magnitude increase
in both intramural and extramural activities seems indicated over the
next 5 to 10 years.
Intramural Program
The Milk and Food Program is currently limited to milk, shellfish,
and food service sanitation. The total resources available for its sup-
port in fiscal year 1962 amount to approximately 160 positions and
$3 million, of which 45 positions and $1,700,000 are for the establish-
ment of 2 new regional shellfish laboratories. Of the remainder,
about 60 positions and $600,000 are allocated for research and training
at the Sanitary Engineering Center, while the rest is utilized by head-
quarters and regional offices for technical assistance and adminis-
tration.
The two regional shellfish laboratories will partially fill research
needs of long standing. These special-purpose facilities, which must
be located in coastal areas, are now urgently needed to undertake re-
search on the survival of enteroviruses and other pathogenic agents in
-------
Milk and Food
155
estuarine areas and to investigate practical shellfish purification proc-
esses. The establishment of these facilities will enable the Public
Health Service to meet research needs in the New England, west coast,
and gulf areas; however, a need will remain for a similar facility in
the important Chesapeake Bay area, and for additional marine labora-
tories to study the neglected public health problems associated with
other seafoods.
The program needs to acquire professional specialists and research
facilities with which to activate projects related to all its long-range
goals. Technical competence will be required in each area of respon-
sibility in order to utilize the scientific output of the extramural
program, provide timely answers to practical problems, and give
responsible leadership to cooperative programs. The Supplement
to this report, entitled "Areas of Specialization Required To Attain
Food Protection Goals," suggests the kinds of professional personnel
required and the appropriate depth of competence.
Within the next 5 years, the program should plan to acquire an
additional 250 professional staff members, about 500 more supporting
personnel, a new central research facility, and an annual operating
budget of approximately $8 to $10 million. In the following 5 years,
a further threefold expansion is recommended, including the estab-
lishment of additional special-purpose regional laboratories.
Extramural Program
In fiscal year 1962 a program of research grants was initiated in the
Division of Environmental Engineering and Food Protection.
Appropriations in the amount of $3,310,000 are provided for this pur-
pose. Of this amount present obligations for food-related research
approximate $2 million. The full amount to be expended for food
research will depend upon approval and priority allocation to applica-
tions reviewed at November and March meetings of the National
Advisory Health Council.
Contracts are limited to the construction of laboratories and provi-
sion of services, such as the collection of specimens for laboratory use.
The anticipated cost of these contracts is about $1,800,000 in fiscal
year 1962.
Support of professional education in universities is limited to the
advanced training of one to two employees annually. Quite obviously,
this level of support is inadequate to meet the food-protection problems
associated with an $80 billion industry that spends at least 1 percent
of its income on research to develop new products, most of which
present health agencies with problems of food safety that they are
presently unable to consider.
During the next 5 years the Research Grants Program should be
expanded both in scope and funds. In addition to the present proj-
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156 ENVIRONMENTAL HEALTH PROBLEMS
ect grants, provision should be made for more broadly based support
to institutions for programs of research, research facilities, and sup-
port for large-equipment items which may be used by more than one
project or research program. Amounts of money required for this
purpose are estimated to require progressive increases in annual
amounts ranging from $2 to $5 million during the 5-year period.
Comparable increases in contract funds for applied research field
studies and surveillance operations will also be needed to support
interagency agreements and collaborative studies with industry.
Special effort should be made to initiate, as soon as possible, a pro-
gram of institutional grants to help train the scientists, engineers, and
other professional personnel needed to strengthen food protection
throughout the United States. Continuing support of interdepart-
mental programs in colleges and universities with strong graduate
training programs will be necessary. On this basis, it is estimated that
the total funds devoted to the extramural program of food protection
may reach $15 to $20 million by fiscal year 1967 and should undergo
a further threefold or fourfold expansion by fiscal year 1972.
Administration
The Milk and Food Program is included in the newly organized
Division of Environmental Engineering and Food Protection. The
Committee notes with satisfaction that, in this title, food protection
is given divisional recognition for the first time in the Public Health
Service. The Division is concentrating its efforts on the several en-
vironmental problems typically facing health agencies in large urban
areas.
The food supply for metropolitan centers presents an increasing
number and variety of public health problems, based on the potential
hazards associated with technological changes, the continuing wide-
spread occurrence of foodborne illnesses, rapidly changing economics
and pattern of distribution, and the influence foods may have on man's
response to environmental stresses. An effective national effort in this
area will require an organization that is considerably more complex
than the current Milk and Food Program. Inasmuch as food protec-
tion is the keystone of environmental health, the organization should
be given status and support comparable to that of other major com-
ponents of this field.
Legislation
Although the Public Health Service Act provides the basic author-
ity for undertaking a national program of food protection, more
specific legislation is needed to delineate Service responsibilities, gen-
erate public recognition and awareness, and establish the working
relationships with other organizations on which the program depends
for its continued development. Federal! legislation relating to the
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Milk and Food
157
certification of interstate milk and shellfish shippers embodying the
principles of the present voluntary State-PHS programs, is very much
needed. Additional authority should be sought which will make the
Public Health Service the focal point of research, surveillance, and
standards necessary to maintain and improve the quality of the food
supply as it may affect the health and welfare of the consumer. Such
legislation should also include provisions for strengthening the
extramural program with respect to training, long-term cooperative
activities, and categorical research.
REFERENCES
1.	Adams, H, S. Environmental Health and Its Complexities, Jour. Milk and
Food Tech. 23:299, October 1960.
2.	Administration of the Cooperative Program for the Certification of Interstate
Shellfish Shippers. Memorandum of Agreement between Fish and Wildlife
Service of the Department of Interior and Public Health Service of the
Department of Health, Education, and Welfare.
3.	Allen, V. D,, and Stovall, W. C. Laboratory Aspects of Staphylococcal Food
Poisoning From Colby Cheese. J. Milk and Food Tech. 23 : 271-274,
September 1960.
4.	American Institute of Nutrition. Symposium on New Aspects of Nutrition
Uncovered in Studies With Irradiated Foods. Fed. of Amer. Soc. for
Exper. Biology Federation Proceedings 19: No. 4, Pt I, pp. 1023-1059,
December 1960.
5.	At the Drop of a Coin: Hot Heals, pp. 2-11, Fast Food Magazine, March 1961.
6.	Buchbinder, L. Current Status of Food Poisoning Control. Public Health
Reports 76: No. 6, 515-520, 1961.
7.	Campbell, J. E., Murphy, G. K., Straub, C. P., Lewis, K. H., and Terrill, J. G.
Radionuclides in Milk. Agricultural and Food Chemistry 9: No. 2, March-
April 1961.
8.	Conference Report: Microbiological Standards for Foods. Public Health
Reports 76; No. 9, 816-822, 1960.
9.	Coon, M. J., and Maynard, E. A. (Editors). Problems in Toxicology. Fed-
eration of American Societies for Experimental Biology. Federation Pro-
ceedings, 19: No. 8, Pt. II, Supplement No. 4, 52 pp., September 1960.
10.	Cornell University Symposium Papers on Food and Health. New York State
Agricultural Experiment Station Bull. 790, 79 pp., Geneva, N.Y., 1960.
11.	Crichton, J. Food Industry Trends All Go One Way—Up. Advertising
Age 31:40,61-74, Oct. 8,1960.
12.	Dack, G. M. Microbiology of poultry and eggs. Institute of American
Poultry Industries, Proceedings of the May Meeting, 7-11, 1961.
18. Dack, G. M. Why microbial standards for foods? Proceedings of the
Thirteenth Research Conference (Sponsored by the Research Council of
the American Meat Institute Foundation at the University of Chicago,
Mar. 23-24), Circular No. 64, pp. 29-88,1961.
14.	Dauer, C. 0., et al. Summary of disease outbreaks. Public Health Reports
69: 588, 1954; 70; 586, 1955; 71: 797, 1956 ; 72 : 735, 1957 ; 73 : 681, 1958;
74:715,1959; 75:1025,1960.
15.	Department of State. United States and Canada Conclude Agreement for
Sanitary Control of Shellfish Industry. Press Release, No. 846, May 5,
1948.
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158 ENVIRONMENTAL HEALTH PROBLEMS
16.	Donnelly, C. B., and Black, L. A, Robert A. Taft Sanitary Engineering Cen-
ter. 1961 (Unpublished data),
17.	Food Additives—What They Ave, How They Are Used. Manufacturing
Chemists' Association, Inc., Washington 9, D.C., 1961.
18.	Food and Nutrition Board, National Research Council, Recommended Daily
Dietary Allowances, Revised 1958.
19.	Food Protection Committee, Food and Nutrition Board. The Use of Chemi-
cals in Food Production, Processing, Storage, and Distribution. National
Acad, Sei.-Nat'l Res. Council Pub. 887, Washington, D.C., 1961.
20.	Galton, M. M., and Steele, J. H,, 1961. Laboratory and epidemiological
aspects of foodborne disease. Jour. Milk and Food Technology 84:
104-114.
21.	Hand, D. B. Group Discussion of Research Needs in Food Technology.
Proc. Conf. on Man Versus Environment, pp. 117-119,1959.
22.	Harris, R. S., and Von Loesecke, H. (editors). Nutritional Evaluation of
Food Processing. John Wiley and Sons, Inc., New York. 1960.
23.	Hendricks, S. L,, Balknap, R., and Hausler, W. J., Jr. Staphylococcal Food
Intoxication Due to Cheddar Cheese. I. Epidemiology. J. Milk and Food
Technology 22:313,1959.
24.	Hobbs, B. C., Smith, M. E., Oakley, C. L,, Warraek, H. G., and Gruickshank,
J. C. Clostridium welchii food poisoning. J. Hyg. 51:74,1953.
25.	Joint Action by Public Health Service and Food and Drug Administration
on Penicillin and Other Antibiotic Residues in Milk. February 1960.
26.	Long Term Trends in the Food Industry; Special Report. Food Business,
Putman Pub. Co., Chicago, 111., January 1961.
27.	Milk and Food Research Panel of Consultants to the Robert A. Taft Sanitary
Engineering Center, Cincinnati, Ohio. U.S. Department of Health, Edu-
cation, and Welfare, Public Health Service. Proceedings of First Meeting,
44 pages, Feb. 14-15, 1957. Proceedings of Second Meeting, 63 pages, Jan.
23-24, 1958.
28.	Morbidity and Mortality Weekly Report, Public Health Service, 6: 51, Dec.
28, 1957.
29.	Morbidity and Mortality Weekly Report. Public Health Service, 10: 17,
May 5,1961.
30.	Morbidity and Mortality Weekly Report, Public Health Service, 10: 13,
Apr. 7,1961.
31.	Morbidity and Mortality Weekly Report, Public Health Service, 10: 30,
Aug. 4, 1961.
32.	Mrak, E. M. Food, History and Problems. Food Technology 15: 9, 20-26,
1961.
33.	Mrak, E. M. Research Problems in Food Technology. Proc. Conf. on Man
Versus Environment, pp. 73-80,1959.
34.	Murthy, G. K., Masurovsky, E. B., Campbell, J. E., Edmondson, L. F. A
Method for the Removal of Cationic Radionuclides from Milk. Jour, of
Dairy Science. (In press.) 1961.
35.	New Trends in Environmental Health. Quarterly Bull. Wise. State Bd. of
Health, 15:1, 36 pp. Madison, Wis., 1961.
36.	Oser, Bernard L. Modern Technology As Related to the Safety of Foods.
What's New in Food and Drug Research. 7: 2-4, September 1960.
37.	Paddleford, C. The Greatest Food Show on Earth. This Week Magazine,
pp. 16-22, Sept. 10, 1961.
38.	Public Health Service and Food and Drug Administration Activities Con-
cerned with Pesticide Hazards, 7 pp. and 2 appendices, July 5, 1961.
-------
MUk and Food
159
39.	Research on the Development of a Feasible Process for the Removal of
Radioactive Contamination From Milk. Memorandum of Understanding
between the Public Health Service, USDHEW, the U.S. Atomic Energy
Commission, and the Agricultural Research Service, USD A, Apr. 7, 1960.
40.	Roos, B. Hepatitis Epidemic Conveyed by Oysters. Svenska Lakartidninger.
53:989,1956.
41.	Schulz, H. W. Chemicals in Foods. J. Am. Dietlc Assoc. %8: 492-495,
May 1958.
42.	Sebrell, W. H., Jr. Trends and Needs in Nutrition. Jour. Amer. Med. Assoc.
152: 42-44, 1953.
43.	Second United Nations International Conference on the Peaceful Uses of
Atomic Energy. District Surveys Following the Windscale Incident,
October 1957, July 1958.
44.	Shellfish, Milk and Food Service Sanitation Activities of the Public Health
Service and the Food and Drug Administration, 26 pp. with 8 addenda,
U.S. Department of Health, Education, and Welfare, Oct. 14, 1959.
45.	Taylor, Joan. Food Poisoning: Salmonella and Salmonellosis. Royal Soc.
of Health Jour. 80:4, 249-72,1960.
46.	Thatcher, F. S., Comtois, R. D., Ross, D.r and Erdman, I. E. Staphylococci
in Cheese: Some Public Health Aspects. Canad. J. Public Health, 50: 497-
503, December 1959.
47.	Tiedeman, "W. D., Problems In Food Technology Research. Proc. Conf. on
Man Versus Environment, pp. 81-85, 1959.
48.	Wilson E., Paffenbarger, R. S., Jr., Foter, M. J., and Lewis, K. H. Prevalence
of Salmonellae in Meat and Poultry Products. Jour. Inf. Dis. 1961. (In
press).
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Supplement
AREAS OF SPECIALIZATION REQUIRED TO ATTAIN FOOD
PROTECTION GOALS
The professional resources needed within the Division of Environ-
mental Engineering and Food Protection to attain the objectives of
food protection are described below under four categories according
to degree of development which each area of specialization is expected
to attain within the next 5 years. The status of these specialties will
undoubtedly change progressively as new problems appear, additional
techniques or other pertinent knowledge become available, and novel
food protection measures are developed. Presumably new subspecial-
ties will need to be added, and the emphasis on existing areas of com-
petence will require adjustment to meet the food sanitation problems
of the next decade.
INDEPENDENT RESOURCES
Areas of specialization in this category form the core of the pro-
fessional resources required to meet the Division's research, technical
consultation, training, and related responsibilities for food protection.
Each area will be developed in depth to serve the principal day-to-day
needs of the Division as well as the lesser related needs of other
divisions.
Food Microbiology
Specialists in bacteriology, virology, mycology, and parasitology
will be required to investigate the causative agents of food infection or
intoxication and to develop control measures. Orientation of mi-
crobial physiology, genetics, and serology, as well as to medical,
veterinary, sanitary, dairy and marine microbiology, will be necessary
to investigate the public health implication of microbial food con-
tamination, develop sanitation standards, and devise preventive meas-
ures applicable to the preparation and serving of foods.
Food Chemistry
Primary emphasis on biochemistry will be required to supply com-
petence in enzymology, metabolism, nutrition, immunology, and other
subspecialties related to the study of natural food products. Strong
support will be needed in physical, organic, inorganic, and analytical
chemistry to deal with the increasing problems of hazardous chemical
contamination of foods. Radiochemistry will be an essential com-
ponent of this area, because of special significance of foods as sources
of environmental radioactivity and the importance of tracer techniques
in research.
160
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MUk and Food
161
Food Engineering
Specialists in sanitary, chemical, mechanical, and electrical engi-
neering will be needed to evaluate problems related to (1) the sanitary
design, construction and operation of food equipment, (2) procedures
of producing, harvesting, processing, storing, shipping, and serving
of perishable foods, and (3) criteria and requirements for inplace
cleaning and germicidal treatment, automatic control of time-tem-
perature dependent operations, and preservation of foods by novel
processes such as dehydro freezing, radiation sterilization, ultra-high-
temperature pasteurization or so-called natural purification of
shellfish.
Food Technology
Technologists will be needed with special knowledge of each class of
highly perishable foods, such as milk, shellfish, meat, and poultry
products, which may serve as vectors of hazardous contaminants.
These specialists will conduct field studies, surveillance operations,
and demonstrations related to food sanitation.
DEPENDENT RESOURCES
Included in this category are areas of specialization for which the
Division must have the competence to meet its ordinary needs, but will
also require the support of other groups with respect to fundamental
or theoretical research and unusual equipment or professional talent.
Statistics
In this area, a distinction is made between statistical design and
analysis of data, on the one hand, and the broader areas of systems
analysis, data retrieval, and operations research which are considered
in the category III, Pooled Resources. The Division will require a
statistical staff and facilities sufficient to develop sound protocols for
research, evaluate technical data, and record information in forms
which can be subjected to more sophisticated statistical treatment.
Although the Division will need machines and staff for coding, sorting,
and collecting statistical information, it will depend on others for
computer services and the development of mathematical statistics to
meet its needs.
Epidemiology
Both "classical" and experimental epidemiologists will be needed to
investigate the occurrence, causes, and circumstances associated with
illness as attributed to foods. Field studies with human populations,
as well as experiments with animal populations will be conducted in
this area to examine critically and perhaps extend the precepts of
epidemiology with respect to the impact of both food contaminants
and food itself on health. No doubt other divisions will have similar
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162 ENVIRONMENTAL HEALTH PROBLEMS
interests in the epidemiological investigation of air- and water-borne
illnesses as well as those attributed to environmental radiation and
occupational hazards; therefore, close cooperation among these
groups seems desirable.
Toxicology
Specialization in this area is usually achieved by experience rather
than formal training. The Division will need the services of chem-
ists, pharmacologists, and pathologists to evaluate experimentally and
judgmentally the health hazards of foreign chemicals and natural
constituents found in foods. Kecommendation of safe practices and
control measure will be a part of their responsibilities. However, the
Division will need the help of a toxicological group with broader
orientation to assess the role of foods in the total exposure of man to
hazardous materials from the environment.
Physios
Specialists capable of utilizing new complex physical instrumenta-
tion and interpreting the results will be needed to characterize foods
and their significant components or contaminants. The orientation
of the work will be primarily to biophysics, but knowledge of both
radiation physics, and the classical physics of heat, light, pressure,
etc., will also be required. In recognition of the very high degrees of
specialization within this area and the large investment required for
proper instrumentation, the Division will also need the support of
other groups with related competences. Quite probably a control
facility will best serve the needs for the more costly items which are
infrequently used by any division.
Ocean ogkafhy
The special problems associated with production, harvesting, and
processing of raw shellfish and other seafoods require the attention of
specialists in marine biology and oceanography to complement the
sanitary engineering, chemical, and microbiological work on sanitation
of these products. Because of the allied interests of the Division of
Water Supply and Pollution Control, coordination of work in this
area is contemplated. It is recommended that representatives of other
departments, both in and out of the Public Health Service, having
allied interests in this area, serve on an interdepartmental oceanog-
raphy committee, to assure a high degree of coordination in this
activity.
Training
Instructors with basic scientific and public health backgrounds will
be required to organize and present specialized courses on food sani-
tation to health workers. They must be capable of recognizing, inter-
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Milk and Food
168
preting, and communicating technical information of value in public
health practice. They will need the support of other professional
staff members and consultants, as well as certain training facilities
available to the Center as a whole.
Administration
In order to work effectively within the administrative framework
of the Bureau, DEEFP will need the full-time services of specialists
in personnel, fiscal, procurement, management, and bibliographic
services, as well as skilled illustrators, draftsmen, shopworkers, jani-
tors, and emergency maintenance personnel. This group will be
heavily dependent on the central management and service groups
available to the Center as a whole.
POOLED RESOURCES
Areas of specialization in this category will be supported in common
with others using divisions at a single location. DEEFP will employ
ancillary specialists who have some knowledge of these fields, but will
depend on the central organization for facilities and additional talent.
Areas included here differ from those in category II with respect to
the degree of internal development required to meet the needs of the
Division.
Climatology
Rainfall, temperature, day length, and other climatic factors are
well known to affect the composition of food crops. In order to assess
the role of these factors in the uptake of radionuclides, agricultural
chemicals, and soil constituents, climatologic studies will be required.
Studies may also be needed on the relation of climate to human
nutrition.
Ecology
Understanding of the health problems associated with foods requires
knowledge of food chains and the factors that determine the dietary
habits of man. These important components of human ecology can
best be investigated in broad studies, but are of special interest to
DEEFP.
Reactor Technology
DEEFP has direct interests in (a) the possible contribution of
reactors to radionuclide contamination of foods and (b) the utilization
of high energy sources as tools for research on radiation sterilization,
neutron activation analysis, and the like. Because of the high costs
involved, the Division would prefer to utilize a central facility which
might be constructed and operated by the Division of Radiological
Health.
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m ENVIRONMENTAL HEALTH PROBLEMS
Systems Analysis
As noted above, DEEFP has need for supporting resources which
will bring to bear advanced mathematical theory and data processing
equipment on the public health surveillance of the food supply. These
resources will supplement the internal statistical competence of the
Division if a central facility is provided.
UNDEVELOPED RESOURCES
The DEEFP will have intermittent use for several areas of speciali-
zation which can be obtained from contractors or consultants, but may
not be available within the Bureau. In the field of food protection,
the following are presented as examples.
Social Sciences
For the understanding of dietary preferences and nutritional prob-
lems, the assistance of psychologists, sociologists, and economists will,
on occasion, be needed, but the Division does not now foresee a con-
tinuing workload in these areas which would justify internal develop-
ment of those specialties.
Medical Sciences
Although physicians and veterinarians with specialized training are
included in several areas covered under categories I and II above,
additional clinical specialists, in such fields as geriatrics, pediatrics,
radiology, allergy, dentistry, and internal medicine, may be needed
to undertake specific studies or provide advice on responses of man
and animals to food constituents or dietary regimens.
Other Areas
Even within the areas where the Division has considerable compe-
tence, situations will almost certainly arise which require the help of
additional specialists in such fields as spectroscopy, organic synthesis,
chemotherapy, electrons microscopy, and the like. The full range of
possibilities can not be clearly defined in advance, but ample provision
should be made for the temporary employment of such individuals on
a basis that will be mutually acceptable to them and the Government.
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Report of the Subcommittee on
OCCUPATIONAL HEALTH
RECOMMENDATIONS
1.	Major strengthening of the PHS program in occupational health
is recommended to secure and maintain the health and well-being of
the gainfully employed of the Nation at the highest possible level, so
that they may realize their full potential as members of society and
the Nation may enjoy, in fullest degree, the benefits from our indus-
trial effort. The PHS must assume primary leadership in the ad-
vancement of the total national effort in occupational health.
2.	To meet the foregoing, we recommend acceptance of the ob-
jectives, specific goals, and plan of action outlined in the accompanying
proposal as a "charter" for the U.S. Public Health Service to follow.
3.	Administrative organization and operation of the occupational
health program within the Environmental Health Center is recom-
mended as a means of insuring a strong position for occupational
health within the Public Health Service structure and in order to
gain strength from close association with other activities having cer-
tain common interest in the field of environmental health. The Sub-
committee wishes, however, to sound a note of caution. Care should
be taken to avoid compartmentalizing environmental health activities
by scientific disciplines and/or professions with consequent loss of
identity of the separate problem areas. The potential strength of
the Center should develop by interdivisional collaboration and mutual
attack upon problems of common interest, with encouragement of in-
terdisciplinary development, rather than by administrative prede-
termination of specific research areas.
4.	As an essential part of the national effort in occupational health,
university research must be encouraged and expanded. To meet these
needs, financial support through the PHS has to be increased. In
addition to the present scheme of support for specific research projects,
we particularly recommend that the PHS be authorized to support
long-term university research programs in broader problem areas in
occupational health, so that effective research groups can be built up
within the universities with better chances of drawing well-trained
research scientists into this field. We also recommended that such re-
search undertakings be employed as a means of training scientists for
work in important areas of occupational health.
5.	Support of specific training programs in occupational health in
appropriate universities, and provision of fellowships for student sup-
port, are recommended.
166
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166 ENVIRONMENTAL HEALTH PROBLEMS
6.	A program of inservice training is recommended, to be operated
within and by the staff of the Division of Occupational Health, to
meet two major needs in technical training: (a) for certain Division
personnel; and (b) for personnel in State and local health services.
In addition to the short-term training provided under (a) above, the
Bureau should intensify the program of formal academic postgrad-
uate out-of-service training for suitable personnel in the Division of
Occupational Health.
7.	To meet the manpower requirements for the proposed program,
an increase in personnel, as set out in table 1 of this report, is recom-
mended over the next 5 years. It is anticipated that the staff needs
for 1971 will exceed those shown for 1966 by approximately 50
percent.
Table 1. Estimated Technical Manpower Requirements
Professional discipline
Engineering	
Physios	
Chemistry.	
Biology		
Medical and paramedical
Allied Sciences..	
Total			
8. The sums of money set forth in table 2 of this report are recom-
mended for the support of the proposed program over the next 5 years.
It is anticipated and recommended that the budget for 1971 exceed
that of 1966 by a factor of approximately 2.
Table 2. Estimated Fiscal Requirements
[.Millions of dollars]
Use
1961
1962
1963
1964
1065
I960
Grants
Research grants	—	
Project training grants—	
1.4
4
6
?
1
1
S
4
2
11
7
3
Other grants and fellowships		
Total, grants.	

.5
1
1.4
4.5
6
e
14
21
Direct operationi
Research			
Training	-	
Technical assistance	-
Total, direct operations	
Total, occupational health	
1.0
.2
.7
1.2
. 2
,7
2.S
.4
1.1
s
1
2
4
1
3
S
1,5
3,fi
1.0
2.1
4
6
8
10
3.3
0.6
10
16
23
31
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Occupational Health
167
INTRODUCTION
The Subcommittee met with representatives of the Division of
Occupational Health on September 10 and the Chairman had a further
conference on September 19. In the course of these meetings, the
mission of the Subcommittee was reviewed and the overall objectives,
present operation of the Division, and needs for continuation and
expansion of the national program of occupational health were exam-
ined in a preliminary way. The Division staff were asked to prepare
a working paper, setting forth in more specific detail a statement
of the present and future problems in occupational health; the objec-
tives and specific goals as developed in the Subcommittee-staff discus-
sion; and an outline of the programs, organization, and facilities
needed to meet these goals. In the preparation of this paper, the staff
was particularly requested to examine the subject in relation to the
central questions confronting the committee on environmental health,
having to do with meeting the scientific and professional manpower
requirements, provision of the necessary organization and physical
facilities for the conduct of essential research, both in the laboratory
and in the industries, proper coordination and balance between the
PHS and non-Federal agencies in respect to research and training of
scientific and professional personnel, and between PHS and other
Federal agencies having personnel and research facilities and respon-
sibilities in the areas of occupational health. These questions, in turn,
center around the main question respecting the need for an organic
Environmental Health Center designed to bring together for mutual
strengthening and to give a central purpose to the several major prob-
lem areas of public health arising out of environmental challenges to
man's health.
The staff working paper was reviewed by the Subcommittee and
consultants on September 27 and is attached as a supplement to the
Subcommittee report. It reflects the Subcommittee views and pro-
vides essential foundation material in support of the conclusions and
recommendations of this report.
NEED'S FOR A STRONG PROGRAM IN OCCUPATIONAL HEALTH
The need for a strong national effort to secure and maintain maxi-
mum health among the gainfully employed men and women of Amer-
ica requires no particular justification. The need is obvious. They
must be given the same protection against ill health as is enjoyed by
other members of our society but, in addition, they require special
protection against the peculiar health hazards that arise out of and
in the course of their work. As individuals, too, and from the stand-
point of total national welfare, both economic and in terms of deeper
human values, every opportunity must be taken to raise their level of
health in a positive sense, over and above the mere elimination of
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168 ENVIRONMENTAL HEALTH PROBLEMS
negative health factors, Great benefits have come from advances in
science and technology and from their application by our industries.
These have not been gained, however, without certain costs in terms
of human values. If we are to enjoy to the fullest extent the benefits
from our modern industrial society, these costs have to be better rec-
ognized, evaluated, and reduced. The national effort in occupational
health must be directed to this end. All of the costs, of course, are
not to be measured in terms of ill health, but it is in this area that we
can especially expect clear-cut returns. The remarkable successes
from organized, scientific public health effort of the past assure this,
and success will be limited only by the extent of our effort to define
the problems, identify significant cause-and-effect relationships, and
devise and apply corrective measures. These broad principles and
methods of operation—the basic, time-tested procedures of public
health—are spelled out for particular application to occupational
health in the accompanying program.
The specific problems of occupational health are many and varied
and, owing to the dynamic nature of American industry, it is impos-
sible to anticipate the exact nature of future problems. Hence, an
occupational health program must be flexible, anticipating new prob-
lems in broad categories and not making rigid commitments to partic-
ular areas of research, development, and operation. The Subcom-
mittee accepts and recommends this program as a broadly conceived,
sound, and essential "charter" to meet the particular responsibilities
of the Federal Public Health Service within the total national effort
to secure and maintain the health of the gainfully employed.
It is significant to note that the total cost of the current program
in occupational health amounts to 5 cents per worker, per year, and
that the estimated cost of the fully expanded program for 1970 would
amount to not more than 70 cents per worker, per year. On the basis
of past accomplishments, the returns to the Nation would more than
offset these expenditures.
RESPONSIBILITY OF THE PUBLIC HEALTH SERVICE IN OCCUPATIONAL
HEALTH
The direct operation of services to protect the health of employed
people has to be done by the industries themselves, and direct govern-
mental assistance in such efforts is carred out by State and local public
health agencies. The esssential role of the U.S. Public Health Service
is one of leadership and advisory assistance, supported by a dynamic
research program designed to provide the necessary scientific and
technical knowledge on which to base effective control measures. Be-
cause the health problems of industry are so varied and involve so
many different man-environment relationships—physical, chemical,
biological, and social—and because the health problems of the gain-
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Occupational Health
169
fully employed cannot be divorced from nor dealt with altogether
separately from those of the general public, it is evident that the re-
search programs, scientific and professional staff, research facilities
and means for undertaking field studies and operation must be broadly
based. It must draw upon scientific skills in all branches of the physi-
cal, biological, behavioral, and social sciences, and their counterparts
in applied science and professional practice, medicine, engineering,
etc. Individuals from these many areas must be brought together to
work faintly upon problems of common concern. Thus, organized
effort in occupational health has to be problem oriented rather than
by disciplines or professions. It cannot be compartmentalized by
disease categories nor by classes of stress agents, nor can it be viewed
solely as an area of environmental health in the sense that common
denominators of the environment dominate the different problems.
Primary importance is given to man-environment relationships that
may disturb health, but from one situation to another the environ-
mental stress factors range over the whole gamut of physical, chem-
ical, biological, and social relationships to man, and the relative
importance of man and of environment in the quation shifts from
one problem to another. Problems are solved in one case mainly by
correcting the environment and in others by working with people.
OCCUPATIONAL HEALTH WITHIN A BUREAU OF ENVIRONMENTAL
HEALTH
In order best to serve the national needs in occupational health, the
Federal program must be organized within the Public Health Service
in such a way as to draw maximum strength from the other activities,
staff, and facilities of the Service. It was with this point in mind
that the Subcommittee examined the question of the place of the
Division of Occupational Health within the Bureau of Environmental
Health, and, physically, within the Environmental Health Center.
The following points are made:
1.	The nature, magnitude, and national importance of a Federal program in
occupational health are such that the program must occupy a strong position
and at a high level within the Service to insure its essential support.
2.	The structure of the Occupational Health Division, its staff and facilities,
must be sufficient, up to a point, to insure its independent capacity to perform
its mission. Since this is not an isolated area of concern, it should be organized,
both conceptually and administratively, with those other PHS activities from
which it will particularly gain strength.
3.	Occupational health has many important and obvious interrelations with
other areas within the proposed grouping of environmental health activities.
Problems of radiologic health, air pollution, and water pollution are inevitably
associated with industry. General sanitary controls, food protection, and other
such environmental problems are encountered in the industries as well as in
the surrounding communities. Basic approaches and the kinds of scientific
627408— 02—13
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170 ENVIRONMENTAL HEALTH PROBLEMS
and professional skills needed in the several areas have much in common, and
close association will give mutual strength to the several divisional programs.
4.	Administrative compactness, efficiency, and economy of operations, avoid-
ance of unnecessary duplication of scientific staff and research facilities, and
the convenience of certain common services are further important advantages
to be gained from operation within the Center.
5.	There are some important common areas of Interest in basic research which
can be properly shared, as well as common scientific and technical services. In
both basic research and high-level services the cost of separate provision would
be prohibitive. There is greater chance, too, of recruiting first-quality scientists
into the larger and broader Center.
In view of the foregoing points, the Subcommittee believes that the
Division of Occupational Health will gain material strength by ad-
ministrative organization within the Environmental Health Center.
In doing so, however, it must have its own integral organization, in-
cluding a staff drawn from all the necessary areas of science and the
professions to insure its effective operation. Thus, for example, it
must have its own research program in industrial toxicology, its own
competence in epidemiological research, etc. The Subcommittee be-
lieves, as matter of administrative policy, that the common scientific
effort of the Center should be developed and maintained by bringing
together appropriate individuals from the several divisions for
common study of problems, rather than by setting up in advance
permanent groups to carry out basic research in separate underlying
disciplines.
MANPOWER NEEDS, TRAINING AND NON-FEDERAL RESEARCH
With respect to special charges to the Committee on Environmental
Health concerning manpower needs, Federal and non-Federal research
and inter-Federal coordination of activities in environmental health,
the accompanying working paper sets forth the needs within the
Occupational Health Division, we believe, in a reasonable manner.
Manpower requirements—for the Division itself—as presented in
the tables are not of great magnitude; they represent about
a fourfold increase over present staff within 10 years. New person-
nel are to be drawn from many areas of science and the professions,
and the numbers from each are not large. For the country as a whole,
the estimates of needs are much bigger, but it must be pointed out that
these are ideal figures for a fully developed program. Actual de-
mands will be much more dependent upon the success with which real
needs are met. We believe that the well-defined needs can be met
without unreasonable expansion of existing university-training pro-
grams, in either the underlying disciplines and professions or in
schools of public health or other university departments devoted to
training of occupational health specialists.
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Occupational Health
171
An important point to be noted is that much of the staff training
for the Division can be done through inservice programs and, with
respect to training of personnel for State health services, major de-
pendence lias to be on such intensive training within the Division.
This has worked very well in the past and will in the future. This
means a continuing training program must be made a part of the
operation of the Division. For convenience and efficiency, such in-
service training activities may share a common administrative setup
within the Center with the other divisions, but we believe that the
actual planning and conduct of training courses should be carried
on within and by the staff of the Division to insure close integration
within its own problem area. Training has to be oriented around the
health problems of the industries and not by disciplines or professions
or in terms of general environmental health.
The Subcommittee agreed that the universities must be encouraged
and supported in a greater research effort in problems of occupational
health, for three reasons: first, proper training of occupational health
specialists (especially research workers) can be done most effectively
by a faculty who are, themselves, deeply involved in solving occupa-
tional health problems; second, there are certain areas of research that
can best be done in the university, free of the government-private in-
dustry relationship; third, such university programs multiply in a
major way the number of research workers throughout the country
who are involved in and committe'd to this important area of research.
The Subcommitteee was not able to draw any sharp lines between
Federal and non-Federal research activities, in respect to either the
nature or magnitude of effort. Given strong leadership within the
Public Health Service, we believe these questions are best left to be
answered as the program develops.
In respect to questions of inter-Federal relationships and coordina-
tion of efforts in occupational health, the Subcommittee found no
problems of immediate concern and does not feel that this matter has
particular application to the present question of how best to organize
occupational health activities within PHS.
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Supplement
PHS PROGRAM IN OCCUPATIONAL HEALTH
DEFINITIONS
The general objective of health programs may be defined, not merely
as maximizing the length of life of the individual but also as per-
mitting him to realize his full potential as a member of society. Mere
length of life is not enough; the effectiveness of the individual
throughout that life is just as important.
The pattern of bodily functions which determines maximum ex-
pression, or health, is the result of interactions between the charac-
teristics of the individual, on the one hand (such as bodily conforma-
tion, physiological reactions, psychomotor functions, psychological
patterns, and immunities); and the environmental conditions sur-
rounding him (such as physical factors, chemical contacts, electrical
conditions, radiation, infective and allergenic agents, psychological
stresses, socioeconomic conditions, etc.), on the other. From whence
it follows that health can be understood and preserved only by ade-
quate and simultaneous attention to both the man and the environ-
ment.
The term "Occupational Health" signifies that part of the total
health picture which is closely associated with the individual's occu-
pation. While it needs to be viewed in relation to the individual's
total life, this segment calls for special consideration because: (a) it
presents certain special environmental influences or risks; (5) the
worker's life centers around his work; (c) it brings persons together
into defined groups which can be studied not only as regards specific
occupational diseases but also in respect to disturbances affecting the
population at large; (d) health enters in an important way into the
relationships between employer and employee; and (e) the products
of industry in turn affect the life of people in general. The term
"occupational" should be taken in the wide sense of including all
types of occupation, and the term "industry" should be taken in a
similarly wide sense of any department or branch of art, occupation,
or business; especially one which employs much labor and capital
and is a distinct branch of trade. Agricultural, educational, and
service work and workers, for example, would be included as well as
those of the mechanical and chemical industries.
The basic objectives of any occupational health program can
be very simply stated: (a) recognition of the influences and risks;
(&) evaluation of their effect upon human health and efficiency; (o)
m
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Occupations Health
173
development of preventive measures, and (d) effective application of
the knowledge so gained to industrial practice.
HISTORICAL
The traditional emphasis in the study of occupational disease has
been on specific, dramatic, and killing diseases apparently caused by
single or small groups of environmental factors. Medical history from
Agricola (mid-16th century) to McCord (early 20th century) affords
eloquent testimony to the success of this approach, but occupational
medicine today suffers to a certain extent by that very success. The
recognition and conquest of such killing and disabling diseases as
lead poisoning, mercury poisoning, tar cancer, phosphorus poisoning,
radium poisoning, and silico-tuberculosis, is a classical story. Such
cases as still develop are nearly always traceable to failure in the
application of knowledge rather than to lack of knowledge. New
industrial materials will produce new hazards requiring careful detec-
tive work before the exact agent or mode of action is incriminated,
and to which the classical approach can be applied, but the principles
are known and the work can proceed along what are now fairly con-
ventional lines.
Occupational health today, however, must not only continue the
application of conventional methods to the detection of new agents,
but also extend its traditional concept in new dimensions. The prob-
lem confronting us today contains many elements that are new, but
our methods of attack have been slow to adapt to the new challenges.
In spite of the attention given to the single dramatically killing and
disabling factors, the health of the worker is far from optimal, and
frank occupational disease also persists. Some of this is due to newer
and as yet imperfectly defined agents, but much of it cannot be ex-
plained upon this basis. Much of this residual disease and disable-
ment may not be apparent to the casual observer, especially if he
relies upon the classical approach using the conventional examination
procedures of clinical medicine, and conventional records of death
and reported disease. This residual disease and disablement may
not be dramatic, it may not kill (or not obviously), and much of the
disablement that it produces is apt to be subtle, of slow development,
and easily confounded with "normal" causes of progressive deteriora-
tion such as aging. The involvement of the individual may be less,
but more persons are involved. Of the 70 members of the civilian
labor force, probably more than half have some degree of physio-
logical impairment which could be greatly reduced if adequate knowl-
edge were available. Furthermore, the impairment is not produced by
single, isolatable, easily incriminated factors; rather it is the result
of multiple factors working together, each adding its own insult and
helping others to add theirs.
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m ENVIRONMENTAL HEALTH PROBLEMS
By way of example, we may point to the paradox that has devel-
oped in the South African mines—dust, as it was known, has been
largely suppressed, and with it has disappeared the gross silicosis of
old; but pneumoconiosis remains, and resultant deterioration of pul-
monary and cardiac function continues. This pneumoconiosis may at
times even show a negative correlation with the environmental dust
count, at least as conventionally estimated. Again, with the decrease
in emphasis upon heavy physical labor, and the introduction of auto-
mation, the incidence of physical strain in industry can be expected to
decrease; but the psychological stresses are obviously increasing at
least in proportion, and probably absolutely as well. For example,
the problem of handling and interpreting masses of incoming infor-
mation, under pressure, in split-second fashion, and often with very
critical consequences, so dramatically seen in airport control rooms, is
developing with increasing frequency in communication centers across
the Nation, in plant control rooms, and in emergency installations.
Modern man shows remarkable ingenuity in the acquisition of infor-
mation, but much poorer ability in digesting it when he has it. In
less intensive fashion the psychological and social concomitants of the
job affect every worker, his relations with others, his productivity, his
anxieties, and his health—that is, the lifetime sum of his realization
as a member of society.
The traditional concept of occupational health as dealing with the
man-environment relationship, as it applies to the job, still holds and
can be as successful in the future as in the past in revealing the true
nature of the relationship, its significance for health, and the measures
that are necessary to optimize that health; but it must be exploited in
the new terms. The interrelated operation of multiple factors, the
existence of new factors, the importance of hitherto neglected classes
of factors, the aging of the population exposed, and the variability of
the human material must be taken into proper account; the less
marked, more slowly developing, less easily defined responses of man
to these factors must become the prime object of examination; and
the significance of total stress as well as individual stresses must be
assessed. The relationship of disability to physiological status illus-
trated in the accompanying diagram remains the same; but whereas
we have hitherto concerned ourselves with the uppor portion of the
curve, applicable to only a small proportion of persons, we must now
give proper attention as well to the middle portion of the curve which
applies to the majority of employees over an extended potentially
rewarding lifespan. This is largely terra incognita., over which the
deteriorative and reparative processes fight out a fluctuating battle
for man's health; we must discover the rules of this warfare, and
devise means for influencing the result in favor of man.
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Occupational Health
175
PREVENTIVE
MEDICINE.
CURATIVE
MEDICINE
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to
3
8
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176 ENVIRONMENTAL HEALTH PROBLEMS
mand being placed upon public health authorities for information,
research, and leadership as a supplement to and eventually, it is hoped,
a replacement for purely regulatory control. On the other hand,
there appears to be a growing tendency for the party at risk to resort
to litigation and claims for compensation, and a tendency on the part
of some jurists to liberalize the basis for granting compensation. Oc-
cupational health programs will necessarily need to temper their
practices to the varying legal winds that blow about them.
THE ROLE OF THE PUBLIC HEALTH SERVICE
The health of the worker is a national asset calling for protection
and conservation at all levels, Federal and State, academy and agency,
management and labor, economic and humanitarian. While it would
be unwise to define too exactly the role of any one group in the total
effort to maximize human health, for fear of restricting individual
freedom in the striving for betterment, the general role of the Public
Health Service can be delineated.
In essence, the function of the Public Health Service is to provide
those opportunities for combined or coordinated action which are un-
likely to develop from the independent action and responsibilities of
the multitudinous individual activities across the Nation. It provides
the technical means for discharging those functions which are ad-
judged at the governmental level to be a Federal responsibility or
opportunity; it provides a set of facilities for such research and in-
vestigation as is not easily developed by individual organizations: it
may sometimes permit review of a problem in a detached fashion not
always possible to those engaged in the daily flux of events; it pro-
vides a link between the more basic sciences and the severely practical
demands of immediate industrial operations; it furnishes a mecha-
nism for supporting those segments of the national effort which have
not developed sufficiently to meet national needs; and in all that it
does it has the opportunity of setting an example of devotion to the
national needs and aspirations. It does not and should not seek to
substitute its efforts for those that are the province of or are being
adequately discharged by individual groups; it does not and should
not undertake routine activities unrelated to its primary mission, or
which can be adequately carried out by others; and however much it
may assist others in the development of their own roles, it cannot and
should not take away from them their rightful initiative in the dis-
charge of those roles.
As was indicated earlier, the basic objectives of an occupational
health program can be simply stated as: (1) recognition of the influ-
ences and risks associated with occupations; (2) evaluation of their
effect upon human health and efficiency; (3) development of preven-
tive measures; and (4) effective application of the knowledge so
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Occupational Health
177
gained to industrial practice. The program operated by the Public
Health Service should provide for all of these, not only by its internal
operations but also by proper support of State, industrial, and aca-
demic organizations engaged in relevant activities.
It is desirable that these objectives be examined in more detail be-
fore proceeding to a specific program. Here, as elsewhere, knowledge
cannot be divided into mutually exclusive compartments, so that there
will be a certain overlap between the categories described; but in gen-
eral the description will proceed from the acquisition of information
to its application, and from the more fundamental aspects to their
practical significance.
1. Recognition and Definition of Occupational Influences and
Rises
An outstanding characteristic of modern industry is change. It
would be unrealistic to rely upon past knowledge and experience to
predict or prepare for the future to say nothing of information con-
cerning those influences which were not previously recognized as sig-
nificant. The acquisition of detailed knowledge concerning the
existence, nature, and mode of operation of all significant factors is
essential to the design and prosecution of any worthwhile effort in
occupational health. Practice cannot be adequate unless this informa-
tion is extensive, representative, accurate, and projective.
a. Nature and trends of indrntrial processes: Except with the most
toxic materials or most damaging conditions, there is necessarily a
timelag between the introduction of a new material or process and the
recognition of deleterious effects in operating personnel. The timelag
is large enough where one is content with preventing frank disease or
disability; but it is apt to be much greater still where the effects are
subtle nonspecific deteriorations of general health and efficiency. It is
very important, therefore, that information on industrial processes
and materials not only be kept current over a wide section of industry,
but that it include projections of the materials and processes that are
scheduled or even proposed for introduction over the following several
years. Had those concerned with public health been fully aware be-
forehand, for example, of the proposed development of epoxy resins,
agents for foaming plastics, or plastic materials for machining, and
in a position to study them, the effects of these substances and the deriv-
atives formed in processing could have been predicted, precautionary
measures devised, and a considerable amount of disability saved. The
rather fortuitous fact that health experts were consulted early in the
newly introduced plasma torch operations, with the consequent recom-
mendation of protective measures, could become the rule rather than
the exception. The institution of an adequate information-collecting
scheme is not easy, but it is as important to the rational practice of
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178 ENVIRONMENTAL HEALTH PROBLEMS
occupational health as a sampling network is to an air pollution pro-
gram. The difficulties, though considerable, are not insurmountable
if attacked with quiet and tactful determination.
b. Mechanisms of human responses to environmental conditions:
In terms of the new dimensions cited earlier, occupational health has
as its goal, not merely the prevention of additional cases of recog-
nized disability but the prevention of any cases at all. It is concerned,
not only with the immediate effects of occupational conditions but also
with the interaction between them and the various other vicissitudes of
the employee's life. It implies knowing enough about all possible
causes and their mode of operation upon the body to recognize and
eliminate them before they have opportunity to be effective. To give
an example, one would not wait until pulmonary distress focused at-
tention upon a new substance X, or emotional outbreaks raised ques-
tions of sensory overloading, before inquiring into the cause and
devising preventive measures; one would have established the probable
toxicity of X-like substances and the probable consequences of sensory
overloading beforehand, drawn attention to their possible occurrence,
and devised measures to eliminate the stress before breakdowns oc-
curred. Similarly with the operation of multiple environmental fac-
tors in the impairment of health, whether frank or insidious, the
significant patterns of combined operation would have been es-
tablished, the probable consequences worked out, and appropriate
preventive measures developed.
As of now, this would be a counsel of perfection indeed; but never-
theless this is the goal toward which the new occupational health must
work. It envisages: (a) careful systematic review of all the environ-
mental factors that may affect human functions; (I) establishment of
their mode of operation on the body singly and in combination; and
(c)	the development of methods whereby their effects upon health,
used in its widest sense, can be systematically examined. In this sec-
tion we are concerned with the more fundamental aspects of this pic-
ture; the resolution of specific problems will be taken up in the next
section.
To meet these needs a comprehensive occupational health program
must provide: (a) mechanisms of keeping thoroughly abreast of cur-
rently available knowledge in the field; (&) support for those extra-
mural groups who have the ability but not the resources to develop the
areas of inadequate knowledge; (c) internal resources to develop those
areas of inadequate knowledge not otherwise being prosecuted; and
(d)	a continuing review and synthesis of emergent knowledge with
subsequent reevaluation of its efforts in the preceding categories.
It must pursue its inquiries wherever they may lead, not duplicating
activities and facilities available elsewhere, but certainly not being
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Occupational Health
179
inhibited in acquiring competence in techniques hitherto characteristic
of some other group or academic field but necessary for the job. Much
of the work can be expected to lie at a fairly basic or fundamental
level, and one of its characteristics will be the search for early and
sensitive indices of bodily response to environmental stresses.
As has been implied in the foregoing pages, recognition of this
pursuit as fundamental and essential to occupational health has been
slow to develop, with the result that such information as has accumu-
lated is still scattered and unorganized. Just how much really new
effort will be necessary, and along what lines it is most needed, will
not be clear until some systematization has been attempted. History
suggests, however, that many more questions will be revealed than
answered in the process. Certainly this type of fundamental and
systematic inquiry is the foundation upon which any adequate occu-
pational health program of the future must be erected.
c. Consideration of the total worker in a total environment: While
much of the scientific study of human responses to environmental fac-
tors must necessarily consider the components one at a time, the
ultimate fact must be kept in mind throughout that it is the total man,
operating in a total environment, with whom the program is concerned.
The necessity for ultimate synthesis of the emergent information must
be considered both in experimental design and in the interpretation of
results. Methods, disciplines, and approaches not now common in
studies of occupational health must be introduced. Psychology, soci-
ology, and economics must enter, not only into the implementation of
preventive measures but also into the basic study of how man—the total
man—reacts to environmental stresses, and how his reactions affect his
realization as a member of society.
The techniques for obtaining a total view of the man-environment
picture are far from complete. Considerable attention must be given
to the techniques of synthesis even before there is much in the way of
information to synthesize. A forward-looking program will place
this item very early in its development, since progress is likely to be
slow and arduous. In general, two types of procedure can be en-
visaged. Certain types of information, particularly of a quantitative
nature, can be integrated by mathematical techniques sometimes called
operational analysis. Other types of information are best synthesized
by the roundtable technique—the repeated matching and attempted
intellectual integration of information into a more meaningful whole,
separated by periods in which the individual contributors have the
chance to rework or expand their evidence in terms of the last
discussion.
As an example of the necessity for considering the combined action
of environmental variables, one may cite the current belief that the
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180 ENVIRONMENTAL HEALTH PROBLEMS
progress of chronic degenerative diseases is influenced, not merely by
diet, or workload, or psychological pressures, or past infective diseases,
or genetic constitution, or age, but by all of these things acting to-
gether. The contribution of the occupational situation to the progress
of a degenerative disease in a given individual, or in a group of em-
ployees, can be properly evaluated only in the light of the nonwork
factors. The significance of noise on work efficiency must similarly
be seen against a background of numerous other physical, psychologi-
cal, and social factors affecting efficiency. When we depart from the
killing or grossly disabling consequences of specific occupational con-
ditions, we find ourselves increasingly handicapped by lack of knowl-
edge on how the total man responds to all of the various stresses in-
herent in his total environment. This deficiency must be remedied.
2. Evaluation of Effects on Human Health and Efficiency
In the previous subsection we were concerned with the basic nature
of human responses to the spectrum of environmental influences
operating singly and in combination, and the establishment of methods
for assessing the significance of these reactions for human health. In
this subsection we will be concerned with the more specific objectives
of evaluating stated environmental conditions for stated groups of
people. Many of the methods to be described here as necessary to
specific evaluations are applicable as well to the more basic studies
already described.
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Occupational Health
181
lation ship between uranium mining and an increased incidence of
lung cancer. It needs to be continued and applied to those industries
which are amenable to it. But new and more sensitive methods of
detecting early deviations from normal function, such as blood enzyme
profiles, need to be added to the more conventional clinical survey
techniques as they emerge from the more basic studies.
c.	Experimental studies—human: These, by contrast with the pre-
vious studies, examine the reactions of selected subjects to the
operation of graded stresses, singly or in small combinations, under
conditions that are otherwise controlled. They yield information on
the precise and quantitative effects of specified environmental factors,
but usually on comparatively few subjects and under necessarily arti-
ficial conditions. The resultant information needs to be carefully
matched with that obtained by the previous method, and discrepan-
cies subjected to further examination. This, the classical method of
scientific investigation, must continue to constitute an important part
of any research program. It has yielded valuable, sometimes critical,
information in the past on the operation of such environmental factors
as heat, sound, vibration, and workload. It must be extended and ap-
plied to the operation on multiple factors, including the psychological.
d.	Experimental studies—animal: It is virtually impossible to ex-
pose human subjects deliberately to many of the potentially injurious
environmental conditions that need to be studied, at least with in-
tensities and for periods that will give significant results. Much of
our knowledge concerning the toxic properties of chemical substances,
ionizing radiation, and physical agents has necessarily come from
animal experiments. Such experiments have the great advantage,
also, that large numbers can be exposed, and proper statistical account
taken of variability. Unfortunately, animals by no means always
react to environmental conditions in the same way as man; in fact,
different species of animals may react in markedly different ways
from each other. Animal experimentation must continue, perhaps on
an even bigger scale, especially with primates, but provision must be
made for very careful comparison of the results so obtained with what
can be learned about human reactions, and final interpretation made
in conjoint terms. The growing use of experimental animals for in-
vestigation of psychological situations will extend both the use and
the significance of this type of evaluation. As more is learned about
the techniques of animal care, and the importance of standardizing
the nonexperimental aspects of their environment, the facilities will
necessarily become more elaborate and the supervision call for more
specialized professional care.
e.	Clinical studies: Medical examination of persons suffering from
diseases believed to be associated with occupation was, of course, the
original method of investigation, and it will continue as long as
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182
ENVIRONMENTAL HEALTH PROBLEMS
employees get sick. It is still an important weapon in the armamen-
tarium, and adequate facilities for its prosecution are essential. But
it is now increasingly supplemented by the other lines of inquiry
described here, and its own methodology is becoming increasingly
complex, to the point that it may be hard to distinguish at times be-
tween clinical and other types of injuiry. Here, as in field studies,
there is a continuing search for more and more sensitive indices of
altered physiological function, which can be applied to their detection
at earlier stages of displacement.
/. Epidemiological studies: Review of statistical information 011
the incidence of death or disease has been one of the standard methods
of determining the existence, extent, progress, and possible causes of
disease in given populations. The basic data may be gleaned from
published vital statistics, hospital or clinic records, field studies,
special census, or insurance returns. It necessarily deals with events
that have already taken place, are recognized as such, and have been
recorded. It cannot take account of the undeveloped, the unrecog-
nized, or the unrecorded. Nevertheless, it will continue to be a major
tool in the investigation of occupational health, and provision must
be made in any comprehensive program for its increasing use as the
volume of recorded data increases, better methods of detection are
devised, and quantitative information is derived from more and more
fundamental aspects of the disease (or nonhealth) process.
g. Economic evaluation: The real cost to the individual, the indus-
try, the community, and the Nation must be known if public health
resources are to be allocated in optimal fashion, attention focused on
the economically important problems, and the most economically ef-
fective control measures selected. Techniques for adequate analysis
are still in the developmental stage, and much remains to be dis-
covered about the guiding principles. Nevertheless, progress is sub-
stantial, so that a realistic program for the future must include pro-
vision for very significant activity in this respect.
3. Development of Preventive Measures
a. Determination of standards of acceptability: It would be un-
realistic to demand that all traces of all potentially deleterious influ-
ences be removed from occupational situations, or to insist on control
measures that cannot be economically sustained, unless the threat to
health were grave indeed. Some levels of intensity which are accept-
able must be set, and control procedures developed to meet those levels.
In many cases more than one level may need to be set for a given en-
vironmental conditions, depending upon the duration and frequency
of exposure, other coincident and influential environmental conditions,
age and sex of persons exposed, national necessity etc. Much work
has been done in the setting of limits for the gases, vapors, and fumes
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Occupational Health
188
encountered in industry, and for certain dusts developed in mining
and kindred trades. But close examination shows many inadequacies
in both the determination and the application of such standards. For
example, the data derived from animal experiments are not usually
backed by any substantial body of information derived from human
reactions, the effect of rate of work on the toxicity of inhaled material
is seldom taken into account, the methods used for determining air
concentrations are not always well adapted to the particular material,
and the evidence upon which to base decisions is sometimes very scanty.
Much the same sort of criticism can be made about current standards
for such things as tolerable hot conditions, noise levels, illumination
qualities such as glare, vibration, and other physical factors in the
environment. Virtually no standards have been devised for accept-
able psychological conditions. An adequate program in occupational
health must provide for marked improvement of standard setting, and
extension of this process over a much wider range of environmental
conditions. The high dependence upon animal reactions needs to be
offset by careful examination of human evidence; and the various
conditions such as work stress, heat, age, prior exposure, and simul-
taneous exposure which may markedly affect tolerance must be much
more carefully defined.
b.	Development of engineering control methods: Engineering pro-
cedures such as ventilation, directed airflows, noise suppression, heating
and cooling devices, air filtration and precipitation, and regulation
of illumination will probably continue to be the mainstay of environ-
ment control practice. They will, however, need frequent revision
to meet the changing needs of industrial situations, and to in-
corporate the benefits of technological advance. Associated with this
more classical type of engineering are the newer techniques often
termed "human engineering," in which the design of tools, machines,
procedures, and installations is adapted to the characteristics and
capabilities of the man who operates them, to maximize his effective-
ness and minimize the stress placed upon him. Both classical and
human engineering must find a prominent place in both the principles
and practice of industrial engineering.
c.	Pharmacological methods of control: As we get to know the
detailed ways in which bodily processes respond to or are affected by
environmental stresses, we begin to see how they may be helped or
protected by the administration of substances having specific pharma-
cological action. To take a simple example, if it is demonstrated that
a particular substance owes its toxicological properties to the fact that
blocks the transmision of impulses from nerve to muscle, then a
rational method of treatment and perhaps of prevention would be to
administer a substance which facilitates the transmission, or some
substances that would lock with the toxic material and prevent its ac-
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m ENVIRONMENTAL HEALTH PROBLEMS
tion at the junction. Or again, less drastic vasodilators than nitro-
glycerin might very well be used to counteract the weekend effects of
temporary deprivation experienced by nitroglycerin workers.
d. Organizational methods of oontrol: In spite of the general tend-
ency to rely more and more on automatic detection devices and regu-
lators, prevention, in the final analysis, arises from a human desire
and by human decision. A great deal can be done, by so arranging
layout that employees are placed in positions of least hazard, by
explaining to employees the toxic potentialities of the materials they
handle, by inculcating an appreciation of control measures, and by
inducing a rational organization of the work regime. Insufficient
attention has been given to a study of the personal factors involved
in requiring, devising, operating, and monitoring control procedures,
or in training employees in proper attitudes toward prevention. Some
place must be found for this type of study in a developing occupational
health program.
4. Practical Applications
Knowledge must come first, but knowledge alone is not enough.
The employee's health will not be improved unless the knowledge is
applied with appreciation, understanding, and patience. It is essential
to the practice of occupational health that there be a strong, active,
informed, and smoothly coordinated machine for putting knowledge
to work at all levels of responsibility through Federal, State, county,
city, and industrial organizations. At each level several modes of
operation are necessary, and all must find proper representation in the
program.
a. Investigative and advisory services: A public health service, by
definition, must be ready to provide service to the Nation in accordance
with the current state of the art, and on a scale commensurate with
the significance for the national interest of the problems presented.
This may take the form of a direct service by PHS personnel, assist-
ance to State or local health authorities, support of the same author-
ities, or collaborative activities with them in varying proportions.
Labor and industrial organizations will have similar claims upon
PHS service, although policy may dictate that such service be given
through or with the consent of the State and local authorities. The
individual taxpayer has some claim to consideration also, and some
provision should be made for answering, or at least directing, such
inquiries into appropriate State or local channels. The service to be
rendered may range from simple answers to specific queries, through
short-term investigations of trouble spots, to long-range studies of
unresolved problems affecting a wide section of the Nation. While
some such services can be integrated with on-going deliberate research,
others may present a competition for available personnel. Neverthe-
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Occupational Health
185
less, the program and the organization set up to conduct the program
must make adequate provisions for such services, and their use should
be encouraged. This is one of the major delivery points of the system,
and everything must be done to make it effective. At the present time
this service is not as highly developed as it might be, partly because of
limited resources, and a reluctance to promote requests that may have
to be denied; but partly also because of a lack of appreciation by those
v?ho could be helped of their needs and opportunities.
b.	Elaboration of codes and, guides; The translation of scientific and
technical information into practical action is often hampered by the
difference between the ways of thinking customary to the two groups
involved. A very important step in such translation is the develop-
ment of illustrative codes or guides for the control of undesirable
situations, which can be used by the health authorities, industrial
health programs, safety associations, etc., as a basis for drawing up
specific regulations or instructions for local use. PHS personnel are
in a particularly advantageous position to assist in this essential trans-
lation, if they can be assured of sufficient freedom from other duties.
c.	Technical instruction: The provision of trained and informed
personnel to meet the national needs in occupational health is a matter
which will be taken up in a later section of this report; but mention
should be made at this stage of the provision that a PHS program
must make for technical instruction in its normal operating program.
There are certain types of instruction, particularly of the short-course,
technical type, which universities are unwilling or even unsuited to
undertake. Intensive training in dust counting, lead analysis, ventila-
tion control, thermal assessment, air-sampling techniques, and kindred
severely practical procedures are illustrative of the training that
PHS facilities can very well provide. More fundamental instruction
in areas of specialization in which individual PHS officers happen to
be authorities constitutes another field in which training might be
offered with advantage. Beyond these, there are areas in which PHS
personnel may well cooperate with universities in conjoint instruction,
either because of special knowledge or equipment, or in the develop-
ment of courses which would afterward be handled by the universities
alone. During the period of growth in occupational health activities,
considerable demand can be expected for this type of training. At a
later date the demand may settle down to a steady, but still very sig-
nificant level. These demands must be foreseen and adequate provi-
sions made in any definitive program.
d.	Publication: The national belief in the importance of the printed
word is certainly as well justified in the application of public health
knowledge as in other fields. Both as a means of dissemination, and
aa a record of what was actually reported or advocated, publication
627408—62——18
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186 ENVIRONMENTAL HEALTH PROBLEMS
stands supreme. Proper provision is essential in every occupational
health program for the preparation, printing, and dissemination of
information of various types: research and professional papers,
monographs, technical bulletins, statistical tables, technical reports,
and instructions, popular articles, handbooks, and exhortative leaflets,
to name only a few. The common tendency to leave the preparation of
material to odd moments reluctantly snatched from "real" work, and
to provide insufficient resources for the costly business of reproduction,
must be corrected if a program is to be adequately known, appreciated,
and used by the potential beneficiaries across the Nation.
e. Public information service: The individual, as well as the in-
volved groups, has a claim to know the current events and beliefs in
this field, not only through his right as a taxpayer but also as a mem-
ber of that mainstay of democracy, an informed public. While it
would be impossible for a service to deal with a hundred million in-
dividual inquiries, it can and should provide mass educational material
for public information. This, too, costs money and effort, for which
adequate provision must be made in a comprehensive program.
SPECIFIC PUBLIC HEALTH SERVICE PROGRAM
The preceding section presented the broad objectives of a realistic,
forward-looking Public Health Service program. This section will
be concerned with formulating such a program in specific terms. The
program items will take the order: intelligence (1), research (2-7),
services (8, 9), technical training, (10), grants (11), and ecology
(12). Item 11 will deal with the support of research and training by
universities and other appropriate institutions or groups. The re-
maining items will deal with direct operations by DOH and work
done under contract by external organizations or individuals.
1. Evaluation of Trends in Occupational Health
Background: The planning of research, the rational allocation of
resources, and the evaluation of preventive efforts demand that the
information be constantly available as to new or potential environ-
mental hazards, the patterns of illness or death as related to occupa-
tion or industry, and the resources available for the study and control
of hazards in the work environment.
Present stains: Information on current industrial practices is ob-
tained only from incidental contacts in the course of investigations,
and a rather unsystematic examination of industrial literature. There
is no organized network for the acquisition of information on current
trends, let alone ideas scheduled for development, and thus little or
no foreknowledge of situations which may be created by new materials
or processes. Vital statistics of a routine character are obtained from
the Bureau of Old-Age and Survivors Insurance (BOASI) and
census returns, and some special information can be obtained by
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Occupational Health
187
arrangement with these agencies. Data are beginning to come in
from the recent addition of occupational information to the National
Health Survey. Information on relevant articles published in foreign
countries is beginning to come in through the recently established
CIS plan.
Five-year goals:
a.	Completion of the analysis of preliminary data obtained as a
result of adding occupational information to the National Health
Survey.
b.	Application of Bureau of Old-Age and Survivors Insurance co-
hort analyses to studies of mortality and disability in four or five
specific industrial groups.
c.	Coding and storage for retrieval of pertinent information on old
and new industrial chemicals and physical agents now being filed in
the Occupational Health Information Exchange.
Completion of cooperative pilot study of one or more major
health plans in which occupational information and health experience
of subscribers will be surveyed.
e. Development of an effective method for the international ex-
change of information on occupational health hazards and studies.
A Development of an effective file of information on medical care
programs and environmental health research programs of all major
American industries.
g. Development of trial surveillance procedures for the recognition
of new or potential problems in selected industry.
Ten-year goals:
~.	Publication annually of statistics on occupational relationship in
BOASI mortality and morbidity records.
~.	Incorporation of occupational data in reports of major medical
care plans.
<7. Assignment of an individual trained and experienced in occupa-
tional health intelligence surveillance in every region.
d.	Institution of surveillance network in selected industry to pro-
vide information on the appearance of new or potential problems.
2. Clinical and Epidemiological Studies of Occupational Disease
Backgromd: Disease, disability, and impairment must be studied
to the extent that they are revealed by vital statistics, case records,
or clinical examination as identifiable entities, and by persons who are
m constant touch with clinical realities, to whom the data represent
something more than a set of statistics, although statistical methods
^ill be employed to the limit of their usefulness. The results of such
studies need, in turn, to be linked with other types of evidence, and
further studies of a similar nature, in the attempt to complete our
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188 ENVIRONMENTAL HEALTH PROBLEMS
understanding of the incidence, severity, progress, causation, and
prevention of the disturbances examined.
Present status: While such studies have classically constituted the
primary mode of attack on problems of recognizing occupational dis-
eases, modern data processing methods have greatly extended the
scope of the information that may be extracted from the data, and the
ease of handling large masses of data and of establishing correlations
between events. At the same time, increased understanding of the
fundamental nature of the disturbances of function set up by environ-
mental conditions has increased the range of phenomena on which
data can be obtained and analyzed by these techniques.
Five-year goals:
a. The development of teams trained and competent in a number of
specialized areas of occupational health, prepared to participate
actively in clinical research and in epidemiological studies. Examples
of areas where competence will be needed include:
(1)	Occupational dermatology.
(2)	Occupational pulmonary diseases, with plans for the systematic study
of selected groups exposed to industrial dusts, irritant gases, mists, or fumes,
to obtain quantitative data on the long-term effects of such exposures upon the
lungs. Concern here is not only with the pneumoconioses, but also obstructive
emphysema, chronic bronchitis, and aggravating effects on other chronle disease.
Specific occupational groups needing study include workers exposed to cotton
and other vegetable fibers, to coal dust, and to asbestos.
(3)	Systemic disease, dealing with the systemic effects of environmental
conditions and substances resulting in clinical disease.
5. The initiation of surveys of major occupational or industrial
groups to define potential areas of risk to health, current and pro-
jected preventive health programs. Each survey, in cooperation with
industry, would lead to a monograph containing practical informa-
tion useful to engineers, physicians, and other health personnel.
g. Development of clinical facilities, preferably in a Public Health
hospital, for the study of problem cases selected for special study or
referred for evaluation from a Federal agency.
d. Constant availability of a medical and industrial hygiene team
for prompt and effective study of suspected outbreaks of occupational
diseases.
Ten-year goals:
a.	Continued development of clinical and laboratory groups oriented
toward specialized areas of occupational health.
b.	Expansion of clinical facilities, with provision for regular rota-
tion of clinical staff members.
Toxicologic Studies in Laboratory and Field
Background: It is imperative that PHS be in a position to evalu-
ate critically all available information on the toxicity of substances
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Occupational Health
189
and materials to which workers may be exposed, to carry out impar-
tial laboratory and field studies where indicated, to resolve conflicting
evidence, to evaluate the risks of submitting familiar materials to
new processes, to develop techniques for the early recognition of
deleterious effects in man, and to apply this information precisely and
quickly to the formulation of standards and the issuance of advice
on preventive measures. When multiple exposures, concomitant
physical agents, infectious agents, and inherited metabolic derange-
ments are considered, the permutations which require consideration
are almost infinite.
Present status: Considerable activity has been maintained, as evi-
denced by recent studies on the toxicology of vanadium, ozone,
nitrogen peroxide, and fluoride, and by current studies on oil mists,
toluene diisocyanate, and intermetallic compounds. Increased atten-
tion has been given more recently to an investigation of the basic
mechanisms by which substances produce toxic effects and by which
bodily tissues respond. But there is no systematic survey of new ma-
terials. The larger chemical firms do a considerable amount of work
toward establishing the toxicity of new substances before they are
released to the public, but this is not so well done in the case of the
smaller companies. Substances with toxic potential which get on to
the market without adequate screening come up for examination only
after deleterious effects have been produced.
Five-year goals:
~.	An expanded program both in toxicologic evaluation and in
studying mechanisms of action. Emphasis will be placed on combi-
nations of chemical agents or of chemical and physical agents known
to occur in industry.
~.	Development of techniques which will facilitate the interpre-
tation of animal behavioral reactions for the estimation of human
reactions to and tolerances for toxic substances.
g. Exploitation of promising leads to determine the usefulness of
biochemical criteria, including enzyme patterns, as early indicators
of toxic reaction in animals and man.
d.	Studies on the effects of fatigue and other body strains upon a
susceptibility to toxic actions.
e.	Strengthening of mechanisms for the coordination of laboratory
toxicology and studies of exposed employees.
Ten-year goals:
a. Continued development along the same lines, with techniques
employed dependent upon results of earlier programs and substances
to be tested dependent upon current industrial practices, number of
persons exposed, character of observed reactions and criticality of
the process.
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190 ENVIRONMENTAL HEALTH PROBLEMS
l>. Increased attention to development of methods for determining
in advance unusually susceptible individuals, which may be found
dependent upon now unsuspected genetic differences.
4. Ergonomics and Stress Evaluation
Background: The physiological processes of the body constitute
the essential mechanism on which environmental stresses operate to
produce the disturbances that eventually lead to the departure from
normal that is termed disease. Every stress evokes both deteriorative
and compensatory reactions. The conditions which determine the
balance between them must be known, measures for measuring the
net balance devised, and the ultimate significance for the individual
determined. Understanding of these processes and their reaction
to environmental conditions is basic to occupational health studies
such as toxicology and occupational medicine.
Present status: Much is known about the major physiological re-
sponses to the more important environmental factors considered
singly, or in very limited combinations, but little is known about
their operation in multiple patterns. Studies of the responses to
stress have been largely confined to rather crude measures of general
reactions, or to the behavior of the endocrine system as judged by
relatively indirect measures. Recent research has greatly increased
the opportunities of studying the responses of the body cells, but
this has not yet been applied to assessment of the strain developed in
man as a result of environmental conditions.
Five-year goals:
a. Initiation of studies on the nature and incidence of impaired pul-
monary function in various workers, in collaboration with clinical
staff, as related both to environmental and constitutional factors.
5. Preliminary investigation into the effect of thermal stresses upon
tolerance to chemicals, susceptibility to infection, response to allergens,
and capacity to perform physical and mental work.
o. Definitive studies on neurophysiological responses to noise and
vibration.
d.	Evaluation of the relative effects of environmental factors upon
work capacity and efficiency, with emphasis upon alertness and respon-
siveness.
e.	Study of bioclimatological aspects of occupational environments
as indicated in recent reports to the Interdepartmental Committee on
Atmospheric Sciences.
f.	Formulation of indices for the evaluation of environment involv-
ing more than one mode of stress.
Ten*year goah:
a. Further development of the above.
5. Active participation in the ecological program (item 12).
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Occupational Health
191
5. Study of the Impact of Psychological, Social, and Economic
Factors Upon the Health and Efficiency of Workers
Background: As the impact of major toxic and physical factors in
the work environment is reduced, and automated procedures are intro-
duced, the significance of psychological and social factors not only
becomes more apparent but increases in absolute value. For the as-
sessment of the effect of the total environment upon the total man, not
only must these influences be understood and taken into account but
the effects produced by their operation must be integrated with the
effects produced by the other environmental factors into a composite
picture.
Present status: No more than isolated and somewhat specialized at-
tempts have been made to study the impact of the psychological and
Social factors on workers, and these have mostly been in relation to
the more dramatic instances, such as very busy communication and
control centers, and have followed the pattern developed in military
studies. There is a very wide scope here for studies ranging all the
Way from the basic aspects of motivation to specific problems of psy-
chological breakdown. The techniques are far from frozen, and in
the matter of synthesis have still largely to be worked out. Goals
can be pointed out, but the method of attainment will largely have to
be developed as the studies proceed.
Five-year goals:
a.	Psychomotor studies, particularly directed at effective informa-
tion-response sequences.
b.	Studies of motivational psychology, directed especially to the
role of motivation in worker satisfaction and control.
c.	Anthropological investigations of man-machine relationship in
the causation of impaired health or efficiency.
d.	Sociological studies designed to elucidate the significance of
extra-occupational conditions in occupational health.
e.	Economic evaluations of impairments caused by occupational fac-
tors and of proposed control measures.
Ten-year goals;
a.	An increase in activities along the foregoing lines.
b.	Active participation in the ecological program (item 12).
8. Methods of Environmental Evaluation and Control
Background: The central objective of an occupational health pro-
gram is the prevention of disease and disability, or, more positively,
the preservation of health. Knowledge needs to be translated into
practical methods for achieving these ends. This, in turn, depends
ill part upon the adequacy and sensitivity of instruments for detecting
and measuring the intensity of relevant environmental conditions,
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192 ENVIRONMENTAL HEALTH PROBLEMS
and on the full use of the technological arts in the suppression or
removal of those conditions which are judged deleterious.
Present status: Good use is made of current technology in the selec-
tion, design, and use of detecting and measuring equipment, to the
extent that the judgment of the PHS personnel is frequently sought
in the selection of equipment. Industry designs control apparatus,
but PHS maintains a watching brief on the adequacy of the systems
devised and makes known practices which are considered inadequate.
Fwe-year goals:
a.	Initiation of a critical review of current dust sampling and
counting techniques, and development of the outline for a definitive
manual of recommended practices.
5. Development and maintenance of reference standards for mate-
rials and substances of importance in occupational health investiga-
tions.
c.	Continued development of techniques for the analysis of multiple
samples to replace long and complicated methods, without undue loss
of precision and sensitivity.
d.	Development or modification of existing instruments for monitor-
ing various aspects of the physical environment, such as radiant heat,
vibration, noise, and pressure, and their evaluation for industrial
hygiene purposes.
e.	Development and application of techniques as needed for epi-
demiologic or clinical studies.
Ten-year goals:
a• Completion of review of dust sampling and counting techniques
and publication of manual of recommended practices.
b.	Continuation and expansion of program set as 5-year goal, with
further development of concepts of preventive engineering, such as
inclusion of essential controls in the actual design of industrial
equipment.
7. Research on Types or Occupational Health Program for State
and Plant Use
Background: Serious practical difficulties are often encountered in
translating knowledge and principles of prevention into actual health
programs at the State, local, or plant level. Objective study is required
of the factors which affect this translation, of methods for overcoming
the difficulties, and of the economic aspects. The problem is akin to
some that are encountered in operations research.
Present status: The most serious deficiency is in the provision of
adequate preventive measures for workers in the small plants of less
than 500 employees, which account for over two-thirds of the work
force. In several States the provision for the control of occupational
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Occupational Health
19S
environments is below the level considered adequate for a variety
of economic, professional, and operational reasons. Of the 584 persons
employed full or part time in occupational health in State and local
units in February 1961, 58 percent were in 6 States; the remaining
States had either no programs or inadequate ones.
Five-year goals:
a. Establishment of the factors which militate against the develop-
ment of occupational health services.
Analysis of the economic aspects of occupational health services.
c. Development of model programs and the setting up of pilot
projects under contract with research supervision.
Ten-year goals: Completion of the research aspects of occupational
health program establishment.
8. Development of Standards tor the Work. Environment
Background: Determination of the environmental conditions which
can be tolerated, or, better still, of the environmental conditions which
are to be recommended for optimal health, productivity, and per-
formance, is basic to the operation of an effective occupational health
program. Without this, every move to control environmental condi-
tions is apt to be met with demands for proof as to why the particular
value taken was chosen, and not some other value more favorable to
the party posing the question.
Present status: Organizations and groups such as the American
Conference of Governmental Industrial Hygienists, the American
Standards Association, and the American Industrial Hygiene Associ-
ation engaged in setting standards look to the PHS for advice, assist-
ance, and support; but the resources to meet these demands are meager.
There are now no agreed standards for the work environment with
respect to allergens, substances absorbed through the skin, or car-
cinogens. The same thing applies to psychological conditions. The
current standards for noise, vibration, heat, and cold are unsatisfac-
tory. Those used for toxic substances cover only a limited number
of substances, and are too often based on evidence of a rather tenuous
character.
Fvoe-year goals:
a. To work with the organizations named above and with other
divisions with responsibilities in environmental health in a critical
reevaluation of the philosophy, criteria, and applications of current
standards for the occupational environment, with the definition of
areas of needed information and the provision of specific staff and
other assistance as needed. Special attention will be given to revising
and strengthening the bases of threshold limits and maximum ac-
ceptable concentrations (MAC) at present in wide use.
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jm ENVIRONMENTAL HEALTH PROBLEMS
b. To develop mechanisms for effective and sustained international
cooperation and interchange of information in the field of standards
for the occupational environment, such as an expansion of the present
cooperative activity with CIS.
Ten-year goal: In cooperation with appropriate committees or or-
ganizations, to develop standards for the work environment in areas
not now covered.
9. Technical Services and Assistance
Background: PUS has 50 potential clients in the States, and several
more in the various Federal departments and agencies. Few of these
have sufficient resources or sufficient need to set up full-scale technical
organizations capable of making all the investigations and solving
all the problems of occupational health that may develop in their
respective spheres. Even where the resources exist, individual insti-
tutions of any magnitude would lead to unnecessary overlapping, and
and unwarranted drain on the national resources, especially of expert
manpower. A central research and investigation facility, at this stage
of development, can maintain a wider range of expertise, and provide
a greater variety of services rather than several smaller institutions,
and keep those services in close contact with research developments
across the Nation. Beyond the State and Federal agencies lies the
mass of industry itself, and beyond it the general public, who also
desire service and assistance in matters of occupational health.
Present status: From its current resources, DOII furnishes three
types of service: (a) technical information and advice; (b) problem-
solving teams; and (c) assistance to States in the building up of their
own programs. These resources are, however, limited. The technical
information service relies 011 a manual storage and retrieval system of
relatively small bulk; requests for visits by problem-solving teams
may have to wait several months before the required personnel are
free from prior commitments: and only two officers are currently
assigned to States for program assistance.
Five-year goals:
a.	The installation of at least a semiautomated information storage
and retrieval system, for the provision of technical information to
States, industry, and the public on environmental hazards associated
with occupations.
b.	The provision of sufficient skilled personnel to be able to main-
tain two teams of four technologists in the field at all times for
problem investigation.
e. The assignment of a physician, engineer, or nurse, trained in oc-
cupational health, to at least 20 of the CO States, on a basis of need,
opportunity, and evidence of adequate support.
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Occupational Health
195
d.	The fiscal support of an occupational health program in each
State.
e.	The continued development of effective working relationships
with industry, labor unions, local agencies, and appropriate Federal
agencies aimed at the fair and equitable attainment of recommended
environmental standards in both large and small industry.
/. The development of a trained and experienced staff for consulta-
tion in the development of the health aspects of union contracts.
g. The development and use of effective methods of educating work-
ers and the general public in the possibilities of and necessity for sound
occupational health practices.
Ten-year goal:
Complete development of the above goals, and particularly the es-
tablishment of an elective occupational health unit in each State, with
close collaboration with PUS.
10. Direct Technical Training
Bachground: The pursuit of studies or the implementation of pro-
grams in occupational health require many techniques, items of in-
formation, points of view, or specialized knowledge, which are seldom
acquired in the course of routine professional training for engineers,
physicians, nurses, or scientists. It is essential that there be some
organization which can provide this training, in conjunction with
the regular professional training, as a postgraduate course, or on
the job.
Present status: A few universities offer postgraduate course in in-
dustrial medicine, occupational health, or industrial hygiene; but these
require one or more academic terms of full-time instruction, and are
not sought by many students. DOII provides 1- or 2-week technical
courses for industrial hygienists, industrial engineers, safety engineers,
and plant medical officers, which are usually oversubscribed. There
is an obvious need for providing still further short-term classes, and
for cooperation with universities in attracting more students to the
long-term professional courses.
Five-year goals:
a.	Increased activity in the presentation of short-term courses for
physicians, chemists, engineers, nurses, and other health workers in
general and specialized aspects of occupational health.
b.	An expanded educational program for health practitioners in the
diagnosis, treatment, and prevention of occupational disease.
c.	Continued education of workers and the general public in the
importance and methods of preventing occupational disease.
d.	An expanded program of cooperation with universities in pro-
moting graduate courses in occupational health.
Ten-year goal: Extension of the same.
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196 ENVIRONMENTAL HEALTH PROBLEMS
11. Grants
Background: Universities, nonprofit research organizations, tech-
nical institutions, and some private groups are actively engaged in
both research and training relevant to the advancement of occupa-
tional health. This is the foundation upon which the PHS helps to
build an adequate national activity in occupational health. In keeping
with the role ascribed to it, the PUS must encourage them in meeting
the national needs, especially in relation to the more basic aspects of
occupational health problems and activities, and must render sub-
stantial support to these activities.
Present status: The award of grants for research in occupational
health have come under the purview of DOH in the last year, and a
substantial increase in funds has been made available for this fiscal
year. As this is a relatively new departure, it remains to be seen to
what extent the national pool of talent can effectively use these funds.
For the research as well as for the proposed increased occupational
health activities in Federal, State, local, and industrial agencies, a
much larger number of trained persons will be required than are at
present in sight. It is doubly important,, therefore, that immediate
action be taken to attract a larger number of good personnel into
training, not only for occupational health itself, but also for the sci-
ences and technologies upon which it is based. The DOH is con-
cerned, however, primarily with those courses which relate directly
to occupational health activities, depending upon the National In-
stitutes of Health and others for the support of the training in the
contributory disciplines, for whom this field will be one of many
competing employers.
Five-year goals:
a.	The support of research in fields relevant to occupational health
to be conducted in universities, technical institutions, nonprofit organ-
izations, and appropriate private groups, to the extent that worth-
while projects can be conducted by the available talent.
b.	The introduction of research training grants and fellowships to
encourage and support capable personnel according to their needs
during the period of training in research.
c.	The introduction of training grants to similar organizations for
the development and conduct of courses in subjects relevant to occupa-
tional health, for physicians, engineers, scientists, industrial hygienists,
and nurses.
d.	The introduction of traineeships to encourage and support ca-
pable personnel according to their needs during the period of training
in occupational health science and technology.
Ten-year goal: Development of the above in accordance with the
available talent.
-------
Occupational Health
197
12. Development of Ecological Picture of Occupational Health
Background: As with most fields, the tendency has been to concen-
trate on the pursuit and conquest of the more easily recognized, iso-
lated, and urgent problems to the exclusion of adequate efforts toward
maintaining a unified conspectus of the field. This tendency has been
accentuated by the absence of well-defined procedures for integrating
independent observations on the simultaneous operation of multiple
factors. In spite of the difficulties, however, such an integration is
vitally necessary, since the worker, who is the prime object of concern,
is and reacts as a whole man, and not as an isolated system responding
to stimuli one at a time. Such a conspectus is necessary not only for
the completion of an intellectually satisfying concept of the object of
study, but also for the organization of activities within DOH in a
manner best suited to the overall purposes of the organization. The
development of this ecological viewpoint is the more essential as atten-
tion passes from the dramatic effects of single environmental con-
ditions to the more subtle but more far-reaching effects of multiple
coincident factors.
Present status: Very little attempt is made at the present to derive
an integrated picture of the total worker in a total environment,
beyond the intuitive and almost casual picture that any keen adminis-
trator develops in his own mind. Two kinds of techniques are avail-
able, although in still rather undeveloped form: (a) mathematical
procedures based on probabilities such as factorial analysis, symbolic
logic, and game theory; and (b) roundtable integration, in which
experts from various fields meet periodically to attempt dialectic syn-
thesis, with progressively penetrating review of the evidence between
sessions.
Five-year goals:
a.	Development of a pilot system whereby an ecological picture
may be established of the total worker in his total environment from
the information available in the several contributory diciplines.
b.	Determination of ways in which this activity can be linked with
corresponding activities in other Divisions and at Bureau level.
c.	Development of methods by which the ecological information may
be applied to DOH program operations.
Ten-year goal: Establishment of definitive activities in the above,
related to the Center type of conjoint activity.
IMPLICATIONS FOR ORGANIZATION AND RESOURCES
While many of the activities described in the preceding Section are
to be found in the current operations of DOH, the scope of each is less
than the level which is adequate to the national needs, and some are
hardly represented at all. The resources currently available for the
-------
198 ENVIRONMENTAL HEALTH PROBLEMS
occupational health program fall far short of supporting the desirable
level of effort. The program which has been described will need con-
siderably more in the way of fiscal support, facilities, and manpower
than are at present employed. The implications of the recommended
program expansion for organization and resources are indicated in
this Section.
Organization
Occupational health, being centered around a well-defined group
of people with rather specific environmental stresses, has a unity of
purpose that is quite marked and should not be disturbed. Intelli-
gence, research, prevention, and service must work together and be
viewed together. The ecological conspectus can emerge only if the
process can draw intimately upon the contributing groups. Admin-
istration should be closely related to the ecology which provides the
integrated viewpoint and to the groups whose actions it directs. An
important item for attention in setting up and operating an expanded
program is the preservation of this unity in spite of increased numbers
and activities. It is strongly recommended that the organization be
so designed that interaction and communication between various dis-
ciplines and operations is an inherent part of the structure. This
would require that all functional segments of the Division be phys-
ically located together, that personnel have laboratories and offices in
closely interlinked groups, and that the work load be focused on prob-
lem areas with personnel from different organizational segments co-
operating in their solution. (The "problem" may equally be one in
fairly fundamental research, as in prevention of a specific disturbance.)
In the association between DOH and other Divisions engaged in
environmental health activities, provision should be made for persons
of similar technical competence or working on related problems to
meet and work together in such a way that between them they bring
to bear ideas and capabilities not available to the Divisions acting in
isolation. This, however, should be done in such a way that their
parent field is not deprived of their services, and new barriers created
as the old ones are removed.
In the course of its activities DOH depends in many instances upon
other agencies or organizations, both within and without PHS, for
advice and assistance. Some illustrations are given in table 1.
Manpower Requirements
a. With DOH: In table 2 are given by various categories the pro-
jected manpower requirements within DOH for the conduct of the
program indicated in Section III, in the years 1966 and 1970, together
with those actually employed in 1961, as at 30 June, for contrast. The
degree of training required specifically in occupational health, in
-------
Occupational Health
199
Table 1. Amodation with Other Organizationt
Facilities and competence shared with otiier elements:
Item
Shared with—
Statistics on 0 II						
National Health Survey, BOASI, etc.
Cohort analyses				 -
BOASI.
Pilot study of health plans	 ... -		 .. _
Selected States, industries, Insurance companies.
International O.K. information exchange... . .
Labor Department, CSI.
O.I I. consultants	_ _ __ ... 	.... .
Ilocional offices, St.itos.
Environmental standards	 . . .. 	
ACGIII.
Applied research...				
Universities, etc., through contracts.
Clinical studies of specific occupational diseases	
Universities and clinicians through grants and

contracts.
Ecological synthesis of total man in total environment
Bureau Office of Ecology and Systems Analysis.
Economic oval uatlon of occupational disease and its
Bureau Office of Ecology and Systems Analysis,
control.

Training programs for Industrial hyclenists, In-
Training Branch, SEC; universities.
dustrial chemists, safety engineers, industrial

physicians, and nurses.

Compilation, storage and dissemination of toxicologic
Other Divisions and Bureau Office of Toxicology
information.
Intelligence.
Reliance upon facilities and competencies enjoyed by others:
Item
Toxicology of insecticides	
Bacteriological and other infective complications of toxic exposures.
Beportlng of disturbances in health of workers			
Air pollution and water pollution as background to occupational
disturbances.
Special techniques and assistance in radiological aspects of occupation.
Special techniques and assistance In psychological aspects of occupa-
tion.
Basic research					
Special techniques and assistance in cancer		
Look to—
CDC,
CDC: NIH.
National Health Survey; States;
BOA8I.
Respective Divisions of BBS.
DRH.
NIMH.
Universities through grants.
NCI.
addition to the normal professional training, can be gauged from
table 3. The proportion of Ph. D/M.S./A.B. desired is given in
table 4.
It is evident from these tables that the manpower requirements of
DOH for internal activities are not great, and that a relatively small
proportion will require orientation to or training in occupational
health aspects before being proficient on the job. Of the latter, some
can be given the requisite orientation after taking up duty. The
heavy demand is upon persons with professional competence in the
supporting fields of chemistry and other sciences, in whom specific
occupational health orientation is a minor requirement which can
certainly be acquired on the job.
b. National needs: In the matter of national needs, the estimated
supply and requirements of personnel in certain professional cate-
gories, trained in occupational health, are given in table 5.
-------
m ENVIRONMENTAL HEALTH PROBLEMS
Taiile 2. Categories of Personnel Required by D0I1

Numbers of personnel
Categories



1061
1966
1970
Engineers 		 _ 	 	
12
35
57
Industrial llygienlsts	 	 . . . - 		
10
20
32
Physicians .		..
14
33
46
Nurses			-.	 . ... . - . - -
3
8
12
Physiologists,.-		 .. 	 	 ... —. - 	
2
10
14
Statisticians	 		 	 .
3
11
15
Toxicologists				 	 		 	
3
12
19
Pharmacologists	 _	 ._
7
14
17
Physicists	 . 	 . .. 	 . .
3
6
10
Chemists	 	-		 . - ... ... - 	
20
65
91
Pathologists		-	 .....	- .		
2
A
10


13
17
Mathematicians	 .. 		 		

4
4
Veterinarians		 		 . . . 	

3
4
Radiochemists		-	_ 	 . ... 	... 	
4
11
13
Electronic Engineers	 - 				

2
4
Health Analysts. . 	... 		
5
16
24
Public Information Specialists.. 	 		 	 . ..
4
7
10
Science Aides				 . .. -
20
78
110
Clerical and Administrative			 		 .. ..	
48
118
170
Labor		 	 		 	
8
24
32

Total							 -	 	
168
494
711

These figures are based on estimates made by eminent persons in the
field, having regard to the expected growth of the work force, and
the institution of that degree of supervision and care that would
adequately apply existing knowledge.
c. Training: It is clear, therefore, that although the demands for
personnel for direct DOII operations is small, the national require-
ments are quite large. It would appear from these figures that there
is already a large deficiency that must be made up. This deficiency,
however, is in number of people who would be necessary to run an
adequate program. It does not follow that the same number could
be employed if they became immediately available. It would take
a great deal of educational effort and time to persuade industry,
for example, that such people should be employed. By 1970, how-
ever, much of this slack should be taken up if the educational aspects
of the recommended program are fully implemented.
The burden of training the required personnel will certainly fall
upon the universities, both in providing the basic professional com-
petence, and in giving the orientation and training in occupational
health required by certain categories. As regards the latter the effort
of the 9 schools now having recognized industrial health curricula,
-------
Occupational Health
201
Table 3, Degrees of Orientation Required in Occupational Health
Classification
1961
1966
1970
With strong orientation, 		... 	
47
8
67
56
124
38
192
140
190
53
266
202
With some orientation	 .... 	 ..		 		
Sciontiflc but no orientation	 			 	 	 ......
Clerical and labor				 			
Effective total	 ... 			 				
168
494
711

Table 4. Degree Status Required
Degree
1961
1966
1970
Ph. D. or M.D				
M.8		 			
37
35
20
111
165
78
160
239
110
A.B		 	
Total			- 				 -
112
354
609
giving advanced degrees in occupational health to approximately 25
physicians, 3 nurses, and 21 hygienists each year, will certainly need
considerable supplementation. This could be by encouragement and
support of trainees and research trainees, by support of program
development, or by the creation of training centers. All except the
last named activity are envisioned under item "11. Grants" in the
proposed program of Section III. The need for training of person-
nel in the contributory disciplines should be brought to the attention
of other appropriate bodies such as the National Institutes of Health
and the National Science Foundation for inclusion in their efforts
for promotion of general science training.
Facilities
The DOH now occupies (or will before the end of 1961) about
75,000 square feet of gross floor space; 63,000 in a converted ware-
Table b. National Ntedt of Personnel
Personnel
Present
(1057-60)
Projected
(1970
Industrial physicians:
2,300
4,800
16,000
30,000
1,300
8,000
2,000
6,000
19,000
35,000
1,600
9,600

Industrial nurses:
Needed								 - 			 		
Industrial scientists:
Needed..				-		

627408—«2	14
-------
W% ENVIRONMENTAL HEALTH PROBLEMS
house building in Cincinnati, and the rest in HEW South Building,
Washington. These facilities are not adequate for or encouraging
to the current program, and fall far short of those required for that
proposed in the preceding Section. Table 6 sets out the net space
requirements envisioned by DOII for operations other than field
stations and clinical facilities in 1970. The corresponding gross space
requirements would be approximately 300,000 square feet. In terms
of the activities to be carried out and the number of personnel involved
in the proposed program, this estimate appears to be modest.
Tablk 0. Total Estimated Net Space Requirements
Element
Office
Laboratory
Exposure
Housing
Other
Total
Division1	__
9,46-
4,000
2,200
5,500
J 10,340
4,840
4, ISO
2,200
1,320
1,980
3,080
2,640
2,200
3,300
3,080


1,540
14,080
4,000
2,200
70,780
28,160
10,800
14,080
6,240
5,500
1,880
3,080
7, 040
4,620
4,620
SS Branch		


R ATS Branch 			




Toxicology Section		
36,080
12,540
14,300
8,580
6,600
4,180
6,600
22,600
5,280

Occupational Medicine Section	

Physical and Chemical Analysis	

660
1,320
440
Engineering Section			


Physiology Section				


Ecology Section	 _ 	


Training Branch	



Requirements Analysis Section	




Training Operation Section	
1,540


2,8(50
2, 420
1,320
Training Methods Section	


Technical Information Section	



Totals			



57,240
86,900
6,600
27,880
10, SCO
189,180
I Includes facilities common to several sections.
The point has been made earlier in this Section that all of the
activities of DOH should be physically located together. It remains
here to point out the further advantages that would accrue to the
activities of DOII if it were physically associated with the other Divi-
sions in Environmental Health. Undoubtedly the economy of service-
type operations that could be expected from joint facilities are sig-
nificant, but over and above this is the more basic advantage, or even
necessity, that through the close proximity and cooperation of the
other Divisions the picture of the total man in the total environment
would be still further advanced. The importance of this for occupa-
tional health has been stressed; the importance of extending it still
further to cover the remaining aspects of man's environment is obvious.
The close relationship of industrial exposures to air pollution, of work
in radioactive environments to radiological health, of industrial hy-
giene to food quality in general, and of industrial environment con-
trol to environmental control in general, including water quality con-
trol, are self-evident. It is strongly recommended that DOH be
-------
Occupational Health
m
brought into close contact and collaboration with the other Divisions,
not merely by contiguity of buildings, but also by arrangement of
space and common living facilities in such a way that frequent meet-
ings inevitably occur between men whose activities are convergent and
knowledge mutually beneficial. It is very desirable that individuals
concerned with matters of interest to several problems be able to work
together without losing sight of the problems.
The DOH Field Station at Salt Lake City is certainly very useful
in the conduct of the current studies on uranium miners, and in pro-
viding technical services to the western region. The continuation of
this field station and the creation of others are matters that manage-
ment will have to judge in terms of requirements as the program
unfolds. It is hoped, however, that field stations have quarters more
adequate to their responsibilities than those now available to the one at
Salt Lake City.
For the conduct of clinical studies, access is required to hospital facil-
ities in which selected cases can be retained for special, continued, or
controlled studies. It is estimated that a total of 10 available beds,
with an average of 5 occupied, would meet the needs. While they
would almost certainly be part of a larger clinical installation, it is
highly desirable that they be contiguous to the facilities occupied by
the clinical portion of the DOH program.
If the universities are to take up the increased scope of training in-
dicated earlier in this Section, larger and better equipped facilities
will probably be needed. Whether these increased facilities should be
provided in concentrated form at one or two places, or scattered
amongst several schools, is a matter that will have to be carefully
considered.
Fiscal Requirements
In Table 7 are set out the fiscal requirements estimated by DOH for
the implementation of the program proposed.
It is considered that the figures shown for direct operations are a
reasonable projection of the program advocated. The figures shown
for Grants represent the amounts that will be necessary for the im-
plementation of an adequate national program, provided that the talent
can be found and attracted to this type of work. The Division has at
present no evidence to guide it in estimating if the talent will in fact be
available.
The high rise in Project Training Grants is largely due to the neces-
sity of training the large numbers of industrial physicians, nurses and
scientists shown in Table 5, as necessary to meet national needs. The
late placing of the rise in support, after 1966, is due to the need for
prior educational efforts in alerting the State and industrial organiza-
-------
204 ENVIRONMENTAL HEALTH PROBLEMS
tions to the need for utilizing such personnel, and for the prior
strengthening of the staff in schools in which such training will be
undertaken.
Table 7. Estimated Fiscal Requirements of DOH (Thouiandi)




Estimated



Actual







1981








19C2
1963
1964
1965
1968
1970
Grants (total)			
$1,410
$4,334
$5,000
$9,000
$14,250
$20,880
$55,200
Research grants (existing).		
1,410
3,884
6,000
6.S00
8,500
11,000
25,000
Research training grants and fellowships:







a. Existing (fellowships)	
0
450
900
1,400
1,900
2,400
4,500
b. Proposed		 	
0
0
0
0
0
0
0
Project training grants:







a. Existing (General Health)	 _ 	
0
0
0
0
0
0
0
b. Proposed	
0
0
0
1,000
3,500
6,800
23,700
Tralneeship:







a. Existing (General Health)		 ...
0
0
0
0
0
0
0
b. Proposed				
0
0
0
100
350
680
2,000
Direct operations (total)		
1,923
2,0417
4,050
5,700
8,000
9,900
12,000
1. Research:







a. Direct	 ... . 		 	
948
988
1,819
1,900
2,900
3,100
3,600
b. Contract				
115
200
700
800
1,000
1,500
1,800
2. Training	
181
194
402
800
1,000
1,300
1,800
3. Technical assistance and control opera-







tions				
679
715
1,129
2,200
3,100
4,000
4,800
Grand total		 	
3,300
6,431
9,950
14,700
22,250
30,780
87,200
-------
Report of the Subcommittee on
RADIOLOGICAL HEALTH
RECOMMENDATIONS
1.	The Public Health Service should assume primary responsibility
for the development of a sound radiological health program in the
United States. Particular attention should be directed to—
~.	research on radiation protection standards;
~.	the continued development of a comprehensive surveillance network
for the measurement of environmental radiation levels; and
c. the development and application of appropriate countermeasures where
radiation hazards exist.
2.	The Service should carry out this responsibility through its
Division of Radiological Health. This Division should be provided
with (a) a scientific staff of high competence and (5) facilities which
include central administrative and laboratory units and a series of
regional field stations wherein the technical operations and suitable
portions of the research and training programs of the Division may be
conducted. The central units might well be developed as part of a
PHS Center for Environmental Health although delay in the devel-
opment of such a center must not be allowed to hold up the construc-
tion of additional facilities for the Division. Estimates for facilities
needed immediately are $10 million of which $7 million are for central
administrative and laboratory units and $3 million are for additional
regional laboratories. Substantial additional funds will be needed
in the not-distant future to meet the rapidly expanding demands being
placed upon the Division of Radiological Health.
3.	The Division of Radiological Health should give increasing
attention to its programs to support university research through
grants and contracts. The current extramural research program of
the Division is far behind the schedule laid out by the National Ad-
visory Committee on Radiation 2 years ago and strong efforts should
be made to bring this program to its proper place in the activities of
the Division.
4.	The program of the Division of Radiological Health to promote
and support training programs for radiation health specialists and
radiation technicians within universities and public health agencies
should also be substantially increased. Annual support at a level of
$5 million is needed immediately to meet the anticipated demands
for radiological health personnel over the next 10 years.
805
-------
206 ENVIRONMENTAL HEALTH PROBLEMS
5.	The Division of [Radiological Health in the development of its
programs should place special emphasis on problems arising from the
use of medical and industrial radiation sources and should pay par-
ticular attention to regional problems that transcend State and local
authority. The measurement of environmental levels of radioactivity
and the application of appropriate countermeasures where excessive
levels are found to exist constitute one set of such problems.
6.	A Radiation Hazards Research Liaison Committee should be
established between the Public Health Service and the Atomic Energy
Commission, to give direction and coordination to the radiation
hazards research programs of the two agencies.
7.	Finally, the growth of the budget of the Division of Radiological
Health should be allowed to proceed at the pace outlined in the 1959
report of the National Advisory Committee on Radiation. This calls
for an annual budget of $50 million by 1964. Currently this growth
is behind schedule, a circumstance that should not be allowed to con-
tinue in view of the rapidly increasing responsibilities of the Division
in today's troubled world.
HISTORY OF RADIOLOGICAL HEALTH
The biological effects of ionizing radiation were first observed by
the physicians who used X-rays in medical practice soon after
Roentgen's discovery in 1895. Early X-ray apparatus was erratic
in its operation and it rapidly became common practice for a physician
to test his equipment each day by holding his hands in the X-ray
beam and observing the clarity of the image appearing on a fluoro-
scopic screen. In a few years, pathological changes appeared in the
skin of the hands of these physicians. In many cases, the changes
progressed until cancerous degeneration took place.
The cause and effect between X-ray exposure and biological damage
was immediately recognized and steps were begun to establish criteria
of safe operating procedure for physicians using X-ray apparatus.
In the late 1920's these criteria were given formal status through a
series of statements issued by the Advisory Committee on X-ray and
Radium Protection, a non-Government group of outstanding physi-
cians and scientists who came together to examine critically the prob-
lems of protection standards in medical X-ray practice. This com-
mittee, since renamed the National Committee on Radiation Protection
has, through the years, recommended an increasingly broad range of
radiation protection standards as the problems of radiation exposure
in the population increased.
Until recent years, the Public Health Service has not been strongly
active in the field of radiological health. Instead, as nuclear science
expanded rapidly with the creation of the Manhattan District during
World War II, concern for the control of ionizing radiation was
-------
Radiological Health
£07
largely confined to those associated with the District. After the war,
this concern continued to reside mainly among those working in nu-
clear science through the programs of the Atomic Energy Commis-
sion with only minor interest in the subject developing in the Public
Health Service. Not until a report of the National Academy of Sci-
ences in 1957 pointed out that exposure to ionizing radiation in the
United States was becoming an important health problem, did the
radiological activities of the Public Health Service take on substantial
proportions. In 1958, the Surgeon General created a Division of
Radiological Health and appointed the National Advisory Committee
on Radiation to advise him in all matters pertaining to the hazards
of ionizing radiation. This committee recommended that the Service
embark upon a strong and rapidly expanding program involving
radiobiological research, training of radiation health specialists and
a series of control operations closely coordinated with State and local
health departments.
As the Public Health Service took an increasingly active position
in the field of radiological health, many uncertainties arose concerning
the respective roles of the Atomic Energy Commission and of the
Service in matters pertaining to radiation regulation and safety.
There were many persons who did not believe that the Atomic Energy
Commission, an agency with substantial responsibility for the promo-
tion of atomic energy as a social and military instrument, should also
have major jurisdiction over the health and safety aspects of ionizing
radiation. On the other hand, there were those who feared the place-
ment of total regulatory authority over radiation exposure in the
Public Health Service since the Service is a Government agency pri-
marily concerned with health risks and hence might establish regula-
tions which are excessively restrictive and which would substantially
curtail the growth of nuclear science.
It soon was recognized that there was need in the federal establish-
ment for an organization of high authority, independent of the AEC
and PHS, to serve as a quasi-judicial body in the resolution of prob-
lems in radiation safety and protection. In 1959, there was there-
fore created, first by presidential order and then by legislative statute,
the Federal Radiation Council, to advise the President on all matters
which involve a balancing of the benefits and risks of radiation ex-
posure. The Council is currently composed of the Secretaries of
Health, Education, and Welfare, of Defense, of Commerce, and of
Labor, and the Chairman of the Atomic Energy Commission, with
the Secretary of HEW acting as Council chairman. One of the first
actions taken by the FRC has been a review of radiation protection
standards. It has now published two reports which henceforth will
serve as a basis for its own judgments and as guides to all who work
with ionizing radiation.
-------
m ENVIRONMENTAL HEALTH PROBLEMS
TASKS OF THE DIVISION OF RADIOLOGICAL HEALTH
Radiation Protection Standards
The establishment of the Federal Radiation Council has clarified
many of the responsibilities of the AEC and the PPIS. Since the
AEC is primarily concerned with the promotional aspects of atomic
energy, it has been suggested that the Commission be the agency to
bear major responsibility for providing the Council with data on the
benefits of nuclear science. Concurrently, it has been suggested that
the Public Health Service be the agency to provide the Council with
data on the risk side of the equation. One of the prime tasks of the
Public Health Service, therefore, is the development of basic data on
the biological effects of ionizing radiation to support the Council in
the formulation of its radiation protection guides. This is not to say
that the Service must itself generate all of these data. Indeed, an
evaluation of the research needed to provide the information required
by the Council in the foreseeable future is of such magnitude that such
a task would be quite impossible for a single agency. Instead, the
Service must utilize all of the resources available to it both inside
and outside of Government. These include the resources of the
Atomic Energy Commission as well as those of the universities and
other laboratories of the Nation. It should be pointed out, however,
that since this research must focus on the fulfillment of specific needs,
for which the Service is responsible, its direction must rest in the
Service and must be supported by a highly competent group of scien-
tists who are provided with adequate facilities and resources.
Surveillance and Interpretation op Radiation Exposure Levels
The formulation of radiation protection standards constitutes, of
course only one phase of a radiation control program. There is also
need for mechanisms to determine the extent to which radiation-
producing equipment and materials and those using such equipment
and materials comply with these standards. This involves the regular
and systematic measurement of environmental radiation levels
through a broad range of circumstances and the wise interpretation of
the resulting data to insure the institution of those countermeasures
which may be necessary when hazardous conditions are found to exist.
These functions of surveillance and interpretation of data fall
logically within the purview of the Public Health Service and have
been so noted in the presidential directive creating the Federal Radia-
tion Council.
To carry out its surveillance and interpretive functions, the Service
should draw heavily on all available resources. Much surveillance
data can and should be collected by State and local health departments.
The sharing of data gathered by other Federal agencies should be
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Radiological Health
W9
promoted. University centers, under contract or through research
grants, may be expected to perform a valuable supporting role. How-
ever, since primary responsibility for these functions lies in the Public
Health Service, overall direction of them must be a Service task.
In this regard, the Subcommittee believes the Service should place
special emphasis on problems arising from the use of medical and
industrial X-ray radiation sources. No other agency has these prob-
lems under study at this time. It should also pay particular attention
to regional problems of population exposure which transcend State and
local authority. An example of one such problem, rapidly increasing
in magnitude, is the widespread exposure of the population from the
fallout of the present series of Russian nuclear bomb tests.
The surveillance and interpretive responsibilities of the Service
are extensive. They should be met with vigor. On them depends the
effectiveness with which the radiation control measures are carried out.
Development and Use of Countermeasures for Radiation
Protection
The third element of a radiation control program is the development
and application of those measures needed to maintain a safe environ-
ment or to restore it when radiation hazards are found to exist. The
Subcommittee believes that the Public Health Service has an obliga-
tion to take leadership in this aspect of the radiation control problem.
It should maintain an active program of research for the development
of methods and techniques by which radiation exposure may be re-
duced. Such efforts should encompass a broad range of activity, ex-
tending from the investigation of methods of food decontamination to
the development of techniques to reduce medical X-ray exposure.
The inevitable corollary to the development of control measures is
the promotion of programs for their effective use. In most areas of
public health, regulatory responsibility properly belongs with State
and local government, with the PHS limited to a dual role of promot-
ing such programs and furnishing technical assistance. In the field
of radiological health, the Service should continue and strengthen this
role, but at the same time must recognize that the character of the
hazard is often not limited by State boundaries. If the public is to be
given adequate protection, the Service, through its Division of
Radiological Health, must therefore take a more active and positive
role than has, in the past, characterized some parts of its activities in
the regulation of environmental health hazards. It cannot passively
wait for requests for assistance, but must actively stimulate the de-
velopment and conduct of radiological health programs and, because
of the technical nature of these programs, must be prepared to give
a higher degree of technical assistance. An even higher degree of
authority to regulate interstate hazards is also essential.
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910
ENVIRONMENTAL HEALTH PROBLEMS
To carry out the foregoing mission, the Service should utilize all
available resources. Those associated with State and local health de-
partments should be particularly valuable. At the Federal level, the
resources of such agencies as the Atomic Energy Commission and the
Food and Drug Administration should be fully utilized. However,
the Subcommittee would like to emphasize once again that in view of
the importance of the health problems created by excessive radiation
exposure, the primary responsibility for coordination of effort and
the provision of technical assistance where needed should reside with
the Public Health Service.
DEVELOPMENT OF THE DIVISION OF RADIOLOGICAL HEALTH
To perform the tasks set forth in the preceding section, the Di-
vision of Radiological Health requires an organizational structure
which includes technical operations, training, and research. In addi-
tion, means must be provided whereby the Division's programs may
grow in an orderly and well conceived manner. This requires the
establishment of a divisional structure for planning and development
which operates continuously to determine the courses of action which
the Division should follow. It is proposed that this structure con-
sist of a divisional advisory board composed of the Division Chiefs,
his several Branch Chiefs and other appropriate personnel. Such a
board should have the responsibility to determine Division policy and
to plan those actions needed for the Division to meet its responsibili-
ties.
Technical Operations
The comprehensive measurement of environmental radiation levels
and the application of appropriate countermeasures where radiation
hazards are found to exist constitute the principal operational func-
tions of the Division of Radiological Health. To perform these tasks
effectively, the Division requires an organization which includes a
central administrative and laboratory group intimately linked to a
series of regional field stations. The central group is needed to give
overall direction to the Division's technical programs, and to provide
the basic scientific competence for problems of national scope. The
field station complex is required to meet the many problems which
have a strongly regional character. For example, the control of radia-
tion hazards in mines can usually best be maintained through the
close surveillance provided by a technical staff operating from a nearby
field station. The subcommittee believes that the Division of Radio-
logical Health should have at least one field station with administra-
tive and laboratory facilities in each of the nine districts of the United
States. Each station should be developed in close affiliation with a
State health department to increase and strengthen the effort which
may be brought to bear on the problems encountered.
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Radiological Health
Ml
During the past 2 years, the Division of Radiological Health, with
the resources available to it, has undertaken responsibility for the de-
velopment of a series of surveillance networks by which the radiation
levels of air, water, and food may be monitored on a continuing basis.
Although this activity has by no means reached the comprehensive
level needed, the Subcommittee wishes to commend the Division for
the progress it has been able to make in this field.
The National Advisory Committee on Radiation, in studies with
tho Division of Radiological Health, believes that by the year 1964, a
minimum of $18 million will be needed to operate the central and
regional programs of the Division. This figure includes funds for
the support of State and local health department laboratories. By
1970, these costs may well rise to a level of $24 million.
Training
It lias been estimated by the National Advisory Committee on
Radiation in its report of 1959 that approximately 1,200 radiation
specialists and 4,000 radiation technicians will be needed by 1970 to
meet the personnel requirements of the Nation in the field of radio-
logical health. The subcommittee finds no reason to alter these esti-
mates. To reach them, the Subcommittee believes that the training
program already underway in the Division of Radiological Health
should be substantially and rapidly strengthened until it approaches
a level of not less than $5 million annually. These funds should be
made available to support university programs in radiological health
and to provide fellowships for suitable students. The specialist train-
ing should be developed principally at the postgraduate level and
should provide at least 2 years of training in most cases. The training
for technicians should be directed principally toward the under-
graduate level of instruction with utilization of the facilities of the
regional field stations where appropriate.
At the present time, the support for training in the Division of
Radiological Health is at a level of $1 million per annum. This is
quite inadequate to meet the needs set forth in the foregoing para-
graph, and the Subcommittee must be critical of the Service for not
having taken greater leadership in promoting such an important part
of its program as the training of radiation health specialists and radia-
tion technicians. Because of the great need for qualified personnel,
it is hoped that the efforts of the Division may be greater in the
future.
It should be pointed out that there is no overlapping between the
foregoing programs and those of the AEC. Training supported by
the latter agency is designed primarily to develop men who will direct
the health and safety operations of AEC and related installations.
The PHS training program has been planned on the other hand, to
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818 ENVIRONMENTAL HEALTH PROBLEMS
develop personnel who can serve effectively in public health operations
at the Federal, State, and local levels. Here, emphasis is placed on
biomedical instruction as well as on work in the physical and engineer-
ing sciences.
The subcommittee would like to say a word now on the administra-
tion of the training grant funds available in radiological health. Al-
though these funds should be provided on a categorical basis, it is
recommended that they be administered, along with similar categori-
cal training funds of other divisions of the Bureau of Environmental
Health, in a central office of the Director of the Bureau. Such ad-
ministrative centralization will do much to assure an orderly develop-
ment of the training program in radiological health as well as those of
the other divisions of the Bureau.
Research
The success of the programs of the Divisions of Radiological Health
in surveillance, data interpretation, counter measures, and control
depends to a great extent upon the ability of the Division to develop
sound programs of research. Indeed, so intimate is the relationship
between research and operation success that research laboratories
should be an integral part of the central and field station organiza-
tion of the Division.
It has already been pointed out that the research requirements for
the Division's programs are so extensive that one cannot expect the
Division to perform more than a small fraction of them within its own
facilities. There is, therefore, a need to develop a strong extramural
program of research grants and contracts with universities. There is
also need to develop close working relationships with other govern-
ment agencies having resources which may be used by the Division.
The National Advisory Committee on Radiation has proposed that
the research activities of the Division of Radiological Health reach
a level of $27 million per year by 1964. This subcommittee finds this
estimate reasonable and endorses it. Of this amount, the Subcommit-
tee finds it difficult to make recommendations concerning the frac-
tions which should be devoted to intramural and extramural research.
It calls attention to the fact that the relationships here are likely to
be different from those which prevail in other agencies due to the
fact that the Division is required to direct its attention to problems
of a highly specific nature. Hence, its research programs are likely
to have a stronger intramural emphasis than is the case in such agen-
cies as the National Institutes of Health.
Like the training program in radiological health, the research pro-
grams of the Division have not, during the past 2 years, received the
emphasis recommended by the National Advisory Committee on
Radiation. The Subcommittee is concerned about this and asks that
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Radiological Health
213
greater effort be made by the Service to provide adequately for the
research, of the Division.
Although many of the problems which the Division of Radiologi-
cal Health is likely to encounter are of a strictly categorical nature,
and hence may be attacked entirely within the limits of the Division's
resources, there are many which are more complex and require the
application of disciplines found elsewhere. The Bureau of Environ-
mental Health should recognize this need for interdisciplinary re-
search and should undertake those measures necessary to assure its
provision.
Relationships of the Division or Radiological Health to the
Atomic Energy Commission
The Subcommittee would like to speak now of the relationship of
the Division of Radiological Health to the Atomic Energy Commis-
sion. Worry has been expressed in a number of quarters lest there
be unnecessary duplication in the effort of the two agencies, worry
which incidentally is shared by this Subcommittee. The Subcom-
mittee believes that this problem should be dealt with, as soon as pos-
sible, by the creation of a Radiation Hazards Research Liaison Com-
mittee composed of the Chief of the Division of Radiological Health,
PHS, an appropriate representative of the Atomic Energy Commis-
sion, and such other personnel from the two agencies as may be needed.
This Committee should meet at frequent intervals to review PHS and
AEC radiation research programs and to plan and devise ways and
means whereby the resources of one agency may be used fully to
advance the programs of the other. This Committee should review
budgetary proposals in all areas of common interest before annual
budgets are submitted for consideration to the Bureau of the Budget.
Although a Radiation Hazards Research Liaison Committee of the
type set forth here may not resolve all of the questions of program
duplication, the subcommittee believes that it will go a long way
to resolve misunderstandings concerning the content of AEC and
PHS programs in radiological health and will assure Congress that
the full resources of both agencies are being brought to bear on the
radiological problems of the Nation.
CURRENT AND FUTURE NEEDS FOR RADIOLOGICAL HEALTH
FACILITIES
The Division of Radiological Health currently operates from facil-
ities located in Washington, D.C., Rockville, Md., Las Vegas, Nev.,
and Montgomery, Ala. The Washington and Rockville facilities
house the Division's central administrative and laboratory operations
respectively; the Las Vegas and Montgomery installations are regional
field stations. A third field station will be opened this year in Win-
chester, Mass.
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m ENVIRONMENTAL HEALTH PROBLEMS
During the past year, the foregoing facilities have become quite
inadequate for the rapidly expanding responsibilities of the Division
of Radiological Health. The resumption of nuclear bomb testing
has placed great demands on the Division to increase its surveillance
network operations. The programs for the development and appli-
cation of countermeasures to reduce medical and environmental ex-
posure levels have lagged far behind because space is not available
for them. Research on radiation protection standards has been cur-
tailed for similar reasons.
The Subcommittee believes that the urgency to today's radiological
health problems require immediate action to expand the facilities
available to the Division. Indeed, this expansion should proceed
regardless of the creation of an Environmental Health Center, al-
though if such a center is built the expansion would desirably take
place as a part of the center's development.
After an examination of the current tasks of the Division of Radio-
logical Health, the Subcommittee believes that the Division has an
immediate need for additional facilities having a value of approxi-
mately $10 million. Of this $7 million is required to provide new
and enlarged administrative and laboratory units at headquarters.
These units should be located together preferably in the Washington
area. The remaining $3 million are needed to enlarge the Division's
field station complex. These are the current needs the subcommittee
visualizes. It is anticipated that substantial additional facilities will
be required in the future and these should be allowed to develop in
an orderly manner as need arises.
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Report of the Subcommittee on
WATER SUPPLY AND POLLUTION CONTROL
CONCLUSIONS
The Subcommittee on Water Supply and Pollution Control con-
cludes that:
1.	The United States is faced with a national water resources prob-
lem of increasingly serious proportions of which water pollution is
a major part.
2.	The rate of national population and industrial growth, and tech-
nological advances have created water supply and pollution problems
national in scope, and that treatment works constructions, knowledge,
manpower, and funds required to solve these problems have not kept
pace with needs.
3.	The rapidly increasing demands for water for all purposes, ade-
quate in quantity and quality, can be met largely by an effective na-
tional water quality management program which will permit use of
the same waters over and over as streams flow from their source to
the sea.
4.	The Federal Water Pollution Control Act, as amended, assigns
a major Federal water resources role to the Department of Health,
Education, and Welfare in which it is responsible for controlling water
pollution to conserve water for all uses—propagation of fish and aqua-
tic life and wildlife, recreation, industrial and agricultural water sup-
plies, and other legitimate purposes, as well as for public water sup-
plies and protection of the public health.
5.	The Public Health Service has made substantial progress in
developing and administering the Federal program authorized by the
Federal Water Pollution Control Act and is providing effective na-
tional leadership.
6.	The Federal program requires further expansion to meet its
legislated responsibilities which will require additional budget, facili-
ties for headquarters staff, research activities and field programs, and
manpower in a wide variety of engineering and scientific disciplines.
Studies and advance planning indicate manpower needs of 2,200 and
a direct operations budget of $22 million in 1965 j by 1970 these figures
will be about 2,700 and $39 million respectively.
7.	The expanding Federal program has urgent need for a national
water quality center for the conduct of basic and applied research on
water resource problems of national significance, and for the regional
laboratories authorized in Public Law 87-88 to support Federal field
programs and provide for the specialized research and service needs
215
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216 ENVIRONMENTAL HEALTH PROBLEMS
of the individual geographical regions, including those of other Fed-
eral agencies, State agencies, and local governments.
8.	National manpower needs for water supply and pollution control
programs—Federal, State, local, and university—are especially urgent,
and there is adequate authority to train the numbers and kinds of
disciplines required for development of the national program. These
programs need to be adequately supported and expanded as rapidly
as practicable.
9.	Water supply and pollution control problems are becoming in-
creasingly diverse and complex, and the development of knowledge
has not kept up. As a result there is a large backlog of urgently
needed research relating to the whole broad spectrum of water quality
management and to human health. The Federal research program
needs to be expanded and extended by full use of grant-supported
extramural research programs.
RECOMMENDATIONS
The Subcommittee on Water Supply and Pollution Control recom-
mends that:
1.	Since concern has been expressed that the health orientation of the
Public Health Service limits its effectiveness in dealing with water
resources problems, actions be taken to assure Congress and the public
of the Service's full capacity for dealing with all aspects of the Federal
water quality program, and that its program is an activity of major
proportions which deals with water quality management for all water
uses.
2.	Responsibilities for all water supply and pollution control ac-
tivities of the Public Health Service should be vested in one organi-
zational unit, in a manner to give clear and separate identification to
this program., with level of personnel status and resources commen-
surate with the importance of the program.
3.	The Headquarters staff of the water supply and pollution control
program be augmented to include sufficient specialists in the engineer-
ing and scientific disciplines, including economic and social sciences,
to provide program direction, for budget preparation, to develop
legislative materials, and to do planning.
4.	The presently authorized regional laboratories be built and
staffed to provide field services and to meet the specialized needs of
individual geographical regions, and these be located on the basis of
carefully developed criteria.1 These should provide space, equipment,
and staff adequate to give technical support to States within regions
on request, provide technical training, provide for the data collection
needs of the Public Health Service, demonstrate new procedures and
1 Criteria recommended by the Subcommittee are presented as a Supplement following
this report.
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Water Supply and Pollution Control	217
processes, and provide for research on problems unique to the region
and for the conduct of field surveys. They should provide support to
regional and State water quality programs, but in no sense substitute
for adequate State laboratory facilities.
5.	Authorization be obtained for a national water quality center
in which can be conducted programs of basic and applied research on
water resource problems of national significance, with financing to
follow completion of the regional laboratories. The national water
quality center does not necessarily need to be contiguous with Head-
quarters.
6.	During the period of constructing and staffing the regional labora-
tories, a comprehensive study be made of the research and data proc-
essing needs which can best be met in a water quality center, and that
the conclusions of this study be used to define in detail the type and
size of central facility needed.
7.	Certain technological and informational activities be located at
the national water quality facility and be organizationally oriented to
serve national program needs. Examples are: (a) Data processing
and computation facilities; (6) highly specialized training at levels
not likely to be justified in geographic regions; (o) development of
uniform procedures for field sampling and analysis.
8.	Adequate staff and facilities be provided to conduct toxicologic
and pharmacologic studies needed to assess the impact of waterborne
substances on plants and animals, including man.
9.	Existing authorizations for training grants, facilities grants, fel-
lowships, and research grants be utilized and supported to the fullest
possible extent to accelerate the training of scientists and engineers
required for development of the national program.
10.	The intramural research program be amplified and extended by
the expansion of grant-supported extramural research activities, with
an ultimate ratio intramural to extramural of approximately 1 to 4.
The extramural effort should include some support of long-term proj-
ects to university research programs.
11.	That greater emphasis be placed on the application of existing
knowledge in the control of water pollution, and that stimulation and
assistance to States be given through a combination of increased pro-
gram grants and technical assistance from the Public Health Service.
These recommendations are related to the necessity to prosecute an
independent water resources program. It is recognized that some
elements could be incorporated into the environmental health concept
but such integration is not essential to the successful prosecution of
the water resources program by itself.
There is strong evidence that the water resources program will be
elevated in organizational status, to a position superior to that of other
62740S—82	IB
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&18 ENVIRONMENTAL HEALTH PROBLEMS
segments of the proposed Bureau of Environmental Health. Argu-
ments have been advanced for separate Bureau status, or for removal
to a level outside the responsibility of the Surgeon General. While
organizational repositioning of the water resources program would not
affect the cogency of the above recommendations, attention is invited
to the probable disruptive consequences of such administrative detach-
ment of the water program from the concept of an integrated environ-
mental health program.
WATER, THE NO. 1 NATURAL RESOURCES PROBLEM
Water has become the Nation's No. 1 natural resources problem—
a direct result of rapid population and industrial growth and changing
technologies. We can. 110 longer afford the widespread illusion that our
water supplies are drawn from a limitless source. We must take com-
prehensive steps now to conserve and protect our water resources in
order to insure the country's continued growth, prosperity, and
security.
The Nation is not running out of water; there is just as much water
falling on this country now as there ever was. But, there is a limit to
our developable dependable water supply, and water needs are ap-
proaching or exceeding this limit in many parts of the country. If this
limited supply is to serve all the purposes for which it is needed, the
same waters must be used over and over. This will require effective
water resources management, both quantity and quality.
Since World War II, the Nation's water resources have been the
subject of important discussions by an impressive number of Federal
committees and commissions set up by the executive and legislative
branches of the Government. Also, most of the States have completed,
have underway, or have authorized comprehensive studies of the water
resources within their jurisdictions. These studies, both Federal and
State, up to now have been concerned primarily with the conservation
and development of water resources for power, flood control, irrigation,
and navigation. Most of the planning effort up to now has been di-
rected toward increasing and conserving the amount of water available
for use. Far too little attention has been given to the all-important
need of planning for the cleanliness of water. It is now generally
accepted that water quality management must have the highest
priority in water resources developments.
Oversimplifying a very complex situation: The water resources
problem confronting the United States from now on is one of making
its relatively fixed supply meet a rapidly increasing demand by pro-
viding the right quantity of water of the right quality where it is
needed.
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Water Supply and Pollution Control	£19
To meet needs we must develop our capturable water resources up to
their maximum dependable amounts and pursue an aggressive, effective
program of pollution prevention and control that will maintain a high
level of water quality in the ground, lakes, and streams across the
country—the Nation's fresh water supply. We must do the same with
respect to our valuable estuarine and coastal water resources.
Most of our present water pollution problems have resulted from too
little attention in the past. Many States have not been provided with
program resources commensurate with their pollution problems and
their role of primary responsibility in dealing with pollution. The
Federal Government has dealt with the problem only in recent years
and then on a small scale.
Many municipalities and industries have resisted constructing
needed waste treatment works, regarding them as a benefit only to
someone else downstream, and as an unnecessary or unbearable finan-
cial burden. The public has been allowed to retain too much of the
outmoded "water purifies itself every 7 miles" philosophy. It has been
oversold on the cheapness and plentifulness of water and undersold
on the value and necessity for pollution control. The engineer has
relied on the stream to do much of the waste treatment job rather than
tailoring treatment to keep the stream as clean as possible.
The problems of water pollution have been brought into sharp focus
by the speed of our population and industrial growths, a new and
changing technology, new agricultural practices, and new contribu-
tions to a continually rising standard of living. These developments
have caught us relatively unprepared to deal with the resulting pollu-
tion problems sociologically, economically, legally, or technically. The
water pollution control administrators are attempting to manage the
new, complex problems of today with tools that were designed for the
problems of yesteryear. The Nation is entering a critical water supply
and pollution control situation that requires immediate attention if it
is to continue to move forward.
NATURE OF THE NATIONAL WATER POLLUTION PROBLEM
In the past, pollution control authorities dealt largely with prob-
lems caused by sewage, industrial wastes of known toxicity and
behavior, and natural organics. Pollution control was aimed prin-
cipally toward protecting downstream public water supplies, abate-
ment of local nuisance conditions, and protection of fish and aquatic
life. For the most part, dilution provided by streams was adequate
to prevent serious pollution; waste treatment plants, where provided,
were designed to take full advantage of the self-purifying capacity
of the stream; and the water purification plant provided the safety
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no ENVIRONMENTAL HEALTH PROBLEMS
barrier for the water-consuming public. Pollution problems were
principally local in extent and their control a local matter.
National growth and change have altered this picture in recent
years. Population and industrial growth have figuratively and lit-
erally moved waste outfalls closer together and increased their num-
ber. Urbanization, increased living standards, and encirclement of
industry by the municipality have increased the volumes and strengths
of municipal wastes. In some instances treated effluents today have
polluting effects approaching and sometimes greater than the raw
sewage discharges of 30 years ago.
Increased production of goods have greatly increased the amounts
of "common" industrial wastes. New technologies are producing
complex, new wastes and products that defy our current ability to
treat or control them, or even detect their presence in water. The
increased application of commercial fertilizers and the development
and widespread use of a vast array of new pesticides are resulting
in a host of new pollution problems from land drainage. The growth
of the nuclear energy field and use of radioactive materials fore-
shadow still another complicating and potentially serious water
pollution situation.
Stream pollution is no longer a local affair. Long stretches of
both intrastate and interstate streams are subjected to pollution which
adversely affects their use for many purposes. Conventional biologi-
cal waste treatment processes are hard pressed to hold the pollution
line and for a growing number of our larger cities, these processes
are not adequate. There is growing concern over the ability of our
water purification plants to adequately protect the public against the
sheer mass of biological and chemical pollutants entering plant intakes.
Ground water pollution is still a local affair, although it is often
an intermunicipal and sometimes interstate matter. Our exploding
population is concentrating in urban areas and constantly moving
outward from the central cities into suburbia and exurbia. Sewerage
construction has not matched either this growth rate or its move-
ments. As a result, a large share (an estimated 23 million in 1960)
of our population must rely on individual septic tanks for its waste
disposal. In an increasing number of places, this is resulting in
serious pollution of ground waters which often must serve the same
population with water supply. Few metropolitan areas are escaping
this serious public health problem, and it plagues many smaller
communities.
Sea water intrusion is a growing ground water pollution problem
in coastal areas. It is caused by excessive pumping of the fresh
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Water Supply and Pollution Control
m
ground water which lowers the water table, allowing salt water to
flow into the ground water aquifers. Already a widespread problem,
it is now of particular significance in California, Maryland, New
Jersey, Texas, and Long Island, New York. Oil field brine disposal
practices also are causing salt pollution of ground waters, particularly
seepage from so-called "evaporation" pits. This is a particular prob-
lem in the oil fields of the Midwest and Southwest.
Sewage and industrial waste oxidation ponds, and waste storage
lagoons are often responsible for ground water pollution, especially
when improperly located in permeable soils.
Although the practice is not yet in extensive use except for oil field
brines, industry is beginning to look to underground strata as the
answer to the problems of disposing of highly toxic and/or untreat-
able wastes. This practice should not be pursued until much more
is known of the geology and hydrology involved, and of the proce-
dures which will insure that pollution of ground water aquifers at
any time and any distance from the disposal site will not result with
particular hazard to public health.
Twenty-three States border on the ocean and their estuarine and
coastal waters have been subject to serious and increasing pollution
for many years. Many of our large cities and industries are located
along the coasts and discharge their wastes, treated and untreated,
into adjacent estuaries, bays, harbors, and coastal waters. These
waters are also subject to significant pollution from inland areas,
transported into them by the drainage basins of the countiy.
The Extent of Sewage Pollution
Since 1900 the number of communities served by sewers has increased
from 950 to more than 11,000. Over 7,500 of these municipalities
have constructed sewage treatment works to serve 80 million people.
At the same time, the amount of municipal pollution has increased
because of growing population, obsolescence of older treatment plants,
failure to construct needed sewage treatment plants, increased inter-
ception of industrial wastes by municipal sewers, and increased num-
ber of water-using services in the home (multiple baths, garbage
grinders, automatic laundries, etc.).
The following table shows the growth in the sewered population
and the increase in municipal sewage pollution, also future conditions
if the present rate of treatment works construction is maintained and
if secondary treatment is provided by all communities by 1980.
Projections are based on estimated urban growth rates and assumption
that municipalities will continue to intercept acceptable industrial
wastes.
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m ENVIRONMENTAL HEALTH PROBLEMS
Population Served by Sewers and Sewage Treatment (t900-1980) 1
[In millions]

Sewered
Served by
Discharging
Population
Year
population
treatment
raw sewago
equivalent




discharged
1900			-
24.5
1.0
23.5
24.0
1920			-		
47.5
9.5
38.0
40.0
1935	 .
69.5
28.5
41.0
61.0
1950			
80.0
64.0
26.0
60.0
I960			
105.0
80.0
25.0
75.0
1970		-				
(145.0)
' (130.0)
' (15.0)
1 (76.0)


• (110.0)
> (35.0)
" (84.0)
1980			 	
(210.05
• (210.0)
< (None)
< (74.0)


' (140.0)
t (70.0)
• (150.0)
1 Data taken or extrapolated from "Modern Sewage
Disposal," Federation of Sewage Works Association,
1938; 1057 Inventory of Municipal and Industrial Waste
Facilities, USPH8; and unpublished data from Baste
Data Branch. DWSPC, USPHS.
1 Assumes that progress toward secondary treatment
for all municipal wastes by 1980 will be made; a per
capita population equivalent (P.E.) of 1.6; and 80 per-
cent removal of P.E. by secondary treatment.
' Same as (2) except assume* present rate of sewage
treatment construction will continue.
4 Assumes that all sewered population will be served by
secondary sewage treatment by 1GS0; a per capita popu-
lation equivalent (P.E0 of 1.75; Md SO percent removal
of P.Ek by secondary treatment,
9 Same aa (4) except assumes present rate of sewage
treatment construction will continue.
This table shows that even if we provide secondary treatment by
present methods for all the sewered population by 1980, the amount
of pollution reaching watercourses in 1970 and 1980 will be substan-
tially the same as today. More importantly, it shows what is likely
to happen if apathy toward constructing needed municipal sewage
treatment continues; intolerable water pollution situations will exist
in many places before 1970 and will be a nationwide situation long be-
fore 1980.
The urban waste problem: The concentration of population and in-
dustry in urban areas is already creating serious water pollution prob-
lems. Such concentrations produce vast quantities of complex wastes
which usually must be discharged into a single and often relatively
small watercourse. We can look forward to many serious pollution
situations below these large centers of population and industry be-
cause the pollution load imposed by high volumes of treated effluents
will result in low water quality in the receiving stream.
The situation at Chicago is a classic example of the profound eco-
nomic, social, technical, and legal difficulties inherent in the growing
metropolitan sewage disposal problems already with us and certain
to increase in number rather rapidly in the years to come. Although
Chicago provides the best treatment available, the city pours into
the Illinois waterway each day an effluent equivalent to the sewage
from 1 million persons and containing solid wastes, suspended and in
solution, amounting to 1,800 tons.
Municipal waste treatment processes in use today were designed
for the wastes of 40 years ago and no essentially new or more effective
-------
Water Supply and Pollution Control	223
process has been developed since. These processes will be effective
for many smaller cities for some time, but for a growing number of
larger cities, they are proving to be entirely inadequate.
It is clear that a major water pollution need is to develop new
municipal waste treatment processes that will remove much more of
the contaminants than is now possible. These new treatment methods
will probably be based on entirely different principles and concepts
than the mechanical and biological processes now in use.
The septic tank problem: Associated with urban growth but not con-
fined to urban areas is the septic tank problem of ground water pollu-
tion. Population movement into suburbs has outraced sewer systems
extensions and planning officials. The table below shows the growth
in metropolitan populations served by septic tanks which implies the
magnitude of the problem.
Septic Tank Installations in Metropolitan Areas
[In millions]

1945
1950
1955
1000
1970
Metropolitan population	
75
84
S4
109
134
Served by septic tanks	
8.7
10
15
23
32
Septic tank pollution is particularly a problem where the ground
water is used for domestic and municipal supply. It is nationwide
and involves large and small cities alike. The health hazards are
obvious and much more attention must be given to providing adequate
water and sewer services to suburban populations by developers,
planning officials, health agencies, and regulatory agencies.
The Extent op Industrial Wastes Pollution
Organic industrial wastes: Studies and surveys by the U.S. Public
Health. Service in recent years indicate that the amount of organic
industrial wastes (treated and untreated) now going into the Nation's
watercourses is about double the amount of municipal wastes; that is,
a population equivalent to 150 million persons.
By 1975, industry is expected to more than double the production
attained in 1950. This would indicate a possible doubling of present
organic wastes by 1980 which may be tempered by certain technologi-
cal and engineering developments, and the extent to which industry
meets is responsibilities for satisfactorily treating its own wastes.
The increase in organic industrial wastes since 1900 and estimated
amounts in 1970 and 1980 are shown in the following table.
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m ENVIRONMENTAL HEALTH PROBLEMS
Increase in Organic Industrial Wastes
Year
Index of
industrial
production '
Population equiv-
alent discharged
(in millions)
1900	 - 	
20
15
1920	 	 	 		
40
49
1940	 	 -	- - - -		
66
75
1950	 ....... 	-- 	
113
100
1959... 		 ... ... 	
159
150
1970	 	 . . 			 .... 	
1 246
•210


' 50
1980..			 . 			
! 367
•310


* 80
1	Based on 1047-49 - 100; from Federal Reserve Board	' Assumes estimated percent rate of industrial waste
Index of Production 1000-59, ^ treatment construction will continue,
2	Estimated by Nutignul Planning Board, "National	* Assumes 80 percent removal of population equivalent
Economic Projections," from annual growth rate of 4,1 by treatment will be obtained.
percent.
These data show that substantial reductions in industrial organic
pollution loads can be effected by waste treatment if industry can
attain 80 percent removal of population equivalents. Such reductions
will require a greatly accelerated construction program and the devel-
opment of new treatment processes, because fully effective measures
have not yet been developed for many organic industrial wastes. The
table also indicates the pollution situation that will exist if the present
rate of treatment construction continues or if treatment processes are
not found which can approach 80 percent removals.
Inorganic indusrial wastes: There have been large increases also
in the discharge of the "common" inorganic industrial wastes (prin-
cipally of mineral and chemical origin). These wastes have polluting
effects different from organic wastes and cannot be measured in terms
equivalent to sewage. Inorganic wastes originate from metal pickling,
acid mine drainage, metal finishing, chrome tanning, and from the
mining, processing, and manufacture of a wide variety of metal and
chemical products. Also organic wastes often containing substantial
amounts of inorganic wastes show that the amounts are very large
and the index of industrial production indicates they are increasing
rapidly. Fully effective treatment processes have not yet been devel-
oped for many inorganic industrial wastes.
New chemical wastes: The chemical industry is the fastest growing
segment of American industry and some of its growth is reflected in
the table below.
Leaderi in Synthetic Organic Chemical Growth '
Production In million pounds]
1028
1938
1946
Tlastics				 	
Synthetic rubbers			
Synthetic detergents and other surface-active agents...
Nylon and other non-cell ulosic fibers...	
Insecticides and other agricultural chemicals		
Medicinals	—			— 	
20
0
0
0
4
130
5
15
0
8
13
1,486
1,173
376
66
97
43
Source: The Chemical Muttrv Factt Booh 1960-61 Edition.
-------
Water Supply and Pollution Control
m
Synthetic dyes, adhesives, surface coatings, solvents, and many other
industrial, agricultural, and commercial products have also registered
substantial production growth.
A major new water pollution problem has emerged with the growth
of the synthetic chemical industry. Wastes from this industry are
reaching watercourses in increasing numbers and amounts each year,
both from the use of the manufactured products and from wastes pro-
duced during their manufacture. These chemicals reach the stream
by way of municipal and industrial sewers, land drainage, or direct
application of chemicals to the stream, lake, or impoundment.
Wastes and products originating with the synthetic chemical indus-
try are extremely complex in their composition and behavior. Some
cause tastes and odors, and a large number are highly toxic to fish and
aquatic life. Many do not respond to biological treatment and persist
in streams for long distances. We do not know how to detect most of
these compounds in water, or how to treat them in waste effluents or
remove them from water. Most important, we do not know their long-
range toxic effects of these new synthetics on man.
The new synthetic wastes are present in low concentrations in most
waters for the moment, but the industry is continuing its rapid
growth. Each year we are finding increasing amounts of these wastes
at our water supply intakes and since neither our sewage nor our water
treatment plants remove them, they are reaching the consumer in
increasing amounts.
Radioactive wastes: Still another new water pollution problem of
serious potential has emerged in recent years from the growth of
nuclear technology. The presence of radioactive materials in our
streams is adding another new contaminant to the Nation's water
supply that has serious health implications if not controlled.
Pollution by radioactive materials from nuclear weapons testing is
well known. Waste products from mining and refining radioactive
minerals, such as uranium or thorium, may wash or be discharged into
streams. Waste products from refined radioactive substances used in
power reactors or for industrial, medical, or research purposes require
adequate control measures to prevent dangerous concentrations from
escaping to streams.
Radioactive materials are characteristic of a newly developing class
of water pollutants that are subtle in effects and not detected by the
usual stream pollution analyses. Even so, their control is a problem
in principle no different than the control of the more common types of
wastes, and in this instance the only practical means of protection
against human exposure to radioactive wastes in water is treatment
and control of such wastes at their source. Since radioactivity is
cumulative, these controls must be effected in light of total human
exposure in the environment.
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226 ENVIRONMENTAL HEALTH PROBLEMS
Heat: Heat pollution is becoming an increasing matter of concern
to water pollution control administrators and conservationists. Since
1900, electric power production has approximately doubled every 10
years and is expected to double again by 1970. Unless controls are
effected, this could mean an increase in heat pollution of more than
100 percent in the next 10 years. This does not even take into account
the increase in water temperatures that will accompany the increase
in impoundments for hydropower, irrigation, navigation, flood con-
trol, and water supply purposes.
In areas of population and industrial concentration, such an increase
in heat pollution in lakes and streams could have a profound effect on
the ability of the waters to assimilate even well-treated wastes, or to
serve increasing demands for recreational and fishing opportunities.
The following example illustrates the potential of heat as a pollutant:
In the Illinois River near Chicago, the effect of thermal pollution from
steam-electric plants is reported to be equivalent to doubling the
organic waste load from the Chicago area; that is, from the present
population equivalent of more than 1 million to more than 2 million.
The Extent of Land Drainage Wastes
Silt: Up to now silt pollution has largely resulted from erosion of
agricultural lands and streambanks. Two examples illustrate the
magnitude of the silt problem. The annual silt load carried by the
Potomac River amounts to as much as 40 million cubic feet. The
Corps of Engineers has estimated the sediment load in the Mississippi
Basin above the delta to be about 500 million tons per year. The
growth of "suburbia" has created a "new" siltation problem. Housing
developers have completely denuded large areas of land of all vegeta-
tive cover, exposing the raw land to severe erosion with resulting heavy
silt pollution of streams. Serious local pollution problems are re-
sulting from such practices, and pollution control agencies are turning
their attention to them.
Brush and, forest fires: With the increasing need for water, particu-
larly in water-short areas, brush and forest fires are a matter of
serious concern. Such fires destroy the vegetative land cover, increas-
ing erosion and stream siltation, causing rapid runoff of needed
waters, and creating tastes and odors from leaching of burned
materials.
Irrigation return flows: Irrigation return flows have been a major
water pollution problem in the 17 Western States for many years which
has increased as more land has been put under irrigation. As irri-
gation waters percolate through the soil, they dissolve important
amounts of minerals and other substances. The same waters are
used over and over, with the result that there are repeated additions of
minerals. Evaporation losses are high and this further adds to the
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Water Supply and Pollution Control
m
concentration of pollutants. In many instances, irrigation return
flows render streams unfit for further use, including irrigation, until
some dilution of their mineral content is provided. With popula-
tion and industry moving steadily westward, even into these water-
short areas, the competition for the available water for public and
industrial purposes is rising. The problems this will generate for
the water pollution control administrator are imposing.
Urban land drainage: Each year additional millions of acres of land
are withdrawn for use for streets, highways, airports, housing, and
other buildings. The runoff from these hard-surfaced areas is nearly
100 percent, and with it all of the accumulated deposits—oils, organic
matter, trash, soil and industrial dusts, other air pollutants, fertilizers
and pesticides used on yards and parks. In addition, municipalities
with combined sewers are bypassing increasing amounts of storm
water sewage as hard-surfaced areas increase. Only recently have
pollution control agencies looked into the matter of urban land drain-
age and have found its pollution potential to be highly significant.
Agricultural 'pesticides and fertilizers: Perhaps the most important
and emerging land drainage problem involves the tremendous increase
in the use of agricultural pesticides and fertilizers. Production of
synthetic pesticides in 1958 amounted to more than 500 million pounds,
and most of this production was used by U.S. farmers. Each new
pesticide introduced on the market is generally more toxic than its
predecessor.
More than 30 million acres of cultivated cropland are sprayed one
or more times annually in the United States. Aerial spraying is in-
creasing. The treatment of pasturelands and noncroplands, such as
highway rights-of-way, is adding to the total use of pesticides. Also,
the chemical control of rough fish, aquatic vegetation, and nuisance
plants such as mesquite is increasing. Urban dwellers account for a
small but significant share of the growing pesticide market.
With some 500 million pounds of highly toxic chemicals being
broadcast over the land, it is inevitable that some of it will reach our
watercourses. They may be applied directly to the water, they may
drift into water during the treatment of adjacent areas, or they may
be washed in from treated areas of the entire watershed. Many of
these materials have a long residual toxicity in the soil. Numerous
fish kills have been traced to pesticides. In other situations, aquatic
life, both animal and plant, making up the food chain of fishes have
been wiped out.
Most pesticides are not removed by ordinary water treatment proc-
esses. While the concentrations found thus far have no apparent
acute toxicity to humans as drinking water contaminants, they are
approaching levels toxic to fish under continous exposure. As the
-------
228 ENVIRONMENTAL HEALTH PROBLEMS
use of these chemicals continues, the chronic effects of long-term in-
gestion may well be of greater significance than acute toxicity.
Some indication of the magnitude of the problem in the immediate
years ahead has been given by Mr. Wayne R. Yoder, manager of
American Cyanamid's pesticides products department, who has pre-
dicted a ten-fold increase in pesticide output in the next 20 years.
This could mean in 1980, pesticide production amounting to more than
5 billion pounds annually.
As scientific farming progresses, the U.S. farmer is using more
and more chemical fertilizers. This practice will undoubtedly in-
crease as new lands are put into use and as more intensive farming
practices become profitable. Fertilizers applied to agricultural lands
find their way into natural waters principally during runoff and
from soil leachings. Their significant pollutional effect thus far
appears to be the adding of nutrients to the water environment, al-
though as their use increases there may be other effects such as in-
creased hardness and mineralization.
These added nutrients are capable of supporting and often do sup-
port heavy aquatic growths, bacterial, algal, vegetation, and others,
particularly in impoundments. Many of these forms of aquatic
growths improve the fishing environment, but usually this proves to
be a more serious detriment than benefit because such growths often
cause serious tastes and odors in water supplies that are difficult and
expensive to remove. Stream pollution from agricultural fertilizers,
supplemented by the increasing amounts of nutrients from municipal
and industrial wastes, is becoming a water pollution problem that
may reach national significance. A widespread increase in the growth
of nuisance organisms and plants would have serious degrading
effects on water quality and use.
Nonwithdrawal Water Uses
Recreation: Recreational use of waters—swimming, water skiing,
and boating—can cause measurable pollution. The pollution result-
ing from water contact sports is principally bacterial. The very
large increase in recreational boating and water skiing is resulting
in increased pollution. Most recreational craft do not have waste-
disposal facilities, and galley and toilet wastes are discharged directly
into the water. These kinds of pollution create particular problems
when recreational watercraft are clustered together in anchorages,
both in fresh waters and coastal salt waters.
A new and perhaps serious problem of pollution is resulting from
the growth of outboard motor boating and water skiing, particularly
on lakes and reservoirs. Public Health Service studies are showing
significant concentrations in such waters of oil, lead, and combustion
products from outboard motor exhaust. These wastes have been
-------
Water Supply and Pollution Control
229
shown to cause tastes and odors, taint fish flesh, and in sufficient con-
centration to be toxic to fish and aquatic life.
Navigation: Navigation is an old and continuing source of water
pollution in estuaries, habors, and coastal waters. With the opening
of the St. Lawrence Seaway, it is a growing problem in the Great
Lakes that is creating concern. Ship pollution consists of bilge
waters, sanitary sewage, garbage (including cargo spoilage), oils,
and whatever can be thrown overboard. Accidental spills in pumping
liquid cargoes to shore occasionally cause serious problems as do
navigation accidents. Few ships afloat today, even those of recent
design, have any facilities for the collection, treatment, or disposal
of shipboard wastes.
The St. Lawrence Seaway has opened the Great Lakes to 90 percent
of the world's commercial vessels and to possible increases in vessel
pollution, a matter of considerable concern in the Great Lakes, in-
volving water supplies, recreational beaches, and real estate values.
The discharge of shipboard sewage near public water supply intakes
is of special concern since many of these intakes are in or near
present port areas or those being planned for development. With
ships from all parts of the world entering and harboring in waters
adjacent to public water supply intakes, the chances are greatly en-
hanced for waterborne disease transmission, and particularly those
diseases from other countries which have long been gone from the
American scene or never have gotten a foothold here.
ECONOMICS OF WATER POLLUTION
The application of basic economics is needed to develop valid yard-
sticks by which reliable dollar measurements can be made of the costs
of water pollution and benefits from its control. With such data,
water resources can be accomplished on a more sound basis. Achieve-
ment of this goal will require measurements for the value of each
water use. These may well differ according to the region or situ-
ation involved. New measurement devices which take into account
social and public values will need to be developed.
Because of the magnitudes of investments required to achieve water
quality control and because of the extensive ramifications throughout
the economy of polluted waters, more economists are scrutinizing the
situation. The increased attention acts as a stimulus to technical
experts already involved and to scholars, public administrators, and
others. It is imperative that the intensity of this pace be increased,
for adverse economic effect on human welfare is too great for cor-
rection to be left to chance or the sporadic attention of the general
public.
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230 ENVIRONMENTAL HEALTH PROBLEMS
APPROACHES TO SOLUTION OF THE NATIONAL PROBLEM
Publjc Awareness
Related to all the elements in water quality management is the need
for a much better public understanding of the water pollution situa-
tion and greater public support for what needs to be done.
Very important water resources decisions are being made and will
continue to be made in the years ahead. The public should have a
voice in these decisions and it should be an informed voice. For ex-
ample, any changes in water rights legislation would have a profound
effect on water use and the public should be heard on such issues.
Further, it is the public which must pay for water resources develop-
ments, including water supply and pollution control, and these pro-
grams will not go forward unless the bond issues are passed.
To have the force of public opinion behind water quality manage-
ment, the facts must be presented to the public through well-thought-
out programs. Public support will make it possible to meet needs
for adequate legislation and appropriations, and for planning, con-
struction, and the other elements of a successful national water quality
management program.
Legislation
The law is the basic framework within which organized society
carries out its public functions, including water pollution control.
Effective pollution control programs must be supported by effective
legislation, tailored to meet the specific problems and needs. As these
change, the supporting legislation should be reviewed and changed
accordingly.
Many States have reasonably comprehensive pollution control leg-
islation, but all should have it. Legislation is needed for metropolitan
areas which will permit communities in the urban fringe to work more
effectively and equitably with the central cities on an integrated
regional approach to common water and waste problems, including
interstate cooperation where necessary. A very pressing need is im-
provement in State laws for the public financing of waste treatment
works. Although most States have liberalized and clarified their
public financing laws since the 1930's, improvements are still needed.
It may be necessary for the States to consider legislation dealing with
the financing of industrial waste treatment works as some have already
done.
The need to manage our water resources effectively and efficiently
is making it increasingly necessary to provide legislation for inte-
grated river basin and regional water resource developments par-
ticipated in by all local, State, and Federal interests concerned.
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Water Supply and Pollution Control
231
Application or Abatement Measures
Construction of treatment works: A great deal of water pollution
abatement could be achieved now if present knowledge were applied,
and the needed sewage and industrial waste treatment, works were con-
structed and properly operated and maintained. A large backlog of
sewage and industrial waste treatment construction has accumulated
through the years. Last year, the Conference of State Sanitary Engi-
neers completed a comprehensive survey of municipal waste treatment
needs as of December 31,1960, which is summarized as follows.
National Summary, Backlog of Municipal]Wa»ie.Treatmtnl Heeds
Typo of need
Number of
Population

communities
served
New plants.-	 		
4,136
22,997,647
Enlargements				 -		 		
660
12,729,981
Additional treatment		—	
431
6,513,197
Total					—
8,127
42,240,725
The estimated cost of the above municipal waste treatment needs is
$2 billion. Elimination of this backlog in 10 years, together with
needs imposed by population growth and obsolescence of existing
works during this period, will require an average annual expenditure
of $600 million, 40 percent higher than is being spent by municipalities
now.
Information on industry's waste treatment construction needs is not
nearly as complete as those for municipalities. This is one of the
serious gaps in basic data collection that must be filled. However,
surveys by the Public Health Service in 1950 and 1954, information in
the 1957 Inventory, and industry's waste treatment record since indi-
cate that more than 6,000 construction projects are needed for indus-
trial wastes. To eliminate this backlog of needed industrial waste
treatment and control measures, and to provide for new needs of a
rapidly expanding industry, industry will need to spend an average
of $575-$600 million a year for the next 10 years to meet its pollution
control obligations.
We cannot afford to continue to lose ground to water pollution by
failing to construct needed municipal and industrial waste treatment
works. Where there are adequate treatment processes available, and
there are no problems of organizing and financing treatment works,
construction should be required without delay, invoking enforcement
when necessary. Where reasonable and effective treatment methods
are not available, adequate research programs should be pursued.
Where there are problems or organzing and/or financing, the necessary
-------
m ENVIRONMENTAL HEALTH PROBLEMS
legislation, incentives, and other mechanisms should be provided so
that construction can proceed.
Efficient operation and maintenance of waste treatment works: It-
is not enough merely to construct waste treatments works—they must
be efficiently operated and maintained thereafter. This responsibility
rests directly on the municipality or other public agency, and on the
industries which own the treatment facilities. The regulatory agency
responsibility belongs to the State.
Municipalities and industries should be strongly urged to employ
the most qualified supervisory, operating, and maintenance personnel
possible. Much more attention needs to be given to training programs
for both professional and subprofessional operating personnel. States
need more staff and funds to properly supervise operation and mainte-
nance of municipal and industrial waste treatment plants. The degree
of efficient operation of a waste treatment plant is usually the differ-
ence between satisfactory and unsatisfactory pollution conditions
downstream. Proper maintenance improves plant efficiency and pro-
tects an important economic investment. If all the existing waste
treatment plants were operated and maintained at a high level of
efficiency, it would result in a very substantial additional reduction in
present pollution of the Nation's waters.
Enforcement: Most States prefer to use persuasion in getting
municipalities and industries to construct needed waste treatment
facilities. However, when reasonable efforts at persuasion have failed,
all States should vigorously apply their own enforcement measures.
In 1959 a survey of the States was made to assess tangibly the utili-
zation of enforcement procedures by the State water pollution control
agencies. An analysis of replies submitted by the 42 States which
reported showed that, of the 37 having authority to issue adminis-
trative orders, 8 had issued none, 17 less than 50 orders, and 12 had
issued 50 or more. All States have authority to take court action, and
the survey showed that 17 States have never brought a court action,
5 have brought only 1 each, 10 had brought from 1 to 5 each, 6 from
5 to 15 each, and 3 States have instituted more than 15 actions each
(1 State did not specify any number).
Since Public Law 660 was enacted in 1956, Federal enforcement
action has been taken in 15 interstate pollution situations. The 2
most recent cases are in the conference stage, but in the other 13 agree-
ments reached as a result of conferences and the findings of public
hearings, facilities costing about $500 million are to be constructed.
When completed and in operation, these will eliminate the interstate
pollution situations and upgrade the water quality of 4,000 miles of
streams.
Enforcement actions will undoubtedly need to be invoked more
frequently in the future if further ground is not to be lost to pollu-
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Water Supply and Pollution Control
233
tion. The States need to be more aggressive in this area, not only
to get the job done for which they are primarily responsible but to
retain the responsibility.
Improvement of watershed management practices: Many activi-
ties on watersheds adversely affect the quality of water draining from
them. Poor agricultural practices which contribute to soil erosion,
injudicious applications of fertilizers, lumbering activities, unwise
use of economic poisons, and construction which lays bare large areas
of land are examples of poor watershed management practices which
contribute to water pollution.
Since land drainage wastes cannot be collected and treated as can
sewage and industrial wastes, their control requires good land man-
agement practices. The application of such practices would result
in substantial improvement in the quality of many waters. Water
pollution control administrators need to give much more attention
to land drainage pollution, especially to the development of controls
through good practices.
In-plant control of industrial wastes; The reduction or elimina-
tion of materials from the liquid effluents of industrial plants by
process changes, equipment modifications, careful housekeeping, and
other in-plant measures can significantly reduce the waste load to be
treated and which eventually reaches the stream. Many industries are
reluctant to institute in-plant waste controls unless this results in
profitable savings. They have overlooked the substantial savings in
waste treatment costs and the beneficial effect on the receiving stream
from reduced effluent loads.
Improved management of nonwitkdrawal water uses: The use of
water supply reservoirs for bathing and other water sports has be-
come a matter of increasing concern for water works officials. Where
recreation use is permitted, a barrier of distance, the maximum rea-
sonably enforceable, should be maintained around the intake. Ade-
quate and properly maintained sanitary facilities should be provided.
The discharge of untreated toilet wastes and garbage from ships
and pleasure craft should be prohibited. Rigid controls are needed to
provide a barrier of distance to protect public water supply intakes.
Studies are needed to determine the effect of the underwater dis-
charge of outboard motor exhaust emissions to provide a basis for
control. Proposals to apply chemical poisons to water to destroy
undesirable fish, weeds, insect larvae, algae, and other nuisance aquatic
life should be approved by the State water pollution control agency.
Collection' and Evaluation of Basic Data
Basic data in water quality management are the counterparts of
inventories and bookkeeping in business. Water is big business today,
027408 —-62. — 16
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m ENVIRONMENTAL HEALTH PROBLEMS
and reliable basic data are necessary to orderly and efficient develop-
ment and administration of river basin water quality management
programs.
In pollution control, basic data consist principally of information
on the sources, kinds and amounts of pollution; the causes of pollution
and its effects on water quality and uses; the present and future in-
tended uses of waters; the pollution prevention and control measures
required to accommodate the planned water uses; the kinds, costs,
and efficiencies of remedial treatment works; and the costs and benefits
associated with pollution and its control.
The dearth of reliable basic data on water resources has been spe-
cifically pointed out by the Presidential Advisory Committee on Water
Resources Policy, the Senate Select Committee on National Water
Resources, and by the 1960 National Conference on Water Pollution.
Basic water pollution data need to be collected, evaluated, and dis-
tributed on a cooperative basis among the water resources agencies
concerned. To make these data more reliable, they need to be col-
lected on a continuing basis in all the river basins; to make them more
usable they need to be made available widely. We need to know
where and why we are gaining or losing ground in controlling pollu-
tion, and to maintain a water intelligence that will detect pollution
situations as they arise before they become major problems. Progress
has been made, but basic data collection and evaluation programs still
need to be greatly accelerated by all water pollution control agencies—
local, State, interstate, and Federal. Most agencies require increased
appropriations before this can be done.
Technical Services
For nearly 50 years, the Public Health Service has been providing
technical services to State and interstate agencies, other Federal agen-
cies, and to municipalities and industries. The solution of many
problems requires scientific and specialized personnel which the State
and interstate agencies cannot justify on a full-time basis.
Technical services have been and will be an increasingly effective
tool in the Federal-State-local cooperative approach to water pollution
problems. As problems become more complex and demands increase,
a much greater resource and variety of skilled manpower and facilities
will be required. The State agencies have a major responsibility to
provide technical services to local agencies, municipalities, and indus-
trial plants. As problems multiply and more treatment works are
placed in operation, the need for technical assistance will increase.
Research and Development
The problems to which research and development must be directed
encompass all phases of the fate of a waste, from its point of origin to
-------
Water Supply and Pollution Control
235
the point of water use. Because of the water quality implications of
water conservation measures, this area of concern is included. The
major problem areas are (1) sources of waste, (2) evaluation of pollu-
tional effects of wastes, (3) treatment of wastes, (4) disposal of
treated waste effluent, (5) water quality surveillance, (6) water treat-
ment, and (7) conservation and water quality. Each of these is pre-
sented in terms of its major research needs.
Special consideration is given to certain activities which may be
most advantageously conducted through pooling program resources
at a central research facility. These needs include fundamental
studies in toxicology, ecology and systems analysis, and instrumenta-
tion.
SOURCES OP WASTE
Our ability to account for pollution in the water resource is un-
satisfactory. This shortcoming is twofold: the pollutional impacts
of several important sources of waste have not been well defined and
methods for determining important characterstics of waste are in-
adequate. On the one hand, therefore, certain significant sources of
waste have been largely ignored (as for example, land drainage), and
on the other, control of wastes has been incomplete (as for example,
alkyl benzene sulfonate in sewage). Only recently have these defects
in accounting for pollution been recognized.
Four major sources of pollution have now been described: sewage,
industrial wastes, land drainage, and nonwithdrawal water uses.
Each presents difficulties in measurement and characterization.
Sewage: Sewage is assuming new and important chemical charac-
teristics. For example, organic chemicals of industrial origin may be
undetected and unsuspected components of sewage. Satisfactory con-
trol of sewage requires improvement of analytical methodology to
detect and measure substances of industrial origin as a first step in
their evaluation and control.
Industrial wastes: The "traditional" industrial wastes are still ma-
jor problems. However, new and even more troublesome wastes are
being encountered, such as radioactive wastes, thermal pollution, and
a vast complex of waste substances discharged by the chemical indus-
tries. The gap in knowledge of the quality and character of such
wastes is a problem of fundamental importance in the protection of
water quality.
Thermal pollution; An Increase in stream temperature caused by Industrial
use may hinder the stream's ability to assimilate wastes, impair valuable aquatic
life, reduce the value of the water for further cooling use, and promote the
growth of objectionable slime or aquatic weeds. No reliable data are yet avail-
able for determining the rate at which a stream will dissipate excess heat, or
on which to base effective controls.
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236 ENVIRONMENTAL HEALTH PROBLEMS
Radioactive wastes: Research is required to determine the behavior and fate
of radioactive materials in sewage treatment processes and in the aquatic en-
vironment (both fresh and salt water), develop treatment processes for wastes
from major nuclear industries, and develop relatively rapid physical-analytical
methods for determining the specific radioactivity of aquatic media.
Chemical wastes: Wastes from the modern chemical industries are inade-
quately described by conventional yardsticks of waste strength and character.
Chemical characterization of waste effluents ia most difficult and their control
requires the availability of analytical procedures that can reliaby reflect the
waste's composition and pollution character.
Land drainage: The pollutional impact of land drainage, except-
ing siltation, is relatively recent but highly significant. There is
increasing evidence that most land uses result in a deterioration of
water quality.
Urban runoff: Drainage from urban areas is now regarded to be an important
factor in pollution. Determination of the chemical, physical, and biological
character of these wastes is a necessary preliminary to the development of
effective methods for their capture and treatment.
Agricultural chemicals: The large increase in use of agricultural chemicals,
particularly the new synthetics, has created a new water pollution problem
from land drainage. It has been stated, for example, if the 466 million pounds
of pesticide sold In the United States in 1958 were diluted by the average annual
runoff of all streams, the resulting concentration would be about 0.13 ppm, and
for ammonia it would be 3 ppm. Research is needed to develop effective methods
for capturing, identifying, and controlling land drainage wastes.
Irrigation return flows: The value of water used for irrigation is seriously
limited by the increase in inorganic salts leached from the soil following each
application. No practicable control measures have been developed.
Nonwithdrawal water use as a pollutional factor: Increasing rec-
reational use of impounded waters is raising questions of consider-
able importance, such as the survival of pathogens in relation to use
for drinking purposes, the pollutional effect of outboard motor ex-
hausts, and the growing use of organic poisons to destroy nuisance
water vegetation, insect larvae, and undesirable fish. The problem
of pollution by wastes from vessels and pleasurecraft using the Great
Lakes and other inland waters has not been adequately studied. The
optimum multiple use of impounded waters requires examination of
the physical, chemical, and biological character of contaminants as-
sociated with each use.
EVALUATION OF POLLUTIONAL EFFECTS OF WASTES
With increasing frequency, control agencies are faced with water
pollution problems that involve new types of wastes whose impact on
water uses and on human health cannot now be fully evaluated. Toxi-
cological and epidemiological studies are essential to assessment of the
public health importance of new wastes, and a protocol of effective
research must be established.
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Water Supply and Pollution Control
237
Predicting toxic effect of a waste on aquatic life: Data on which
to base the environmental requirements of aquatic life are needed,
and must be developed through research. These requirements, which
include such items as temperature, dissolved oxygen, carbon dioxide,
and pH, should be based on scientific fact so that reliable criteria can
be developed for managing water quality to restore and maintain a
suitable aquatic environment. These criteria may also prove valuable
in managing water quality for other uses.
Predicting impairment of water treatment processes by a waste:
A waste may impair water treatment processes by retarding floccula-
tion, increasing chlorine demand, or other effect. Reliable predictive
methodology for such effects should be developed to guide water
purification practices.
Predicting effect of a waste on palatability: Objectionable taste and
odor in drinking water is the most common manifestation of indus-
trial pollution which is difficult to identify and trace. Development
of effective methods for predicting a waste's taste and odor potential,
and for identifying and tracing the responsible substance is needed.
Epidemiological studies: Current methods of disease reporting indi-
cate that waterborne infection is infrequent and not a major route
of dissemination; yet there remain troublesome endemic occurrences
of diarrheal diseases, infectious hepatitis, and poliomyelitis not ex-
plained by "contact" spread. More refined techniques must be de-
veloped to reveal the relationships of less obvious cause and effect.
Few systematic appraisals of the health effects of pollutants have
been made other than traditional investigations of infectious diseases.
We need to know much more of the effects of mineral salts, organic
compounds, domestic and industrial waste components, as well as
the etiological agents of infectious disease; also, we need to know the
effects of deficient trace elements, molybdenum, selenium, vanadium,
nickel, zinc, and copper.
Evaluating toxic effect of a waste on humans: Many of the waste
substances now entering water supplies are known to be toxic in suf-
ficient concentrations, but there are many others of which toxicity is
unknown. Detailed studies of the toxicologic effects of individual
chemicals and mixtures of chemicals are time consuming and costly,
and it is hazardous to predict toxicity potentials of mixtures on the
basis of individual components, especially if they vary in specific
biological, physical, and chemical properties. Increased attention
must be directed to the development of rapid screening tests for waste
materials which may carry toxicity hazards in the area of water
supply. The fundamental studies in toxicology and the related sci-
ences required by the development of such tests can probably be best
conducted in concert with other programs having similar interests
and competency.
-------
$38 ENVIRONMENTAL HEALTH PROBLEMS
TREATMENT OF WASTES
The important need for the development of new methods for treat-
ing wastes more effectively and cheaply is not being adequately met.
Also, since conventional treatment methods remove only 40-60 per-
cent of pollutants in wastes, there is a real need to develop entirely
new processes which will approach actual purification. This is be-
coming a particular requirement for large cities and in areas of
population and industrial concentration where treated effluents are
too great a burden on receiving streams, and where the same water
must be used several times to meet needs.
Improvement of biological systems of waste treatment: Improve-
ment of methods for selecting and rapidly adapting micro-organisms
to metabolize new organic compounds will increase the effectiveness of
present biological treatment systems. Whether organisms can metab-
olize a given compound or not will provide regulatory bodies and
industry with information to determine whether a waste is acceptable
in a waste treatment system and the receiving water.
Treatment of wastes in stabilization 'ponds: The waste stabilization
pond is a recent important low-cost treatment development. Pond
design presently is on an empirical basis and understanding of the
natural forces (solar energy, respiration, wind, etc.) involved in the
stabilization processes is too fragmentary to properly evaluate their
effect on design criteria. Additional knowledge is needed on effects of
hydraulic loading and of waste character on pond efficiencies in re-
moving pathogenic organisms.
The application of physical-chemical principles to separation of
soluble solids (The Advanced Waste Treatment Research Program) :
In the face of a naturally fixed water supply, the growing needs of
expanding population and industry is requiring that a given water
source be used more and more intensively. Eventually reuse will be-
come an accepted and necessary practice in most densely populated
areas. The development of satisfactory waste treatment techniques
which will provide for repeated reuse of the receiving stream repre-
sents a major, challenging research problem.
Because present methods of waste treatment, stream sanitation, and
water purification cannot remove many of the new pollutants and
only a fraction of the older ones, a major research program has been
undertaken to evaluate physical-chemical principles applicable to
much more complete removal of contaminants from water. Some of
the research areas of interest are: adsorption, extraction, foam frac-
tionation, freezing, ion exchange, oxidation, and various membrane
processes. The major question will revolve about the eventual eco-
nomic feasibility of such operations. Participation in this program
by universities, research institutions, and industry is highly desirable.
-------
Water Supply and Pollution Control
DISPOSAL OF WASTE EFFLUENTS
In disposal of waste effluents, the receiving water is seldom used
effectively for maximum dilution which raises pertinent questions re-
garding the adequacy of outfall design techniques. Effective tech-
niques need to be developed to assure optimum use of all available
receiving water, whether this be in a stream, the Great Lakes, or coastal
marine waters.
The discharge into top soil of the liquid wastes from millions of
homes and many industrial plants represents a potential, and often
actual, nuisance and public health hazard. Discharging liquid indus-
trial and radioactive wastes into very deep porous strata emphasizes
the need for more information on this method of final disposal.
WATER QUALITY SURVEILLANCE
Until recently, few programs of water quality intelligence could
present a realistic picture of changing quality conditions in a stream.
The minimum criteria for effective quality surveillance are clear. An
acceptable program must be based on stream data that accurately re-
flect the stream's condition. Sampling and analytical procedures
must be dependable and inexpensive.
With increasing demands for water of good quality for all water
uses, the demand for dependable and economical sampling and analy-
tical techniques becomes more acute. Even the application of our
most advanced laboratory methods would presently provide only a
partial picture of water quality conditions. Because of the impor-
tance of such data in water quality management programs, consider-
able emphasis must be given to research directed to satisfying this
need.
Improvement in bacterial indices of fecal contamination: The ma-
jor research goal of sanitary microbiology is to develop simpler, more
rapid and more specific procedures for identifying contamination by
human wastes. Such procedures are important in health protection
and are needed where questions of important regulatory action are
involved.
Recovery, identification and evaluation of viruses: During the last
15 years more than 70 viruses have been detected in human feces. All
may be present in sewage. Viruses pass through the sewage treat-
ment plant, persist in contaminated waters, and may penetrate the
water treatment plant. Numerous outbreaks of infectious hepatitis
have been traced to contaminated drinking water. The occurrence of
such incidents appears to be increasing. An assessment of the sig-
nificance of water in transmitting viruses will depend on the develop-
ment of improved techniques. The development of an effective
-------
uo ENVIRONMENTAL HEALTH PROBLEMS
method for culturing the virus of infectious hepatitis represents the
single most important task for research on waterborne viruses.
Use of biota in water quality surveillance: Changes in aquatic popu-
lation reflect changes in water quality. A number of attempts have
been made to employ aquatic life in water quality surveillance. No
system has, however, been generally accepted as satisfactory by ac-
quatic biologists. The potential value of employing acquatic biota in
water quality surveillance should be determined by research.
Recovery and identification of chemical contaminants: Increased
production and widespread use of organic chemicals are introducing
more new and highly complex chemicals into the water resource for
which no methodology for their detection and measurement exist.
The development of more effective methods for capturing, concen-
trating, identifying, and measuring organic contaminants represents
an important need in water quality surveillance, and in development
of controls. Improved, highly refined instrumentation for micro-
chemical analysis must be developed for this purpose. It is clear that
this will require evaluation and adaptation of the most advanced
techniques of chemical separation and analysis.
WATER TREATMENT
The modern water purification plant represents a solution to the
treatment problems of a generation ago. Its main function then, as
it is now, was to remove particles suspended in the water and to destroy
micro-organisms that manage to survive flocculation and filtration
procedures. A well operated modern water treatment plant still per-
forms this function efficiently.
However, the modern water treatment plant does not remove dis-
solved impurities efficiently and is unable to handle satisfactorily
problems involving soluble organics. This situation will become pro-
gressively worse as the challenge increases. Where taste and odor are
objectionable, carbon is usually applied, but carbon is selective in its
action, and sometimes ineffective.
To increase the efficiency and economy of water treatment, it is
necessary to develop a fundamental understanding of physical-chemi-
cal principles applicable to the removal of foreign substances in water,
soluble and colloidal as well as in particulate form.
Improved separation of suspended solids: Although it has been in
use for some 50 years, the mechanism by which the filter component
functions has not been well defined. Because the filters represent the
most expensive part of the plant, an improved understanding of filter
function and performance is essential to a reduction of water produc-
tion costs. Although current research is directed to water purification,
-------
Water Supply and Pollution Control	%hl
it should also be applied to suspended solids separation in waste
treatment.
Improved separation of dissolved substances: The growing taste
and odor problem in drinking water taken from streams subject to
chemical wastes is evidence of the inefficiency of modern conventional
water purification plants in removing chemical contaminants. Re-
search on improving separation procedures is needed and would be
mutually complementary with the Advanced Waste Treatment Re-
search Program. Developments in this program can be applied to
water purification. This potential benefit to the quality of municipal
water supplies supports the need for the Advanced Waste Treatment
Research Program.
Disinfection: Chlorine, the disinfectant used almost universally in
safeguarding water, is not effective against all micro-organisms in the
concentrations of chlorine normally used in water works systems. Cer-
tain viruses, the cysts of Endamoeba histolytica, nematodes, and slime
bacteria are resistant or invulnerable to chlorine in the amounts gen-
erally applied. Research on new and more effective disinfectants
should be supported.
CONSERVATION AND WATER QUALITY
The need of our growing population, industry, and agriculture make
it essential that practicable ways be found to conserve for use and re-
use, waters now being lost or wasted. Phases of present effort include
impoundment of water, desalination of brackish and salt water,
weather modifications, long distance piping, recharge of ground water
and evaporation control. Many of these phases present special prob-
lems requiring research effort on methods of protecting water quality.
TOXICOLOGY
The time and expense required to evaluate the long-term toxicity
of a substance by classic methods preclude such determinations as a
routine procedure in the water supply field. An important need exists
for a presumptive test or a screening procedure which would permit
the identification of chemicals of real significance, a difficult and ex-
pensive research task. Toxicologists, biochemists, pharmacologists,
physiologists, and other scientists allied to toxicology, capable of
undertaking fundamental work in physiological response to subtle
chemical challenges, would be required for toxicology research. Be-
cause this need is probably general in all environmental health phases
such research should be conducted through pooling of resources in a
central facility.
-------
ENVIRONMENTAL HEALTH PROBLEMS
ECOLOGY AND SYSTEMS ANALYSIS
The Federal water supply and pollution control program has in-
itiated epidemiological investigations on the relationship, if any,
between drinking waters of differing chemical character and the illness
experience in communities using these waters. The project must be
conducted independently because an important condition is the specific
geographical area served by the water supply of concern.
Supraprogram considerations are involved, however, where a chemi-
cal of critical interest occurs simultaneously in several environmental
phases. For example, specific cancer promoting chemicals encoun-
tered coincidentally in water, food, and air. In this case, it is doubtful
that classical epidemiology could resolve satisfactorily the relative
importance of each of the several environmental phases. More
sophisticated techniques based on analysis of the total system must be
employed.
The most complicated situation would be a concurrent challenge by
diverse environmental stresses, each of which may be insignificant by
itself. This might conceivably involve a simultaneous exposure to
toxic chemicals in trace concentrations in food, water, and air, a patho-
gen in low concentration in food, radiation slightly above background,
and, say unusually high ambient temperature. This kind of situation
probably is a frequent occurrence and is actually concerned with hu-
man ecology. An evaluation of the public health problem presented
is not believed to be within the present capability of modern analytical
techniques. Research on "human ecology and systems analysis" might,
however, produce analytical procedures for the evaluation of the pub-
lic health significance of multiple environmental stresses occurring
simultaneously. Such research could probably be carried on best by a
team having competency in mathematics, physics, analytical chemistry,
microbiology, biometrics, and epidemiology working at a central
facility.
INSTRUMENTATION
Certain basic analytical methods and their required equipment,
because of their wide applicability, costliness, complexity, or need for
scarce high-level personnel, are best made available as service facili-
ties for use across the lines of individual programs at a central facility.
These activities would also involve the development and/or application
of highly precise and difficult analytical methods and instruments to
research procedures.
Dissemination of Knowledge
A basic approach to the solution of the national water pollution
problem is in effective dissemination of the knowledge needed to do
the job. This need reaches from the operator of the waste treatment
works upward through the highest policymaking levels. There is, of
-------
Water Supply and Pollution Control	2J^S
coux-se, dissemination of knowledge now through professional meet-
ings, seminars, conferences, and publications but a much more
concerted program is needed. There is a great deal of valuable in-
formation available in files across the country and in the experiences
of many competent persons which is not available to others. An effec-
tive program is needed to: (1) Result in the rapid translation of the
findings of research and studies into practical application to existing
problems; (2) improve professional competencies through the sharing
of experiences and information; (3) prevent unnecessary duplication
of effort; (4) point up gaps in needed information; and (5) encourage
new ideas and approaches for solving problems. A great deal could
be accomplished through use of a wide variety of publications, tech-
nical training, demonstration projects, conferences and seminars on
subjects of special interest, and establishment of a national data
retrieval service.
Comprehensive Programs
For nearly 30 years the Nation has been moving toward basinwide
and regional water resources planning. The need for this type of
comprehensive water resources management is accelerating as com-
petition for the available water increases and as problems of water
pollution multiply.
Since the economic and social structures of whole regions often
depend upon the available water resources, and how these are de-
veloped and used, comprehensive pollution control plans need to be
integrated with all other land and water resources planning for a
river basin or a region. The growing requirement for multiple
water reuse to meet water demands makes integrated water quality
management planning a matter of highest priority.
Research or systems analysis for application to comprehensive pro-
gram planning for pollution abatement is needed to produce a rational
basis for management of water quality. A typical river basin may
include multiple sources of pollution, multiple water uses, and mul-
tiple possibilities for reservoir development for streamflow augmen-
tation. There may be several possible methods of treatment available
for certain wastes. In addition, there are natural variables such as
rainfall and runoff patterns. With such an assortment of interrelated
variables, the choice of the best water quality management decision
under any given situation and time will require the development and
application of methods of systems analysis.
SCOPE OF FEDERAL WATER SUPPLY AND POLLUTION CONTROL
PROGRAM
Responsibility
Four major points need to be considered in reviewing the broad
scope of the program contained in the Federal Water Pollution Con-
-------
m ENVIRONMENTAL HEALTH PROBLEMS
trol Act as amended, and the responsibility of the Secretary of Health,
Education, and Welfare for conserving and improving water quality
for all uses:
1.	The Act makes it clear that there is to be a strong Federal role in water
pollution control;
2.	The provisions of the Act make it mandatory that the Secretary carry out
the specified programs;
3.	The Act provides for broad water quality control responsibilities for all
water uses; and
4.	The Act assigns to the Department the primary Federal responsibilities for
water pollution control and in so doing, assigned it the role of a major Federal
water resources agency.
The Federal Water Pollution Control Act goes beyond the usual
public health legislation in that it assigns to the Department the re-
sponsibility for controlling water pollution to conserve and improve
water for all uses—propagation of fish and aquatic life and wildlife,
recreation purposes, industrial and agricultural (including irrigation)
supplies, and other legitimate purposes, as well as public water sup-
plies and protection of the public health.
Legislated Responsibilities
The programs authorized and directed to be carried out by the Act
provide a broad base for dealing with both the water resources and
the health aspects of water pollution prevention and control. Spe-
cifically, the Secretary is:
X. Directed to encourage cooperative activities by the States in—
~.	Prevention and control of interstate pollution.
~.	Enactment of improved laws to control water pollution.
c. Establishment of interstate compacts.
2. Authorized to make grants to State and interstate agencies to assist
them in meeting costs of water pollution control programs ($5 million annually
through fiscal year 1968).
5.	Authorized to make grants to municipalities for the construction of waste
treatment works ($80 million in fiscal year 1962, $90 million in 1663, and $100
million annually thereafter through fiscal year 1967. Individual grants lim-
ited to 30 percent of cost of project or $600,000, whichever is smaller; where
project will serve more than one municipality, the total of such grants is
limited to $2.4 million).
4.	Authorized to make grants-in-aid to public and private agencies and insti-
tutions and to individuals for the conduct of research or training projects and
for demonstrations, and to contract for such activities.
5.	Authorized to establish and maintain research fellowships.
6.	Authorized to provide technical training to personnel of public agencies
and other qualified persons.
7.	Authorized to provide technical assistance to any State water pollution
control agency or interstate agency, community, or industrial plant.
8.	Directed to develop comprehensive river basin programs for the preven-
tion and control of water pollution, in cooperation with the other Federal
-------
Water Supply and Pollution Control

agencies, State and Interstate water pollution control agencies, municipalities
and industries involved.
9.	Directed to determine the need and value of storage in any Federal reser-
voir for flow regulation for the purpose of water quality control, and make
recommendations thereto.
10.	Directed to Institute Federal enforcement action for the control of pol-
lution of Interstate or navigable waters endangering the health or welfare
of any persons whenever requested by the Governor of any State or a State
water pollution control agency, or (with the concurrence of the Governor
and the State agency) the governing body of any municipality; or when he
has reason to believe that pollution originating in one State is endangering the
health or welfare of persons in another State.
11.	Directed to conduct a broad program of research, experiments, investi-
gations, demonstrations and studies relating to the causes and control of water
pollution; and specifically to develop and demonstrate: (a) Practicable mwna
of removing the maximum possible amounts of pollutants from sewage and
other waterborne wastes; (B) improved methods and procedures for identifying
and measuring the effects of pollutants on water uses; and (c) methods and
procedures for evaluating the effects on water quality and uses of augmented
streamflows to control water pollution not susceptible to other means of abate-
ment ($5 million annually up to an aggregate of $25 million authorized for
these three areas of research).
12.	Directed to collect and disseminate basic data on chemical, physical,
and biological water quality and other information relating to water pollution
prevention and control.
13.	Directed to establish, equip, and maintain field laboratory and research
facilities, including but not limited to locations in the Northeast, Middle At-
lantic, Southeast, Midwest, Southwest, Pacific Northwest, and Alaska, for the
conduct of research, investigations, experiments, field demonstrations and
studies, and training relating to pollution control.
14.	Directed to conduct research and technical development work and studies
with respect to present and future water quality on the Great Lakes and means
of solving water pollution problems.
Further, the Act authorizes the establishment of a Water Pollution
Control Advisory Board appointed by the President to advise, consult
with, and make recommendations to the Secretary on matters of
policy relating to his activities and functions under the Act; and a
cooperative program to control pollution from Federal installations.
Additional Responsibilities
In addition to its legislated programs, the Department has addi-
tional responsibilities of providing specialized technical services to
other Federal agencies relating to water supply and pollution control.
These stem from the Department's membership on the Interagency
Committee on Water Resources and on U.S. Study Commissions, its
agreements with other Federal agencies, services required by Inter-
national Commissions, and special needs of States and regional juris-
dictions. Also, by agreement with the Department of the Army, the
Department is required to make determinations of the needs for mu-
nicipal and industrial water supply storage, and the value thereof.
-------
no ENVIRONMENTAL HEALTH PROBLEMS
RESOURCES NEEDED TO SOLVE THE NATIONAL PROBLEM
The national water pollution problem is seriously complicated by
the very large backlog of needed waste treatment works; the unsolved
problems left over from the past; the development of new and highly
complex problems at a rate much faster than our ability to deal with
them; the inadequate numbers and diversity of skills available in this
field, and the competition in recruiting and maintaining them; and
inadequate support to obtain the resources required to catch up and
keep up with the national problem.
Manpower Needs
A major resource need is adequate manpower at all levels of pollu-
tion control responsibility. Manpower needs are threefold: (1) The
sheer number of persons required; (2) a wide diversity of skills not
previously required; and (3) the need for graduate level training
among these persons. No real problems are foreseen in competing for
subprofessional personnel; the difficulty lies in training, obtaining and
maintaining the numbers of professional persons in the various dis-
ciplines that are needed.
Based on a study of graduate needs by Herbert Bosch, Professor of
Public Health Engineering, University of Minnesota, and other esti-
mates of graduate and undergraduate professional personnel needs by
1970, the following projections of national manpower requirements
for water supply and pollution control are made, including those of
Federal, State, and interstate agencies, local government units, uni-
versities, and industry:
Trained Perionnd Needs in Water Supply and Pollution Control, 1981-701
Period
Engineers
Scientists
Total
1961-62					
Graduate trained
200
600
800
1,200
1,600
600
1,200
2,000
3,000
4,000
700
1.700
2.800
4,200
5,600
1053-64		
1606-66 _							
1067-68	 -				
1969-70				-		

4,300
10,700
15.000

Undergraduate trained
100
200
800
475
625
240
475
760
1,225
1,600
840
on
1.000
1.700
J, 235-

IGflfv-flfi 									
1967-68 	-	
lQftG-7fl 					

1,700
4,300
tooo
a. ooo

6,000
18,000

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Water Supply arul Pollution Control	ftlfl
These projections show that in the 1961-70 period we will need an
additional total of 6,000 engineers and 15,000 scientists (in this sense
includes lawyers, political scientists, economists, and other specialized
professions), two-thirds of which have graduate training. This is
a very substantial increase over the estimated presently employed
2,000 engineers and 2,000 scientists. The current rate of recruitment
for these professions in water supply and pollution control is about
10 percent of needs.
Federal Water Supply and Pollution Control Program Needs
The Federal program needs for manpower and budget were the
subject of a detailed study early in 1961 by the Presidentially ap-
pointed Water Pollution Control Advisory Board. Various projec-
tions were made based on the total responsibilities assigned by Public
Law 660, and on legislation then pending (later enacted) in Congress;
also additional water resources responsibilities to other Federal agen-
cies, including interdepartmental agreements. Long-range plans to
meet these responsibilities had been made which showed a need for
a fairly rapid buildup of programs to 1966, after which needs would
begin to level off in sustaining a full-scale program.
The fiscal year 1962 budget contains $80 million for construction
grants, $8.77 million for operating grants, and $11.5 million for direct
Federal activities; it authorizes personnel numbering 969. The study
of Federal program needs showed for fiscal year 1965 manpower re-
quirements of 2,220 persons and budget needs of $100 million for
construction grants, $22 million for operating grants, and $30 million
for direct Federal activities. For fiscal year 1970 manpower needs
will be 2,700 persons, construction grants of $100 million (if author-
ized), $36 million for operating grants, and $39 million for direct
Federal activities. About half the manpower needs will be for engi-
neering and scientist personnel and the remainder for administrative,
clerical and maintenance personnel. The Advisory Board accepted
the above estimates as "conservative and realistic, and in line with
expanding program needs."
Facilities Needs
Water quality management requirements are becoming increasingly
scientific and precise, and a fundamental need is adequate facilities in
which the intelligence needed for decisions can be produced.
States: The individual States have a need to considerably expand
their programs in basic data collection, enforcement, field surveys
and investigations, cooperative river basin planning with other agen-
cies ; developmental research, and technical assistance to communities
and industries; also, to participate fully in comprehensive river basin
planning. All of these activities require substantial laboratory sup-
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US ENVIRONMENTAL HEALTH PROBLEMS
port for which adequate facilities, fully equipped and staffed, must
be provided.
Federal: The Federal program is basically a field program and in-
cludes responsibilities for research, basic data collection, enforcement,
technical assistance, development of comprehensive river basin pro-
grams, training and administration of grant programs—construc-
tion, State program, research, training, and demonstration. To ef-
fectively discharge Federal responsibilities the program requires
considerable expansion and there is a pressing need for both central
facilities and regional facilities.
Central facilities: In the Federal program there is need for ade-
quate facilities to accomplish the following purposes:
1.	Housing the Headquarters staff that is responsible for program policy,
planning, and direction and budgeting; central administrative and personnel
services; liaison with higher echelons in the Department; cooperation with
other Federal agency headquarters; and communication with Members of the
Congress.
2.	House the staff responsible for the basic Federal water supply and pollu-
tion control research program; for the direction of Federal field research pro-
grams; liaison with the research programs of universities, industry, States,
and others; and coordination with other Public Health Service Divisions in
the environmental health aspects of water pollution. The nature of these
responsibilities is such that it would not be necessary for this staff to be housed
in the same facility as the Headquarters staff but should be readily accessible
to it.
Regional facilities: The 1961 Amendments to the Federal Water
Pollution Control Act recognized the need for field laboratory and
research facilities to support field programs in the various regions
of the country. These regional facilities are required for the following
specific purposes:
1.	Laboratory support of a detailed and diversified nature for the extensive
field programs in comprehensive program development, basic data, enforce-
ment, and technical assistance.
2.	Research, basic and developmental, on water supply and pollution control
problems peculiar to the individual regions.
3.	Technical training of qualified personnel from State and interstate agen-
cies, municipalities and industries, including demonstrations, seminars and
conferences.
4.	Coordination of Federal water supply and pollution control programs with
the water resources development programs of other Federal agencies, the State
programs, and university research and training activities.
These facilities should be strategically located on the basis of care-
fully developed criteria and the Subcommittee's recommendations are
appended.
MEASURES NECESSARY TO PROVIDE REQUIRED MANPOWER
Research and administrative programs in water supply and pol-
lution control require the skills of many disciplines, including not
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Water Supply and Pollution Control	249
only sanitary engineers, but specialists such as chemists, physicists,
biologists, and many others. The critical shortage of qualified en-
gineers and scientists creates the need for support of the graduate
training potential of university departments which have competence
in the water supply and pollution control field.
The major share of funds to support these research and training
programs must come from the Federal Government and the States.
Industry, which has considerable manpower needs in water supply
and pollution control needs to contribute also. The Federal Water
Pollution Control Act authorizes the Secretary of Health, Education,
and Welfare to make grants-in-aid to public or private agencies, insti-
tutions, and to individuals, for research or training projects and for
demonstrations. These several types of support are described below,
and all need to be fully implemented as rapidly as orderly expansion
permits.
Manpower for research: Research grants are awarded to institu-
tions and individuals to support the study of basic and applied investi-
gations in problems of water supply and pollution control. These
grants apply the talents of engineers and scientists to research related
to water quality problems, stimulate investigations throughout the
country, and add to the specialized knowledge needed in this field.
Demonstration grants: Demonstration grants are awarded to public
and private institutions and agencies to support field investigations
and studies of an applied nature, and to demonstrate the feasibility
of new methods. These grants are intended to evaluate the applica-
tion of new research findings and to expedite incorporation of new
knowledge into routine water supply and pollution control prac-
tice. Grants of this type are particularly applicable to utilizing the
resources and competencies of State water pollution control agencies,
water resources agencies, and conservation organizations.
Health research facilities grants: Health research facilities grants
are awarded to assist universities and other institutions to construct
and equip additional research facilities as a means of insuring ade-
quate laboratory space and equipment to conduct research.
Manpower for training: Research fellowships are awarded to
broaden the base of manpower, competent in the application of various
disciplines to research needed in water supply and pollution control.
These fellowships assist outstanding graduate scientists and engineers
to carry on independent research.
Research training grants: Research training grants are awarded to
institutions to establish or expand graduate research training in water
supply and pollution control by providing funds to defray institution
expenses for research training activities and to support graduate
students participating in the program.
627408—82	17
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m ENVIRONMENTAL HEALTH PROBLEMS
Project training grants: Project training grants are awarded to
institutions to establish or expand graduate training in water supply
and pollution control. These grants support new and expanded train-
ing programs in a variety of departments, encourage multidiscipline
teaching concepts, and expand and improve faculties.
Traineeships: Traineeships are awarded to increase the number of
service and administrative personnel and to bring new people into
the field through training opportunities afforded.
PHS inservice training: Inservice training support provides for the
postgraduate training of professional PHS staff members to fill gaps
in earlier training or broaden their competency in environmental
sciences.
Future utilization of grant support: Measures necessary to provide
the required manpower for problems of water supply and pollution
control through the research and training grants support would
include:
1.	Stimulation of interest of engineers and scientists by disseminating informa-
tion about the technical and research opportunities in this field so that these
will be recognized, particularly by those who might be recruited into the field.
2.	Provide opportunities for summer employment to stimulate the interest of
high school and undergraduate students.
3.	Implement, expand, improve, and extend research and training grant pro-
grams; specifically, the several public health service programs In the field of
water supply and pollution control.
The future effectiveness of training programs will require close inte-
gration of the concepts and skills of the physical and biological sci-
ences with engineering. The logical way to achieve this goal is to
encourage the development of schools that assemble these varied
disciplines in a united faculty, and that combine the training of scien-
tists and engineers related to problems of water supply and pollution
control.
DISTRIBUTION OF NATIONAL EFFORT; FEDERAL, STATE, LOCAL,
INDUSTRIAL, UNIVERSITY
REsroNSiBiLrrr
The national scope of the water supply and pollution control prob-
lem generates the need for action at all levels, resulting in a five-way
sharing of responsibility. In broad terms, these responsibilities are
defined as follows:
The State has primary responsibility for water pollution control. It sets the
standards in its Jurisdiction, and applies its laws and regulations, including
intrastate enforcement. It conducts surveys and investigations, collects and
analyzes data, provides technical assistance to local governments and industry,
including training, and does development research.
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Water Supply and Pollution Control
251
Local Governments construct and operate municipal sewage treatment works,
conduct surreys, provide technical assistance and consultation to Industries,
and enforce their regulations and ordinances.
Universities are responsible for conducting research and for training engineer-
waste reductions, and construct and operate waste treatment works if separate
from municipalities. Industries make alterations in the plant or adopt new
processes to reduce or eliminate pollutants. They conduct research to develop
or Improve waste treatment processes, and to reduce waste production.
Universities are responsible for conducting research and for training engineer-
ing and scientific manpower needed by the other jurisdictions. They also provide
technical services and consultation.
The Federal Government supplements and supports programs of the other
four. It conducts research and investigations, collects and analyzes data on a
nationwide basis, and provides technical assistance to State and local govern-
ments and industries, including training. It develops comprehensive water
supply and pollution control programs and coordinates these with the States
and with the water resources programs of other Federal agencies. It carries
out the enforcement provisions of the Federal Water Pollution Control Act. It
provides grants for State program development and incentives to municipalities
for construction of sewage treatment works, and for research, demonstrations,
and training.
Distribution or Effort by Manpower Needs
The distribution of effort in the national program can be demon-
strated by manpower needs in 1970. Based on the previous projection
of these needs, the distribution of manpower effort would be as follows:
Distribution of National Effort Baud on Manpower Neeit by 1S70
States •	—
Municipalities •
Industries»	
Universities
Federal1	
Total	
Engineers
2,300
2,800
3,000
300
1,000
9,400
Scientists
2,300
2,800
3,000
700
3,000
11.800
I Band on irariKi of 1 enilneer md 1 aelentlat par	* Bund on 1050 faculty, atudent output, and manpower
100.000 population, 1070 population of 330 million.	mad projection!.
'Bawd on anno of 1 engineer and 1 aolentiat per	I Baaed on preaent ataff member* In other Federal agen-
do,OOO urban population, 1070 urban population of 1*3 otaa and on apeelJieetudr of Dhriaton of WaterSupply and
million-	Pollution Control need* by the Water Pollution Advlaory
(Baaed on estimate that 1 outof Swetprooenlnduatriea Board in 1901.
having separate dlaeharga will be of a alia and nature to
naulre an avtrnt of 1 engineer and 1 ehemlat.
The above table would indicate the operations efforts should be fairly
well divided among the State agencies, municipalities, industries, and
Federal agencies. The kinds and scope of operations will differ in
accord with the individual primary responsibilities of these groups.
Distribution op National Effort by Expenditures
From a budgetary standpoint, the distribution of effort for pollu-
tion control will be quite different. Municipalities, in addition to
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252 ENVIRONMENTAL HEALTH PROBLEMS
supporting personnel, will be constructing, operating, and maintaining
sewage treatment facilities. With needs indicating an annual expendi-
ture of $600 million per year for sewage treatment plant construction,
and their operating and maintenance costs estimated to be at least
$215 million in 1970, municipalities will probably need to be spending
close to $1 billion annually by 1970 for the pollution control measures
for which they are responsible.
The next largest expenditure for pollution control will need to be
made by industry. Its construction needs are less well known than
municipal but believed to be about equal in dollars when inplant
changes are included. Its operation and maintenance costs will be
lower because of the fewer number of individual plants involved, and
because a number of industries will be able to make part-time use of
regular plant employees. On the other hand, industry's annual ex-
penditures for pollution control by 1970 may well be in the area of
$750 million.
The Federal operating grant programs account for the major share
of the Federal water pollution control budget effort. It has been
estimated that these programs will need support amounting to more
than $31 million in 1970. Direct operations needs by 1970 have been
estimated to be at least $39 million. Should the State program and
construction grant program be continued at present levels through
1970, this will require another $105 mill ion. For the programs under
the Federal Water Pollution Control Act, then, 1970 budget support
should be in the $175 million range annually. The related programs
in other Federal agencies (e.g,, Saline Water Conversion, U.S. Geolog-
ical Survey) will substantially increase this total.
The States at present appropriate a total of about $7 million an-
nually for pollution control activities. To meet needs by 1970, it is
estimated that States will have to more than triple present appropria-
tions to the $25-$30 million range. Should more of the States enact
legislation providing financial incentives for waste treatment works
construction, their appropriations will be substantially higher.
Not enough water supply data are immediately available on which
to base estimates on distribution or expenditures. There are data
which show that water supply needs approach the magnitude of sew-
erage and sewage treatment needs, and the distribution of expenditures
among the regulatory agencies, municipalities, and industry is propor-
tionately the same for each activity.
RECOMMENDED OBJECTIVES FOR THE FEDERAL WATER SUPPLY AND
POLLUTION CONTROL PROGRAM
The Federal Water Pollution Control Act, as amended, assigns to
the Secretary of Health, Education, and Welfare broad responsibili-
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Water Supply and Pollution Control
258
ties in leadership and program to be carried out in cooperation with
Federal, State, and local agencies, and with organizations and indi-
viduals having responsibilities and interests in water resources.
The national program objective is the conservation of water quality
and quantity to assume continuously an adequate supply of water
suitable in quality for public and industrial water supplies, propaga-
tion of fish and aquatic life and wildlife, recreation, agriculture, and
other legitimate uses.
Specific program goals for each of the legislated activities in the
act have been developed and these are described in a Supplement
following this report.
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Supplement
WATER SUPPLY AND POLLUTION CONTROL PROGRAM COALS
1. Recommended Criteria for the Selection of Sites for Federal Re-
gional Water Pollution Control Field Laboratory and Research
Facilities
Authorization
Public Law 87-88, approved July 20,1961, provides that the Secre-
tary shall establish, equip, and maintain field laboratory and research
facilities including, but not limited to, one to be located in the north-
eastern area of the United States, one in the Middle Atlantic area, one
in the southeastern area, one in the midwestern area, one in the south-
western area, one in the Pacific Northwest, and one in the State of
Alaska, for the conduct of research, investigations, experiments, field
demonstrations and studies, and training relating to the prevention
and control of water pollution. Insofar as practicable, each such
facility shall be located near institutions of higher learning in which
graduate training in such research might be carried out.
Functions
Each facility must provide the laboratory and technical support to
the field programs, required in carrying out the following depart-
mental responsibilities under the Federal Water Pollution Control
Act:
1.	Developing comprehensive programs for control of pollution of interstate
waters.
2.	Providing? technical assistance on specific problems, in response to and in
support of the needs of State and interstate water pollution control agencies.
3.	Determining the need for and value of including storage for regulation of
streamflow for water quality control, in the survey or planning of any reservoir
by the Corps of Engineers or other Federal agency.
4.	Conducting research, investigations, experiments, demonstrations, and other
studies, within the Department relating to the causes, control, and prevention of
water pollution.
5.	Training personnel of public agencies and other suitably qualified persons
in technical matters relating to the causes, prevention, and control of water
pollution.
6.	Collecting, evaluating, and disseminating basic data on water quality and
other aspects related to the existence, prevention, and control of water pollution.
7.	Enforcing measures for the abatement of pollution of interstate or navigable
waters.
8.	Encouraging and facilitating cooperation by all Federal agencies with
State and Interstate agencies in preventing or controlling the discharge of pollu-
tion from Federal installations.
m
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Water Supply and Pollution Control
Im
In addition, the Department has responsibilities for providing tech-
nical assistance on matters relating to water supply and water pollu-
tion to the Interagency Committee on Water Resources, with its five
field committees, the International Joint Commission, and the U.S.
Study Commission, current and future. The Department is also
responsible, under agreement with the U.S. Army Corps of Engineers
(signed November 4, 1958), for determining the need for and value of
including storage for municipal and industrial water supply purposes
in the planning of any reservoir by the corps. A large portion of this
technical assistance requires laboratory services.
She Considerations
In order to serve these functions, the site should meet as many as
possible of the following requirements:
1.	Proximity to universities, institutes, and other operating research installa-
tions covering a broad spectrum of scientiflo disciplines and activities. This
requirement is contained in the act. Relatively close proximity to such installa-
tions will provide important opportunities and scientific resources for cooperative
programs in research, technical services, and graduate training. They are
important as sources of personnel, as well as for providing the "scientific com-
munity" which will prove stimulating to the staff. The institutions should be
strong in the fields which support engineering, sciences, and medicine. Good
computer laboratory facilities are another asset.
2.	Proximity to major regional tcater resources problems. Because water-
courses do not limit themselves to political boundaries, and each major drainage
area has its own characteristics insofar as regional problems are concerned,
water resources should be dealt with on a river basin basis. Therefore, each
water pollution control laboratory should be centrally located, insofar as prac-
ticable, with respect to both the water resources area it must serve and to the
principal problem areas.
3.	Availability of transportation facilities. Good transportation facilities
must be available in order that the Installations may (a) adequately serve and
support the Department's programs in comprehensive planning, basic data,
enforcement, research, and others; (6) facilitate coordination with water re-
sources program of Federal, interstate, State, and other agencies; (c) provide
the technical services and assistance to the Federal and State agencies; and (d)
bring about close coordination with the maximum number of universities.
Good transportation assures prompt transfer of personnel and samples from
And to all points within the area served, as well as ready accessibility to cooperat-
ing agencies.
4.	Special library facilities suitable for scientific and technical research needs.
Good library facilities are necessary and should include broad coverage In engi-
neering, physical sciences, biological sciences, and economics.
5.	Availability of needed technical and nontechnical personnel of the required
quantity and quality. The municipality In which the facility is located will be
an important source of needed manpower. While the key staff may initially be
drawn from other Department activities or sources elsewhere, much of the
nontechnical staff required for continuing and day-to-day operations must be
recruited locally.
6.	Public utilities, including communications, power, water supply, and waste
disposal. These are necessary for the proper operation of the laboratory facility
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m ENVIRONMENTAL HEALTH PROBLEMS
and of the various experimental, demonstration, and research projects which
must be conducted at these installations.
7.	Proximity to Federal, State, and other agencies having related responsi-
bilities in water resources development. The Federal agencies having major
related responsibilities in water resources development include the Department
of Defense (Corps of Engineers) ; Department of the Interior (Geological Sur-
vey, Bureau of Reclamation, Fish and Wildlife Service, and National Park
Service) ; Department of Agriculture (Soil Conservation Service, Agricultural
Research Service) ; Department of Commerce (Census Bureau, Weather
Bureau) ; and Federal Power Commission.
State and other agencies having related responsibilities are generally located
in the capital city or the largest city, and frequently in or near the field head-
quarters cities of the Federal agencies cited above.
Proximity to as many of these as possible is essential to assure maximum
coordination of the Department's responsibilities with those of other agencies
concerned with water resources programs.
8.	The Community: social, cultural, and general living conditions. Attractive
community facilities are very important in the recruitment and retention of
personnel. Factors to be considered include a good school system, housing to
accommodate several economic levels, recreational and religious facilities, and
general attractiveness of the area.
SI. Recommended Objectives for the Federal Water Supply and,
Pollution Control Program
National Program: Objective: Conservation op Water Quality
and Quantity
To assure continuously an adequate supply of water suitable in
quality for public and industrial water supplies, propagation of fish
and aquatic life and wildlife, recreation, agriculture, and other legiti-
mate uses.
The act assigns to the Secretary of Health, Education, and Welfare
broad responsibilities in leadership and program to be carried out in
cooperation with Federal, State, and local agencies, and with organi-
zations and individuals having responsibilities and interests in water
resources.
The area of effort should include—
~.	Development of comprehensive programs for all drainage basins of the
country; Federal enforcement; basic data collection, evaluation, and dissem-
ination ; direct research; research fellowships, grants, and contracts for research
or training projects and for demonstrations; administration of construction
grants to municipalities and program grants to State and interstate agencies;
technical assistance to other Federal agencies, State and Interstate agencies,
municipalities and industries; training and information.
~.	Cooperation to the maximum extent with other Federal agencies and with
State agencies in the best development of the Nation's water resources.
o. Encouragement and support of State, Interstate, and local agencies In
Improving and maintaining water supply and pollution control programs ade-
quate to meet their responsibilities and commensurate with the problems.
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Water Supply and Pollution Control	267
OlWF.CTTVE FOR DIRECTED RESEARCH
To conduct research and to contract for research by others designed
t<: improve processes for purifying water to remove from water or
ivnder harmless, sewage, industrial waste, and other contaminants,
and to extend knowledge of the physical, chemical, and biological
characteristics of substances found in water and their effects on human
health.
The area of effort should include—
a.	Bsicterial. virus, fungus. Adaption, epidemiological and toxicologlcal studies
designed to solve problems relating to long-term toxicity of water impurities,
epidemiological sign idea nee of water contaminants, the adaption of organisms
to degrade wastes, and the role of water In tlie transmission of viral diseases.
b.	Projects in Industrial waste, their interference and persistence, and par-
ticularly organic contaminants and petrochemical waste processes.
o. Research In water conservation, water quality criteria, suspended solids
and colloid separation and interference organisms.
ft. Investigations of advanced waste treatment methods Including the tech-
nological practicability and economic feasibility of processes Involving absorp-
tion. extraction, freezing, hydration, oxidation, and membrane procedures.
e. The use of research contract to bring Into the direct research effort those
highly specialized skills, equipment, and facilities not available in the Federal
program or which cannot be Justified on a full-time basis: and to facilitate I hose
phases of research projects which can be more economically and quickly per-
formed by others.
Objective for Research Grants
To support research by others in a wide variety of basic and applied
problems of water supply and pollution control, to develop a nation-
wide interest among many scientific disciplines in conducting studies
of this nature, and to encourage investigators to undertake research
in neglected areas.
The area of effort should include—
a.	Detection, determination, and evaluation of all types of hazards Involved
in the use and consumption of water.
b.	Water supplementation and management by various means, such as: ground
water recharge, suppression of evaporation, low-flow augmentation, reduction
of waste materials at source, Improved water, sewage and waste treatment
processes, and byproduct discovery and recovery.
o. Fundamentals of chemistry, physics, biology used or useful in a better
understanding and utilization of natural and induced water phenomena.
d.	Water and wastes engineering applications of mathematical models and
systems analysis and techniques.
e.	Sociological and economical aspects of water supply and pollution.
f.	Ecology of aquatic organisms related to water resources, treatment, dis-
tribution. and pollution.
g.	Fish and wildlife as affected by water quality.
h.	Lake, river, estuarine, and ocean waters In relation to man's health, com-
fort, and welfare.
627408—62	18
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258 ENVIRONMENTAL HEALTH PROBLEMS
Objective for Research Fellowships
To complement the research grants and direct research operation
programs by the award of research fellowships to support outstand-
ing graduate scientists and engineers in the conduct of independent
research needed for water supply and pollution control.
The area of effort should include—
a.	All scientific and engineering disciplines related to water supply and pollu-
tion control research.
b.	Support of predoctoral, postdoctoral, and special research fellowships.
c.	Award of research fellowships for study at appropriate institutions chosen
by applicants.
Objective for Training Grants
To award training grants to institutions to support the develop-
ment and expansion of teaching programs at an advanced level for
training research and administrative manpower required in the opera-
tion of water supply and pollution control programs.
The area of effort should include—
a.	Support of staff, facilities, and students at an advanced level for training
in public and private institutions.
b.	Augmenting competence of institutions and departments to provide training
in needed ureas.
c.	Establishing specialized and multidisclpline training facilities for scien-
tists, engineers, and administrators in water supply and pollution control.
Objective for Demonstration Grants and Contracts
To award demonstration grants and contracts to public and private
agencies to support held investigations and studies of an applied or
developmental nature. These awards provide the necessary step be-
tween the completion of research investigations and the direct appli-
cation of results to use, and thus broaden the water pollution control
effort.
The area of effort should include—
~.	Demonstration of the feasibility of new methods of water pollution control.
~.	Development of field studies or multidisclpline approaches to the solution
of problems.
o. Stimulating the application of data, skills, and facilities of organization!
not otherwise available.
Objective for Traineesiiips
To provide individual stipend awards directly to qualified scien-
tists in order that they may undergo advanced, specialized training
in one of the fields relating to water supply and pollution control.
The area of effort should include—
a. Advanced training for the development of highly competent administrative
personnel in Federal. State, interstate, and local water pollution control agencies.
T>. Expansion of Individual competence In the multidisclpline approach toward
problems in this general area.
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Water Supply and Pollution Control
269
c. Development of research and administrative effectiveness In newly develop-
ing applications of knowledge In the solution of problems relating to water
supply and pollution control.
Objective for Comprehensive Programs
To develop and maintain comprehensive water pollution control
programs for the major drainage basins of the Nation and their
tributaries.
The area of effort should include—
~.	Detailed demographic, economic, hydrologlc, and engineering studies of
the Nation's river basins.
~.	Determination of present and future water requirements of the river
basins, in terms of quantity nnd quality.
c.	Determination of prenent and future pollution loads of each drainage basin
und the remedial measures required to maintain water quality commensurate
with the needs.
d.	Integration of comprehensive water supply and pollution control program
with all other water resource development.
Objective for Technical Assistance
To provide technical services to overcome unusual problems that
delay implementation of State and interstate water supply and pol-
lution control programs; to render technical assistance in the water
supply and pollution control aspects of Federal water resource de-
velopments; and to assist municipalities, industries, and individuals
on difficult problems when they cannot sustain the necessary staff and
facilities.
The area of effort should include—
a. The necessary budgetary, administrative, and consultative services re-
quired in support of field staffs providing technical assistance.
&. Assignment of headquarters personnel to technical assistance projects
requiring special competencies not available in the field, such as administrative,
legislative, ond economics.
o. In cooperation with the Research Branch, the assignment of personnel
having highly specialized scientific and engineering talents not available In
regional offices.
Objective for Protection of Water Quality Tiibouoh Enfohce-
ment Activities
To establish and maintain the quality of the Nation's waters at a
level that will insure human health and welfare by assisting and
encouraging States to enforce their laws and to invoke Federal action
when necessary.
The area of effort should include—
0. Support of State enforcement activities at their request by providing con-
sultation and technical services.
5. The maintenance of up-to-date flies on all waters under Federal enforcement
Jurisdiction and the evaluation of possible detrimental effects to water users
in those areas.
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260 ENVIRONMENTAL HEALTH PROBLEMS
o. Preenforcement surveys of possible problem water areas, and where needed,
informal discussions with States of remedial actions necessary,
d.	Institution of Federal enforcement proceedings consisting of a conference
of State and Interstate agencies concerned a public hearing for the purpose of
making a finding of interstate pollution and, when necessary, Federal court
action to abate the pollution each step taken if the previous one fails.
e.	Tost action surveillance to determine whether or not progress in the pol-
lution abatement is in accord with the enforcement action taken.
Objective for Basic Data Collection and Dissemination
To collect, analyze, and disseminate the necessary data to detail the
causes and effects of water pollution on water quality and use, and to
develop the intelligence upon which successful control and prevention
programs can be based.
The area of effort should include—
a.	The collection, analyzation, and dissemination of data regarding municipal,
industrial, and Federal waste disposal facilities, contract awards for water
and sewage works, municipal bond sales for water and sewage, municipal water
facilities, and pollution-caused flshkills.
b.	Information on long-term water quality trends through the operation of
th National Water Quality Network, scheduled to consist of 300 sampling
stations.
c.	Special related studies that obtain data on the effects of pollution on water
quality; the present and future required uses of the affected waters; the re-
medial measures needed to accommodate the water uses; the kinds, costs, and
efficiencies of the remedial measures; and the costs and benefits of pollution
and its control.
Objective for Increased Municipal
Waste Treatment Construction
To stimulate municipal treatment construction to a level com-
mensurate with existing and future needs, including Federal grants-
in-aid.
The area of effort should include—
~.	Program policy and guidance for field staffs administering grants-in-aid
to municipalities to assist in the construction of sewage treatment plants; review
and decision making on matters that cannot be reconciled in the field.
~.	Collection and evaluation needed on construction costs data.
c. In cooperation with State regulatory agencies, the determination of sew-
age treatment construction needs and progress.
Objective for Uniform State Legislation and Interstate
Cooperation
To promote interstate cooperation in water pollution control through
interstate compacts and enactment of uniform State legislation.
The area of effort should include—
a. The preparation of digests of State water pollution control laws and an
analysis of the legislative situation.
ft. The revision of the existing suggested State water pollution control act
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Water Supply and Pollution Control
261
c.	The provision of technical assistance and a legislative reference service
relative to pollution control legislation and compacts.
d.	Encouragement of informal Interstate collaboration on specific problems.
Objective fob Strengthening State Programs
To strengthen State water supply and pollution control programs
to enable them to meet adequately their responsibilities, including
grants-in-aid.
The area of effort should include—
~.	Administering grants-in-aid to State and interstate agencies to assist
them in establishing and maintaining adequate water pollution control programs.
~.	Review and approval of State water pollution control plans as required
by the Federal Water Pollution Control Act.
c. All areas of effort involved in other program goals pertain also to the
goal of strengthening State programs.
Objective of Information and Education
To fully inform the lay public and to quickly disseminate to the
scientific and administrative personnel concerned, all publications,
research results, investigation reports, basic data, and other material
pertinent to water pollution, its prevention and control.
The area of effort should include—
~.	Stimulating the Interests of national organizations and providing them
with the kinds of information and assistance they require in supporting water
pollution control, Including articles for journals, exhibits and films for meet-
ings, and instruction kits and Government publications for distribution.
~.	Publishing at regular Intervals basic data, summaries of pollution control
programs, reports on research, scientific and administrative progress and other
appropriate Information.
c.	Support of regional and other field personnel with information, visual
aids, and publications for use In working with any persons or groups requesting
their aid.
d.	Obtaining wide publicity through the various news media on the water
supply and pollution control situation.
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APPENDIX
A.	Membership of the Committee on Environmental Health
Problems
B.	Subcommittee Memberships
C.	Consultants to Subcommittees
D.	Public Health Service Organization for Environmental
Health
E.	Minutes of May 18, 1961, Meeting of the President's
Science .Advisory Committee Ad Hoc Panel on Environ-
mental Health
F.	Letter Dated July 5, 1961, to the Secretary of Health,
Education, and Welfare From the Deputy Director,
Bureau of the Budget
203
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A. MEMBERSHIP OF THE COMMITTEE ON ENVIRONMENTAL HEALTH
PROBLEMS
Ahloebo, Clark D., Db.
Anderson, Gatlobd, De.
Chambebs, Leslie A., Db.
Dack, G. M., Db.
Dambaoh, Charleb A., Db.
Dubois, Kenneth P., Db.
Goldblith, Samuel A., Db.
Gordon, Seth, Mb.1
Gboss, Paul M., Dr., Chairman
Handles, Philip, Db.
Batch, Theodore F., Db.1
Logan, John, Db.
Merbill, Malcolm, Db.*
Metzleb, Dwight, Mb.
Morgan, Russell, Db.*
Vice President for Administration and Re-
search, Syracuse University, Syracuse
10, N.Y.
Mayo Professor and Director, School of
Public Health, University of Minnesota,
Minneapolis, Minn.
Scientific Director. Allen Hancock Foun-
dation for Scientific Research, Univer-
sity of Southern California, Los Angeles,
Calif.
Director, Food Research Institute, Univer-
sity of Chicago, Chicago, III.
Director, Natural Resources Institute,
Ohio State University, Columbus, Ohio.
Professor of Pharmacology, University of
Chicago, Chicago, III.
Professor, Department of Food Technology,
Massachusetts Institute of Technology,
Cambridge, Mass.
Vice President, North American Wildlife
Foundation, 1390 Seventh Avenue, Sac-
ramento, Calif.
Professor, Department of Chemistry, Duke
University, Durham, N.C.
Chairman, Department of Biochemistry
and Nutrition, Duke University School
of Medicine, Durham, N.C.
Professor of Industrial Health Engineer-
ing, University of Pittsburgh, Pittsburgh,
Pa.
Chairman, Department of Civil Engineer-
ing, Northwestern University, Evanston,
III.
Director of Public Health, State Depart-
ment of Public Health, Berkeley, Calif.
Director, Division of Sanitation, Kansas
State Board of Health, State Office
Building, Topeka Aveune at 10th, To-
peka, Kans.
Professor of Radiology, Johns Hopkins
University Medical School, Baltimore,
Md.
i Water Pollution Control Advisory Board Member, August 7, 1958-June 30, 1961.
* Snrjreon General's Advisory Committee on Occupational Health Member.
¦National Advisory Committee on Community Atr Pollution Member,
4 National Advisory Committee on Kadlatlon Member.
m
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£66
ENVIRONMENTAL HEALTH PROBLEMS
Mrak, E. M., Db.
Silverman, Leslie, Db.
Weckel, K. G., Db.
Chancellor, Department of Food Technol-
ogy, University of California, Davis,
Calif.
Science Director, School of Public Health,
Department of Industrial Hygiene,
Harvard University, Boston ir>, Mass.
Professor of Dairy and Food Industries,
College of Agriculture, University of
Wisconsin, Madisou. Wis.
Holuster, IIal, Mb.
Hyde, Robert T., Mb.
Chief, Radiological Health System Anal-
ysis, Division of Radiological Health,
Public Health Service.
Executive Secretary, Committee oil En-
vironmental Health Problems.
Chief. Scientific Publications, The Robert
A. Taft Sanitary Engineering Center,
Public Hpnlth Service.
Final Report Editor, Committee on En-
vironmental Health Problems.
r
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B. SUBCOMMITTEE MEMBERSHIPS
Manpoweb Resources amd Trainino	Dr. Handler (Chairman)
Dr, Morgan
Applied Mathematics and Statistics	Dr. Silverman (Chairman)
Dr. Dambach
Dr. Ahlberg
Dr. 6. Anderson
Dr. Logan
Pharmacology Toxicology, Physiology and Dr. DuBois (Chairman)
Biocuemistby	Dr. Handler
Dr. Mrak
Dr. Hatch
Mr. Gordon
Analytical Methods and Instrumentation Dr. Chambers (Chairman)
Dr. Goldblith
Dr. Merrill
Mr. Metzler
Dr. Morgan
Dr. Merrill (Chairman)
Dr. Dambach
Dr. Logan (Chairman)
Dr. Silverman
Dr. Ahlberg
Dr. Dack (Cochairman)
Dr. Goldblith (Chairman)
Dr. Mrak
Dr. Weckel
Dr. Hatch (Chairman)
Dr. DuBois
Dr. Handler
Dr. Morgan (Chairman)
Dr. G. Anderson
Water Supply and Pollution Contbol	Mr, Metzler (Chairman)
Dr. Chambers
Mr. Gordon
Dr. Dambach
m
Air Pollution
Environmental Engineering
Mtt.it and Food
Occupational Health
Radiological Health
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C. CONSULTANTS TO SUBCOMMITTEES
Applied Mathematics and Statistics
Dr. Frank Murray: Professor of Mathematics, Mathematics Department,
Duke University, Durham, N,C.
Dr. Thomas F. Mancuso: Chief, Division of Industrial Hygiene, Ohio State
Health Department, Columbus, Ohio.
Dr. A. G. Oettlnger: Computation Laboratory, Harvard University, Cam-
bridge, Mass,
Dr. Wilfrid Joseph Dixon: Professor of Preventive Medicine, University of
California Medical Center, Los Angeles 44, Calif.
Dr. Frank Corbato: Deputy Director, Computer Department, Massachu-
setts Institute of Technology, Cambridge, Mass.
Analytical Methods and Instrumentation
Dr. Arnold Beckman: President, Beckman Instrument Co., Fullerton, Calif.
Air Pollution
Dr. Eugene Gillls: Health Commissioner, Philadelphia Department of Pub-
lic Health, Philadelphia, Pa.
Mr. S. Smith Griswold: Air Pollution Control Officer, Los Angeles County
Air Pollution Control District.
Dr. Glenn R. Hilst: Vice President, Travelers Research Center, Inc.
Dr. H. F. Johnstone: Research Professor of Chemical Engineering, De-
partment of Chemistry and Chemical Engineering, University of Illinois.
Dr. Robert A. Kehoe: Professor of Industrial Medicine, Kettering Labora-
tory, University of Cincinnati.
Dr. John T. Mlddleton: Chairman, Department of Plant Pathology, Uni-
versity of California.
Dr. Norton Nelson: Director, Institute of Industrial Medicine, New York
University.
Mr. Alexander Rihm, Jr.: Executive Director, Air Pollution Control Board,
New York State Department of Health.
Dr. Waldo L. Treuting: School of Public Health, University of Pittsburgh.
Environmental Engineebing
Mr. Samuel Baxter: Commissioner and Chief Engineer, Philadelphia Water
Department, Philadelphia, Pa.
Mr. Brick Mood: Director Bureau of Environmental Sanitation, New Haven
Health Department, New Haven, Conn.
Mr. Paul Opperman: Executive Director, Northeast Illinois Metropolitan
Area Planning Commission, Chicago, 111.
Mr. Paul W. Purdom: Director, Division of Environmental Health, Depart-
ment of Public Health, Philadelphia, Pa.
Mr. William A. Xanten: Superintendent, Division of Sanitation, District of
Columbia Government, Washington, D.C.
Occupational Health
Dr. Clyde Berry: University of Iowa.
Dr. Earl Irvin: Medical Director, Ford Motor Co.
m
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270 ENVIRONMENTAL HEALTH PROBLEMS
Radiological Health
Dr. Charles L. Dunham: Director, Division of Biology and Medicine,
U.S. Atomic Energy Commission, Washington, D.C.
Dr. Donald R. Chadwick: Secretary, Federal Radiation Council Washing-
ton, D.O.
Wateb Supply awd Pollution Control
Dr. Lewis Koenlg: Physical Chemist Consultant, San Antonio, Tex.
D. PUBLIC HEALTH SERVICE ORGANIZATION FOR ENVIRONMENTAL
HEALTH
The Environmental Health activities of the Public Health Service
are carried on principally through its Bureau of State Services. This
Bureau is responsible for two main types of activities: (1) Community
health services, having to do with the provision of health services for
the individual in a community; (2) environmental health. The en-
vironmental health activities are in turn carried out in five divisions:
1.	Water Supply and Pollution Control
2.	Environmental Engineering and Food Protection
3.	Air Pollution
4.	Occupational Health
5.	Radiological Health
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E. PRESIDENTS SCIENCE ADVISORY COMMITTEE AD HOC PANEL ON
ENVIRONMENTAL HEALTH
An Ad Hoc Panel was convened on May 18, 1961, to consider the
Department of Health, Education, and Welfare proposal for an En-
vironmental Center at Rockville, Md. Members of the panel attend-
ing were:
Dr. Colin MacLeod, Chairman
Dr. Rolfe Eliassen
Dr. George Kistiakowsky
Dr. Robert Loeb
Dr. Gerald McDonnel
Dr. Russell Morgan
Dr. Dickinson Richards
Dr. James H. Sterner
Dr. James Whittenberger
Dr. Abel Wolman
Dr. Herbert Bosch
The Panel heard briefings by representatives of Health, Education,
and Welfare on the scientific aspects of the proposed Center program,
the personnel requirements and a general discussion of the overall
program plans, including budget estimates for grants, contracts, and
fellowships for the next 5 years. Bureau of Budget representatives
discussed long-range significance of the proposed Center.
The Panel identified what appeared to be the major issues and
discussed each of the following:
1. Does the Public Uealth Service require a new center for adminis-
trative and research activities in environmental health f
The consensus was that such a center is necessary, not only to house
its present activities, but also for future development. There was
agreement that activities at the Taft Center and associated laboratories
in Cincinnati plus those required by the rapid expansion proposed
for the next 5 years, cannot be accommodated without extensive addi-
tional construction. For a variety of reasons, Cincinnati is not con-
sidered a suitable location for expanded facilities. These include
inadequate land area at the present sites, difficulty in attracting sci-
entific and technical personnel, lack of strong academic institutions in
the area and physical separation from administrative branches of the
PHS and other departments of Government such as Interior, Agri-
culture, and Commerce.
271
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372 ENVIRONMENTAL HEALTH PROBLEMS
2.	Should the new environmental health center be located in the
Washington area?
The Panel endorsed the plan to locate the regulatory, technical assist-
ance, and administrative functions of the program in the Washington
area, but had reservations as to the requirement for housing the major
Government research facilities of all phases of the proposed program
in a single Center.
The Washington Area has clear-cut advantages because of prox-
imity to administrative branches of PHS, the research activities of the
NIH, and the related programs of other departments of the Federal
Government. Further, it can be argued that administrative, control,
and enforcement activities will benefit from close proximity to labora-
tories conducting research on the technical problems. At the same time,
it is recognized that decentralization has been successful in the cases
of the Communicable Disease Center in Atlanta and the various
laboratories of the Atomic Energy Commission. The Panel was not
aware of a study to determine the feasibility of establishing decentral-
ized Federal Research Units either at existing Government labora-
tories or in association with universities. See paragraph 4 below.
3.	What is a reasonable rate of growth for the proposed center
program,?
It is clearly apparent that the chief problem in developing sound
scientific as well as control programs is the availability of competent
people in the various fields of science who can contribute to the solution
of problems of environmental health.
The Surgeon General's Report to the Congress in 1960 and the testi-
mony of experts before the Appropriations Subcommittee of the House
in March 19G0 emphasized the critical shortage of persons qualified for
research on problems of environmental health. In recognition of this
need the PHS established research training grants and "project" grants
in the fields of radiological health, industrial hygiene, etc. These
grants have had the immediate effect of increasing competition among
universities for competent faculty members as well as for the few
promising students entering the environmental health field. Undoubt-
edly, in the long run, these grants will enable universities to train more
highly qualified people, particularly when the importance and the
attractions of the field of environmental health become better recog-
nized. In the meanwhile, the best interests of the program will be
served by restricting expansion to limits set by the availability of
highly qualified people.
One of the difficulties besetting environmental health research is the
requirement of participation by many disciplines, including not only
medical scientists and engineers, but also a long list including chemists,
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Appendix
MS
physicists, ecologists, and many others. Past experience has shown
that, on the average, the less able graduates in the various disciplines
have been attracted to the environmental health field. After entering
the field, they may suffer by isolation from the main streams of advance
in the parent discipline. This factor is also relevant to a decision about
the wisdom of centralizing Federal research in a single facility in
Washington, since there are no strong academic institutions in the
community, with interests in environmental health.
For these reasons, the Panel believes that Government research
facilities should be developed on a selective basis to satisfy specific
needs. The proposed broad expansion appears too rapid for the supply
of qualified manpower. Implicit in this consideration is the necessity
for a clear delineation by the PHS of the substantive nature of the
research program to be carried out in the proposed Center. The Panel
is of the opinion that the program has not been given adequate con-
sideration and that this is a fundamental requirement for sound plan-
ning for the Center.
4. Need for evaluation of existing governmental laboratories thai
can contribute to studies of environmental health.
Program planning of new facilities for the five major areas of re-
search proposed for the Center should include an evaluation of existing
Government laboratories with demonstrated competence in closely
related scientific areas. For example, in the field of radiological health,
the Panel noted the potential availability of the several AEC National
Laboratories for the conduct of large scale radiobiological and chronic
toxicity experiments. The PHS does require laboratories for epi-
demiologic research on human populations, since this area of public
health concern is not adequately provided for by other agencies.
Whether or not an expanded central laboratory is established in the
PHS, some leaders in the environmental health field believe strongly
that there should be regional laboratories, based in or very closely
associated "with universities having interest and competence in one or
more of the fields of environmental health. Three considerations lead
to this conviction:
a. The critical shortage of research personnel creates the need to take advan-
tage of the leadership and training potential of university departments which
have competence in environmental health. One of the recognized limitations of
Government research laboratories is that they contribute very little as research
training institutions, in contrast with universities.
T>. Environmental health problems are often of greater regional interest than
national concern, for example, air pollution in California and water pollution In
the Ohio River basin. Such regional challenges increase the likelihood of attract-
ing able research workers, especially if a university is involved. The Public
Health Service has taken advantage of some opportunities of this kind, but could
do bo In more effective fashion.
627408—82	IB
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274 ENVIRONMENTAL HEALTH PROBLEMS
c. The field of environmental health is very broad and engages the attention of
many disciplines. A university-centered laboratory would enable research
workers to maintain close contact with other workers in their own discipline.
Continuing contact with the parent discipline promotes research skills of the
individual and also increases the possibilities of fruitful interchange between
basic and applied research.
RECOMMENDATIONS
1.	The Panel recognizes and endorses the position of the Public
Health Service that there is an urgent need for expanded activities
in research and control measures related to environmental health and
concurs that a Center in the Washington Area to house administrative
support and certain research activities will facilitate development of
the field.
2.	The proposed program expansion (to the level of $300 million
per year in 5 years) is rapid. The Panel is acutely aware of the
severe shortage of well-qualified scientists in the field, and for this
reason recommends that major emphasis for the immediate future be
given to the development in the universities of scientific personnel.
The expansion of the proposed central facility should be related to
availability of personnel for the needs of the Federal Government as
well as those of communities and universities throughout the country.
3.	The research program of the proposed center requires much more
careful delineation and projection. Except in the case of ongoing
programs to be transferred from facilities such as the Taft Center,
the Panel did not feel that enough effort had been directed to identifi-
cation of major problems and drafting of the blueprints of specific
research to be undertaken.
4.	In consonance with recommendations of other committees, it is
recommended that strong, university-based centers be set up not only
for research and education, but also to help in the solution of local
environmental health problems. The present and proposed "regional
laboratories" which are in essence "field stations" do not fulfill this
requirement.
5.	The potential of other Federal laboratories to assist in the solution
of problems of environmental health requires serious exploration.
This does not appear to have been done with the thoroughness and
imagination that the potentialities merit. For example, the superb
facilities at the Brookhaven and Oak Ridge National Laboratories
have not been considered in the field of radiological health.
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F. EXECUTIVE OFFICE OF THE PRESIDENT
Bureau of the Budget,
Washington 25, D.C., July 5,1961.
My Dear Mr. Secretary: On June 14, the President sent to the Con-
gress an amendment to the 1962 budget in the amount of $3,515,000 for
site acquisition and detailed planning for the proposed Environmental
Health Center. The discussion which preceded this action, in which
you, members of your staff, the President's Science Adviser and staff
of the Office of the President participated, produced a number of
understandings which I would like to confirm in this letter.
1.	The funds for detailed planning included in the budget amend-
ment will be reserved pending a further study and review of environ-
mental health research programs and facility needs. As a part of the
review, a Departmental task group will prepare long-range research
objectives in each program area and recommendations on the appro-
priate Federal programs to accomplish those objectives. The task
group will give special attention to (a) research manpower require-
ments, both Federal and non-Federal, and necessary training and other
programs to meet those requirements, (b) the appropriate emphasis
between intramural Federal research efforts and extramural efforts,
and Federal programs, both as to personnel and facilities, needed to
carry both efforts forward, and (o) the current research activities and
facility resources of other Federal agencies and appropriate inter-
relationships and coordination, including the possible sharing of
research facilities. The review will be concluded by December 1, with
a target date of November 1 for completion of work by the Depart-
ment's task group. The plans and conclusions developed in this re-
view will produce a determination of facility requirements for the
various environmental health programs which will permit detailed
planning for the new facilities to proceed. Enclosed is a more com-
plete outline of the steps involved in this review,
2.	Acquisition of about 690 acres for the main population center at
the facility and special radiation research facilities will proceed as
soon as funds become available, with the understanding that no com-
mitment is involved as to the type or extent of the latter facilities.
The decision to seek funds for 690 acres in the absence of an approved
facility plan was based in large part upon a general belief that land
acquisition requests should take into account the full range of possible
future needs. Should the needs in this case fail to materialize, the
excess acreage can either be retained as a general Federal acreage
reserve for future development or can be returned to private
ownership.
£76
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tie ENVIRONMENTAL HEALTH PROBLEMS
3.	Procurement of land for special open area facilities for such
purposes as an animal farm is postponed indefinitely pending further
development of research program and facility needs. If needed at a
later date, it is understood that acreage for these general purposes
would be sought at a separate location in an area not planned for high
density development.
4.	The Department will continue to work closely with the National
Capital Planning Commission, both with respect to the specific acreage
to be acquired and with respect to the size and location of structures,
utilities, and facilities to be constructed.
Sincerely yours,
(Signed) Elmer B. Staats,
Deputy Director.
The Honorable Secretary of Health, Education, and Welfare.
Enclosure.
General Outline for Review of Environmental Health Research
Programs and New Facility Needs
1.	A departmental task group will be formed to undertake the necessary
review In each of the five program areas. The task group will Include, In addi-
tion to departmental officials, appropriate outside consultants, and possibly
representatives from other interested Federal agencies. Consultants will be
selected in consultation with the President's Science Adviser. The task group is
to prepare long-range research objectives in each program area and recom-
mendations on the appropriate Federal programs to accomplish those objectives.
Special attention will be directed to (a) research manpower requirements, both
Federal and non-Federal, and necessary training and other programs to meet
those requirements, (b) the appropriate emphasis between inhouse Federal
research efforts and extramural efforts, and Federal programs, both as to per-
sonnel and facilities, needed to carry both efforts forward, and (c) the current
research activities and facility resources of other Federal agencies and appro-
priate interrelationships, coordination, and possible sharing of research facilities.
2.	The Bureau of the Budget and the Office of the Science Adviser, with agency
representatives, will broaden and Intensify its current review of the relative
biomedical research responsibilities and activities of the Atomic Energy Com-
mission and the Department of Health, Education, and Welfare in the radiation
field in order to formulate an effective delineation of responsibility for major
research areas between the two agencies. Such study will give specific attention
to future utilization of existing research facilities as between the two agencies.
3.	Following completion of steps 1 and 2, the Executive Office will undertake,
through the facilities of the Science Adviser's Office and the Budget Bureau, to
obtain the views of other Interested Federal agencies with respect to the proposed
research programs and related facility needs.
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Appendix
4.	The ad hoc panel of scientists convened on May 18 by the Science Adviser
to review the Public Health Service research plans and facility proposals will be
recalled for an overall review of the plans and conclusions stemming from the
foregoing.
5.	Step 1, above, will be completed by November 1 and entire review will be
completed by December 1.
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Index
A
ACCIDENT CONTROL, 99, 102, 104
ADVISORY COUNCIL ON ENVIRONMENTAL HEALTH, 4
AIR POLLUTION, 17-20, 51, 65-98
Air Pollution Potential Forecasting Service, 90
applications of existing knowledge, 76
areas needing research, 74-76
current status of control methods, 73
deaths from, 17
Division of Air Pollution, 78-82, 84, 88-92, 270
economic aspects, 72
economic losses, 17, 74, 75
facilities, 67, 68-69, 94, 96
funds, OS, 82-84, 86-87, 89
identification and measurement of pollutants, 74
industrial threshold limits, 72
industry research, 83-84
Information dissemination, 91-92
Instrumentation and analysis, 81, 90-91, 94
integration with other environmental health programs, 93-®5
Interstate and Intrastate problems, 89
Intramural training;, 84
legislation, 70, 78-79
motor vehicle emissions, 18, 74-75, 80-81, 84, 88, 93
National Advisory Committee on Community Air Pollution, 6B
National Air Sampling Network, 81, 90
nature and extent of air pollution problem, 71-79
Public Law 84-159, 70, 87
Public Law 86-493, 70, 74, 80
program of Public Health Service, 61
Public Health Service Act, 70
relation to health, 71-73
research, 80-84
research grants, 82-83
role of public and private agencies, 79-93
smog, 18, 19, 72-74, 78
social aspects, 77
Subcommittee on Air Pollution, 65-96, 267, 269
recommendations, 65-69
Surgeon General's Task Group on National Goals In Air Pollution Research,
60, 67, 79-80, 95
technical assistance role of Public Health Service, 76-77
training activities of Robert A. Taft Sanitary Engineering Center, 84-88
AIR POLLUTION POTENTIAL FORECASTING SERVICE, 90
\MERICAN PETROLEUM INSTITUTE, 84
AMERICAN PUBLIC HEALTH ASSOCIATION, 99, 110
279
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280 ENVIRONMENTAL HEALTH PROBLEMS
ANALYTICAL METHODS AND INSTRUMENTATION, 32, 51-53, 50-04, 72,
150-151, 160-164, 1S0-182, 208, 237, 242, 260
facility requirements, 61-63
in air pollution research, 81, 82, 89-91, 94
Subcommittee on Analytical Methods and Instrumentation, 59-04, 267, 269
recommendations, 59-60
types of analytical methods and instrumentation requirements, 63-64
ARMY CHEMICAL CORPS, 144
ARMY CORPS OF ENGINEERS, 255
ATOMIC ENERGY COMMISSION, 12, 60, 62, 83, 144, 206-208, 210, 211, 213, 273
Automobile Exhaust, see MOTOR VEHICLE EMISSIONS
AUTOMOBILE MANUFACTURERS ASSOCIATION, 84
B
Bacterial Contaminants, see FOOD CONTAMINANTS
BUREAU OF ENVIRONMENTAL HEALTH, 3, 4, 9, 39, 40, 46, 83, 93, 169,
212, 213, 218, 270
BUREAU OF MIXES, 12, 83
BUREAU OF OLD-AGE AND SURVIVORS INSURANCE, 186
BUREAU OF PUBLIC ROADS, 98
BUREAU OF STATE SERVICES (ENVIRONMENTAL HEALTH), 3, 4, 270
O
CARCINOGENS, 19, 81, 101
CHEMICAL CONTAMINANTS, 24, 26, 32, 51, 52, 114, 115, 128, 133-134,
148-149, 162
Chemical Wastes, see under WASTES
CLINICAL CENTER (NIH), 12
COMMITTEE ON ENVIRONMENTAL HEALTH PROBLEMS, 1-35, 265-266
CONSULTING AND RESEARCH DESIGN GROUP, 47
D
DATA PROCESSING, 10, 45-48, 63, 94, 129, 130,152, 161, 164, 194, 199, 208-209,
242, 254
DEPARTMENT OF AGRICULTURE, 60, 83, 144, 256
DEPARTMENT OF THE AIR FORCE, 83
DEPARTMENT OF COMMERCE, 12, 98, 256
DEPARTMENT OF DEFENSE, 12, 83, 144,256
DEPARTMENT OF INTERIOR, 12, 256
DEPARTMENT OF URBAN AFFAIRS, 101
DISEASE, 19, 30-32, 34, 45, 51
and air pollution, 17-20, 71-73, 81-82
and water pollution, 24
control, 106
from food contamination, 30
outbreaks (charts), 140-141
DIVISION OF ACCIDENT PREVENTION, 99, 100
DIVISION OF AIR POLLUTION, 41, 78-82, 84, 88-92, 270
National Air Sampling Network, 81, 90
training grants, 85-87
DIVISION OF COMMUNITY HEALTH PRACTICE, 41
DIVISION OF ENVIRONMENTAL ENGINEERING AND FOOD PROTEC-
TION, 97-106. 126-132, 270
DIVISION OF GENERAL MEDICAL SCIENCES (NIH), 41
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Index
281
DIVISION OF RADIOLOGICAL HEALTH, 12, 41, 154, 205, 210-214, 270
DIVISION OF RESEARCH GRANTS (XIH) 41, 83
DIVISION OF WATER SUPPLY AND POLLUTION CONTROL, 41, 83, 222,
251, 270
E
ELECTRONIC COMPUTING, 45-40, 48, 94, 112
ENVIRONMENTAL ENGINEERING, 27-30, 63,97-132, 270
guidelines or criteria of performance, 103-104
levels of responsibility, 105-100
long-range objectives, 104-105
metropolitan area problems, 108-113,121-125
metropolitan planning, 28-30, 111-113
regional laboratories, 14, 55-56, 248
research
funds. 13-14,07
goals, 108-132
grant funds, 104
objectives, 102-103
on bousing and occupied space, 108-110
on solid wastes, 117-119
on urban and recreational areas, 111-113
on water supply, 113-116
Research Grants Branch of Division of Environmental Engineering, 104
social and economic aspects, 27-30
Subcommittee on Environmental Engineering, 28, 07-132,267, 269
recommendations, 97-99
trends, 100-102
ENVIRONMENTAL HEALTH
biochemistry and environmental health, 53
facility requirements, 54-57
manpower funds for national program, 2
manpower requirements, 13-10
Office of Environmental Health Sciences, 3, 4
participation of social sciences in environmental health research, 119-121
physiology and pharmacology in environmental health, 53-54
relation to social science, 119-125
resources required for needed effort, 13-10
toxicology and environmental health, 52
ENVIRONMENTAL HEALTH CENTER, 2-4, 9-12, 45-49, 54-55, 65-69, 93, 97,
134, 165. 1(19-170, 202, 214. 271-277
ENVIRONMENTAL HEALTH PLANNING GUIDE, 28,101
F
FACILITIES
for air pollution, research. 08-69, 93-95
for electronic computing and data processing, 47-48
for environmental health activities involving basic biological sciences, 54-57
for environmental health programs. 54—57, 59-63
for occupational health activities, 201-203
for radiological health, 213-214
for water supply and pollution control programs, 217, 247-248
site selection for water polutiou coutrol facilities, 254-256
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282 ENVIRONMENTAL HEALTH PROBLEMS
FEDERAL AGENCIES
see also INDEPENDENT AGENCIES
see also STATE AGENCIES
Army Chemical Corps, 144
Army Corps of Engineers, 255
Atomic Energy Commission, 12, 60, 62, 83, 144, 206, 207, 208, 210, 211, 213, 273
Bureau of Mines, 12,83
Bureau of Public Roads, 98
Department of Agriculture, 60, 83,144, 256
Department of the Air Force, 83
Department of Commerce, 12, 08,256
Department of Defense, 12, 83,144, 256
Department of Interior, 12, 256
Department of Urban Affairs, 101
Federal Power Commission, 256
Food and Drug Administration, 144, 210
Housing and Home Finance Agency, 98,106
Library of Congress, 83
National Bureau of Standards, 12,60, 83
National Institutes of Health, 12,40, 83
National Science Foundation, 15,16,40
Public Health Service, 1-4, 8, 9, 10, 11, 12, 14, 15, 16, 20, 28, 31, 39, 41, 42, 43,
51, 54, 65-70, 77, 80, 83, 90-98,106, 121, 125, 133-136, 142-145, 147, 151, 153,
154, 157, 165, 167-108, 171, 176, 187-188, 193-194, 197-204, 205-210, 215-
218, 223, 234, 250, 270, 271-274
research in air pollution, 80
FEDERAL POWER COMMISSION, 256
FEDERAL RADIATION COUNCIL, 207-208
FERTILIZERS, 114,227-228
Food, see MILK AND FOOD
FOOD AND DRUG ADMINISTRATION, 143, 210
FOOD CONTAMINANTS, 30-33,52
FUNDS
costs of Environmental Health Center, 13-14
for environmental engineering, 97
for radiological health, 205-206,210-214
grants for environmental engineering, 97-99
proposed budget for data facility, 48
recommendations for air pollution program, 68
requirements for manpower in national program in environmental health, 2
requirements for water supply and pollution control, 215,247, 251-252
requirements in occupational health, 166,203-204
research grants in air pollution, 82-83
research grants In environmental health, 16, 50,56-57
research grants in milk and food, lOt, 155-156
research grants in occupational health, 190
research grants in water supply and pollution control, 217, 249, 257
training funds in radiological health, 211
training grants activities of Public Health Service, 3£>-42
training grants In air pollution control, 41, 85-87. 95
training grants in water supply and pollution control, 251-258
training grants of Division of Air Pollution, 85-87
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Index
283
H
HOUSING, 30, 07-98,104,108-110
research, 108-110
HOUSING AND HOME FINANCE AGENCY, 98-106
I
INDEPENDENT AGENCIES
research in air pollution, 83-84
Industrial Wastes, see under WASTES
INFORMATION DISSEMINATION, 2, 3, 16, 54, 61-64, 91-92, 128, 130, 140, 146,
152, 163, 184, 187, 194, 199, 202, 216-217, 230, 234, 242-243, 261
INFORMATION STORAGE AND RETRIEVAL, 10, 45, 47-48
L
Land Drainage Wastes, see under WASTES
LEGISLATION, 1, 4, 275
Federal Water Pollution Control Act, 215,243-245,252,254-256
for air pollution control, 78
for water pollution control, 215,230-233,243-245, 254, 260
needs, 4
Public Law 84-159,70, 87
Public Law 86-493, 70, 80
Public Law 87-88, 215,254
Public Law 410,142
Public Law 660, 232, 247
Public Health Service Act, 70,104,142,156
responsibilities for water supply and pollution control, 243-245
uniform state legislation and Interstate cooperation in water pollution
control, 230-233, 260
LIBRARY OF CONGRESS, 83
M
MANPOWER, 2,11,13-16, 39-43, 54-56, 272-273, 274
for research in water pollution control, 246,248-251
graduate training of staff, 43
personnel recruitment, 43
proposed staffing of data facility, 48
requirements for water supply and pollution control programs, 246-247, 251
requirements in air pollution research, 85
requirements in national program In environmental health, 2,11,13-16
requirements In occupational health, 170,198-201
requirements in radiological health, 211-212
requirements In water pollution control, 246-247, 251
short-term training, 42
Subcommittee on Manpower Resources and Training, 14,39-43,08,267
recommendations, 39
Metropolitan Areas, see URBAN AREAS
MILK AND FOOD, 30-33, 62, 133-164
chemical contaminants, 32-33, 51-55,148-149,100,162
evaluation of food equipment and processes, 152-153
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284 ENVIRONMENTAL HEALTH PROBLEMS
MILK AND POOD—Continued
food protection, 52,153
food protection goals, 160-164
food safety, 150-151
foodborne disease outbreaks and population (chart), 140-141
Implementation of protection activities, 154-157
legislation, 136,142-143,150
microbiological contaminants, 30-32,146-147
Milk and Food Program of Public Health Service, 02,134-136,146-154
nutritional quality of market foods, 140-150
problem areas and goals, 143-153
radionuclide contamination, 32, 52, 62,133,144,148-149,160
relation to waterborne disease outbreaks (chart), 140
research grant funds, 104,155-156
shellfish, 30,31,62,127, 142,143,144,145,151,153, 154-155,162
Subcommittee on Milk and Food, 133-164, 267
recommendations, 133-136
types of foodborne disease outbreaks (chart), 140
Monitoring, see SURVEILLANCE NETWORKS
MOTOR VEHICE EMISSIONS, 18, 74-75, 80-81, 84,120
N
NATIONAL ADVISORY COMMITTEE ON COMMUNITY AIR POLLU-
TION, 65, 96
NATIONAL ADVISORY COMMITTEE ON RADIATION, 206, 211, 212, 265
NATIONAL ADVISORY HEALTH COUNCIL, 87
NATIONAL AIR SAMPLING NETWORK, 81, 90
NATIONAL BUREAU OF STANDARDS, 12, 60, 83
NATIONAL COMMITTEE ON RADIATION PROTECTION, 241
National Environmental Health Center, see ENVIRONMENTAL HEALTH
CENTER
NATIONAL INSTITUTES OF HEALTH, 12, 40, 83, 86
NATIONAL LIBRARY OF MEDICINE, 12
NATIONAL SCIENCE FOUNDATION, 15,16, 40
O
OCCUPATIONAL HEALTH, 33-35,51, 62-63,165-204
Bureau of Environmental Health, 3, 4, 9, 39, 40, 46, 83,93,170, 212,217
Bureau of Old-Age and Survivors Insurance, 186
facilities, 201-203
fiscal requirements, 166,203-204
formulation of Public Health Service program, 186-197
historical aspects, 173-176
manpower requirements, 166,198-201
research, 165,180-182
research grants, 196
role of Public Health Service, 176-188
Subcommittee on Occupational Health, 165-204
recommendations, 165-166
training, 165-166,170-171,195
OFFICE OF ENVIRONMENTAL HEALTH SCIENCES, 3,4, 9,10,11
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Index
£86
P
Personnel, see MANPOWER
PESTICIDES, 52, 227
PUBLIC HEALTH SERVICE, 1-4, 8, 9,10, 11, 12, 14, 16, 20, 28, 31, 30, 41, 42, 43,
51, 54, 65-70, 77, 9(5-98, 106, 121, 125, 133-136, 142-145, 147, 151, 153, 154, 157,
105, 167-168, 171, 176, 187-188, 193-194, 197-204, 205-210, 215-218, 223, 234,
250,270, 271-274
R
RADIATION HAZARDS RESEARCH LIAISON COMMITTEE, 12, 213
Radioactive Wastes, see under WASTES
RADIOLOGICAL HEALTH. 52, 205-214
Division of Radiological Health, 154,205-214, 270
facilities, 213-214
Federal Radiation Council, 207-208
funds, 205, 206, 211, 212
historical aspects, 206-207
manpower requirements, 205, 211
National Advisory Committee on Radiation, 206,211,212,265
National Committee on Radiation Protection, 206
program of Public Health Service, 62, 210-213
protection measures, 209-210
protection standards, 20S
radiation exposure levels, 208-209
Radiation Hazards Research Liaison Committee, 12,213
radiation monitoring, 62
relationship to Atomic Energy Commission, 12, 213,273,274
research, 212
Subcommittee on Radiological Health, 205-214,267,270
recommendations, 205-206
training, 211-212
training funds, 211
RADIONUCLIDES, 46, 63,64,115
contamination of milk and food, 33,131,149
RECOMMENDATIONS
objectives for Federal water supply and pollution control program, 256-261
of Committee on Environmental Health Problems, 1-4
of Subcommittee on Air Pollution, 65-69
of Subcommittee on Analytical Methods and Instrumentation, 5&-60
of Subcommittee on Applied Mathematics and Statistics, 45
of Subcommittee on Environmental Engineering, 97-99
of Subcommittee on Manpower Resources and Training, 39
of Subcommittee on Milk and Food, 133-136
of Subcommittee on Occupational Health, 165-168
of Subcommittee on Pharmacology, Toxicology, Physiology, and Bio-
chemistry, 49-50
of Subcommittee on Radiological Health, 205-206
of Subcommittee on Water Supply and Pollution Control, 215-218
RECREATIONAL AREAS, 102,111-113
RESEARCH
funds for environmental engineering, 97
goals in environmental engineering, 108-125
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286 ENVIRONMENTAL HEALTH PROBLEMS
RESEARCH—Continued
grants for environmental engineering, 97-98
grants for milk and food, 104,155-156
grants in air pollution, 82-83
grants in environmental health, 56-57
grants in occupational health, 196
grants In water supply and pollution control, 257-258
in air pollution, 79-84
in radiological health, 212-213
manpower for research in water pollution control, 246, 249
objectives in Federal water supply and pollution control program, 257-258
on housing and occupied space, 108-110
on solid wastes, 117-119
on urban and recreational areas, 111-113
on water supply, 113-116
Research Grants Brunch of Division of Environmental Engineering, 104, 155
site selection for water pollution control research facilities, 254-256
social science participation in environmental health research, 119-125
training grants in water pollution control, 249-250
university programs in environmental health, 56
ROBERTA. TAFT SANITARY ENGINEERING CENTER, 84,154, 271
S
SErTIC TANKS, 223
Sewage, see under WASTES
Shellfish, see under MILK AND FOOD
SILT. 226
SMOG, 18,19, 72, 73, 75
SOCIAL SCIENCES
participation in environmental health research, 139-141
Solid Wastes, see under WASTES
Staff, see MANPOWER
STANDARD METROPOLITAN STATISTICAL AREAS, 29
STATE AGENCIES
research in air pollution, 83
responsibilities in water pollution control, 250
uniform State legislation and interstate cooperation in water pollution
control, 260-261
water supply and pollution control programs, 261
STUDY GROUP ON THE MISSION AND ORGANIZATION OF THE PUB-
LIC HEALTH SERVICE, 45-46
SUBCOMMITTEE ON AIR POLLUTION, 65-96, 267, 269
SUBCOMMITTEE ON ANALYTICAL METHODS AND INSTRUMENTATION,
59-64.267. 269
SUBCOMMITTEE ON APPLIED MATHEMATICS AND STATISTICS, 45-48,
267,269
SUBCOMMITTEE ON ENVIRONMENT ENGINERING, 97-132,267, 269
SUBCOMMITTEE ON MANPOWER RESOURCES AND TRAINING, 14, 89-43,
98. 267
SUBCOMMITTEE ON MILK AND FOOD, 133-164, 267
SUBCOMMITTEE ON OCCUPATIONAL HEALTH, 165-204,267,269
SUBCOMMITTEE ON PHARMACOLOGY, TOXICOLOGY, PHYSIOLOGY,
AND BIOCHEMISTRY, 49-67,267
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Index
287
SUBCOMMITTEE ON RADIOLOGICAL HEALTH, 205-214, 267, 270
SUBCOMMITTEE ON WATER SUPPLY AND POLLUTION CONTROL,
215-261, 267, 270
SURGEON GENERAL'S TASK GROUP ON NATIONAL GOALS IN AIR
POLLUTION RESEARCH, 66, 67, 68, 79-80, 95
SURVEILLANCE NETWORKS, 61, 64
air quality monitoring, 81, 90
monitoring instrumentation, 63
Notional Air Sampling Network, 81, 90
National Water Quality Network, 260
radiation monitoring, 63-04
surveillance of consumer food supply, 151-152
water quality surveillance, 26-27, 60, 239-240
T
TRAINING, 2. 9, 14, 3fM3
funds for grants activities, 41-42
funds for radiological health, 211-212
graduate training of staff, 43
grants in air pollution, 83-86, 96
grants in water supply and pollution control, 246, 247, 258
grants programs, 41
in air pollution control, 84-87
in occupational health, 165-166, 170-171, 195
in radiological health, 211-212
in water supply and pollution control, 248-251, 258
objectives of tralneeshlps in water supply and pollution control, 258
research fellowships in water supply and pollution control, 298
short-term training 42, 85, 135, 162-163, 160, 170-171, 195, 211, 250, 258, 272
Subcommittee on Manpower Resources and Training, 39-43
recommendations, 3D
university programs in environmental health, 56-57
U
URBAN AREAS, 27-30, 33, 46, 65-66, 72, 73, 74, 77-78, 98, 99-102, 108, 107,
108-119, 121-125, 139, 156, 219, 220, 221-223
Urban Wastes, see under WASTES
W
WASTES
chemical, 21-22
disposal, 25, 239
industrial, 20-27, 46, 223-226
treatment of, 24-25, 238
land drainage wastes, 226-228
radioactive, 22-23, 33
sewage, 100, 221-222, 260
solid, 08, 117-119
research on, 117-119
treatment of, 24-25
urban, 222, 260
WATER TOLLUTION CONTROL ADVISORY BOARD, 245, 251, 265
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288
ENVIRONMENTAL HEALTH PROBLEMS,
WATER SUPPLY AND POLLUTION CONTROL, 20-27, 41, 51, 61, 102, 104,
113-110. 215-261
chemical contaminants. 21, 22, 2G, 224-225
chemical wastes, 224-225
criteria for selection of sites for Federal control facilities, 254-256
disposal of waste effluents, 239
economic aspects, 229
facility requirements, 247-248
Federal Water Pollution Control Act, 215, 243-245, 252, 254-256
funds, 215, 247. 251-252
heat pollution, 23, 226
industrial wastes, 20-22, 223-226
land drainage wastes, 220-228
legislated responsibilities, 215, 244-245, 254, 256
legislation, 215, 260
manpower for research, 246, 251, 257-258
manpower requirements, 30-43, 215, 246, 251, 257-258
National Water Quality Network, 260
Public Law 87-88, 215 254
Public Law 84-660, 232, 247
pollution from recration and navigational uses, 228, 229
protection of water quality through enforcement activities, 250-260
radioactive wastes, 22-23, 225
recommended objectives for Federal program, 252, 256-261
research and development, 23-24, 113-116, 234-242, 257
scope of Federal program, 243-245
septic tank problem, 223
sewage pollution, 221-223
sources of pollution, 234-230
State programs, 250, 261
Subcommittee on Water Supply and Pollution Control 215-201, 207, 270
recommendations, 215-218
training, 246-251
uniform state legislation and interstate cooperation, 230-233, 260-261
urban waste problem, 222-223
waste treatment methods, 24-25, 238
waste treatment works, 221-222, 231-232
Water Pollution Control Advisory Board, 245, 251, 265
water quality surveillance, 26-27, 233-234, 239-240, 260
water resources, 218, 219, 241, 253, 256
WEATHER BUREAU, 12, 90
O
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Public Health Service Publication No. Wit
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