My Pledge to Kelvin

In the CIEH’s Royal Charter, environmental health is described as an art and a science. I suspect that this duality has long undermined the collective will of the profession to do our damnedest to put environmental health practice on a sound scientific basis. After all, if we have no evidence base for a particular way of doing things, we can always claim art, can’t we?
It is true that the stressors that affect public health and drive health inequalities are not all biological like typhoid, or physical like noise, or chemical like lead. Some are social as when people are in overcrowded housing or have no security of tenure. Some are financial such as being unable to afford to heat a home in winter or buy fresh food for a family.
Equally, some of our professional interventions are scientific, such as ensuring that water is clean and that E. coli O157 is absent from the steak pie you’ve just bought for your Sunday lunch.
Other interventions are social, providing money to enable people to insulate their homes and thus afford to heat them.
And yet others are more artful, such as providing training to workers in health and safety or food safety, or carers in first aid for young children.
But the crucial question remains: how do we know what works? Is someone else on the other side of the country, or in another agency, or even in the next town, doing it better than I am and really making a difference in tackling health inequalities and thus ensuring that people live longer, healthier, more fulfilling lives? Conversely, have I just struck on the best way of getting people to install radon treatment in their homes (I haven’t) and this knowledge could save money and lives elsewhere?
My last post was about professional ethics and I suggested the ethical principle “to miniimise harm through my actions and not permit harm to arise through my inactions”. (And if that sounds a little like Isaac Asimov’s Laws of Robotics, it’s probably intentional – the old boy was really onto something.) This principle has its outworking in practise in the sense that I have a moral obligation to find out the best way to intervene in a particular situation and, equally, to share how I do things with the rest of my colleagues without fear or false humility. Better still, we should design our interventions as fair trials to test whether or not one model is better than another. Therefore, I have an ethical duty to contribute to and refer to the environmental health evidence base. I must become a real world researcher.
Yesterday, at the meeting of the Assembly of Representatives, Dr Chris Day of CIEH’s Education team and Kelvin Woodward of the Education and Research Special Interest Group, started to outline what CIEH was going to do to see the environmental health evidence base built. This is actually an obligation from its Royal Charter, which charges the Chartered Instute “to undertake and promote research in environmental health and associated subjects and to disseminate the results of that research”.
There is now a draft research policy for the Assembly and Membership Network (Regions, SIGs and Branches) which sets out the principles of, and need for, research and exemplifies what it might look like for this particular art and science. Because it’s still in draft, I won’t yet go into the detail, but a broad front is about to be opened up in the campaign to place our professional practise on a firmer foundation.
And the pledge? Kelvin challenged everyone to pledge one thing they could do to start on that project. Here’s mine: to write about what I learn from practice right here in this blog.
At the CIEH Annual Meeting this morning, someone said that research was more than just writing up what we’re doing. That’s true, but it’s also not a bad place to start.

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4 thoughts on “My Pledge to Kelvin

  1. “Conversely, have I just struck on the best way of getting people to install radon treatment in their homes…?”

    How serious a hazard is radon, what would treatment consist of, and is it worth it? Or is this just an example of exaggerated fear of the scientifically complicated, invisible, and not caused by our own actions?

    Now if you were talking about how to persuade people not to smoke in front of their children …

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    • Radon is chemically inert, being a noble gas, but it is radioactive and decays emitting an alpha-particle. Unlike the other radionuclides in its decay series which are solids, radon is a gas and can migrate from the ground into sub-soil air. Pressure differences between the ground and an occupied building can then draw subsoil air containing radon into the building, exposing people.
      The radiological hazard depends on an individual radon atom decaying inside the lungs and the cells of the lung lining are thereby irradiated by the alpha-particle. If the concentration of radon is sufficient, and the building occupiers are exposed for a sufficient period of time, then the risk of lung cancer rises. That risk is synergistically increased if the owner of the lungs is a smoker.
      Prevention of exposure is based on three priniciples: preventing subsoil air containing radon getting into the building, reducing the air pressure under the building and venting the radon to atmosphere (where it would normally end up) and reducing the amount of time someone might spend in parts of the building with higher radon concentrations.
      Modern building regulations will require radon control measures to be built in where the radon risk is higher. For existing buildings, the subsoil venting option is reasonably cheap and easy to install – this is the preferred remedy. For workplaces, where perhaps a basement is affected, then the use of the basement could be restricted to archive storage and access limited to keep exposure below occupational exposure levels.
      There’s more information on radon and remedial measures at http://www.hpa.org.uk/radon for UK readers and http://www.epa.gov./radon for American readers. There may be small differences in the exposure limits that trigger action, but the science is the same.
      Patrick

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      • Quite so. As your source states, most homes in the UK are at less than 10% the radon level at which action would be justified, and that’s after bearing in mind the pessimistic assumptions made in radiation exposure recommendations. It’s a bit different when you’re building in the Rockies.

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  2. Pingback: My pledge to Kelvin – fulfilled | Patrick Mackie

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