Helping To Protect the World's Health

By Alec Solomita

Special to the Gazette

When Fred Chang analyzes blood and breath samples in a lab at the School of Public Health (SPH) in Boston, samples which were collected from industrial workers in Taiwan, something more than a chemical reaction is taking place. Chang's activity is the crystallization of a rich and rewarding intellectual and collegial relationship between scholars at SPH's Department of Environmental Health and the international community of scholars.

Joseph Brain, Cecil K. and Philip Drinker Professor of Environmental Physiology and chair of SPH's Department of Environmental Health, sees Chang's international experiment as a wonderfully concrete example of the department's vigorous efforts to nurture relationships with foreign countries and their educational, business, and governmental institutions.

"This year," Brain says with pride, "we passed the 50 percent mark. Of the 99 students in the department, 51 are foreign nationals." They hail from 18 nations in all, but the largest number, 21 students, is from Taiwan.

"Most of the Taiwanese students, like the majority of our foreign nationals, tend not to be fresh university graduates who want to come here, get a Ph.D., and stay. They're midcareer, mostly, who are sent by their universities, governments, or businesses, and they almost all go back to apply their knowledge. But, happily, when they do go back, their connection with SPH very often continues," says Brain.

Hazards in the Workplace

Chang, who trained at National Taiwan University, where he received a bachelor's degree in environmental health and a master's in industrial hygiene, and is presently a member of the faculty, is one of these students. In his pursuit of a Ph.D. at the Department of Environmental Health, he is developing ways to improve the biological monitoring of chemical hazards in the workplace.

"What we are working on," explains Chang, "is both the identification and control of chemical hazards through, in part, a more precise way of measuring workers' levels of exposure to these hazards."

The tried but not necessarily true method of workers wearing monitoring devices such as respirators has a number of drawbacks, including people's varying respiration rates and different levels of intensity of labor. Chang is refining an alternate monitoring method, the use of "biomarkers" -- that is, samples of blood, breath, and urine -- which are measured to see how the chemical under investigation is metabolized.

Chang says that at Harvard, "I am getting exposed to the theoretical and conceptual framework behind much of the technical training I brought with me from Taiwan," adding, "I really like the whole atmosphere. SPH encourages international cooperation, and students like me enjoy the benefits. I can find material in my country and then come here and share ideas in an open-minded, intellectually generous setting."

Dangerous Waters

Shih-Chun Lung, another graduate of the National Taiwan University, agrees -- "SPH is a unique environment. There are lots of different programs filled with people of widely different scientific as well as regional backgrounds."

Lung is working on a problem as challenging as Chang's: she is developing more effective ways of collecting water contaminated with PCBs, industrial chemicals which, because of their persistent toxicity, are particularly dangerous environmental hazards.

She gathers her samples from the busy harbor in New Bedford, Mass. "The sediment," she explains, "is continuously releasing PCBs into the water. But a difficulty in sampling and analyzing the water is that the PCBs stick to the glass containers, so by the time the sample gets to the lab, all estimates are underestimates." Lung is quantifying the rate of loss during transport to ensure more accurate measurements. Like Chang, Lung plans to return to Taiwan in the next year or so with her doctorate and continue her work there.

There are strong ties between the Department of Environmental Health and Taiwan. "We have just renewed a formal agreement with National Cheng Kung University in Tainan, Taiwan. The assistant to the president is a graduate of our department," says Brain, "and, in fact, we have a lot of graduates there and we're working together on a number of projects. Only recently, we had a video conference with some of the folks there."

International Networking

"But," Brain continues, "Taiwan is not unique in this way. We have established and continue to establish well-developed contacts with a number of countries. China is a good example. We have a faculty member, Xiping Xu, a physician who got his M.D. in China, his Ph.D. in Japan, then came to Harvard and got a master's, and now is on our faculty. He's put together a Web network of Chinese universities, government officials, and factories. We have a number of graduates who have gone back to positions of prominence in their homelands. Through them we are beginning to form partnerships with other universities in Korea, Japan, Mexico, and elsewhere."

Another country with which SPH is strengthening ties is Kuwait. "Not surprisingly, Kuwait got sensitized to environmental issues as a result of the disastrous oil fires and oil spills during the Gulf War," says Brain.

"And," he adds, "we're currently trying to develop a Middle East-Harvard program on environmental health and occupational safety and health as they relate to the petrochemical industry in Kuwait and Saudi Arabia. Kuwait's former minister of health, Abdul Rahman Al-Awadi, a member of the Regional Organization for the Protection of the Marine Environment, is a key player in helping us link together government agencies and universities in our respective countries."

A Little History

This is an exciting time for the School of Public Health, which is currently planning its 75th anniversary activities. The school began as a joint effort with M.I.T. around issues of water quality and sanitary engineering. In the early 1900s, SPH scientists designed water and sewage treatment systems that checked scourges such as typhus and cholera.

Efforts to eradicate these diseases and control other dangers in the environment were commemorated recently when the federal government honored Dr. Alice Hamilton, the "Mother of Industrial Hygiene," and the first woman faculty member anywhere at Harvard, with the issuance of a 55-cent stamp. Hamilton's groundbreaking work is history, but her concerns are still on the front burner at the School of Public Health.

Brain says of Hamilton, "She was interested in women and children, child labor and related issues, and she really created the field of industrial health and hygiene. This is, of course, still an area we're very much involved in. As a result of the efforts of Hamilton and her successors, the workplace has, to some extent, been cleaned up in the U.S., but real problems persist in Central and South America, Africa, and Asia."

Getting the Lead Out

Environmental dangers lurk outside of the workplace as well. Salma Elreedy, a Sc.D. candidate from Egypt, is currently working on several projects related to community exposure to lead. Elreedy went straight from her undergraduate work at George Washington University, where she received a B.S. in chemistry, to obtaining a one-year master's degree in environmental health at SPH, and is now pursuing her doctorate in environmental science and engineering.

"For my thesis," says Elreedy, "I am involved in certain projects from inception to completion." And that takes a lot of different skills. Public relations, for instance -- persuading people to provide both support and information can actually be more difficult than coaxing answers from a test tube.

Recruiting institutions to participate, then recruiting subjects, developing questionnaires and collecting field samples, analyzing samples and putting together the final data-- this complex combination of hard science and social science competencies was called for in a pilot study that Elreedy recently completed.

"We looked at lead exposure in a group of 16- to 22-year-old participants from a variety of socioeconomic backgrounds and racial groups. I had to master, or at least become acquainted with, lots of different aspects of research, which is one of the main reasons I chose this department to begin with," says Elreedy.

Elreedy is ultimately interested in working on environmental health issues in developing countries, and she feels her experience at SPH will serve her well. Echoing Chang and Lung, she comments, "Here, you get an opportunity here to meet people from a variety of backgrounds. It's vital to get a number of perspectives, and that happens in class discussions as well as in group projects."

The international community is a pretty big group, but the ambitious Department of Environmental Health is helping to make it smaller by establishing connections among disparate communities both through earnest discussion and far-reaching projects. These discussions and the projects they foster are not simply academic. They result in profound and lasting changes in the health and safety of individuals and populations around the world.