Cost of Environmental-Related Health Effects A Plan for Continuing Study (1981) / Chapter Skim
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Chapter 5: Issues Related to Administration and Coordination
Chapter 5: Issues Related to Administration and Coordination
Pages 105-132
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From page 105... ...
State and local governments collect large amounts of information in the course of carrying out environmental programs.2,3 International sources may be rich for some kinds of information. Various international groups, such as the International Agency for Research on Cancer and other parts of the World Health Organization, collect and analyze data on environmental hazards.4 In addition, certain kinds of epidemiologic studies are conducted in countries such as Sweden and Norway more east ly than in the United States, partially because these countries have individual personal identifying numbers and researchers can link a variety of records for person.
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From page 106... ...
The data instead were collected as by-products of various service functions, or to help in research undertaken for other purposes, or to serve as the basis for various environmental and health regulatory programs.2, 3,8 Some of them were provided by private corporations, responding to regulatory demands; others by state and local governments incidental to various programs and purposes; and some by independent scholars following their own lines of interest. The National Center for Health Statistics (NCHS)
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From page 107... ...
a desire to expand and improve the available statistical data, as against a desire to reduce the burden of paperwork on public and private institutions;l~l° (2) a desire to provide more effective regulation of environmental hazards and threats to health, as against putting less of a regulatory burden on the economy; 12 and (3 ~ a desire to provide financial support for the necessary research and data collection, as against the current budgetary pressures on the federal government.
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From page 108... ...
Recent bills, moreover, have undertaken to guarantee that data collected, for example, in the Bureau of Labor Statistics, would not be made available outside of the collecting agency.l4 Various studies have discussed the problems.5~15-18 In one study, ~ subcommittee of the Toxic Substances Strategy Committee convened by the Council on Environmental Quality, examined the confidentiality provision of 14 major statutes that deal with Pollutants and toxic substances, as well as agency practices based on the statutes.l5,l6 The subcommittee considered confidentiality issues related to interagency data sharing; agency data sharing with contractors' public disclosure of confidential health, safety, and . efficacy data ~ and disclosure of confidential info`-~uation in administrative proceedings.
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From page 109... ...
sought to protect the confidentiality of health care information and to establish procedures for patients to gain access to their own records.21,22 o The Labor Statistics Confidentiality Act (S.2887) , would have assured confidentiality of material the Bureau of Labor Statistics receives under a pledge of confidentiality.14 Differing purposes of data collection The specialized purposes of various programs from which data may be required, and the specialized interests and commitments of the personnel administering the programs, may make it difficult to provide comparable and uniform coverage of information for any such broad effort as the ongoing study.
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From page 110... ...
95-623 assigned certain responsibilities to the National Center for Health Statistics for issuing guidelines for collecting and compiling environmental health statistics, these are overlapping responsibilities assigned by other statutes to other coordinating authorities, especially the Office of Federal Statistical Policy and Standards, in the Department of Co~erce at present.2,10, 24, 25 If the specific statutory authority and responsibility of a department head comes into conf 1 ict with a more general responsibility for coordination assigned by statutes to a subordinate officer of another department, the coordination is not likely to be very ef fective unless it is supported by the constitutional or political authority of the President or the congressional leadership. On this subject, the President may not be personally involved, and various institutions in his Executive Office may play roles that are not always in harmony.
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From page 111... ...
Additional actions If consideration of the several higher priority problems suggests that voluntary cooperation is inadequate, several options exist, ranging from reorganizing interagency committees to involving the Executive Office of the President.
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From page 112... ...
As the ongoing study proceeds, it may wish to consider recommending that some part of the Executive Office of the President (perhaps the Office of Management and Budget, or the Office of Science and Technology Policy, or some cooperative arrangement between the two) establish a system for monitoring on a continuous basis the activities of the continuing committees and the temporary interdepartmental task forces that deal with health problems related to the environment.
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From page 113... ...
The Regulatory Analysis Review Group and the Regulatory Council, for example, come at the problem from different points of view and with different preoccupations.* The Office of Management and Budget may be concerned from the point of view of the efficiency of the various operating agencies and interagency committees involved, or the reorganization or transfers of programs.
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From page 114... ...
Table 5-l briefly lists various possibilities using three approaches: 0 the lead agency approach o the interdepartmental committee approach o the Executive Office of the President approach. The list is not exhaustive.
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From page 115... ...
Secretary of Health and Human Services The Cabinet member, with the status and access to Presidential little time per support that that venally to devote implies, with the to such inter heaviest responsi bilities in this field (Food and Drug Administration (FDA) , National Cancer Institute (NCI)
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From page 116... ...
Other possibilities, but with weaker cases to be made for them: Departments of Agriculture, Energy, Transportation, Labor (Bureau of Labor Statistics, Occupational Safety and Health Administration) ; Consumer Product Safety Commission; Nuclear Regulatory Commission.
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From page 117... ...
-117It might be possible to an existing interdepartmental by Precut ive Order or Disadvantages It is cons idered a leader in the pro-regulation side of political cant roversy; future status unce rtain. Al so rather large, and perhaps unwie lay, in membership.
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From page 118... ...
THE EXECUTIVE OFFICE OF THE PRESIDENT APPROACH. Even if interagency collaboration is essential, it is often considered desirable to assign the leadership of an enterprise to some part of the Executive Office of the President (EOP)
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From page 119... ...
This trend already is apparent in environmental regulation. To a great extent, state agencies implement federal regulations relating to air pollution, wastewater discharges, and hazardous waste disposal.2,30~31 This section is based partially on a workshop for state and local environmental health officials held on March 26, 1980 as part of the TOM planning study.
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From page 120... ...
However, these officials are responsible for directly spending more than half of the public monies spent on environmental quality control.32 Most public expenditures go for water quality control, and most of that is spent locally. According to the Bureau of the Census, local governments directly spent $9.9 billion of the $12 billion spent by governments in FY 1978 for environmental quality control activities.*
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From page 121... ...
A recent report listed the location of environmental health programs within each state, and broadly divided the states into four categories, based primarily on the location and degree of centralization of their environmental health programs. No particular organization was deemed preferable.36 Nonetheless, such structural diversity can lead to coordination problems and difficulties in getting information to the appropriate state or local officials.
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From page 122... ...
A variety of surveillance programs have been developed by labor and industry.39~44 These range in complexity and degree of development from hazard checklists to sophisticated longitudinal * This section draws on a workshop on occupational health surveillance held on April 8, 1980 as part of the TOM planning study.
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From page 123... ...
The ongoing study should remain aware of occupational surveillance programs conducted by labor and industry and particularly of innovative developments in the area by means of the aforementioned mechanism of periodic consultation. In addition, special occupational surveillance programs by labor and industry could be encouraged, perhaps by special funding or other inducements.
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From page 124... ...
Private foundations and voluntary health organizations need current information about the burden of disease, particularly of the Organizations queried for this section include: The Arthritis Foundation, the American Medical Association, the Josiah Macy Foundation, the American Cancer Society, the American Heart Association, the American Lung Association, the March of Dimes Birth Defects Foundation, the American Red Cross, the National Center for Health Statistics.
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From page 125... ...
Few, however, have the resources or technical capability to sustain an independent data source upon which to base fund-raising campaigns, scientific or service program plans, public policy recommendations or materials for health education. These organizations obtain most of their data from existing federal agencies, such as the National Center for Health Statistics and the National Cancer Institute, and from the medical and public health literature.
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From page 126... ...
to recommend and coordinate federal programs concerned with reduction of environmentally related cancer and heart and lung disease. It has published an inventory of relevant research programs in its eight member agencies.47 Of 115 research programs divided among 15 subject categories, only 4 programs are in the category "estimating costs of environment-related illness." The Regulatory Calendar is published semiannually, in May and November, by the Regulatory Council and describes some regulations under development by member agencies.29,48 Subject headings include energy, environment and natural resources, and health and safety.
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From page 127... ...
U.S. Department of Health and Human Servicese National Center for Health Statistics.
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From page 128... ...
Report to the Toxic Substances Strategy Committee by the Subcommittee on Trade Secrets and Data Confidentiality.
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From page 129... ...
(California Department of Health Services, Sanitary Engineering Section, Berkeley, CA. ~ Statement submitted to the TOM Workshop for State and Local Environmental Health Officials, held as part of this ION planning study in Washington, D.C., March 26, 1980.
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From page 130... ...
Discussion paper for the workshop on occupational health surveillance. Paper distributed at the occupational health surveillance workshop held as part of the IOM planning study in Washington, D.C.
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From page 131... ...
Office of Toxic Substances. TSCA Confidential Business Information Security Manual.
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