Many of the major health factors around the world relate to the environment. Urbanization, desertification, and the formation of “megacities” challenge our abilities to maintain clean air and water and good sanitation practices. Globalization and industrialization in the developing world have increased the organic and man-made pollutants we breathe every day. Infants and children, often the first affected by environmental health changes, are now exposed to unprecedented amounts of pesticides, lead, and mercury. At NCEH/ATSDR, this complex interaction between humans and environmental hazards is the focus of research studies, health services, and laboratory science.

Global environmental health is among the top priorities at the CDC. As such, NCEH/ATSDR’s role in global health includes

• Safeguarding the health of people from environmental threats;
• Providing leadership in environmental health sciences (environmental epidemiology, environmental sanitation, and laboratory sciences) to protect public health;
• Responding and sharing solutions to environmental health problems worldwide; and
• Communicating information about genes, diseases, and environmental risk factors.

Each division at NCEH/ATSDR plays a role in our global environmental health efforts.

The Division of Environmental Hazards and Health Effects (EHHE) investigates the relation between human health and the environment. EHHE uses this knowledge to develop, implement, and evaluate policies and programs aimed at preventing disease. EHHE studies ways to prevent or control health problems associated with exposure to air pollution, nuclear radiation, pesticides, and other toxicants, as well as those health problems that result from natural, accidental, and terrorist disasters. Recent EHHE global projects include

• Saudi Arabia: Gulf War Syndrome investigations
• Central America: Health impact evaluations following Hurricane Mitch
• Japan: Investigation of dioxin exposure and incidence of endometriosis
• Malaysia: Studies to measure the risk for adverse health outcomes following devastating regional forest fires

The Division of Emergency and Environmental Health Services (EEHS) provides national and international leadership in coordinating, delivering, and evaluating emergency and environmental health services. EEHS helps local, state, federal, and international agencies plan, prepare, and respond to emergencies (including terrorist attacks, technologic accidents, and natural disasters). EEHS also provides grants, technical assistance, scientific guidance, and direct services to state, local, and nongovernmental agencies engaged in food safety, rodent control, water quality, or sanitation. Recent EEHS global projects include

• Tanzania: Carried out quantitative surveys of anemia and iron deficiency in a Burundian refugee camp in western Tanzania, where iron deficiency anemia is a serious public health problem among children younger than 5 years of age
• Thailand: Completed two surveys assessing the prevalence of mental illness related to traumatic experiences among the Karenni State refugees in three camps in Mae Hong Son, Thailand
• Afghanistan: Conducted a nationwide mental health assessment in Afghanistan in collaboration with the United Nations Children’s Fund (UNICEF)
• Sierra Leone: Conducted an HIV/AIDS seroprevalence and behavioral risk factor survey in all accessible areas of Sierra Leone, representing 79% of the population
• Federated States of Micronesia, Palau, Republic of the Marshall Islands (RMI), Samoa: Founded the Pacific Emergency Health Initiative (PEHI) in 2000 with the mission of strengthening the capacity for emergency health preparedness and response among Pacific island nations
• Iraq: Helped to coordinate the Office of Foreign Disaster Assistance's response to the war in Iraq

The Division of Laboratory Sciences (DLS) develops and applies laboratory science to prevent disease and death (caused by exposure to environmental chemicals) and to improve the diagnosis, treatment, and prevention of selected chronic diseases. DLS specializes in biomonitoring, which is the assessment of individual human exposure to environmental chemicals (as measured in human specimens such as blood or urine). Biomonitoring provides valuable information that guides health officials in risk assessment, treatment, and prevention. Recent DLS global projects include

• El Salvador: Surveying micronutrient malnutrition in children
• Italy: Working on the Seveso Women's Health Study, a cohort of women potentially exposed to high levels of dioxin in 1976
• China: Continuing the collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology (ongoing since 1981)
• United Kingdom: Performing the external laboratory review for the United Kingdom National Diet and Nutrition Survey
• Canada and Norway: Coordinating CDC's participation in an interlaboratory comparison of analytical methods to detect polychlorinated biphenyls (PCBs) and pesticides as part of the Arctic Monitoring and Assessment Program (AMAP) quality assurance program
• India: Participating in an ongoing collaboration to foster improved environmental and occupational health
• Netherlands: Establishing an informal collaboration for developing analytical methods for select chemical terrorism agents

The Agency for Toxic Substances and Disease Registry (ATSDR) is the lead public health agency responsible for implementing the health-related provisions of Superfund (the Comprehensive Environmental Response, Compensation and Liability Act of 1980). ATSDR assesses health hazards at specific hazardous waste sites, helps to prevent or reduce exposure and illnesses, and increases knowledge and understanding of the health effects that may result from exposure to hazardous substances. Recent ATSDR global projects include

• India: Collaborative research and environmental health education projects with the Indian Ministry of Health, prioritizing arsenic exposure and toxicity, indoor air pollution, emergency response, pneumoconioses, chemical toxicants, children's environmental health, and gene-environment interaction
• Czech Republic: A study of the effects of perinatal exposure to a mixture of bio-persistent chemicals on the neurobehavioral development of infants
• Canada: Status report of the Great Lakes and St. Lawrence River basins every 2 years (joint responsibility with EPA)
• Mexico: Emergency preparedness and response for environmental disasters in the U.S.-Mexico border area
• Qatar: A presentation on the health effects of natural and depleted uranium