The CEECHE: a practical approach for reducing exposures and disease outcomes in Central and Eastern Europe.

While each region of the world faces unique challenges, environmental threats to vulnerable populations throughout Central and Eastern Europe (CEE) present a significant public health challenge. Environmental pollution is widespread, resulting from the consequences of rapid industrialization during the Soviet Union era. To help address these concerns, a meeting, sponsored in part by the National Institutes of Health (NIH)/National Institute of Environmental Health Sciences (NIEHS) Superfund Research Program (SRP), was convened in 1994. The meeting, "Hazardous Wastes - Exposure, Remediation, and Policy," brought together representatives of the governments of seven countries in the region, scientists from the United States and Western Europe, and representatives from international organizations to explore hazardous waste problems in the region. Since 1994, the SRP and partners have been holding meetings throughout CEE to share important information regarding environmental health. The general sessions have shifted from a focus on describing the problems in each country related to hazardous waste, exposure assessment, risk reduction, and risk communication, to an exchange of information to better define links between health and the environment and strategies to improve regional problems. The 1994 meeting and subsequent meetings raised issues such as heavy metal contamination, exposures from hazardous waste, and pollution caused by deficiencies in disposal of waste overall. Research priorities that were identified included development of reliable biomarkers, better understanding of the relationship between nutrition and chemical toxicity, more epidemiological studies in CEE, better methods of environmental data analysis, and development of remediation tools. Here, we review examples of research from current SRP grantees that address many of these issues. In 2004, the first official Central and Eastern European Conference on Health and the Environment (CEECHE) was held, and has been held biannually at venues across CEE. The CEECHE provides a forum for researchers and engineers, and organizations with diverse professional expertise and backgrounds, to jointly examine pressing environment and health issues, engage in cooperative research, and develop and disseminate innovative prevention strategies for addressing these issues. The CEECHE facilitates more intentional integration of disciplines to achieve a fundamental understanding of biological, environmental, and engineering processes and exploit this knowledge to contribute to solving environmental exposure-related issues. Critical to the CEECHE mission is the participation of trainees and junior scientists who will share their data and engage broadly with the scientific community. Scientific inquiry that supports a paradigm whereby knowledge gained through understanding disease processes resulting from environmental exposures would further our understanding of potential human health effects, and provide a creative, holistic approach to integrate seemingly discrete biological systems and geological, ecological and human health risk assessments into more comprehensive models. Such models will be discussed which advance the mission of reducing the public health burden of hazardous substances through interdisciplinary research and training.