Goldstein B D
Department of Environmental and Community Medicine, UMDNJ-Robert Wood Johnson Medical School, Busch Campus, Piscataway, New Jersey 08854.
Regul Toxicol Pharmacol. 1988 Sep;8(3):328-34. doi: 10.1016/0273-2300(88)90019-0.
Much of EPA's actions are driven by concerns for public health. The public's perception of the potential adverse consequences to their health of chemical and physical agents in the general environment is a common motivating force in setting EPA's agenda and in making regulatory decisions. Despite its responsibilities in public health, and the major role that public health plays in its decision making, EPA is not part of the Department of Health and Human Services, the federal cabinent-level department with primary responsibility for human health. Rather, EPA is an independent agency with its own Administrator who is the decision maker for over a dozen legislative acts, many of which are based on public health concerns. For very few of these laws is there more than a minimal tie to the activities of classic public health agencies in the Department of Health and Human Services. Unfortunately, this organizational approach has led to a relative lack of individuals trained in the discipline of public health which hinders EPA's ability to approach public health problems. While there are many good reasons to keep EPA a separate entity from the Department of Health and Human Services, it is imperative there be close cooperation between EPA and the appropriate units of the U.S. Public Health Service. Most importantly, the number of people within EPA who are trained in public health disciplines must be increased. As a corollary there must be a concerted effort to educate students in a manner responsive to the need for public health manpower at EPA and at State and local agencies active directly or indirectly in environmental health issues.
美国环境保护局（EPA）的许多行动都是出于对公众健康的担忧。公众对一般环境中化学和物理因素可能对其健康造成的不良后果的认知，是推动EPA制定议程和做出监管决策的常见动力。尽管EPA负有公共卫生方面的责任，且公共卫生在其决策中发挥着重要作用，但EPA并非卫生与公众服务部（负责人类健康的联邦内阁级部门）的一部分。相反，EPA是一个独立机构，有自己的行政长官，该行政长官是十几项立法法案的决策者，其中许多法案都基于对公共卫生的担忧。这些法律中，与卫生与公众服务部传统公共卫生机构的活动仅有极少关联。不幸的是，这种组织架构导致了相对缺乏受过公共卫生学科培训的人员，这阻碍了EPA应对公共卫生问题的能力。虽然有许多充分理由让EPA与卫生与公众服务部分开，但EPA与美国公共卫生服务局的相关部门必须密切合作。最重要的是，必须增加EPA内部接受过公共卫生学科培训的人员数量。相应地，必须齐心协力以满足EPA以及直接或间接参与环境卫生问题的州和地方机构对公共卫生人力需求的方式来培养学生。
