fever, and bovine tuberculosis. Even in the present day we are applying techniques of the disinfection of water, the pasteurization of foods, and the filtration of air which are reducing the viral content of these media without a complete knowledge of the behavior of viral agents which have been released into the physical environment. The span of man's surprisingly successful efforts to manage the hygiene of the physical environment covers approximately one and a half centuries. During the last half of that period, it has become increasingly scientific and has become more certain and more economical in its practices. There is a very long path yet to be traveled. Only a part of that path involves the illumination of specific disease causation relationships and the pinpointing of physiological effects of long-term, low-level exposures to chemical, biological, and physical insults which are so much with us as man remakes and fills up the physical environment. The development and the effectiveness of professional practitioners will be hopelessly impeded if their procedures and their activities are constantly measured against a proven disease cause-effect relation. We must follow the doctrine of the eminent practitioners of the first half of this century, Milton J. Rosenau, a physician; William Sedgwick, a bacteriologist; Earle Phelps, a chemist and, later, engineer; Alan Hazen, a civil engineer who followed the sanitary road; and C.-E. A. Winslow, a bacteriologist and health educator, who in "Who's Who" identifies himself as a sanitarian. These great figures of the sanitary and public health movement of the first half of this century were men of a high scientific integrity, but they never hesitated to strike at the filth and contamination by the methods which were at hand. The first attack often was expedient and empirical. In the light of later knowledge, which they themselves later developed, the attack was made with a more complete scientific rationale. The very boldness of their first attack gave them the knowledge and gave them the understanding to probe deeply to the extent that scientific knowledge and methods at hand permitted. The concept of the quality of the environment, that it not only be free of disease producing agents, but that it contribute to the well-being and happiness of people was not foreign to these great men of the recent past. The concepts are easily identified in their writings and in their works. I urge the removal of the restraint of the disease only concept. I recommend to this committee that they give serious thought and study of the need to create a bureau of "HOPE," the Hygiene of the Physical Environment, and that it be given a clearly visible duty and responsibility to put the brakes on the despoilment of the physical environment which can be most rewarding in its health giving powers, but completely vindictive when violated and despoiled. We must recognige that our use and enjoyment of it during our transient stay is a sacred trust. The need for development as well as research: The Surgeon General's proposal places the research activity in environmental health in the National Institutes of Health, but with the assurance that the proposed Environmental Health Sciences Center will be built in North Carolina. This is the most promising place for that desperately needed center in the family and framework of public health and environmental hygiene. It is likely that it will be best initiated within the structure of the National Institutes of Health as it will emerge through the reorganization. There is, however, a need which must be coupled to that great effort; that is, the increasingly difficult task of implementing research when it is of rather pure form and developing the technology by which the benefits reach the people who have been sorely taxed to support the original research. There must be some instruments of exchange and of day-to-day working relationships by which the research people, the development people, and the field practitioners are a continuum of exchange, interchange, and effort. As an initial thought, I would like to submit that something of the organism of the Robert A. Taft Sanitary Engineering Center be maintained and strengthened and perhaps even have regional centers within the structure of the suggested Bureau of Hygiene of the Physical Environment and that these have an extremely close liaison with the Environmental Health Sciences Center under the NIH. Some part of that can be accomplished by sharing adjacent physical facilities, having interchange of personnel and consciously planning for the free exchange of problems and solutions. Surely we have sufficient ingenuity to create these mechanisms which will accomplish two things. One is that the formidable gap between the information producer at the one end, the information user at the other end, does not continue to grow. One of the most interesting products of the Robert A. Taft Sanitary Engineering Center was not at all in the minds of those that fought so valiantly to bring about its creation. This is the tremendous stimulation and strong inspiration which all men and women from State and local health departments from throughout our Nation and visitors from overseas have drawn from the Robert A. Taft Sanitary Engineering Center. In many instances, it was in regularly scheduled short-term instruction. In others, it was special visits of varying duration for specific purposes of learning techniques to tackle some new facet of activities they were implementing in their home setting. Every environmental health worker in this country, local, State, and Federal, and many of our overseas counterparts identify with the splendid research and investigative arm embodied in the Robert A. Taft Sanitary Engineering Center, and feel it to be a continuum, an extension of the spectrum of field work, methods development and fundamental research. This we must preserve; this we can preserve. To be sure, it will require additional effort, another trial of our ingenuity and of our flexibility. It can and it must be done if we are not to lose the rich harvest of fundamental research for one or two educational generations, before it comes into the general practice carried through the slow pace of textbooks, field manuals and timid or venturesome trial. One may think of the continuous interchange I have sought to delineate as just as vital as any vast scheme or system of information retrieval by the most sophisticated computers. Indeed it is more vital, because it is the living exchange of the minds of men and women. For a living exchange, we must bring the human beings together across the conference table, across the lunch table, even across the barbecue pit. Dr. Paul Gross, of Duke University, a member of the National Environmental Health Advisory Committee, has set forth the concept of a National Laboratory of Environmental Health Sciences akin to our great nuclear energy centers such as the Oak Ridge National Laboratory, Brookhaven, Argonne, and Lawrence. These thoughts were expressed in a letter in March to Secretary Gardner. Dr. Gross agreed to my mentioning this throught to you this morning. I hope that that letter will be made part of the record of this hearing, either by Dr. Gross or by Secretary Gardner. If I may try your patience for just a few more moments, I will summarize my viewpoint, which I know to have a strong endorsement from a very large number of professional colleagues and from professional associations engaged in what may be variously identified as sanitary engineering, environmental sanitation, environmental health, and environmental hygiene. Then what is it that I seek for my profession and for our people so that they may enjoy an environment healthful not only from the narrow base of disease but from the level of the quality of that environment and its importance to their full well-being? 1. That with reorganization granted by the Congress, the Secretary of the Department of Health, Education, and Welfare and the Surgeon General of the Public Health Service work cojointly with the professional practitioners of such special fields as are now identified as environmental sanitation, radiological health, industrial hygiene, sanitary engineering, air pollution control, and solid wastes management, to the end that there be established a Bureau of the Hygiene of the Physical Environment. This will give us HOPE, an organization with a clear, visible, dedicated and effective character under the forceful leadership of a professional practitioner of environmental health, prepared by a sound education in the specialties and dedicated for his whole professional life to its extension to all the people. 2. That in pursuit of the Surgeon General's proposal that there be added to the structure of the National Institutes of Health, a National Institute of Environmental Health Sciences based in North Carolina, there be the careful study, delineation, and establishment of mechanisms of liaison and interchange between the field forces and a developmental laboratory with the National Institute of Environmental Health Sciences to the end that the dissemination of knowledge, its implementation, and its application for the benefit of all our people be rapid and thorough. That through such mechanisms the activities and the products, the people and the equipment of the Environmental Health Sciences Center give nurture and strength to every man and woman who have cast their lot and their hopes for a cleaner, happier, and healthier world through their dedication, and through their daily practice at all levels from the most remote villages to the most sophisticated and complex urban centers. Dr. Paul Gross' proposal for a National Laboratory of Environmental Health Sciences fulfills these needs. For it is through the capacities and competences of men and women that we move to a richer life, that we preserve the heritage of a physical environment free of the threat of disease and full of a life-giving quality which makes life so meaningful that we are determined to make sacrifices so that we may hand it down undespoiled to our children's children unto all the generations to come. I thank all of the members of the committee for their patience and indulgence in permitting me to express my thought on these environmental health decisions which will impact these vital operations in every county, city, State and Nation, and indeed the nations throughout the world. Thank you again, sir, and I would be pleased to address myself to any questions you may have. REFERENCES 1. "Report on Environmental Health Problems," Subcommittee of the Committee on Appropriations, House of Representatives, John E. Fogarty, Chrm. 196086th Congress. 2. "Environmental Health Problems," Gross Committee Report, 1961-62— H.E.W.-P.H.S. 3. "Restoring the Quality of Our Environment," Environmental Pollution Panel, President's Science Advisory Committee, 1965-The White House. 4. "Waste Management and Control," National Academy of Sciences, National Research Council, Committee on Pollution, Spilhaus Report, 1966. 5. "Environmental Determinants of Community Well-Being," Third Meeting of PAHO Advisory Committee on Medical Research, 17 June 1964, Scientific Publication No. 123, December 1965, PAHO, Washington, D.C. Senator RIBICOFF. Professor, I don't have any. I do appreciate your coming here and giving us the benefit of your ideas. Your statement is a valuable one, and we are pleased to have it for the record, and I am glad, of course, to see how strongly you feel about the environment. It is obvious to me you understand the problems, the hazards, and the potential, and I do thank you very much for coming here from North Carolina to give us the benefit of your views. Dr. CHANLETT. And let me say I am proud to be a citizen of a country which has mechanisms by which I, as an individual, may come before this eminent body and address indirectly the entire Senate and in turn the House of Representatives as well. Thank you very much. Senator RIBICOFF. Thank you very much. The hearing will be adjourned. (Whereupon, at 11 a.m. the subcommittee adjourned subject to the call of the Chair.) EXHIBIT 3 INDIANA UNIVERSITY MEDICAL CENTER, Senator ABRAHAM RIBICOFF, Chairman, Subcommittee on Government Operations, DEAR SENATOR RIBICOFF: May I be among those to commend you for the strong and forthright position which you took at the hearing of your Sub-Committee held on 27 May 1966. I refer to the hearing held on that date in connection with certain plans for the reorganization of the Public Health Service and particularly that portion of the Plan which would relegate Environmental Health to become a section in a new Bureau to be known as the Bureau of Disease and Injury Prevention. As is well known by you and by other knowledgeable persons, the preservation and protection of our citizens through the adequate and scientific control of the environment is more critically needed today than ever before. I will not attempt a long documentation to substantiate this statement because there is ample testimony and other voluminous evidence available. Suffice it is to say that the Congress has recognized these many new problems and their potential hazardous effect upon the people and has provided funds and manpower to work toward feasible solutions. The complexity of many of them is well known to us both. Unfortunately, it now appears that Surgeon General Stewart and his advisers have practically ignored the gravity of national environmental health problems and would submerge the need for more complete and comprehensive activity in this field by placing this work in a new Bureau, the very name of which denotes this as mainly a medically oriented activity allied to disease control. This appears to be a sign of retrogression and could be interpreted to mean that the Public Health Service wishes to deemphasize environmental health and let it be taken over by some other arm of the Federal Government. History and events have revealed, time after time that progress in`environmental health control has come about through the combined efforts of many scientific disciplines. The biologist, the statistician, the engineer, the chemist, and the educator through reesarch, joint effort, and collaborative activity have evolved many effective solutions to difficult problems of the environment. Yet as our technology becomes more complicated and sophisticated, new problems arise calling for the best in technical skill and talent. If we are to make full use of the abilities and the imagination of these many scientists, they must be under the guidance of men skilled in many scientific areas and not by persons, skilled as they may be in their fields, but trained basically in the healing arts. From the reorganization plan under discussion, it can only be assumed that environmental health activities would be directed by persons with medical training, which for an activity as varied as the one under discussion, would mean limited direction too narrowly circumscribed. I would therefore recommend for the consideration of you and your Committee, that a Plan be evolved which sets up Environmental Health as a separate and distinct entity with a capable scientist at its head and with Bureau status. While I am associated with the faculty of the Indiana University School of Medicine, this letter is being addressed to you as representing the judgment of another organization, namely, the American Intersociety Academy for the Certification of Sanitarians, Inc. This Academy if composed of persons whose professional life is devoted to the preservation of the public health through the control of our environment. I trust what has been said in this letter may be used as further testimony that there are many professional people entirely opposed to the current proposal for the reorganization of the Public Health Service, and it is trusted that your Committee will make definitive recommendations so that the whole area of Environmental Health will be placed in a setting compatible with its critical importance to the health and life of all citizens. Yours most respectfully, HAROLD S. ADAMS, Associate Professor and Chairman, Intersociety Academy for Certification of Sanitarians, Inc. EXHIBIT 4 OREGON STATE UNIVERSITY, SCHOOL OF ENGINEERING, Corvallis, Oreg., June 28, 1966. Senator ABRAHAM RIBICOFF. Chairman, Subcommittee on Executive Reorganization, DEAR SENATOR RIBICOFF: I am writing to you to express my concern over the plan for reorganization of the U.S. Public Health Service. The portion of this plan which, I feel, falls far short of the needs of the American people, the best judgement of several panels of prominent experts.1 and the wishes of the Congress is that section dealing with the Bureau of Disease and Injury Prevention and Control. Certainly no one can argue with the need for attention to matters of disease and injury control. However, the concept seems to represent the “tired old thinking" that if something doesn't make you immediately sick or if it doesn't injure you it's not worth worrying about. This view is not held by most knowledgeable people and the need to develop a forward looking and dynamic program in "Environmental Health" has been made adequately clear by the works of the various expert panels cited above. Burying the functions of water supply engineering, solid waste control, environmental engineering, air pollution, health aspects of public works engineering and urban planning and other environ 1 Fogarty Committee, 1960, Report on Environmental Health; Gross Committee report. 1962; Tukey report, 1965; Spilhaus report, 1966. |