Some definitions of “environment” follow:

“en-vi-ron-ment: n. 1: the circumstances, objects, or conditions by which one is surrounded 2 a: the complex of physical, chemical, and biotic factors (as climate, soil, and living things) that act upon an organism or an ecological community and ultimately determine its form and survival b: the aggregate of social and cultural conditions that influence the life of an individual or community” [1].

“Environment: The sum of all external conditions affecting the life, development and survival of an organism” [2].

“In its broadest sense, the environment is a major determinant of human health and well-being […] and unhealthy environments can create substantial morbidity, mortality, and disability […]” [3].

The term “environment” has in English many (more or less) equivalent terms, like milieu, ambiance, ambient, setting, surroundings, medium, atmosphere and others. For our objectives, we will not use any of them but exclusively the word “environment”.

Thinking of planet Earth, the whole of all existing things and living beings (the aggregate of the planet’s ecosystems) could be called “physical environment”. When humans and their works are not taken into account, one usually talks on “natural environment”. It appears that the environment is generally viewed as an “object-centric”, and particularly an anthropocentric, concept or relative to something (live or inanimate). The following could be a general approach:

“Environment, for each human being, human group, living or inanimate entity, at a chosen scale, is the whole of the surrounding physical world with its entities (living and/or inanimate and/or man-made) and their actions, interactions and interrelations.”

People are immersed in the environment, and they can, for instance:

to know the environment’s generalities and details;

to measure environment’s parameters;

to use/control those circumstances of the environment which act on mankind’s life;

to conserve/sustain environment’s desirable, positive and pleasant characteristics.

Interactions as to know, to measure, to use/control and to conserve/sustain, bring about the need to manage and solve a multitude of environmental problems.In the second half of the XX century, it became conspicuous the appearance of two different views (even with colors attached) as to the management of environmental problems, particularly in the national and international public sector. The green sideis worried about what people’s activity can do to the natural environment and includes aspects like sustainable development, biodiversity protection, climate change, ozone layer, poverty, demographic dynamics, land management, deforestation, desertification and drought, mountain areas, seas and coast protection, biotechnology, etc. The blue side (brown for some) is concerned about what the environment can do to the health and welfare of people; it has usually been called environmental health, and the discussion of its scope and structure is one of the main goals of this paper. The two sides or points of view are, of course, closely related, frequently embracing overlapping issues. Sometimes the separation or identification of scopes could be deemed difficult or artificial. However, such identification is important because, presently, there is a sort of institutional work distribution in the countries and at international level.

Nowadays the same “environmental health” designation or its equivalents is applied not only to an analytic set of knowledge and practices but also to a system of resources—human, physical, financial and institutional—dedicated to putting into action such knowledge and practices. Therefore, it is convenient to demarcate both aspects, and it could be as follows: call environmental health, or EH, to the analytic set, and environmental health services, or EHS, to the system of resources.

A number of EH equivalent denominations exist, for instance: “environment hygiene”, “environmental sanitation”, “environment protection and development”, “health and environment”, “environment and health”, and others. In the public health domain, the name “environmental public health” is sometimes used. The term “environmental sanitation”, still employed in various countries, is prone to confusion because the current practice frequently reserves the word “sanitation” for wastes or excreta management. The term “environment protection and development” is wide enough to include EH, but by its very breadth, it could also embrace the entire “green” universe. The “health and environment” and “environment and health” names might receive as many meanings as many could be the interrogated persons or institutions. For some, “health and environment” signifies, literally, (human) health on the one side and environment on the other, in each case with whatever could be the arbitrarily designated range. The reverse may occur with “environment and health”. According to others, “health and environment” implies the influence of environment on health, but with an emphasis on health, and there is no lack of arguments to claim that “environment and health” points at an emphasis on environment. In summary, just “environmental health” is probably preferable.

Within virtually every public governmental sector some kind of nationwide technical-administrative body exists, or more than one, with name, structure and institutional position largely varying from country to country, but anyway in charge to administer actions identifiably belonging to environmental health. Also, there exist, usually, local bodies (in regions or states or provinces or municipalities, etc.) among whose responsibilities are EH ones. As said above, we will apply to all of these bodies the uniform name of “Environmental Health Services” (EHS). Predictably, the name and affiliation of nationwide EHS throughout the world are diverse and we give some examples (Table 1).

In some cases, the EHS are not given all the political power or means to fully enable them to properly take care of the blue side of the environmental problems, and this is dangerous for public health. One significant aspect which is easily

(a) After documents of the Regional Meeting on Institutional Development of the Ministries of Health’s environmental health units. PAHO/WHO. San Juan, Puerto Rico, August 1998. (b) After documents of the WHO Interregional Meeting on the guidelines for the strengthening of environmental health services towards improved governmental action on environmental determinants of health. Geneva, Switzerland, May 1998. (c) https://www.epa.gov/aboutepa (retrieved August 2010). (d) https://apambiente.pt/index.php?ref=16 (retrieved August 2010). (e) https://www.gov.ie/en/help/departments/ (retrieved August 2010). (f) https://www.environnement.gov.ma/fr/# (retrieved August 2010).

neglected by local or national governments is the maintenance and conservation of physical installations or qualified human resources.

The following broad categorization in areas was applied to EH towards the end of the 80’s:

Water supply and sanitation;

Solid wastes;

Environmental risks for health;

Workers health.

A document of 1994 [7] contains the following list of 22 program areas, which are said to “summarize all of the Sanitation Technicians activities, according to information gathered in the [American] Region’s countries”:

Drinking water;

Excreta, wastewater and storm water;

Solid wastes;

Food hygiene;

Improvement of housing and human settlements;

Vector control;

Zoonosis control;

Public buildings sanitation;

Sanitation of tourism and recreation places;

Sanitation applied to sea, air and land transportation;

Sanitation planning for urban and rural development;

Workers health, hygiene and safety;

Toxic materials control;

Ionizing radiation;

Accidents prevention;

Environmental impact and health;

Sanitary steps in special cases (natural and technological disasters, migrations, epidemics, etc.);

Environmental pollution prevention and control;

Prevention of water resources pollution;

Prevention of flora, fauna and landscape pollution;

General and management activities;

Promotion of community involvement and sanitary and environmental education.

PAHO/WHO [8] used for EH in 1998 the designation “Environmental Protection and Development”. About technical cooperation, it listed the following items (as condensed by the author):

Community mobilization and inter-sectoral coordination;

Education in environmental epidemiology and toxicology;

Leadership and advisory role of ministries of health for environmental health planning and programming, and in developing local capabilities for the operation and maintenance of systems and services;

Projects on the effects of environment on children’s health;

Primary environmental care activities;

Updating of standards and regulations governing the quality of environmental services and products;

Mechanisms to gather, analyze and utilize data and indicators on the quality of the environment;

Taking action in the countries on factors that adversely affect workers’ health;

Water supply and sanitation to expand service coverage, improve the bacteriological quality of drinking water and intensify activities in rural areas and for indigenous populations;

Improving municipal solid waste management.

When the United Nations Conference on Environment and Development (UNCED) convened in Rio de Janeiro, 1992, WHO presented the book Our Planet, Our Health [9] containing the main following chapters with a very thorough treatment of green and blue issues:

1) Health, environment, and development;

2) Global challenges to health and the environment;

3) Food and agriculture;

4) Water;

5) Energy;

6) Industry;

7) Human settlements and urbanization;

8) Transboundary and international problems.

Euro/WHO has the conceptual model DPSEEA (Driving Forces—Pressures—State—Exposure—Effects—Actions) [10] of health-environment interlinks to help design a system of EH indicators within the decision-making context. The driving forces component refers to the factors that motivate and push the environmental processes involved, and they generate pressures that often modify the state of the environment. This state creates an exposure that poses risks to human well-being only when people are present both at the place and at the time that the hazard occurs. Such exposure leads to a wide spectrum of health effects, acute or chronic. In face of the environmental problems and its health effects society attempts to adopt and implement a range of actions, for example, to reduce or control the hazards concerned, or preventive ones to eliminate or reduce the forces that drive the system.

This document [11], also presented at the UNCED, devoted to the environmental health area (although not with this explicit name) seven out of 14 chapters of Section II, “Conservation and Management of Resources for Development”:

Protection of the atmosphere (Chapter 9);

Integrated approach to the planning and management of land resources (Ch. 10);

Protection of the quality and supply of freshwater resources: application of integrated approaches to the development, management and use of water resources (Ch. 18);

Environmentally sound management of toxic chemicals, including prevention of illegal international traffic in toxic and dangerous products (Ch. 19);

Environmentally sound management of hazardous wastes, including prevention of illegal international traffic in hazardous wastes (Ch. 20);

Environmentally sound management of solid wastes and sewage-related issues (Ch. 21);

Safe and environmentally sound management of radioactive wastes (Ch. 22).

Information was collected by the author (Table 2) in order to summarize what three organizations reported (c. 1993) as the scope of environmental health.

PAHO/WHO = Pan American Health Organization/World Health Organization; EURO/WHO = WHO Regional Office for Europe; USAID/WASH = Water and Sanitation Program of the US Agency for International Development.

The Department of the Environment and Local Government [12] works mainly on EH issues as these:

Atmosphere;

Water;

Eutrophication prevention;

Waste management;

Environmental Radiation;

Noise;

Environment Technology Action Plan;

Chemicals;

Genetically modified organisms;

Agenda 21EU & International Unit;

Sustainable development;

Environmental liability;

Emergency planning;

Information on the environment;

Environmental Assessment.

The Department of the Environment [13] is advancing a number of law projects in order to get a legal basis for the management of green and blue issues like these (condensed by the author):

Atmospheric pollution;

Accidental sea pollution;

Wastes management and disposal;

Environmental impact;

Production/use of plastic bags;

Coast protection;

Surface water quality (incl. water for human consumption, irrigation and fish farming);

Quality parameters for domestic and some industrial wastewaters.

The Portugal Environmental Agency [14] manages green and blue issues. It proposes, develops and monitors the implementation of environmental policies, particularly in (condensed by the author):

Health and transportation sectors;

Climatic change;

Ozone layer;

Air quality;

Noise prevention and control;

Wastes management;

Contaminated soil reclamation;

Integrated pollution prevention and control;

Serious industrial risks prevention;

Environmental and population safety;

Ecological labeling, ecological purchasing, voluntary systems for environmental management;

Environmental impact assessment;

Environmental liability;

Risk management (technological, chemical, genetically modified organisms’ risks);

Alert network for radiological and nuclear risks;

Environmental education;

Protection of sea areas;

Environmental regulations and permits.

The United States Environmental Protection Agency (EPA) [15] indicates that its mission is “to protect human health and the environment”. Also, it gives [16] the following alphabetical list of topics (which contains about 219 subtopics and a very large number of detail issues):

Air;

Cleanup;

Compliance & Enforcement;

Economics;

Ecosystems;

Emergencies;

Environmental Management;

Environmental Protection Agency;

Environmental Technology;

Government;

Human Health;

Industry;

International Cooperation;

Pesticides;

Pollutants;

Toxics;

Pollution Prevention;

Radiation and Radioactivity;

Research;

Treatment & Control;

Wastes;

Water.

It is interesting to note that certain environmental concerns of the United States (see, below, examples of “green” and “blue” topics) go to federal administrations other than EPA, and also to tribal, state or local agencies [17]. EPA works cooperatively with many of these instances.

Some “green” issues:

Endangered Species Act is primarily managed by the U.S. Fish and Wildlife Service;

Wildlife and destruction of wetlands has much to do with the U.S. Army Corps of Engineers;

Situations of human development and wildlife such as foxes, birds, etc. are managed by state or local wildlife offices;

Information on gardening or farming is offered by the local Agricultural Extension office.

Some “blue” (EH) issues:

Environment inside the workplace is under the Occupational Safety and

Health Administration (OSHA);

Safety of products used in daily life is the concern of the Consumer Product Safety;

Commission;

The Federal Insecticide, Fungicide and Rodenticide Act is managed cooperatively by EPA;

and the Food and Drug Administration(FDA);

Safety of food and any substance applied to human body is a concern of FDA;

Noise complaints are mainly regulated by local governments (e.g., cities’ and counties’);

Dust in roads is a local issue;

Issues about local landfill are for the county environmental agency.