With few exceptions, every industrial chemical exposure that threatens “environmental health” emerged from a workplace, often at a higher concentration. A similar pattern often occurs with ionizing radiation and even some infectious diseases: what becomes today’s community exposure may well have been yesterday’s occupational exposure.
The scientific tools we use—epidemiology, toxicology, and exposure assessment—do not vary depending on whether and when a risk crosses the workplace boundary. Nor do many of the solutions. Engineering controls and safer chemical design that protect working people “from 9 to 5” (half their waking hours) are often the same ones that would protect the same people (or other people) “from 5 to 9.” The same is true of our growing and welcome commitment to considering justice in risk distribution as well as aggregate risks and benefits. Exposure hot spots associated with race, income, and other structural inequities affect people both on and off the job.
A Single Continuum of Exposure
And yet, public health education typically requires students to choosebetween environmental health and occupational health early in their training—as if the rest of their careers must disclaim interest in one of the two types of involuntary exposures or the other. Students in environmental health may study epidemiologic evidence from workers that underlies standards issued by the U.S. Environmental Protection Agency (EPA), but without focusing on how that evidence could directly benefit workers. Students in occupational health may learn to design ventilation systems or reduce musculoskeletal strain, but without being asked to apply those same principles in homes, schools, retail settings, or other places where people spend their time.
Academic public health has an opportunity to bridge this divide. We need a new generation of scholars and practitioners who can connect findings and remedies across environmental and occupational epidemiology. Studies of broad populations may detect modest increases in risk across many people, while occupational studies may reveal larger risks in smaller, more concentrated groups. Considered together, these bodies of evidence can provide a fuller picture of harm and strengthen decisions about prevention, or they can reveal important differences that cast doubt on the magnitude of some risks.
The same integrated perspective should inform toxicology and exposure science. Evidence from laboratory studies, worker populations, and communities should be assessed together rather than placed in separate conceptual boxes. Real or concocted concerns about “high-dose effects” and hypothetical thresholds can be put in context by examining worker disease, where exposures are often close to the effect levels found in toxicology studies.
Connecting Education, Evidence, and Policy
The folly of bifurcating what is a singular issue matters for policy as much as for science. Partial solutions that address pollution only after it leaves the workplace miss a critical opportunity for prevention. In many cases, one of the most effective ways to protect people living downwind, downstream, or otherwise near a pollution source is to improve the processes and conditions inside the workplace where the hazard originates. In contrast, focusing myopically on reducing worker exposure may merely increase emissions to the environment, while controlling only what comes out of the smokestack or effluent may perversely move more of the harm back inside the workplace.
Some schools and programs do already house environmental and occupational health in the same department. But the separate labels can still reinforce separate ways of thinking. I have sometimes used the phrase “total involuntary exposure” to describe the combined effects of chemicals, radiation, and other hazards throughout people’s daily lives and across the lifespan. The phrase may be imperfect, but the underlying concept is essential: exposure does not respect administrative boundaries, disciplinary silos, or the clock.
A more unified approach would also create stronger career pathways. Graduates trained to see the full continuum of exposure could bring that perspective to government, industry, and nonprofit organizations. Over time, they could change how these institutions identify, study, and manage health hazards.
Rebuilding for the Future
That need is especially urgent as the nation considers the future of its federal regulatory and research infrastructure. The severe reductions in staffing and capacity at federal agencies are deeply concerning. However, they also create a once-in-a-lifetime opportunity to consider how these institutions should be rebuilt—and whether they were structured effectively in the first place.
As a former chief regulatory official at the Occupational Safety and Health Administration (OSHA) and a former member of the EPA Science Advisory Board, I have long believed that the creation of these institutions more than half a century ago was a major public health achievement. At the same time, their separation across departments, agencies, and oversight structures has limited our ability to address connected risks as connected risks. The National Institute for Occupational Safety and Health (NIOSH) and the National Institute of Environmental Health Sciences (NIEHS) add essential research capacity, but they, too, operate within a fragmented system. Readers are welcome to join our Facebook group “Out of Their Ashes: Rebuilding the Federal Regulatory Agencies in 2029,” to continue this discussion.
We should consider whether a single entity—or, at minimum, much stronger coordination—could reduce chemical and radiation risks more efficiently, advance “exposure justice” by protecting workers and communities from disproportionate hazards, and preserve economic freedom. The goal should not be institutional consolidation for its own sake. It should be a system designed around how hazards actually move through workplaces, communities, and people’s lives.
This is not simply an organizational question. It is a question about how academic public health prepares the next generation. Students should be trained to follow hazards wherever they travel: from a production line to the air outside a facility, from a worker’s body to a family’s home, and from long-standing threats such as lead and chlorinated solvents to emerging concerns such as per- and polyfluoroalkyl substances (PFAS) and nanoplastics.
We have an opportunity to renew environmental and occupational health as a coherent field of knowledge and practice. Doing so can reinvigorate industrial hygiene and exposure science, improve prevention, and equip a new generation of public health professionals to protect people in every environment they encounter—at work, at home, and throughout their communities.