Direct from CDC’s Environmental Health Services Branch Hugh Mainzer, M.S, D.V.M., Dipl. ACVPM Veterinarians and Environmental Health Practitioners: Partners in Prevention
vents such as urbanization, globalization, become licensed to practice on all but human Editor’s note: NEHA strives to provide up and terrorism have brought the need animal species in any U.S. state or territory. Vet to-date and relevant information on en E for a stronger, larger, more diverse, and erinarians are among the few clinicians whose vironmental health and to build partner more competent public health workforce to success requires both a solid understanding of ships in the profession. In pursuit of these the forefront of public planning (Pappaio the importance of diagnosing and treating the anou, 2004). A growing number of medical “whole” animal and a thorough application of goals, we will feature a column from the issues are resulting from increasing human- herd/population health principles and preven Environmental Health Services Branch wildlife contact, environmental changes, tive medicine. Like their physician colleagues, (EHSB) of the Centers for Disease Con expansion of international travel, antimicro many veterinarians also complete an intern trol and Prevention (CDC) in every issue bial misuse, intensification and integration of ship/residency or advanced training that leads to of the Journal. food production, and growth of the immu board certification in one or more of the 20 vet nocompromised population (World Health erinary specialties. Of note to the environmental EHSB’s objective is to strengthen the Organization, 1999). health practice community, one such specialty role of state, local, and national environ Veterinarians have training that gives them organization may be of particular interest for mental health programs and profession a unique capacity to address public health is the environmental health practice community: als to anticipate, identify, and respond to sues and to help meet public health needs. The American College of Veterinary Preventive On completion of their clinical training, vet Medicine requires demonstrated proficiency in adverse environmental exposures and the erinarians take an oath that states: “I solemn the public health domains of epidemiology and consequences of these exposures for hu ly swear to use my scientific knowledge and biostatistics, food safety, infectious and para man health. The services being developed skills for the benefit of society through … the sitic diseases, environmental health and toxi through EHSB include access to topical, promotion of public health and the advance cology, and public administration and health relevant, and scientific information; con ment of medical knowledge” (American Vet education. A recent World Health Organiza erinary Medical Association, 1999, emphasis tion (WHO) technical report defined veterinary sultation; and assistance to environmen added). Although veterinary medicine and public health as “the sum of all contributions to tal health specialists, sanitarians, and environmental public health have long had the physical, mental, and social well-being of environmental health professionals and many common competencies, practices, and humans through an understanding and applica practitioners. accomplishments in common, it may be use tion of veterinary science” (WHO Study Group EHSB appreciates NEHA’s invitation to ful to reintroduce this important emerging on Future Trends in Veterinary Public Health, professional partnership. p. 4, 2002). This definition establishes the con provide monthly columns for the Journal. text—protection and improvement of human EHSB staff will be highlighting a variety What Is Veterinary Medicine? health—in which veterinarians make their con of concerns, opportunities, challenges, and Veterinary medicine is “real medicine.” School tribution. It also describes how those who learn successes that we all share in environmen ing consists of a rigorous four-year postbaccalau and apply the scientific principles of veterinary tal public health. reate program of medical and surgical training. medicine are part of a core public health practice After successfully passing a national exami activity with global impact. There is an explicit nation, veterinarians in the United States can understanding that “veterinary public health
Reprinted with permission from NEHA 0 Volume 69 • Number 8 activities must be carried out in close partner teractions and clinical experience—as well Veterinarians in the ship with other public health efforts to ensure as their roots in preventive medicine—vet Contemporary Practice positive health outcomes” (WHO Study Group erinarians are ideal environmental health of Public Health: Some on Future Trends in Veterinary Public Health, service partners. Clinical, Scientific, and p. 4, 2002). As the veterinary profession broadens the Administrative Functions perception of what a veterinarian can do, the Veterinarians in the term “one world—one medicine” may signify • Public health policy makers Contemporary Practice the acceptance that veterinary medicine is • Public health or environmental health of Public Health also a human health activity. Together with program managers and executives Today, veterinarians serve many public health their partners in health protection and pro • Epidemiologists roles. Although veterinarians are estimated motion, veterinarians can improve public • Community practitioners to make up less then 1 percent of the public health practice with a renewed focus on the • Local, state, federal, or international health workforce (Gebbie, 2000), recent edu complex interactions that affect environmen health officers cational and policy influences have renewed tal, animal, and human health. • Public health laboratory scientists the interest in increasing the numbers of vet • Public health educators and commu erinary professionals in public health. Exam Corresponding Author: Hugh Mainzer, Cap nications experts • Animal control consultants and shel ples of such professionals and their functions tain, Chief Veterinary Officer (select), U.S. ter medicine practitioners can be found in the sidebar on this page. Public Health Service, Supervisory Preven • Occupational safety and health advisors Because veterinarians work at the interface tive Medicine Officer/Epidemiologist, Di • Teachers of public health sciences of human, animal, and environmental health, vision of Emergency and Environmental and preventive medicine they are uniquely positioned to view health Health Services, National Center for Envi • Subject matter experts on zoonosis, through the lens of public health impact. ronmental Health, CDC, 4770 Buford High vectorborne-disease, and even non- Changes in land use, creation and operation way, MS F-28, Atlanta, GA 30341. E-mail: infectious-disease prevention and of large terrestrial and marine food production [email protected]. Web site: www. control programs units, and microbial and chemical pollution cdc.gov/nceh/ehs. Some Typical Activities of land and water sources have created new • Environmental risk assessment and threats to the health of both animals and hu References study of health hazard effects mans (Zinsstag, Schelling, Wyss, & Mahamat, American Veterinary Medical Association • Ecologic and environmental health 2005). The intensive responses to the inten (1999). Veterinarian’s oath. Retrieved sciences tional release of anthrax, the periodic contam January 20, 2007, from http://www.avma. • Disease surveillance ination of seafood production beds, the spread org/about_avma/whoweare/oath.asp. • Conservation medicine practice • Quarantine services and select agent of West Nile virus, the importation of monkey Cassady, J., Higgins, C., Mainzer, H., Seys, S., oversight pox, the widely publicized occurrence of large Sarisky, J., & Musgrave, K. (2006). Beyond • Food and water safety foodborne-disease outbreaks, and the threat of compliance: Environmental health prob • Biomedical research pandemic influenza all serve as recent models lem solving, interagency collaboration, • Drug and medical device quality/safety illustrating the impact and burden of disease and risk assessment to prevent waterborne assurance on the resources of public health infrastruc disease outbreaks. Journal of Epidemiology • Agricultural program, nutritional ture (Kahn, 2006; King, 2006). The need for and Community Health, 60, 672-674. guideline, and sustainable community integrated animal and human health surveil Gebbie, K. (2000). The public health workforce development consultation lance, diagnostic laboratory systems, and de enumeration 2000. New York: Center for • Food animal disease control activities livery of effective health interventions among Health Policy, Columbia School of Nursing. • Global health improvement pro animal, human, and public health professions Kahn, L.H. (2006). Confronting zoonoses, grams (including malaria control and HIV/AIDS prevention) has never been more essential. linking human and veterinary medicine. • Biologic, chemical, and radiologic Veterinarians are turning to environmental Emerging Infectious Diseases, 12, 556-561. terrorism preparedness, prevention, health scientists and practitioners to devel King, L. (2006). Veterinary medicine and and response op their understanding that many outbreaks public health at CDC. Morbidity and Mor • Natural/technologic disaster and pan and public health emergencies are failures tality Weekly Report, 55 (Suppl. 2), 7-9. demic preparedness, prevention, and of veterinary prevention infrastructure. It Pappaioanou, M. (2004). Veterinary medi response has been demonstrated that the professions cine protecting and promoting the public’s can work together to investigate the envi health and well-being. Preventive Veterinary ronmental antecedents that lead to adverse Medicine, 62, 153-163. World Health Organization. (1999) Vet health outcomes (Cassady et al., 2006). By WHO Study Group on Future Trends in erinary medicine in public health. Weekly strengthening epidemiologic and laboratory Veterinary Public Health. (2002). Future Epidemiological Record, 19, 154-156. investigations that assess the role of envi trends in veterinary public health: Report Zinsstag, J., Schelling, E., Wyss, K., & Ma ronmental influences, this partnership can of a WHO study group. Teramo, Italy: hamat, M.B. (2005). Potential of coopera help to develop and apply sustainable and World Health Organization. Retrieved Jan tion between human and animal health to effective community health interventions. uary 11, 2007, from http://whqlibdoc.who. strengthen health systems. Lancet, 336, With their understanding of biological in- int/trs/WHO_TRS_907.pdf. 1242-1245.
Reprinted with permission from NEHA April 2007 • Journal of Environmental Health 1