The development of Environmental Health and Occupational Health at the Institute of Preventive Medicine (IPM) at the end of the 1990s is the fulfilment of an earlier idea about “Environmental Studies” as part of the topic of prevention and which started ten years earlier with the allocation of an “Environmental Studies Laboratory” in the project of the Egas Moniz Building. Activity in these areas started with an environmental epidemiological surveillance project on an urban solid waste treatment plant, which is still underway a decade later, and whose main goal is to safeguard the health of the population who live or work around the area.

Initially associated with this first project to provide services to the community, new projects have since materialized and rapidly became autonomous. These projects are research-based for the most part, and aim to contribute to the advancement of scientific knowledge in these areas through the best possible participation in the clarification of outstanding issues that were identified as activities progressed.

Environment, in its various manifestations, is admittedly one of the most important aspects of Health, as it defines new aspects of human health and quality of life of present and future generations, and which needs to be addressed, particularly in terms of prevention. Hence the need for all health professionals, particularly physicians, to be aware and able to offer their indispensable contribution to prevent, combat and mitigate the pernicious influence of environmental factors, or to explore the positive factors of the environment in order to promote the health of individuals and communities. In this context and with the double purpose of combining research with teaching and offer future FML doctors a distinct opportunity to train in these areas, an elective subject in Environmental Health was created in 2001, which was followed a year later by another called Occupational Health.

Service to the community, research and education in the specific areas of Environmental and Occupational Health were the bases and are the strategic axes of the work of the Environmental Health Unit (UniSA), which was set up at the Institute of Preventive Medicine ten years ago and continued to develop over the decade. Most of the activities of this IPM unit are executed at distinct levels and contexts, of which the ones described next, grouped according to the area that best describes the work done, stand out.

With regard to community service, and as part of the consistent strategy that the IPM has been carrying out with a view to strengthening the dialogue and cooperation between the University and the outside world, UniSA has been monitoring three solid waste plants in the country as part of environmental epidemiological surveillance programmes, and the population who live around the areas and, in some cases, the actual workers. In addition, it has cooperated in the preparation of environmental impact studies to help IPM becoming a resource centre for the community in the field of Environmental and Occupational Health.

In what concerns research, the activity of UniSA has two key aims: firstly, to contribute to fill the knowledge gap with regard to Environment and Health, and, secondly, to divulge the knowledge generated and thus participate in the raising of awareness concerning the impacts that sustain environmental quality and influence health and contribute to give a voice to those suffering the effects of an injured environment and who, more often than not, are the least empowered in society.

In terms of contributing to the advancement of knowledge, several research projects have been carried out, and continue to be, most of which funded by the Foundation for Science and Technology (FCT) and by the Directorate General for Health (DGS), or by external sources, like the European Commission, through the Directorate General for the Environment (DG Environment) and the Directorate General for Health and Consumer Protection (DG SANCO), as well as by the World Health Organization, in conjunction with the Centre for Disease Control and Prevention (CDC) of the US and the Canadian Public Health Association (CPHA).

In this context, UniSA has been and still is the leading national institution for Portuguese projects executed as part of European projects, such as the ESBIO[1] and the current COPHES and DEMOCOPHES[2] . The dissemination of results of scientific research is widespread, including publications in peer-reviewed international journals, participation is specialist books, presentations at scientific and technical meetings, most of them by invitation, and a large number of dissemination/awareness raising measures aimed at the public at large or specific audiences.

The educational activity at undergraduate level and the responsibility of UniSA has focused basically in the Environmental Health and Occupational Health course subjects, which are electives in the syllabus of the Integrated Master Degree in Medicine (IMM) and have been studied by about 1000 future physicians, and boast a pass rate of over 95%. This denotes an extremely encouraging level of satisfaction on their part.

On a marginal level, UniSA was also involved in the Epidemiology subject of the IMM and in the bachelor degrees in Microbiology and Dietetics and Nutrition.

More recently, and as part of the Bachelor Degree in Health Sciences, the subject Ecology and Health, organized at UniSA and which has a more practical approach centred on ecological balance – mostly of a social nature but also of an individual one supporting environmental quality, hence human health – has contributed to raise the awareness of future health professionals to these topics, requiring them to voice their opinions, make decisions and define potential interventions as part of their rights and citizenship duties to prevent, fight or mitigate human aggression to the environment and corresponding negative effects on the health and well-being of the population.

As for the Research Traineeships in the Community that UniSA also offers on a yearly basis, they have been a privileged way to raise awareness of the topic of Environmental and Occupational Health, as well as to learn research methodology. Some of the projects carried out in this area have been presented at conferences and the corresponding articles have been published in international specialist journals.

At postgraduate level, UniSA’s educational activity has always focused on the Environment-Health binomial. It has been involved in the Master/PhD Degrees in Epidemiology, which are more centred on Environmental Epidemiology issues, and in the Master in Health Communication, particularly in the complex aspects of communication, drawing students’ attention to the importance of communication in the effective management of environmental risks, to the need to identify the best strategies and enforce communication tools that are more appropriate to distinct target groups in normal or crisis situations. The other aspect of our postgraduate activity includes receiving and supervising master and doctoral theses (7 are currently in progress), and which are of enormous value for the progress and dynamism of the Unit.

Over the ten years of UniSA’s existence, there has been a concern to manage activities and resources as best as possible, continuing to act in the areas where the Unit has gained competence, and looking out for the necessary funding to support research and the actual researchers, integrating young human resources (and other less young ones, like physicians) in research projects and encouraging synergies with other institutions at national and international level, the latter as part of the effort to consolidate and increase the level of internationalization that the IPM and the FMUL have implemented and sustained. One hopes that the ballast of what has been achieved is enough to make us look at the questions posed by an always uncertain future as levers for progress, particularly in UniSA’s anchor areas, where there is so much to do.
M. Fátima Reis (Professor)
Coordinator of the Environmental Health Unit
Programme Coordinator of the course unit Environmental Health, Occupational Health, Research Traineeships in the Community and Ecology and Health
mfreis@fm.ul.pt
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[1] ESBIO – Expert team to Support BIOmonitoring in Europe.
[2] The twin European projects COPHES (Consortium to Perform Human Biomonitoring on a European Scale) and DEMOCOPHES work in full cooperation on complementary actions to measure environmental exposure of children and their mothers in a European human biomonitoring survey: a feasibility study.