impairments, seemingly of no specific etiology, and apparently not related to a single precipitating episode. Unfortunately, diseases of this nature, at clinical stages, usually represent advanced and generally irreversible processes. The challenge now is to develop new epidemiologic approaches, directed at the determinants of health as well as disease. It is essential to do this for better understanding of the normal state of well-being, and it is necessary to develop and employ new, preclinical sensors. Research which takes recognition of social factors must be initiated, employing new concepts, particularly as they may involve computer technology, large and complex population studies, new disease determinants, and new time factors. We may expect such studies to be large; to require considerable time; and to be expensive. Modes of action Rapid advances have occurred in theoretical knowledge in the physical and chemical sciences in the recent past. This has been true to a less optimal degree in the technical offshoots which bear on the biosciences. The biological sciences themselves, although the subject of much intense effort, have failed to produce answers to many questions of great importance to the environmentalist. This is particularly true where some measure of the biological effect of stressful events must be made. Are the chemical, or physical, or biological insults to the body independent of each other? Are they independent in a time series? Or do they produce cumulative, or synergistic, effects? How does the biological reserve or the adaptability of the body influence the outcome? How variable within an individual, and from person to person, is the reserve or the ability to adapt or compensate? Questions such as these cannot be answered at present. To simply do more of the same things we are now doing will not provide answers. One of the important steps which must be taken is toward acquiring better and more comprehensive knowledge of the normal functioning of the living organism. Only with such a background can we recognize metabolic deviations promptly. Further, it is not reasonable to apply present methodology step by step to each of the myriad environmental hazards around us. Our base of knowledge must be sufficiently broad, and our techniques sufficiently sensitive, so that we can predict. In addition to epidemiological methods, those of toxicology and pharmacology must be applied to the newer environmental health problems. The task of these methods will be to explore and identify biological implications of harmful, or potentially harmful, substances. Underlying these should be bio-chemico-physical studies directed at improved methodology-the development of preclinical sensors based upon the most sensitive methods available. Research should be initiated on the effects at the cellular level and on structured cell systems employing new methods which hold great promise for the future. New resources Data analysis procedures. and operations research methods-including computer techniques considered impractical a few years ago-are now being applied to problems in biology. Application of these techniques to broadened concepts of epidemiology, where ecologic systems can be treated as total problems, is badly needed. Until such methodolgy can be applied to the epidemiology of environmental health, it seems unlikely that we can bring together the biological, social, engineering, and other factors important to an appraisal of the total problem. At the present time, computers are being used to simulate biological phenomena at many levels of complexity. Procedures involve the use of available knowledge to formulate a first approximation, the development of a hypothesis, and a determination of whether performance resembles known evidence. But when applied to the simplest of ecological systems, problems of such complexity are encountered that present techniques are inadequate. It is clear, however, that this is only a temporary impasse. New interdisciplinary sciences are being developed. Increasing sophistication on their part will provide the needed parameters and the mathematical models essential to this application. DIVISION OF AIR POLLUTION While limited efforts had been made by the Public Health Service, prior to 1955, to cope with emergency air pollution problems-such as occurred at Donora, Pa., in 1948-no Federal air pollution program as an entity existed until the passage of Public Law 84-159 in 1955. At that time, the Public Health Service established an engineering air pollution program which began limited technical assistance and research activities into the sources, nature, concentration, and control of air pollutants. Laboratory facilities for parts of this work were developed at the Robert A. Taft Sanitary Engineering Center, with the remainder being undertaken through contracts and grants. A medical air pollution program was begun at the same time, for the primary purpose of evaluating health effects of air pollution. Lacking facilities at the beginning with which to conduct research, this work was inaugurated almost entirely through grants and contracts. By 1960, sufficient progress had been made, and problem area defined, to justify combining the two programs into the present Division of Air Pollution which was estaiblshed on September 1, 1960, and under which a coordinated activity provides a much more effective approach to the overall problem. While continuing to make use of the research resources of educational institutions and other private or public agencies through contracts or grants, the Division has also strengthened its own research capabilities. The passage of Public Law 86-493 (1960), provided a particular stimulus to research, ac celebrating the development of facilities and personnel for the study of motor vehicle pollution problems. Of importance to the planning and development of the program was the report issued in 1960 by the Surgeon General's Task Group on National Goals in Air Pollution Research, a distinguished outside group, which clearly set forth the respective roles of the Federal Government, the States and communities, and industry in air pollution research. In brief, the task force held: That "the Federal Government should be largely responsible for research of a broad nature and of general applicability * ** and for the training of specialized personnel" and should have "primary responsibility for development of information required to establish air quality standards and for the collection and distribution of information." That "the States and communities have a responsibility to support research on problems of primary interests to them ** That "the major contribution to be expected of industry relates primarily to the development of adequate and economical control equipment and procedures" and that "the cost of research involved in the development of control processes and equipment is largely the responsbility of industry." That "funds from private sources, such as research foundations and philanthropic organizations, may also be available" and "that the role of the universities and nonprofit research institutes will largely be confined to the conduct of research, the education and training of personnel, and the provision of consulting services." That "the full costs of enforcement will fall on the States and communities, and that the entire cost of control of industrial sources must be borne by industry.” And finally that "all such costs are ultimately borne by the public, so that it becomes a matter of how much society is willing to pay for research, control, and enforcement to maintain a clean and healthful environment." In December 1962, the Second National Conference on Air Pollution was held. President John F. Kennedy, in a message read at the opening session said: "It is imperative that this Nation act to preserve now, and for the years ahead, the purity of its air. The pollution of this priceless resource continues to jeopardize the economic vitality of our Nation and the health of millions of our citizens. This fact we can neither condone nor tolerate; we can and must, instead, resolve to use every appropriate means in a concerted effort to clear the air of its burden." Attending the Conference were approximately 1,400 professional and lay representatives of public groups, universities, industry, and local State and Federal Governments from both legislative and executive agencies. A fundamental change from the previous Conference, held in 1958, was evident. At the first conference the basic question was: "Is air pollution a significant problem, except for a few areas of the country?" At the 1962 Conference this was not even considered debatable. There was full consensus that air pollution is an important problem of nationwide significance. There was also general agreement that most air pollution is unnecessary, being preventable or controllable. Clean air can be obtained, usually at less cost to the public than it is now paying for dirty air. Of greater importance was the overwhelming body of evidence accumulated which substantiates the adverse effects of air pollutants on health. There was full agreement at the Conference that more must be done to reduce air pollution. Air must be regarded as an important and limited natural resource, whose quality must be conserved in the common interest. As a minimum, its quality must be sustained at a level which can be breathed with safety by all segments of the population, including individuals already in impaired health as well as the more susceptible groups. Over and above this minimum the citizens of the United States should be able to have, and can afford, air which is not only safe but pleasant to breathe. The Federal program Scope, philosophy, and objectives.-The Public Health Service air pollution program to date has been based on the philosophy that the basic responsibility for the regulatory control of air pollution rests with the States and local governments, and that the Federal role should be a supporting one of research, technical assistance to public and private organizations, and training of technical personnel. The basic objectives of the program are threefold: (1) To improve the status of knowledge about the causes and effects of air pollution and about the means of controlling it within acceptable limits; (2) to apply present and future knowledge to the actual control of air pollutants through technical assistance to States, communities, and industry; and (3) to stimulate all levels of government, industry, and the general public to devote increased attention and greater resources to the prevention and control of air pollution. In carrying out the Public Health Service program, the Division of Air Pollution, in addition to its own resources, accelerates its research by using the resources of many other organizations. These include Federal agencies, universities, and other research facilities. Contracts, grants, and cooperative projects are all employed for such purposes. Industrial groups also participate directly with the Division of Air Pollution in some of these cooperative undertakings. As examples, a joint project on measurement and evaluation of opacity of plumes from powerplant stacks is underway with the Edison Electric Institute. Another to study emission from the chemical industries has just been started with the Manufacturing Chemists Association. For several years, there has been close liaison with the Automobile Manufacturers Association, including joint support and planning of various research activities on air pollution related to motor vehicles. Out of these coordinated efforts has come the recent action of the industry of incorporating crankcase emission control procedures on all new vehicles this year, and intensified efforts to find effective methods for further reducing vehicular pollution. State and local agency cooperation is exemplified by their assistance in collecting samples for the National Air Sampling Network of the Division of Air Pollution. This network now numbers 250 stations, including at least one urban and one nonurban sampling point at every station. Fifty of these stations now sample gaseous, as well as particulate, pollutants. In nine cities, more comprehensive automatic sampling and analysis of gaseous contaminants is recorded continuously around the clock. These networks provide continuing information to assist States and communities in evaluating and dealing with their specific problems. Technical assistance (role of the Public Health Service) In a large majority of the jurisdictions which need control activity, State and local programs are nonexistent at present, or are grossly inadequate. Nationally, technical work in the field directed toward appraisal of problems and development of solutions is at a level far below that required for maintenance of an acceptable level of air quality. Over the next few years, the broad objectives of the technical assistance activity will be to assist States and communities in appraising overall problems and in developing "tailored" control programs, and to provide technical consultation on specialized problems. Cooperative FederalState-local demonstration projects will be used to foster and facilitate program development and to provide some of the information upon which to base program design. In general, the Public Health Service activity will be directed toward helping initiate programs and toward providing tools and techniques in a form useful in attaining this end. The provision of Federal grants to State and local agencies would furnish the stimulus necessary for the State and local control activity and would render the initial support for surveys to determine needs. In the more distant future, as State and local programs develop, greater emphasis can be given to assistance in the more technical aspects of air pollution control. Present non-Federal programs State agencies.-In 1961 there were only 17 States budgeting $5,000 or more for the administration of air pollution control programs. These are listed in table A. Of the $2 million total for these 17 States, 57 percent was spent by California. Most of these States engage in programs of technical assistance and development of local programs. Less than half “enforce" regulations. Six States monitor air quality on a statewide basis, and five review and approve plans for certain new installations which may cause air pollution. New York has recently adopted rules which require that the air pollution control board approve plans, before construction begins, for certain installations; provision is made to delegate such plan approval to qualified local agencies. One State, California, has set up a program for regulation of emissions from motor vehicles. Nine States have adopted laws which authorize cities or counties to operate air pollution control agencies with authority transcending municipal boundaries or otherwise to undertake interlocal cooperation. Two States (Oregon and California) have adopted standards for ambient air quality. Thirteen States have conducted statewide surveys to develop bases for programs, and four others are underway. Other activities of State agencies include training, dissemination of information, nuisance abatement work, provision of laboratory services to local agencies, study of pollutant emissions, and research on effects of pollution on man's health. However, only a few States engage in more than a few of these activities. Local agencies.-Data obtained from local agencies indicated the existence of 85 local air pollution control programs with annual budgets in 1961 of at least $5,000. From table B it will be seen that 34 of these had budgets of at least $25,000. The median per capita annual expenditure of these was 14.1 cents while the median for the other 51 was 7.8 cents. The median staff for all local programs was 1.3 per 100,000 population. Total expenditures for local programs was slightly over $8 million. TABLE A.-State air pollution programs, 1961 (those spending $5,000 per year or more) 1 Comprehensive includes regulation (control) technical assistance, studies, etc. ? Part time. 1959 estimate. |