Presenting author profile
Prof. Joachim von Braun, is distinguished Professor at Center for Development Research (ZEF) of Bonn University, Germany. He is President of the Pontifical Academy of Sciences, The Vatican. His research is on social, economic, technology, health and environmental issues related to low-income contexts. He studies related issues at macro and local community levels.
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Presenter - Policy Discussion
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Joachim von Braun (1)
1. University of Bonn, Bonn, Germany
Background
Export-oriented agriculture - especially coffee, horticulture, tea, and groundnuts - remains a cornerstone of economic growth, foreign exchange earnings, and rural livelihoods in East Africa. However, a substantial share of these gains relies on unpriced environmental, health, and social costs, including pesticide exposure, reduced school participation, and health effects of hazardous child labor, as well as land and water degradation. These externalities are systemic rather than marginal.
Methods/Approach
Evidence highlights three central policy insights: most externalities originate at the production stage, making farm-level interventions the most effective leverage point; no single instrument is sufficient: effective responses require balanced policy mixes combining regulation, incentives, voluntary standards, and enforcement; and third, fair cost-sharing along value chains is critical. Smallholders cannot bear transition costs alone; downstream actors and consumers must contribute through pricing, contracts, and co-investment. True Cost Accounting emerges as a practical policy tool to make trade-offs explicit, prioritize interventions, and design development-sensitive regulations. While not all externalities can be eliminated, many—particularly hazardous child labor and pesticide-related health risks—are preventable at relatively low cost.
Results
Priority actions include: integrating sustainability incentives, regulation, certification, and digital traceability into national agricultural and trade policies; sharing compliance costs through fair contracts and long-term sourcing commitments by private-sector actors;
Conclusions
Strengthening farmer organizations to reduce certification and compliance costs, providing subsidies and technical support for sustainable practices and ensuring sustainability regulations in consumer markets are development-sensitive.
Presenting author profile
Oladele (Dele) Ogunseitan holds the title of Distinguished Professor in the Departments of Global Health & Biobehavioral Sciences, and Environmental & Occupational Health at the University of California, Irvine. He co-directs the World Institute for Sustainable Development of Materials (WISDOM) and is a partner of the Institute for Sustainable Process and Resources Convergence for Critical Materials (SPARC).
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Presenter - Research Data
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Oladele A. Ogunseitan (1); Julie M. Schoenung (2); Seth Mehalic (2)
1. University of California, Irvine, California, USA
2. Texas A&M University, College Station, Texas, USA
Background
High Entropy Alloys (HEAs) are revolutionizing healthcare due to their exceptional biocompatibility, corrosion and wear resistance, and bone-mimicking properties. By strategically selecting non-toxic components, HEAs can replace flawed materials such as titanium alloys. Comparative assessment of the potential sustainability of complex materials including mixtures and alloys requires methodologies that appropriately distinguish between additive and non-additive material properties. Current approaches apply uniform weighted-average calculations across all sustainability criteria, which inadequately captures the complex, synergistic behaviors exhibited by toxicity and other non-additive indicators in alloys and other multi-component materials. This study develops and applies an improved methodology for criteria assessment in sustainability evaluation that explicitly distinguishes between additive criteria (e.g., cost, embodied energy) and non-additive criteria (e.g., human health damage, human and labor rights pressures).
Methods/Approach
We developed a toxicity-weighted scoring system that accounts for the disproportionate influence of highly toxic constituents through non-linear weighting functions. The methodology is applied to binary alloys (Fe-Ni, Fe-Mo), dilute alloys (Fe-based stainless steel, Ni-based superalloys), and HEA compositions (transition metal, refractory, and light-weight systems). Human health damage scores for individual metallic elements, derived from a published dataset, are used to calculate alloy-level scores as a function of alloy composition.
Results
The new methodology significantly influences materials selection options, with differences between the conventional and improved assessment ranging from 1 to 28 points (out of 100 possible points) in alloy-level human health damage scores. Alloying elements such as molybdenum and tantalum, with high individual elemental scores and known toxicity burdens, cause significant increases in alloy-level scores even when present in low concentrations. Reducing nickel content from >50% in superalloys to 20% in HEAs is advantageous due to nickel’s known carcinogenicity.
Conclusions
The study advances sustainability-informed materials selection for complex multi-component systems where empirical data remain unavailable, with implications extending beyond HEAs to other mixtures, formulations, compounds, and multi-material products.
Presenting author profile
Dr. Liliana Tenney is an Assistant Professor at the Colorado School of Public Health and Director of Strategy and Programs for the Centers for Health, Work & Environment. Her research and practice focus on implementation science, Total Worker Health®, organizational policy, workplace mental health, and employer adoption of evidence-based strategies to improve worker safety, health, and well-being across diverse industries.
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Presenter - Research Data
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Liliana Tenney (1); Lee S. Newman (1); Rebeca Velasco Reyna (2); Ivo Iavicoli (3)
1. University of Colorado, Aurora, Colorado, USA
2. Instituto Mexicano del Seguro Social, Mexico City, Mexico
3. Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
Background
Although evidence supporting Total Worker Health® (TWH) continues to grow, fewer studies describe how organizations successfully adopt and implement TWH in real-world settings. Since 2013, the Health Links® program at the Centers for Health, Work and Environment has partnered with more than 1,000 employers representing diverse industries, organizational sizes, and geographic regions to assess workplace policies and practices, build organizational capacity, and support implementation of evidence-based TWH strategies.
Methods/Approach
Health Links uses a structured implementation model centered on the Healthy Workplace Assessment, an organizational assessment aligned with six benchmarks of healthy workplaces: organizational support, health and safety, work-life integration, employee engagement, policies and benefits, and community engagement. Employers receive benchmarked feedback, tailored recommendations, advising, training, and recognition through a continuous quality improvement process. Assessment data collected over more than a decade have been used to evaluate implementation, characterize organizational needs, identify predictors of successful adoption, and refine implementation strategies.
Results
More than 1,000 employers, representing over 1 million workers across public, private, and nonprofit sectors, have participated in one or more Health Links activities, creating one of the largest organizational datasets examining TWH implementation in the United States. Findings demonstrate substantial variation in TWH maturity by employer size, industry, and organizational characteristics. Longitudinal assessment data show that repeated measurement, tailored advising, and sustained engagement support incremental improvements in workplace policies and practices while generating implementation evidence to inform continuous program refinement.
Conclusions
Scaling TWH requires implementation strategies that are practical, data-driven, and responsive to organizational context. The Health Links model demonstrates how assessment, technical assistance, and organizational partnerships can accelerate employer adoption of integrated worker health, safety, and well-being practices while advancing implementation science.
Presenting author profile
Dr. David Prezant is the New York City Fire Department's Chief Medical Officer, having started there as its pulmonary physician in 1986. Since September 11, 2001 (9/11), he has directed its World Trade Center Health Programs including its Data Center. He also is a Professor of Medicine at the Albert Einstein College of Medicine.
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Presenter - Research Data
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David Prezant (1,2,3); Rachel Zeig-Owens (1,2); David Goldfarb (1,2); Micheal Weiden (1,3); Anna Nolan (1,3); Krystal Cleven (1,2); Theresa Schwartz (1,2); Madeline Cannon (1,2); Charles Hall (1,2); Jaeun Choi (1,2); Brandon Vaeth (1,2); Ankura Singh (1,2); Alexandra Mueller (1,2); Julia Sese (1,2); Tyrone Moline (1,2); Yang Lui (4)
1. World Trade Center Health Program at Fire Dept of City of New York, New York, USA
2. Albert Einstein College of Medicine and Montefiore Medical Center, New York, New York, USA
3. New York University (NYU) Langone Medical Center, New York, New York, USA
4. Fire Department of City of New York, New York, USA
Background
The September 11, 2001 (9/11) World Trade Center (WTC) disaster resulted in large scale exposure to the tragedy including the respirable particulate matter and combustion byproducts among responders and community survivors. Compassion driven advocacy mobilized philanthropic and governmental resources to provide medical monitoring. Data driven advocacy led to long-term funding under the federally mandated WTC Health Program, providing medical monitoring and treatment of WTC-qualifying conditions and supporting WTC health-related research.
Methods/Approach
Nearly all Fire Department of City of New York (FDNY) responders were present within 48 hours and remained on-site for months. FDNY’s pre-existing occupational health infrastructure enabled immediate initiation of post-exposure monitoring and facilitated comparisons with pre-WTC data. This review synthesizes findings from numerous studies involving FDNY firefighters and EMS responders, including analyses of respiratory, cancer, autoimmune, cardiovascular, sleep-related, and cognitive disorders.
Results
Long-term follow-up confirmed elevated rates of accelerated lung function decline, upper and lower respiratory diseases, sarcoidosis, PTSD and sleep apnea. Cancer surveillance detected modest excess incidence, (SIR) of 1.10 (95% CI 0.98–1.25) for all cancers compared with US males, and relative rates (RR) between 1.19 and 1.32 when WTC-exposed firefighters were compared to non-exposed firefighters with site-specific cancer elevations for melanoma, thyroid, prostate and lymphoma. Autoimmune outcomes showed those highly exposed having ~7.7 excess cases relative to background rates. Based on growing epidemiologic evidence, submitted petitions to the federal government seeking expansion of program coverage to include autoimmune, cardiovascular, and cognitive conditions.
Conclusions
Continued long-term surveillance remains essential for characterizing conditions with multi-decade latency. Future research will focus on identifying biomarkers that could assist in early diagnosis, potentially leading to improved outcomes. For future disaster responses, lessons learned from the WTC attack underscore the importance of pre-existing occupational health systems, standardized data, early cohort establishment, biomarker collection, and structured longitudinal follow-up in future disaster responses.
Presenting author profile
Dr. Maria Ferri is a physician currently completing her residency training in occupational medicine and is board-certified in nephrology.
Format
Presenter - Policy Discussion
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Maria Ferri (1,2); Giulia Piazza (1); Simonetta Cimino (3); Loretta Casolari (2); Gabriele Donati (2); Roberto Lucchini (1,4); Alberto Modenese (1)
1. University of Modena and Reggio Emilia, Modena, Italy
2. Modena University Hospital, Modena, Italy
3. AUSL di Modena, Modena, Italy
4. Florida International University, Miami, Florida
Background
Chronic Kidney Disease (CKD) is a growing global public health burden. Beyond metabolic and vascular determinants, environmental and occupational exposures are increasingly recognized as potentially modifiable contributors. CKD was the ninth leading cause of death worldwide in 2023 and is projected to rank fifth by 2040.
Methods/Approach
CKD is classified according to estimated glomerular filtration rate and albuminuria. In the CARHES survey, the prevalence of advanced CKD (stages 3–5) in Italy was 2.89%. In Modena Province, we found a prevalence of 5.64% in 2023, almost twice the national estimate and higher among women than men (6.19% vs 5.07%). Since 2017, Modena has recorded the highest incidence of dialysis initiation in Emilia-Romagna, reaching 196 cases per million population in 2023, compared with 167 regionally, together with longer dialysis duration. This persistent excess is not readily explained by a single clinical or genetic determinant. Employment in industry is substantially higher in Modena Province than nationally (42% vs 27%): over 60,000 workers are employed in metalworking/mechanical engineering and ceramic activities. Notably, excess end-stage kidney disease has previously been reported in both sectors (Rapiti et al., 1999; Shrestha et al., 2022). Other locally relevant exposures may include heat stress, inadequate hydration, heavy physical workload, nephrotoxic metals, agrochemicals and silica. Migrant workers may be particularly vulnerable: in 2022, they represented over 18% of the local hemodialysis population and initiated dialysis younger than Italian-born patients.
Results
Modena’s excess CKD and dialysis burden constitutes a persistent epidemiological signal. Integrated research linking clinical and registry data with occupational histories, environmental monitoring, socioeconomic conditions, migration-related vulnerabilities and heat exposure is urgently needed.
Conclusions
Collaboration among nephrology, occupational medicine and public health could strengthen surveillance, prevention and early detection of kidney dysfunction in high-risk populations.
Presenting author profile
Linda Reinstein, BCPA, is President and CEO of the Asbestos Disease Awareness Organization (ADAO). For more than two decades, she has collaborated with physicians, scientists, Congress, and federal agencies to advance evidence-based asbestos prevention policy. Her work focuses on translating scientific evidence into regulatory, legislative, and public health action in the United States and internationally.
Format
Presenter - Policy Discussion
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Arthur L. Frank (1); Linda Reinstein (2); Christian Hartley (3)
1. Drexel University, Philadelphia, Pennsylvania, USA
2. Asbestos Disease Awareness Organization, Manhattan Beach, California, USA
3. Maune Raichle Hartley French & Mudd, LLC, Mount Pleasant, South Carolina, USA
Background
Despite possessing the world’s most extensive scientific and clinical records on asbestos-related disease, the United States remains among the few industrialized nations without a comprehensive asbestos ban. This presentation examines the gap between scientific consensus and public health policy and the factors that have limited the translation of evidence into effective action.
Methods/Approach
Using a policy-analytic framework, this presentation examines the scientific record established through Dr. Irving Selikoff’s epidemiologic studies and its translation into judicial proceedings, including Borel v. Fibreboard Paper Products Corp. (1973). Drawing on two decades of engagement in asbestos policy, the analysis identifies structural factors limiting the participation of physicians and scientific institutions in policymaking. Recent EPA actions illustrate progress and continuing gaps. In 2024, EPA finalized its TSCA Part 1 risk management rule addressing chrysotile asbestos, while development of the Part 2 rule addressing legacy asbestos has been delayed despite EPA’s determination that legacy uses present an unreasonable risk. The bipartisan Senate reintroduction of the Alan Reinstein Ban Asbestos Now Act of 2026 offers an opportunity to translate scientific evidence into comprehensive public health policy and protection. Three findings emerge: scientific consensus has not produced comprehensive prevention policy; regulatory action has remained incremental despite decades of evidence; and scientific expertise has not been consistently integrated into policymaking.
Results
The U.S. experience demonstrates that scientific consensus is insufficient to achieve effective asbestos prevention. Translating scientific evidence into public health policy and protection requires engagement by physicians, scientists, and public health experts throughout the regulatory, legislative, and administrative policymaking process.
Conclusions
The Collegium Ramazzini is uniquely positioned to strengthen the translation of science into prevention by fostering collaboration between scientific experts and policymakers. Participation by physicians and scientific institutions can help advance evidence-based asbestos policy and public health protection in the United States and in jurisdictions where asbestos bans remain unresolved.