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Sustainable production refers to technological and social systems for making, using, and delivering products or services in a manner that integrates concerns for the long-term viability of the environment, the health and safety of workers and community-members, and the economic life of a particular firm.[1] It involves the elimination of hazards early in the design phase for goods or services, as opposed to controlling hazards after they have been released into the environment, with a goal of designing and using products, work processes, and practices that do not harm human or environmental health. Sustainable production, by focusing on design, can create incentives for business innovation.

Sustainability

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The most frequently cited definition of sustainability comes from the term ’sustainable development’ popularly identified in the 1987 report “Our Common Future”, by the United Nations World Commission on Environment and Development, often called the ‘Brundtland Report’[2][3]. By that formulation, the term sustainable development means ‘‘development that meets the needs of the present without compromising the ability of future generations to meet their own needs.’’ Since the publication of the Brundtland Report, the term ’sustainable’ has been used broadly to refer to the conservation of natural resources in general, use of energy that does not disrupt climate, and the promotion of economic development that does not jeopardize environmental quality.

Production

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‘Production’ refers to those activities intended to create and distribute goods and services for economic and/or social benefits. This broad definition includes such activities as caregiving, food preparation, health care, office work, and cleaning services as well as agriculture, construction, manufacturing, and other industrial activities.

The framework of sustainable production is facility or industry specific. It focuses on specific production processes within a particular business enterprise, rather than on global development. Sustainability includes the health and safety of workers and the community as well as the environment. ‘Workers’ refers to all those employed at a facility, and ‘community’ refers to all those living near a particular production facility or those impacted by a facility’s behavior and output, including consumers. The idea that environmentally-sound business practices should include worker and community concerns is already well developed in labor [4] [5] [6] and environmental justice[7]. Sustainable production methods assist individual businesses to meet the United Nations Department of Economic and Social Affairs Sustainable Development Goals, particularly Sustainable Development Goal 12: ensure sustainable consumption and production patterns [8].

How Sustainable Production Works

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Premise

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Production is a common source both of social benefit and harm. Production materials, processes and products generate essential economic development and prosperity but also the potential harm of environmental damage and workplace and community hazards. Often, harm to human health and the environment are considered inevitable consequences of economic ‘progress.’ Sustainable production challenges this notion of inevitability and offers a framework for ‘designing out’ the harm currently inherent in many of our products and the way we make and use them and, instead, ‘designing in’ health and ecological benefits.

Sustainable Production and the Climate Crisis

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The energy used to produce and distribute materials and consumer products comes mainly from fossil fuels. Additionally, many toxic materials themselves are derived from fossilized carbon in the forms of coal, oil, and natural gas, such as benzene and other aromatic hydrocarbons and plastics. [9] Experts suggest that to effectively address the climate crisis, it is essential to shift energy sources from fossil fuels to renewables, such as solar, wind, and geothermal sources. Thus, as this shift occurs, it also is essential that the carbon from oil, coal, and gas be left in the ground and not simply shifted into the production of consumer products and materials. Recent data show that the amount of carbon going into consumer products and plastics is increasing at the same time that the use of renewable energy sources are increasing. Sustainable production methods can be used to decarbonize products and materials[10] as an important strategy to reduce fossil carbon use overall[11]. [12][13]

Basis in Continuous Improvement Methods

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Sustainable production is an ongoing process, rather than a specific endpoint. Safer materials and practices are emerging regularly and so applying sustainable production methods at a worksite will involve continuous improvement practices[14].

A major tool for engaging in sustainable production is ‘Alternatives Assessment,’ a method to evaluate the relative differences between a conventional material or practice and one or more alternatives for a particular application. This is accomplished by characterizing products or processes from many aspects (e.g., climate impacts, human and environmental toxicity, cost, ergonomics, space requirements) and systematically comparing overall performance. Thus, the focus is on the process by which an alternative is evaluated and implemented rather than on a particular alternative. When a new alternative becomes available, the process to evaluate it is repeated. Alternatives assessment is now applied in many business enterprises[15]. The professional organization ‘Association for the Advancement of Alternatives Assessment’ addresses the science, policy, and practice of alternatives assessment and informed substitution with safer alternatives[16].

As conventional products and practices are assessed and safer alternatives considered, Sustainable production uses participatory models of decision-making, action, and evaluation. That is, those impacted by an existing product or practice should be involved in the definition and scoping of its problems and by solutions to be implemented and maintained[14].

Guidelines for Implementing Sustainable Production

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Experts use these nine principles as guidelines for implementing sustainable production [17]:

  1. Products and packaging are designed to be safe and ecologically sound throughout their life cycle and services are designed to be equally safe and sound;
  2. Waste and ecologically incompatible byproducts are reduced, eliminated or recycled;
  3. Energy and materials are conserved, and the forms of energy and materials are ecologically compatible;
  4. Chemical substances, physical agents, technologies, and work practices that present significant hazards to human health or the environment are eliminated;
  5. Workplaces are designed to minimize or eliminate physical, chemical, biological, and ergonomic hazards;
  6. Workplace decision making is an open and participatory process of continuous evaluation and improvement, encouraging the long-term over short-term economic viability of the enterprise;
  7. Work is organized to conserve the efficiency and enhance the creativity of all employees;
  8. The security and well-being of all employees is a priority, as is the continuous development of their talents and capacities; and
  9. The communities around workplaces are respected and enhanced economically, socially, culturally and physically with a commitment to social equity and fairness.

Why the Sustainable Production Framework is Needed

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Current regulatory and compliance frameworks address environmental and worker protection separately[1]. However, most hazards to workers, community members, and the environment come from the same sources; and conventional workplace vs. environment approaches create a gap in the way we define the problems and especially in how we develop comprehensive solutions in order to create a more ecologically sustainable and socially equitable world.

Limitations of Focusing Only on Controlling Occupational and Environmental Pollution and Other Hazards

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U.S. occupational and environmental regulation since 1970 has involved intensive and costly programs to reduce air pollution in workplaces and in ambient environments, water pollution, and hazardous wastes[18][19][20][21]. Both occupational and environmental regulatory strategies involve enforcement of emission controls or other hazards generated by production processes such as safety and ergonomic hazards, work organization and psycho-social hazards. These strategies take the hazards as a given and then aim to control them downstream. The term “end of the pipe” is sometimes used to describe downstream control strategies, drawing on the image of a waste pipe or smokestack that comes out of a workplace emitting water or air pollution. Current controls strategies[1] are aimed at placing pollution collection technologies like air cleaning or water filter systems on the waste pipe, that is, at the end of the pipe.

While regulatory and compliance policies continue to be essential incentives for producers to reduce pollution and other environmental and workplace hazards, they also have limitations:

  • In the USA, each pollutant or other type of hazard is regulated separately and thousands of chemicals currently on the market are unregulated with thousands of new chemicals being commercialized each year. The regulatory process is slow and costly including expensive debates over what are "safe" levels of pollution or "acceptable" health risks.
  • Reducing exposure by capturing or limiting it after it has been produced, but not before people and environment are exposed, can never be completely safe.
  • Control technologies represent an unproductive cost in that end-of-pipe strategies are often aimed at limiting production and resources invested in control are not spent developing and commercializing the product. Additionally, cost rises exponentially with pollution removal efficiency and a device to remove nearly 100% of a pollutant is very expensive. Thus controlling existing hazards is often viewed by business as limiting economic activity. This framing perpetuates conflicts between environmental quality and economic development and between labor and environmentalists
  • Additionally, control technologies can fail through unforeseen catastrophes which are increasing in frequency and severity with climate destabilization including environmental disruption from wildfires, floods, hurricanes, or earthquakes and social disruption from war, mass population migration, and terrorism and with financial disinvestment, neglect or reduced commitment to safety.

In the long-term, it is often more effective and less costly to remove a hazard than to try to control it after it has been created (“at end of pipe”). For existing processes and products, this involves re-design to eliminate hazards; for new processes, design for inherent safety and health for workers, communities, and environment.[1]

A combined “carrot and stick” approach is needed to move towards sustainable production: incentivizing production innovations that promote ecosystem health and safety while penalizing harmful production.

Government

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In the USA, state and national regulatory agencies are moving to include strategies aimed at eliminating hazards at their source in addition to compliance activities aimed at controlling existing hazards[22]. Examples of state programs include the Massachusetts Toxics Use Reduction Institute (TURI)[23] and the University of California Berkeley Center for Green Chemistry[24].

Examples of federal programs include: US National Institute for Occupational Safety and Health Program on Prevention through Design and US Environmental Protection Agency Safer Choice program[25].

Business

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In an economic environment where demand-side growth predominates, sustainable production can help firms gain an advantage by increasing supply-side capabilities and productivity[26]. New materials or processes that are healthier or more efficient yield benefits that are often scalable in ways that “end-of-pipe” fixes are not. Additionally, healthier and happier workers are inherently more productive, reduce employee turnover, and are less costly to insure[27].

There are challenges to bridging the gap between current production methods and desired new methods. While customers can often effectively pressure firms to make production more sustainable, the transition to a new process can be costly and difficult, even more so for smaller firms. When constant production is required, larger firms may be able to slowly shift production in a stepwise fashion, but this is much harder for smaller firms, that may have only one production process. Resources need to be made available to help firms manage the transitional costs of making production more sustainable[28].

Education

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The sustainable production perspective has important implications for university education at the undergraduate and graduate levels[29]. To move a firm toward sustainable production, occupational health and safety professionals need to participate in interdisciplinary workplace teams that design and build new production processes and that continuously evaluate and redesign existing processes.

Occupational and environmental professional practice currently focuses on the development of solutions to environmental problems after they have occurred. Often, the development of solutions begins from the identification and quantification of harm that is accepted to be inherent in production processes, rather than from a review of the purpose and function of the production process itself. This approach continually reduces an end-of-pipe problem to smaller scales in pursuit of the single, causal agent or fundamental physical principle that governs it. Such focus on first principles is useful because it can provide a sound scientific basis for controls. However, professional education in the sciences and engineering often overlooks the large-scale forces that are the social, economic, and political context of production processes[30]. Another way to look at this is as if we are looking through an ever more powerful microscope lens that focuses on the molecular level but obscures the whole organism.

There is growing acknowledgment, even among some sectors of private industry, that the production processes that generate the problems need fundamental redesign. This means that the environmental professional must be trained to be much more flexible, collaborative, and creative than in the past. The transition to Sustainable Production calls for professionals who are not simply trained to monitor a static industrial environment, but who are agents of change[31]. The Department of Work Environment[1], which trained master’s and doctoral students at the University of Massachusetts Lowell from 1987 to 2015 was a highly successful example of an interdisciplinary training program with a focus on sustainable production.

Sustainable Production and Work Environment Programs at the University of Massachusetts Lowell in the USA

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The Department of Work Environment was founded in 1986 as a department of the College of Engineering at the University of Lowell. Between 1988 and 2020, it graduated nearly 500 students with master’s of science (MS) and doctor of science (ScD) degrees in Work Environment.

The Work Environment Programs had four broad objectives: (1) to recognize and evaluate environmental and occupational health and safety hazards; (2) to control and prevent environmental and occupational health and safety hazards; (3) to develop, implement and evaluate sustainable interventions to improve health, safety and the environment in workplaces and communities; and (4) to promote and disseminate technologies and practices which are shown to be effective and consistent with a healthy and safe approach to economic development[32].

The core of the academic programs were the MS degree programs in Occupational & Environmental Hygiene, Pollution Prevention-Cleaner Production, and Occupational Ergonomics & Safety. There was also an MS program in occupational epidemiology. In addition, the ScD program in Work Environment attracted outstanding students from many countries who were trained in a strong interdisciplinary curriculum. An important resource for the graduate training programs was federal funding in the form of a National Institute for Occupational Safety and Health (NIOSH) Training Program Grant (TPG)[33].

Research

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Sustainable production proceeds with practical, actionable steps. Some of these are already clearly defined and achievable, but many require innovation and entirely new materials, technologies and ways of living on the planet. The Lowell Center for Sustainable Production is one example of a research center established to do this work. It engages with businesses, labor, communities and non-governmental organizations (NGOs) on specific projects to apply and expand sustainable production in a variety of contexts[34].

Lowell Center for Sustainable Production

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Founded at the University of Massachusetts Lowell USA in 1994, the Lowell Center for Sustainable Production is a leading academic center for action-oriented research, policy development, and collaborative initiatives focused on eliminating health and environmental hazards in products, workplaces, and communities and promoting safer alternatives[34]. The team is comprised of faculty, staff and students trained in environmental and occupational health sciences and policy, and experienced in research translation, systems thinking and strategic convening. The Lowell Center for Sustainable Production works closely with an affiliated organization at the University of Massachusetts Lowell, the Toxics Use Reduction Institute (TURI), which provides technical and other resources to businesses and communities to reduce or eliminate their use of toxic chemicalsFounded at the University of Massachusetts Lowell USA in 1994, the Lowell Center for Sustainable Production is a leading academic center for action-oriented research, policy development, and collaborative initiatives focused on eliminating health and environmental hazards in products, workplaces, and communities and promoting safer alternatives[34]. The team is comprised of faculty, staff and students trained in environmental and occupational health sciences and policy, and experienced in research translation, systems thinking and strategic convening. The Lowell Center for Sustainable Production works closely with an affiliated organization at the University of Massachusetts Lowell, the Toxics Use Reduction Institute (TURI), which provides technical and other resources to businesses and communities to reduce or eliminate their use of toxic chemicals.

The Lowell Center for Sustainable Production has been instrumental in the founding and nurturing of a range of impactful collaborations that apply the principles of sustainable production, evaluate their effectiveness and identify improvements in specific industries, production processes, materials’ redesign, and/or community initiatives to reduce toxic exposures and promote health and safety. These collaborative projects include: Change Chemistry[15] (formerly known as the Green Chemistry and Commerce Council - GC3[35]; the Interstate Chemicals Clearinghouse; the Association for the Advancement of Alternatives Assessment[16]; the Sustainable Hospitals Program[36]; the Asthma Regional Council of New England[37]; the Cancer Free Economy Network[38], and the Southwestern Pennsylvania Cancer and Environment Network[39]; and the Safe Home Care Project[40].

Major projects of the Lowell Center for Sustainable Production and the questions they address include:

Transitioning away from fossil fuels

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Change Chemistry (formerly GC3)

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Change Chemistry[15] is an international, multi-stakeholder collaborative that drives the commercial adoption of green chemistry by guiding action across all industries, sectors and supply chains. Formerly called the Green Chemistry & Commerce Council (GC3), the name Change Chemistry was adopted to better reflect the organization’s mission.

Change Chemistry works to accelerate the development and commercialization of sustainable chemistry solutions in response to market, science, and policy drivers. Developing and commercializing innovative chemistry solutions and the products that incorporate them is a necessarily disruptive market process that can result in replacement of—and/or improvement on—existing chemistry. Change Chemistry’s efforts to drive large scale commercial adoption of safer, sustainable and high performing chemical solutions may focus on specific functions, chemicals or classes identified by members as priorities for innovation and substitution, which may disrupt the market for incumbent chemicals. In setting priorities for its projects, Change Chemistry seeks input from its members, scientists, government authorities, and others to develop its priorities for innovation and commercialization.

Alternatives Assessment and Informed Substitution

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The Association for the Advancement of Alternatives Assessment (A4)[16] is a professional association solely dedicated to advancing the science, practice, and policy of alternatives assessment and informed substitution. A4 is an interdisciplinary community of researchers and practitioners from government agencies, academia, industry, and non-profits working collaboratively to accelerate the transition to the use of safer chemicals, materials, processes, and products.

Sustainable Hospitals Program

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The Sustainable Hospitals Program[41] works with hospitals and other healthcare facilities to replace hazardous products and materials with alternatives [14] [42]safer for healthcare workers and for the environment. Projects were conducted in the USA, Mexico and Ecuador.

Reducing cancer risks

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Cancer remains a devastating health crisis nearly forty years after the declaration of war on the disease. People with cancer are living longer, thanks to improved treatment and earlier detection, but the incidence of many types of cancer continues to rise – cancers with strong links to environmental and occupational exposures. Lowell Center[43] conducts and tracks research on the role of environmental and occupational exposures in the cancer epidemic and develop tools and strategies for reducing the use of toxic chemicals that contribute to the disease. LCSP publishes journal articles, reports and fact sheets that translate studies on links between industrial chemicals and pesticides and various types of cancer, and trends in exposure and disease.

Much of this cancer prevention work is directed through two principal initiatives:

The Cancer Free Economy National Network

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A national network[38] of over 50 organizations working together on strategies to eliminate toxic chemicals from the economy and lift the burden of cancer caused by these chemicals within a generation.[44] [45] Among the projects of the Cancer Free Economy Network are: advancing research and raising attention to environmental contributors to cancer among health and science professionals; shifting markets away from toxics and towards safer alternatives; supporting community-based and grassroots organizations disproportionately exposed to toxic chemicals; and amplifying communications on links between environment and cancer.

The Southwestern Pennsylvania Cancer and Environment Network

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This community initiative[46] was established by the Lowell Center and regional partners. The Network designs and implements projects in Pittsburgh and the surrounding counties in the realms of policy, education/outreach to cancer-impacted people, engagement with communities disproportionately exposed to environmental chemicals, and research/science support.

Creation of safer workplaces[1] and improvement of social equality

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The Safe Home Care Project

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The UMass Lowell Safe Home Care Program was founded in 2004 and partners with home care industry stakeholders, such as home care agencies, home care industry associations, labor unions, and government agencies. The project works from the premises that:

  1. the creation of safe and healthy jobs with living wages is a concrete way to improve social inequalities; and
  2. improving safety and health in home care will improve the safety of home care recipients as well as the safety of home care workers.

Home health and home care aide jobs are among the fastest growing in the USA and home care provides an important alternative to facility-based care for older adults and people living with disabilities. The Safe Home Care Project’s earliest research focused on reducing needlesticks and other medical sharps injuries and blood exposures that cause serious infection risks among home healthcare nurses and aides. The research expanded to investigate a broad range of occupational hazards and good practices. Additional phases were undertaken to develop guidance for the home care industry on infection prevention and effective and safe cleaning and disinfection products and practices. An intervention study produced materials and methods to promote home care worker and patient safety[47].

See also

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References

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  1. ^ a b c d e f Quinn, Margaret M.; Kriebel, David; Geiser, Kenneth; Moure-Eraso, Rafael (October 1998). "Sustainable production: A proposed strategy for the work environment". American Journal of Industrial Medicine. 34 (4): 297–304. doi:10.1002/(SICI)1097-0274(199810)34:4<297::AID-AJIM1>3.0.CO;2-Q.
  2. ^ Our Common Future: World Commission on Environment and Development, The Brundtland Report, United Nations 1987 https://www.un.org/en/academic-impact/sustainability
  3. ^ United Nations Academic Impact: Sustainability, https://www.un.org/en/academic-impact/sustainability
  4. ^ Slatin C; Rosenberg B; Siqueira E (August 2009). "New Solutions and the Blue Green Alliance—Good Jobs, Green Jobs Conference". NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy. 19 (2): 105–106. doi:10.2190/NS.19.2.a.
  5. ^ Rossi, Mark (November 2007). "The Louisville Charter for Safer Chemicals: A Platform for Creating a Safe and Healthy Environment through Innovation". NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy. 17 (3): 173–175. doi:10.2190/NS.17.3.b.
  6. ^ Wilson, Michael P.; Schwarzman, Megan R. (August 2009). "Toward a New U.S. Chemicals Policy: Rebuilding the Foundation to Advance New Science, Green Chemistry, and Environmental Health". Environmental Health Perspectives. 117 (8): 1202–1209. doi:10.1289/ehp.0800404.
  7. ^ Bullard, Robert (2008). Differential Vulnerabilities: Environmental and Economic Inequality and Government Response to Unnatural Disasters. Social Research: An International Quarterly 75:753-784.
  8. ^ https://sdgs.un.org/goals
  9. ^ Tickner, Joel; Geiser, Ken; Baima, Stephanie (2 November 2021). "Transitioning the Chemical Industry: The Case for Addressing the Climate, Toxics, and Plastics Crises". Environment: Science and Policy for Sustainable Development. 63 (6): 4–15. doi:10.1080/00139157.2021.1979857.
  10. ^ Joel Tickner, Ken Geiser & Stephanie Baima (2022) Transitioning the Chemical 1) Industry: Elements of a Roadmap Towards Sustainable Chemicals and Materials, Environment: Science and Policy for Sustainable Development, 64:2, 22-36, doi.org/10.1080/00139157.2022.2021793
  11. ^ Joel Tickner, Ken Geiser & Stephanie Baima (2021) Transitioning the Chemical Industry: The Case for Addressing the Climate, Toxics, and Plastics Crises, Environment: Science and Policy for Sustainable Development, 63:6, 4-15, DOI: 10.1080/00139157.2021.1979857 https://www.tandfonline.com/doi/epdf/10.1080/00139157.2021.1979857?needAccess=true
  12. ^ Joel Tickner, Ken Geiser & Stephanie Baima (2022) Transitioning the Chemical Industry: Elements of a Roadmap Towards Sustainable Chemicals and Materials, Environment: Science and Policy for Sustainable Development, 64:2, 22-36, doi.org/10.1080/00139157.2022.2021793
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  14. ^ a b c Quinn, Margaret M.; Fuller, Thomas P.; Bello, Anila; Galligan, Catherine J. (April 2006). "Pollution Prevention—Occupational Safety and Health in Hospitals: Alternatives and Interventions". Journal of Occupational and Environmental Hygiene. 3 (4): 182–193. doi:10.1080/15459620600584295.
  15. ^ a b c https://changechemistry.org/
  16. ^ a b c https://saferalternatives.org/
  17. ^ Veleva, V; Hart, M; Greiner, T; Crumbley, C (October 2001). "Indicators of sustainable production". Journal of Cleaner Production. 9 (5): 447–452. doi:10.1016/S0959-6526(01)00004-X.
  18. ^ US Environmental Protection Agency Clean Air Act 1970 https://www.epa.gov/clean-air-act-overview/evolution-clean-air-act
  19. ^ US Environmental Protection Agency Clean Water Act 1972 https://www.epa.gov/laws-regulations/summary-clean-water-act
  20. ^ US Environmental Protection Agency Superfund Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) 1980 https://www.epa.gov/superfund/superfund-cercla-overview
  21. ^ US Occupational Safety and Health Act https://www.osha.gov/laws-regs/oshact/completeoshact
  22. ^ Geiser K, Materials Matter: Towards a Sustainable Materials Policy (2001), The MIT Press, Cambridge, Massachusetts.
  23. ^ https://www.turi.org/
  24. ^ https://bcgc.berkeley.edu/
  25. ^ https://www.epa.gov/saferchoice
  26. ^ Geiser K. Chemicals without Harm. Policies for a Sustainable World. MIT Press 2015. ISBN 9780262512060
  27. ^ Harvard Chan Center for Work, Health and Well-Being: https://centerforworkhealth.sph.harvard.edu/
  28. ^ https://www.turi.org/
  29. ^ Approaches to Sustainable Development, The Public University in the Regional Economy. Robert Forrant, William Lazonick, Charles Levenstein, Jean L. Pyle, eds. University Of Massachusetts Press 2001. ISBN: 978-1-55849-305-6
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  31. ^ Kriebel D. Occup Environ Med 2023;80:485–488. https://oem.bmj.com/content/oemed/80/9/485.full.p
  32. ^ Kriebel D, Geiser K, Crumbley C, The Lowell Center for Sustainable Production: Integrating Environment and Health in Regional Economic Development, Chapter in Approaches to Sustainable Development, The Public University in the Regional Economy, Edited by Forrant R, Pyle J, Lazonick W, and Levenstein C, University of Massachusetts Press, 2001
  33. ^ https://www.cdc.gov/niosh/oep/trainprojgrnts.html
  34. ^ a b c https://www.sustainableproduction.org
  35. ^ https://www.greenchemistryandcommerce.org/
  36. ^ https://www.uml.edu/research/shch/sustainable-hospitals/
  37. ^ https://www.asthmacommunitynetwork.org/node/710
  38. ^ a b https://www.cancerfreeeconomy.org/
  39. ^ https://censwpa.org/
  40. ^ https://www.uml.edu/Research/SHCH/
  41. ^ https://www.uml.edu/research/shch/sustainable-hospitals/
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  44. ^ Kriebel D, Cancer Prevention through a Precautionary Approach to Environmental Chemicals, President’s Cancer Panel, September 2008
  45. ^ Kriebel, David; Hoppin, Polly J.; Jacobs, Molly M.; Clapp, Richard W. (1 November 2016). "Environmental and Economic Strategies for Primary Prevention of Cancer in Early Life". Pediatrics. 138 (Supplement_1): S56–S64. doi:10.1542/peds.2015-4268I.
  46. ^ https://censwpa.org/
  47. ^ https://www.uml.edu/research/shch/