About Publications

Publications from the National Academies of Sciences, Engineering, and Medicine provide objective and straightforward advice to decision makers and the public. This site includes Health and Medicine Division (HMD) publications released after 1998. A complete list of HMD’s publications from its establishment in 1970 to the present is available as a PDF.


  • Technologies to Enable Autonomous Detection for BioWatch ... Released: September 04, 2013
    In response to a request from DHS, the Institute of Medicine and the National Research Council hosted a workshop June 25-26, 2013, that explored alternative cost-effective systems that would meet the requirements for a BioWatch autonomous detection system for aerosolized agents. The workshop, which was catalyzed by five commissioned white papers, considered the advantages and disadvantages of several technologies—nucleic acid signatures, immunoassays and protein signatures, genomic sequencing, and mass spectrometry — and the timeframe in which an integrated autonomous biodetection system using these technologies might be deployed. Additionally, the features and capabilities of an autonomous detection system that would be of value to public health officials and decision makers were discussed. This document summarizes the workshop.
  • Health Impact Assessment of Shale Gas Extraction ... Released: August 30, 2013
    The governmental public health system lacks critical information about environmental health impacts of shale gas extraction technologies and is limited in its ability to address concerns raised by federal, state, and local regulators, as well as employees in the shale gas extraction industry and the general public. Members of the IOM Roundtable on Environmental Health Sciences, Research, and Medicine recognized the need to discuss the human health impact of shale gas extraction through the lens of health impact assessment. The Roundtable held a workshop in 2012 to examine the state of the science regarding shale gas extraction, the direct and indirect environmental health effects of shale gas extraction, and the use of health impact assessment as a tool to help identify the public health impact of shale gas extraction.
  • Public Health Linkages with Sustainability - Workshop ... Released: July 19, 2013
    It has been 20 years since the 1992 Earth Summit in Rio de Janeiro when world leaders gathered to reaffirm the Declaration of the United Nations Conference on the Human Environment that was adopted in 1972. From this meeting, the member states adopted Agenda 21, an unprecedented framework for the transition to a more sustainable world. As leaders prepared to gather again in 2012 in Rio de Janeiro, to assess and reaffirm the importance of the world’s progress toward these efforts, the IOM Roundtable on Environmental Health Sciences, Research, and Medicine organized a workshop to inform the policies that would be considered at the conference and discuss the linkages between sustainability and health.
  • Review of the Department of Labor's Site Exposure Matrix ... Released: March 27, 2013
    In 2000, Congress authorized compensation for Department of Energy (DOE) workers and contractors who attest that they suffer from a disease that is linked to their occupational exposure to toxic material at nuclear-related sites and facilities. To assist with compensation determinations for DOE contractors, the Department of Labor (DOL) uses a database, the Site Exposure Matrix (SEM), which was designed to organize, display, and communicate information on the toxic substances found at those sites and health effects associated with exposure to the substances. The IOM reviewed the SEM database and its use of a particular database, Haz-Map, as the sources of its toxic substance-occupational disease link. This report describes the strengths and shortcomings of both databases, and offers recommendations for improvements that could be made in both databases with a focus on enhancing the scientific rigor of SEM for both DOL claims examiners and former DOE workers.
  • Challenges and Opportunities for Change in Food Marketing ... Released: March 04, 2013
    The childhood obesity epidemic is an urgent public health problem, and it will continue to take a substantial toll on the health of Americans. The most recent data show that almost a third of U.S. children and adolescents are overweight or obese. Children are exposed to an enormous amount of commercial advertising and marketing for food. In 2009, children age 2-11 saw and average of more than 10 television food ads per day. The marketing of high-calorie, low-nutrient foods and beverages is linked to overweight and obesity. The IOM hosted a workshop which examined contemporary trends in marketing of foods and beverages to children and youth and the implications of those trends for obesity prevention.
  • Environmental Decisions in the Face of Uncertainty : Health ... Released: February 08, 2013
    The EPA estimates the nature, magnitude, and likelihood of risks to human health and the environment; identifies the potential regulatory actions that will mitigate those risks and protect public health and the environment; and uses that information to decide on appropriate regulatory action. Uncertainties in the data and analyses on which these decisions are based enter into the process at each step. As a result, the informed identification and understanding of the uncertainties inherent in the process is an essential feature of environmental decision making. The EPA asked the IOM to provide guidance to its decision makers and their partners in states and localities on approaches to managing risk in different contexts when uncertainty is present as well as guidance on transparency in its communications with the public.
  • Alliances for Obesity Prevention: Finding Common Ground ... Released: May 11, 2012
    Many organizations are making focused efforts to prevent obesity. To achieve their goals, accelerate their progress, and sustain their success, the assistance of many other individuals and groups—not all of them with a singular focus on obesity prevention—will be essential. In October 2011 the Institute of Medicine held a workshop that provided an opportunity for obesity prevention groups to hear from and hold discussions with many of these potential allies in obesity prevention. They explored common ground for joint activities and mutual successes, and lessons learned from efforts at aligning diverse groups with goals in common.
  • Breast Cancer and the Environment: A Life Course Approach ... Released: December 07, 2011
    More than 230,000 new cases of breast cancer are expected to be diagnosed in the United States in 2011. The IOM was asked to review the current evidence on breast cancer and the environment, review challenges in studying this topic, explore evidence-based actions that women might take to reduce their risk, and recommend future research. Overall, it finds that major advances have been made in understanding breast cancer and its risk factors, but more needs to be learned about its causes, how environmental exposures affect risk for the disease, and how to prevent it.
  • Long-Term Health Consequences of Exposure to Burn Pits in ... Released: October 31, 2011
    Many veterans returning from the conflicts in Iraq and Afghanistan have health problems they believe are related to their exposure to the smoke from the burning of waste in open-air “burn pits” on military bases. Particular controversy surrounds the burn pit used to dispose of solid waste at Joint Base Balad in Iraq, which burned up to 200 tons of waste per day in 2007. The Department of Veterans Affairs asked the IOM to form a committee to determine the long-term health effects from exposure to these burn pits. Insufficient evidence prevented the IOM committee from developing firm conclusions. This report, therefore, recommends that, along with more efficient data-gathering methods, a study be conducted that would evaluate the health status of service members from their time of deployment over many years to determine their incidence of chronic diseases.
  • Incorporating Occupational Information in Electronic Health ... Released: September 30, 2011
    Each year in the United States, more than 4,000 occupational fatalities and more than 3 million occupational injuries occur along with more than 160,000 cases of occupational illnesses. Incorporating patients’ occupational information into electronic health records (EHRs) could lead to more informed clinical diagnosis and treatment plans as well as more effective policies, interventions, and prevention strategies to improve the overall health of the working population. At the request of the National Institute for Occupational Safety and Health, the IOM appointed a committee to examine the rationale and feasibility of incorporating occupational information in patients’ EHRs. The IOM concluded that three data elements – occupation, industry, and work-relatedness – were ready for immediate focus, and made recommendations on moving forward efforts to incorporate these elements into EHRs.