lecture eu policy on eh risks
DESCRIPTION
Lecture to bachelor students European Public HealthTRANSCRIPT
Tackling environmental health risks with policy
A European policy perspective
Leendert van Bree & Eva Kunseler
Overview
Introduction to Environmental Health Risks Environmental Legislation – Leendert
Hazard-oriented Standard-setting approach
Environmental Health Programmes – Eva Effect-oriented Health in All Policy approach
Break Policy Evaluation
Indicators - Eva
Impact assessment - Leendert
New developments - Both
Environmental Health Risks
What kind of environmental risks are negatively affecting health? What is health? What environmental risks?
What can EU policy do to tackle these risks What policy orientation? What policy instruments?
Health Perspective
Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity
(WHO 1948)
Conceptual model of public health
Source: RIVM (2006). Care for health. The 2006 Dutch Public Health Status and Forecasts Report
Environmental Risks: what perspective?
Hazard-oriented: air pollution, water pollution, soil pollution, waste and chemicals
Effect-oriented: ecological damage, social degradation, public health impact e.g. Gastrointestinal diseases: food safety, water and sanitation Cancers: air quality (indoor and outdoor), UV and ionizing radiation,
chemicals, radon Cardiovascular diseases: air quality (indoor and outdoor), noise Respiratory diseases: air quality (indoor and outdoor), dampness
and mould
Overview
Introduction to Environmental Health Risks Environmental Legislation – Leendert
Hazard-oriented Standard-setting approach
Environmental Health Programmes – Eva Effect-oriented Health in All Policy approach
Break Policy Evaluation
Indicators - Eva
Impact assessment - Leendert
New developments - Both
Environmental Legislation
Basically simple questions, simple answers?
1. Is there a problem?
2. What causes the problem?
3. Can we do something about it?
4. Will it help?
5. What does it cost?
6. Who is going to pay?
------------------------------------------------------
7. What is effective and efficient policy?
Environmental Legislation (2)
1. Focus on control and prevention
2. Hazard-oriented rationale behind environmental health policy targets for chemicals, external safety, food, air, and water
3. Checking quantified risks against standards
4. Equal (rights-based) protection of every citizen: no one above 10-6 norm for mortality!
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>> Environmental problems with relatively large risks have been controlled or at least substantially reduced !
History of Environmental Policy
1. Environmental policy is a relatively recent EU policy area.
2. The Single European Act (1986) marked the beginning of a more prominent role for environmental protection in EU policy-making:- introducing the principal that environmental protection should be
considered in all new Community legislation.
3. EU environmental policy expanded by the Treaties of Maastricht (1992) and Amsterdam (1997): sustainable development one of EU's central objectives.
4. Sustainable development also forms a key part of the Lisbon Strategy (2000): EU policy regarding the single market.
Why EU Environmental Policy?
Arguments for The threat to the environment is global and should be tackled on an
international scale, but… the EU plays an important role in setting this agenda.
EU's commitment to environmental protection encourages other countries to adopt similar measures.
Environmental policy is an area with substantial public support for action at a Europe-wide level.
Arguments against The cost of EU environmental regulation can undermine the competitiveness
of EU businesses. If maximal environmental emission levels are set too high, firms have little
incentive to cut their emissions to meet the EU's wider targets.
Our Common (Sustainable) Future
Also known as the ‘Brundtland Report’, from the UN World Commission on Environment and Development, published in 1987.
An often-quoted definition of sustainable development is defined as:Development that meets the needs of the present without compromising the ability of future generations to meet their own needs.
Leading to the 1992 Earth Summit, the adoption of Agenda 21, the Rio Declaration, and the establishment of the Commission on Sustainable Development
Sustainable Development
Millennium Development Goals (2000)
Committing nations to a new global partnership to reduce extreme poverty and setting out a series of time-bound targets - with a deadline of 2015: Ranging from halving extreme poverty to
halting the spread of HIV/AIDS and providing universal primary education;
Goal 7: Integrate the principles of sustainable
development into country policies and programmes and reverse the loss of environmental resources
Goal 7…
Environmental Policieshttp://ec.europa.eu/environment/policy_en.htm
Example: Air Quality Legislation
Air Quality Framework Directive 96/62/EC: limit values for PM10, NOx, SO2, O3 Emission ceilings Source emission requirements for vehicles and constructions
New EU Air quality Directive 11 June 2008: New PM2,5 legislation: Mean exposure index
Concentrations measured at urban background levels Enforcement not needed at locations that are restricted to the
general public and do not hold permanent occupation
Environmental Health Programmes
WHO Europe environment and health process (since 1989 Helsinki) Aim: eliminating the most significant environmental threats to
health, based on the premise that prevention is better than cure Framework: Health for All (since 1977)
European environment and health strategy (since 2003) Environment and Health Action Plan 2004-2010: reduce the
adverse health impacts of specific environmental factors and to enhance cooperation between actors in the environment, health and research fields
Framework: Health in All Policy (since 2007)
Health Frameworks
WHO Health for All: a process of bringing countries to progressive improvement in the health of all their citizens. Equity: everyone has a fair opportunity to attain his or her full health
potential; Solidarity: everyone contributes to the health system according to
his or her ability
EU Health in All Policy: Important health determinants cannot be influenced by health policy
on its own; There is a need for co-ordinated actions involving other policy areas
such as environmental, social or economic policies.
Focus in Environmental Health Programmes
Children’s health Children’s Environmental Health Action Plan for Europe Priorities: air quality, healthy transport, water&sanitation,
chemical safety, healthy housing
Climate change and health Fifth Ministerial Conference
on Environment and Health
(Parma 2010)
Sustainable Development
BREAK
Steering Paradigm for Policy Development & Evaluation
Decisions, regulatory actions, and legislation Risk management analysis
Regulatory options Evaluation of public health, social, and economic consequences Target achievement, cost-benefit, health effectiveness, equity,
cost-efficiency, scenario’s
Risk communication Data and information exchange Stakeholders needs and participation
Impact and exposure assessment Quantifying health impacts, exposures, and link to sources Indicators for ‘mortality, morbidity and(‘quality of life’)
The cause-effect pathway
WHO 2005
CO2 emitting activities
Climate change
Higher mortality / Heat stress/ Adaptation?
Exposed to higher temperatures
Temp. rise
Mitigation: towards energy neutral act.
Accomodating buildings; spatial planning: more green, water, wind
Information & education
Environmental Health Indicators
Environmental Health Indicators are usually numbers that represent and communicate a certain state of the environment, exposure, health state and/ or policy actions.
Use and purpose of indicators:1. Policy development and priority-setting
2. Health impact assessment and monitoring
3. Policy implementation or economic consequence assessment
4. Public information and awareness raising or risk perception
Indicators to evaluate EU and WHO programmes
WHO ENHIS: Environment and Health Information System (www.enhis.org)
EEA (European Environment Agency): Core set of indicators (http://themes.eea.europa.eu/IMS/CSI)
Prevalence of asthma symptoms in children aged 6–7 years and 13–14 years, ISAAC Phase Three, 1999–2004
Degree of implementation of action to reduce exposure of the population to UVR in 26 countries in the WHO European Region, 2006
Risk Management Indicators
Decision-making based on appraisal of: How is the risk quantified? (impact) How is the risk perceived? (acceptability) Weighing costs and benefits? Is it a governmental responsibility? Is action feasible with policy?
PBL/RIVM ‘Weighing and Appraisal’ indicators: 1. Policy deficit index
2. Burden of disease index
3. Economic consequence index
4. Risk perception and acceptability index
Examples of policy deficit indicators
Distance to emission standards Distance to environmental quality standards Distance to exposure / intake / body burden standards Distance to health risk / disease burden reduction targets
Burden of disease indicator
DALY = YLL + YLD
Years of Lost Life
(due to mortality)
Years Lived with Disability
(due to injury & illness)
1 0
0
1
2 0 3 0 4 0 5 0 6 0 7 0 8 0
popu la tion
le u k a e m iap n e u m o n ia p ro g re s siv e c a rd io -p u lm o n a ry d is e a se
se r io u s a n n o y a n c e
age
d isab ilityw eigh t
p oten tia l h ea lth y life yea rs
'hea lth ' lo ss
Risks ranked according to DALYs
1,E
+00
1,E
+01
1,E
+02
1,E
+03
1,E
+04
1,E
+05
1,E
+06
1,E
+07
Blik
sem
insl
ag
Ext
erne
Vei
lighe
id
Hoo
gspa
nnin
gslij
nen
Gro
otsc
halig
e ov
erst
rom
ing
Cam
pylo
bact
er (
alle
gev
alle
n)
Won
ingb
rand
en
Bod
emve
ront
rein
igin
g
Aid
s
Arb
eid:
ong
eval
slet
sel
Rad
on in
won
inge
n
Spo
rtbl
essu
res
Gel
uid
Sch
ipho
l
Arb
eid:
blo
otst
ellin
g aa
n st
offe
n
Ver
keer
song
eval
len
Afh
anke
lijkh
eid
van
alco
hol
Lich
amel
ijke
inac
tivite
it
Gel
uid
weg
verk
eer
Fijn
sto
f
Ove
rgew
icht
Ong
ezon
de v
oedi
ng
Rok
en
DA
LY's
(/jr
)
Risks ranked according to YLL
1,E+00 1,E+01 1,E+02 1,E+03 1,E+04 1,E+05 1,E+06 1,E+07
Sportblessures
Blikseminslag
Externe Veiligheid
Hoogspanningslijnen
Grootschalige overstroming
Geluid Schiphol
Campylobacter (alle gevallen)
Geluid wegverkeer
Woningbranden
Bodemverontreiniging
Aids
Arbeid: ongevalsletsel
Lichamelijke inactiviteit
Ongezonde voeding
Overgewicht
Radon in woningen
Afhankelijkheid van alcohol
Arbeid: blootstelling aan stoffen
Verkeersongevallen
Fijn stof
YLLs (/jr)
Risks ranked according to costs (€)
1,E+00 1,E+02 1,E+04 1,E+06 1,E+08 1,E+10
Lichamelijkeinactiviteit
Ongezonde voeding
Overgewicht
Roken
Hoogspanningslijnen
Externe Veiligheid
Campylobacter (allegevallen)
Geluid Schiphol
Woningbranden
Grootschaligeoverstroming
Verwachtingswaarde economische schade (euro per jaar)
Family of impact assessments
EC Impact Assessment Guidance Methodologies:
Health Impact Assessment Equity Impact Assessment Environmental Impact Assessment Ensures that environmental consequences of projects are identified and assessed
before authorisation is given.
Strategic Environmental Assessment Key tool for sustainable development.
Integrated Assessment Cross-sectoral policy assessment (multi-hazard, multi-effect) Example: climate-proof & sustainable cities
Assessment framework (INTARESE)
Issue framing Design Execution Reporting
Initial-isationScoping
ComplexificationPrioritisation &
screening(simplification)Alternatives
Indicatorselection
Definition ofscenarios
Quality criteriaMethods & models
Data sourcesAssessment protocols
Data collectionExpert elicitation
Modelling & estimationUncertainty analysisTesting & validation
Evaluation
InterpretationCommunication withusers & stakeholders
Documentation &presentation
StakeholdersPolicy-makers
Industry
Scientists
Media
Public
Generators
Purveyors
Assessors
Regulators
Victims
Example: Integrated Assessment in Practice
Source: http://en.opasnet.org/w/Assessment_on_impacts_of_emission_trading_on_city-level_(ET-CL)
New Developments in EH Risk Policy
1. Putting integrated assessment in practice
2. Appraisal of risks from wider perspective
3. Stakeholder involvement?
4. Dealing with uncertainty and controversy on risks?
5. The precautionary principle?
Environmental health risk as technical construct
Dictionary: (bad) chance for injury, damage, or loss
Dutch Health Council 1995: possibility, with a certain probability, of damage to human health, in combination with nature and extent of damage
Risks are objective and can be univocally measured or assessed from cause-effect pathways
Environmental health risk as societal construct
Risks are societal perceptions of danger, damage, injury Risks are value-loaded: the acceptability of a risk depends
on the context and individual perspective Voluntary vs. Involuntary Controllable vs. Uncontrollable Direct & short-term effect vs. Indirect &long-term effect Observable vs. Not observable