Purpose Life cycle assessment (LCA) has been used to assess freshwater-related impacts according to a new water footprint framework formalized in the ISO 14046 standard. To date, no consensus-based approach exists for applying this standard and results are not always comparable when different scarcity or stress indicators are used for characterization of impacts. This paper presents the outcome of a 2-year consensus building process by the Water Use in Life Cycle Assessment (WULCA), a working group of the UNEP-SETAC Life Cycle Initiative, on a water scarcity midpoint method for use in LCA and for water scarcity footprint assessments. Methods In the previous work, the question to be answered was identified and different expert workshops around the world led to three different proposals. After eliminating one proposal showing low relevance for the question to be -017-1333-8 answered, the remaining two were evaluated against four criteria: stakeholder acceptance, robustness with closed basins, main normative choice, and physical meaning.Results and discussion The recommended method, AWARE, is based on the quantification of the relative available water remaining per area once the demand of humans and aquatic ecosystems has been met, answering the question BWhat is the potential to deprive another user (human or ecosystem) when consuming water in this area?^The resulting characterization factor (CF) ranges between 0.1 and 100 and can be used to calculate water scarcity footprints as defined in the ISO standard.Conclusions After 8 years of development on water use impact assessment methods, and 2 years of consensus building, this method represents the state of the art of the current knowledge on how to assess potential impacts from water use in LCA, assessing both human and ecosystem users' potential deprivation, at the midpoint level, and provides a consensusbased methodology for the calculation of a water scarcity footprint as per ISO 14046.

Purpose In recent years, several methods have been developed which propose different freshwater use inventory schemes and impact assessment characterization models considering various cause-effect chain relationships. This work reviewed a multitude of methods and indicators for freshwater use potentially applicable in life cycle assessment (LCA). This review is used as a basis to identify the key elements to build a scientific consensus for operational characterization methods for LCA. Methods This evaluation builds on the criteria and procedure developed within the International Reference Life -012-0519-3 Cycle Data System Handbook and has been adapted for the purpose of this project. It therefore includes (1) description of relevant cause-effect chains, (2) definition of criteria to evaluate the existing methods, (3) development of subcriteria specific to freshwater use, and (4) description and review of existing methods addressing freshwater in LCA. Results and discussion No single method is available which comprehensively describes all potential impacts derived from freshwater use. However, this review highlights several key findings to design a characterization method encompassing all the impact pathways of the assessment of freshwater use and consumption in life cycle assessment framework as the following: (1) in most of databases and methods, consistent freshwater balances are not reported either because output is not considered or because polluted freshwater is recalculated based on a critical dilution approach; (2) at the midpoint level, most methods are related to water scarcity index and correspond to the methodological choice of an indicator simplified in terms of the number of parameters (scarcity) and freshwater uses (freshwater consumption or freshwater withdrawal) considered. More comprehensive scarcity indices distinguish different freshwater types and functionalities. (3) At the endpoint level, several methods already exist which report results in units compatible with traditional human health and ecosystem quality damage and cover various cause-effect chains, e.g., the decrease of terrestrial biodiversity due to freshwater consumption. (4) Midpoint and endpoint indicators have various levels of spatial differentiation, i.e., generic factors with no differentiation at all, or country, watershed, and grid cell differentiation. Conclusions Existing databases should be (1) completed with input and output freshwater flow differentiated according to water types based on its origin (surface water, groundwater, and precipitation water stored as soil moisture), (2) regionalized, and (3) if possible, characterized with a set of quality parameters. The assessment of impacts related to freshwater use is possible by assembling methods in a comprehensive methodology to characterize each use adequately.Int J Life Cycle Assess (2013) 18:707-721 DOI 10.1007/s11367

This chapter is dedicated to the third phase of an LCA study, the Life U N C O R R E C T E D P R O O F 24Learning Objectives 25After studying this chapter, the reader should be able to: 26• Explain and discuss the process and main purposes of the LCIA phase of an 27LCA study. 28• Distinguish and explain the mandatory and optional steps according to inter-29 national standards for LCA. 30• Differentiate and describe each of the impact categories applied in LCIA 31 regarding: 32-the underlying environmental problem. 33-the environmental mechanism and its fundamental modelling principles. 34-the main anthropogenic sources causing the problem. 35-the main methods used in LCIA. and factors, and to accessibly explain (1) its main purpose and characteristics, 49(2) the mandatory and optional steps according to ISO and (3) the meaning and 50 handling of each impact category. While this chapter is a pedagogical and focused 51 introduction into the complex and broad aspects of LCIA, a more profound and

Life cycle impact assessment (LCIA) is a lively field of research, and data and models are continuously improved in terms of impact pathways covered, reliability, and spatial detail. However, many of these advancements are scattered throughout the scientific literature, making it difficult for practitioners to apply the new models. Here, we present the LC‐IMPACT method that provides characterization factors at the damage level for 11 impact categories related to three areas of protection (human health, ecosystem quality, natural resources). Human health damage is quantified as disability adjusted life years, damage to ecosystem quality as global species extinction equivalents (based on potentially disappeared fraction of species), and damage to mineral resources as kilogram of extra ore extracted. Seven of the impact categories include spatial differentiation at various levels of spatial scale. The influence of value choices related to the time horizon and the level of scientific evidence of the impacts considered is quantified with four distinct sets of characterization factors. We demonstrate the applicability of the proposed method with an illustrative life cycle assessment example of different fuel options in Europe (petrol or biofuel). Differences between generic and regionalized impacts vary up to two orders of magnitude for some of the selected impact categories, highlighting the importance of spatial detail in LCIA. This article met the requirements for a gold – gold JIE data openness badge described at http://jie.click/badges.

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Water footprinting has emerged as an important approach to assess water use related effects from consumption of goods and services. Assessment methods are proposed by two different communities, the Water Footprint Network (WFN) and the Life Cycle Assessment (LCA) community. The proposed methods are broadly similar and encompass both the computation of water use and its impacts, but differ in communication of a water footprint result. In this paper, we explain the role and goal of LCA and ISO-compatible water footprinting and resolve the six issues raised by Hoekstra (2016) in "A critique on the water-scarcity weighted water footprint in LCA". By clarifying the concerns, we identify both the overlapping goals in the WFN and LCA water footprint assessments and discrepancies between them. The main differing perspective between the WFN and LCA-based approach seems to relate to the fact that LCA aims to account for environmental impacts, while the WFN aims to account for water productivity of global fresh water as a limited resource. We conclude that there is potential to use synergies in research for the two approaches and highlight the need for proper declaration of the methods applied.

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The study shows a high impact of cancer on planned hospitalizations whereas cardiovascular diseases and COPD generates a high percentage of unscheduled admissions. We conclude that integrated care services including patient-oriented guidelines are strongly needed to enhance both health and managerial outcomes.