A framework for integrated environmental health impact assessment of systemic risks

Abstract

Traditional methods of risk assessment have provided good service in support of policy, mainly in relation to standard setting and regulation of hazardous chemicals or practices. In recent years, however, it has become apparent that many of the risks facing society are systemic in naturecomplex risks, set within wider social, economic and environmental contexts. Reflecting this, policy-making too has become more wide-ranging in scope, more collaborative and more precautionary in approach. In order to inform such policies, more integrated methods of assessment are needed. Based on work undertaken in two large EU-funded projects (INTARESE and HEIMTSA), this paper reviews the range of approaches to assessment now in used, proposes a framework for integrated environmental health impact assessment (both as a basis for bringing together and choosing between different methods of assessment, and extending these to more complex problems), and discusses some of the challenges involved in conducting integrated assessments to support policy.Integrated environmental health impact assessment is defined as a means of assessing health-related problems deriving from the environment, and health-related impacts of policies and other interventions that affect the environment, in ways that take account of the complexities, interdependencies and uncertainties of the real world. As such, it depends heavily on how issues are selected and framed, and implies the involvement of stakeholders both in issue-framing and design of the assessment, and to help interpret and evaluate the results. It is also a comparative process, which involves evaluating and comparing different scenarios. It consequently requires the ability to model the way in which the influences of exogenous factors, such as policies or other interventions, feed through the environment to affect health. Major challenges thus arise. Chief amongst these are the difficulties in ensuring effective stakeholder participation, in dealing with the multicausal and non-linear nature of many of the relationships between environment and health, and in taking account of adaptive and behavioural changes that characterise the systems concerned.

Evaluación de riesgo para la salud pública: nuevo instrumento de gestión ambiental para Chile

“…Más recientemente Briggs (2008) ha propuesto la evaluación del impacto en salud ambiental integrada como un medio para valorar los problemas sobre la salud de la población derivados de las intervenciones sobre el medio ambiente, de una forma que tome en cuenta la complejidad, las interdependencias e incertidumbres del mundo real 9 .…”

A framework for assessing and predicting the environmental health impact of infectious diseases: a case study of leptospirosis

“…The presentation of fi ndings to multiple stakeholders could be a challenging process because of inevitable differences in their background, agendas, knowledge, and ability to interpret scientifi c information. It is nevertheless an essential component of an assessment, not only to communicate the fi ndings, but also to reduce chances of barriers to future access to communities that might arise from dissatisfaction caused by lack of feedback about research outcomes (8) .…”

“…To put such a conceptual assessment framework into action, an operational framework is also proposed by Briggs (8) to provide structure and organisation for the process and help with identifying stakeholders, defi ning the scope of the assessment and questions to be answered, selecting indicators, developing protocols, deciding on the methods of data analysis, defi ning a baseline or reference scenario, determining alternative scenarios that could be modelled, estimating and predicting health outcomes under alternative scenarios, and fi nally, communicating the fi ndings to stakeholders.…”

“…Stakeholders are individuals who represent communities and organisations that have an interest or concern with the problem or who might be affected by the assessment ' s processes or outcomes (8) . Stakeholders are essential for confi rming the relevance of the project in the context of cultural or political issues, providing inside knowledge about the problem, and identifying questions that need to be answered.…”

“…In this article, we discuss the application of an IEHIA to quantify current and estimate future health impact of a zoonotic disease (leptospirosis) in a tropical Pacifi c Island setting. Whilst the IEHIA process has been proposed for the analyses of complex environmental health problems involving the full causal chain (8,9) , this case study demonstrated that this process could also be applied effectively for simpler assessments involving one hazard or disease agent ( Leptospira ) with a single disease outcome (infection) in a single population [the people of American Samoa (AS), an island nation in the South Pacifi c].…”