WorldWideScience

Sample records for assessing health impacts

  1. Health equity impact assessment.

    Science.gov (United States)

    Povall, Susan L; Haigh, Fiona A; Abrahams, Debbie; Scott-Samuel, Alex

    2014-12-01

    The World Health Organization's Commission on Social Determinants of Health has called for 'health equity impact assessments' of all economic agreements, market regulation and public policies. We carried out an international study to clarify if existing health impact assessment (HIA) methods are adequate for the task of global health equity assessments. We triangulated data from a scoping review of the international literature, in-depth interviews with health equity and HIA experts and an international stakeholder workshop. We found that equity is not addressed adequately in HIAs for a variety of reasons, including inadequate guidance, absence of definitions, poor data and evidence, perceived lack of methods and tools and practitioner unwillingness or inability to address values like fairness and social justice. Current methods can address immediate, 'downstream' factors, but not the root causes of inequity. Extending HIAs to cover macro policy and global equity issues will require new tools to address macroeconomic policies, historical roots of inequities and upstream causes like power imbalances. More sensitive, participatory methods are also required. There is, however, no need for the development of a completely new methodology. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Introducing Health Impact Assessment

    DEFF Research Database (Denmark)

    Mannheimer, L N; Gulis, G; Lehto, J

    2007-01-01

    BACKGROUND: Intersectoral Action for Health (IAH) and its Health Impact Assessment (HIA) tool are built on collaboration between actors and sectors, requiring multidimensional and horizontal way of working. The study aims to analyse the enablers and barriers when such a new way of working and tool...... used by which the actual problems, the governmental actions (or non-actions) (politics) and the understanding, implementation and evaluation of the initiative (policy) could be analysed. All actors involved, civil servants, politicians, representatives of the local public health institute...... and researchers, were interviewed and made to answer a questionnaire. RESULTS: The results showed that there were a number of factors behind the initiation of HIA, which either delayed or accelerated the process. The problems identified were e.g. the prevailing traditional health care focus and the deteriorating...

  3. Health impact assessment in Korea

    International Nuclear Information System (INIS)

    Kang, Eunjeong; Lee, Youngsoo; Harris, Patrick; Koh, Kwangwook; Kim, Keonyeop

    2011-01-01

    Recently, Health Impact Assessment has gained great attention in Korea. First, the Ministry of Environment introduced HIA within existing Environment Impact Assessment. Second, the Korea Institute for Health and Social Affairs began an HIA program in 2008 in alliance with Healthy Cities. In this short report, these two different efforts are introduced and their opportunities and challenges discussed. We believe these two approaches complement each other and both need to be strengthened. We also believe that both can contribute to the development of health in policy and project development and ultimately to improvements in the Korean population's health.

  4. Health Impact Assessment: Linking Public Health to ...

    Science.gov (United States)

    The goal of this presentation is to explore how HIA can help inform hazardous waste permitting regulations and incorporate community vulnerability and cumulative impacts to their potential health risks into permitting decision making by the California Department of Toxic Substances Control. Presented the Health Impact Assessment (HIA) at the State of California Cumulative Impacts and Community Vulnerability Symposium on July 27 in Diamond Bar, CA.

  5. Untapped potential of health impact assessment

    OpenAIRE

    Winkler, Mirko S; Krieger, Gary R; Divall, Mark J; Cissé, Guéladio; Wielga, Mark; Singer, Burton H; Tanner, Marcel; Utzinger, Jürg

    2013-01-01

    The World Health Organization has promoted health impact assessment (HIA) for over 20 years. At the 2012 United Nations Conference on Sustainable Development (Rio+20), HIA was discussed as a critical method for linking health to “green economy” and “institutional framework” strategies for sustainable development. In countries having a high human development index (HDI), HIA has been added to the overall assessment suite that typically includes potential environmental and social impacts, but i...

  6. National Built Environment Health Impact Assessment Model ...

    Science.gov (United States)

    Behavioral (activity, diet, social interaction) and exposure (air pollution, traffic injury, and noise) related health impacts of land use and transportation investment decisions are becoming better understood and quantified. Research has shown relationships between density, mix, street connectivity, access to parks, shops, transit, presence of sidewalks and bikeways, and healthy food with physical activity, obesity, cardiovascular disease, type II diabetes, and some mental health outcomes. This session demonstrates successful integration of health impact assessment into multiple scenario planning tool platforms. Detailed evidence on chronic disease and related costs associated with contrasting land use and transportation investments are built into a general-purpose module that can be accessed by multiple platforms. Funders, researchers, and end users of the tool will present a detailed description of the key elements of the approach, how it has been applied, and how will evolve. A critical focus will be placed on equity and social justice inherent within the assessment of health disparities that will be featured in the session. Health impacts of community design have significant cost benefit implications. Recent research is now extending relationships between community design features and chronic disease to health care costs. This session will demonstrate the recent application of this evidence on health impacts to the newly adopted Los Angeles Regional Transpo

  7. Untapped potential of health impact assessment.

    Science.gov (United States)

    Winkler, Mirko S; Krieger, Gary R; Divall, Mark J; Cissé, Guéladio; Wielga, Mark; Singer, Burton H; Tanner, Marcel; Utzinger, Jürg

    2013-04-01

    The World Health Organization has promoted health impact assessment (HIA) for over 20 years. At the 2012 United Nations Conference on Sustainable Development (Rio+20), HIA was discussed as a critical method for linking health to "green economy" and "institutional framework" strategies for sustainable development. In countries having a high human development index (HDI), HIA has been added to the overall assessment suite that typically includes potential environmental and social impacts, but it is rarely required as part of the environmental and social impact assessment for large development projects. When they are performed, project-driven HIAs are governed by a combination of project proponent and multilateral lender performance standards rather than host country requirements. Not surprisingly, in low-HDI countries HIA is missing from the programme and policy arena in the absence of an external project driver. Major drivers of global change (e.g. population growth and urbanization, growing pressure on natural resources and climate change) inordinately affect low- and medium-HDI countries; however, in such countries HIA is conspicuously absent. If the cloak of HIA invisibility is to be removed, it must be shown that HIA is useful and beneficial and, hence, an essential component of the 21st century's sustainable development agenda. We analyse where and how HIA can become fully integrated into the impact assessment suite and argue that the impact of HIA must not remain obscure.

  8. The relation of risk assessment and health impact assessment

    DEFF Research Database (Denmark)

    Ádám, Balázs; Gulis, Gabriel

    2013-01-01

    The level and distribution of health risks in a society is substantially influenced by measures of various policies, programmes or projects. Risk assessment can evaluate the nature, likelihood and severity of an adverse effect. Health impact assessment (HIA) provides similar function when used...... as a powerful tool for the evaluation of potential health consequences of planned measures. It is often discussed whether HIA is not just another term or form of risk assessment and what is their relation. Our aim is to discuss similarities and differences between the two methods so as to clarify...... their relationship. The experiences accumulated during the preparation of several case studies in a large scale international project (RAPID) are used for argumentation and formulation of recommendations on how risk assessment can be systematically integrated into the HIA process. Risk assessment uses well...

  9. Assessing the health impact of urbanization.

    Science.gov (United States)

    Williams, B T

    1990-01-01

    Several components of urbanization influence health status, but it is difficult to attribute changes in health status to any particular component. The overall impact may be estimated by relating the degree of urbanization of populations to some proxy measure, like the under-5 mortality rates. In this respect the net effect of urbanization is shown to be beneficial. A variety of survey and computational methods have been used to clarify the relationship. Some illustrate the effects of urbanization upon particular clinical conditions, such as promoting the eradication of leprosy, others of particular components, such as overcrowding and pollution, on infant mortality. To help set goals, excess or avoidable mortality may be computed for a country or region by relating its experience to current mortality levels in a developed country; and changes in the levels of avoidable mortality from sentinel conditions such as infectious diseases may be related to changes in particular aspects of urbanization, e.g. improvements in levels of sanitation. Migration to the urban environment imparts the tendency to acquire the health characteristics of the host population. Rapid urbanization causes problems of psychosocial adjustment for older children. Urbanization may impact upon the incidence and prevalence of disability. Where sex-age disability-survey data exist, they may be combined with age-specific mortality data to construct an index of disability-free life expectancy, a more subtle measure for assessing the progressive impact of urbanization. Up to now, however, there have been no international studies of how levels of disability change according to the progress of urbanization, and there are no international census or survey recommendations for harmonizing the classification of disabled people.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Exploring Health Impact Assessment in Europe

    Directory of Open Access Journals (Sweden)

    Matthias Wismar

    2007-09-01

    Full Text Available

    Background: Health impact assessment (HIA prospectively judges the potential health impacts of pending decisions and feeds the assessment back into the decision making process. HIA is considered as a key tool for intersectoral collaboration. This article presents selected results of a mapping exercise on HIA in Europe. The mapping exercise is complemented by the presentation of a conceptual framework on the effectiveness of HIA and illustrative examples.

    Method: Two methodologies are employed in this article: First, the use of HIA across Europe is based on a survey conducted by 21 teams in 19 countries. A semi standardized questionnaire was employed, using a wide variety of sources. Second, for the discussion on the effectiveness of HIA, a conceptual framework using four types of effectiveness was employed. Results: HIA is a common practice only in a handful of European countries. In most of Europe, HIA is at an early developmental stage. The mapping exercise, however, provides evidence that HIA can work across all sectors and at all political level, although there is currently a focus on the local level. HIA is conducted in different countries by different sets of actors and organizations, reflecting the existing setup. The evidence on the effectiveness of HIA is still inconclusive. However, single case studies and upcoming evidence suggests that HIA has the capacity to inform and influence the decision making process.

    Conclusions: HIA can work and deliver. The variations in context across European countries have resulted in different forms of implementation and different dynamics of developing HIA.

  11. Impact assessment of Iran's health technology assessment programme.

    Science.gov (United States)

    Yazdizadeh, Bahareh; Mohtasham, Farideh; Velayati, Ashraf

    2018-02-22

    Following approximately 10 years from the beginning of Iran's national Health Technology Assessment (HTA) programme, the present study aims to evaluate its success by examining the impact of HTA and identifying the determinant factors leading to the implementation of HTA report results. The triangulation method was employed herein. HTA reports were initially identified and their impact and determinant factors were then examined from the perspectives of both researchers (by preparing a questionnaire according to the Payback model and sending it to HTA principle investigators) and stakeholders (semi-structured interviews held with each HTA stakeholder). Simultaneously, the quality of the HTA reports was examined with relevant critical appraisal checklists. The impact of 19 equipment technologies and four pharmaceutical technologies were assessed in this study. Twenty researchers replied (response rate, 86.96%) to the questionnaire on the impact of HTA reports from the researcher's perspective. To assess the impact of HTA reports from the stakeholder's perspective, seven policy-makers were chosen and interviewed as the main target audience. The most common step taken to disseminate the results of the HTA projects was publication. Conducting the HTA had taught researchers and their colleagues' new skills and had facilitated the securing of research grants from other organisations. Most reports had used the systematic review method but the relevant details had been scarcely presented regarding outcomes, costs and analysis. The greatest impact of HTA reports on decision-making had been on policy-makers providing and allocating finances. Barriers in stewardship, identification and prioritisation of topics, performance and dissemination of HTA results were the main barriers of implementing HTAs. In most aspects, the status of HTA impact reports need improvement. Thus far, the barriers and facilitators of the HTA programme in Iran have been investigated in other studies

  12. Using Health Impact Assessment as an Interdisciplinary Teaching Tool.

    Science.gov (United States)

    Chinchilla, Melissa; Arcaya, Mariana C

    2017-07-08

    Health Impact Assessment (HIA) courses are teaching public health and urban planning students how to assess the likely health effects of proposed policies, plans, and projects. We suggest that public health and urban planning have complimentary frameworks for training practitioners to address the living conditions that affect health. Planning perspectives emphasize practical skills for impacting community change, while public health stresses professional purpose and ethics. Frameworks from both disciplines can enhance the HIA learning experience by helping students tackle questions related to community impact, engagement, social justice, and ethics. We also propose that HIA community engagement processes can be enriched through an empathetic practice that focuses on greater personal introspection.

  13. Experience and lessons from health impact assessment for human rights impact assessment.

    Science.gov (United States)

    Salcito, Kendyl; Utzinger, Jürg; Krieger, Gary R; Wielga, Mark; Singer, Burton H; Winkler, Mirko S; Weiss, Mitchell G

    2015-09-16

    As globalisation has opened remote parts of the world to foreign investment, global leaders at the United Nations and beyond have called on multinational companies to foresee and mitigate negative impacts on the communities surrounding their overseas operations. This movement towards corporate impact assessment began with a push for environmental and social inquiries. It has been followed by demands for more detailed assessments, including health and human rights. In the policy world the two have been joined as a right-to-health impact assessment. In the corporate world, the right-to-health approach fulfils neither managers' need to comprehensively understand impacts of a project, nor rightsholders' need to know that the full suite of their human rights will be safe from violation. Despite the limitations of a right-to-health tool for companies, integration of health into human rights provides numerous potential benefits to companies and the communities they affect. Here, a detailed health analysis through the human rights lens is carried out, drawing on a case study from the United Republic of Tanzania. This paper examines the positive and negative health and human rights impacts of a corporate operation in a low-income setting, as viewed through the human rights lens, considering observations on the added value of the approach. It explores the relationship between health impact assessment (HIA) and human rights impact assessment (HRIA). First, it considers the ways in which HIA, as a study directly concerned with human welfare, is a more appropriate guide than environmental or social impact assessment for evaluating human rights impacts. Second, it considers the contributions HRIA can make to HIA, by viewing determinants of health not as direct versus indirect, but as interrelated.

  14. Computer-assisted health impact assessment for intersectoral health policy

    NARCIS (Netherlands)

    Mooy, J. M.; Gunning-Schepers, L. J.

    2001-01-01

    Intersectoral health policy implies negotiations with politicians outside the health sector. Health politicians have a stronger position if they can quantify health impact. In this Dutch case-study we used a computer simulation approach to answer the following questions: Which anti-tobacco

  15. Quantitative health impact assessment: current practice and future directions

    NARCIS (Netherlands)

    J.L. Veerman (Lennert); J.J.M. Barendregt (Jan); J.P. Mackenbach (Johan)

    2005-01-01

    textabstractSTUDY OBJECTIVE: To assess what methods are used in quantitative health impact assessment (HIA), and to identify areas for future research and development. DESIGN: HIA reports were assessed for (1) methods used to quantify effects of policy on determinants of health

  16. Health Impact Assessment as a Student Service Learning Experience

    Science.gov (United States)

    Stone, Cynthia; Greene, Marion S.

    2012-01-01

    Health Impact Assessments (HIAs) incorporate a combination of tools, methods, and procedures to evaluate the potential health effects of a proposed program, project, or policy. The university public health department, in collaboration with the county health department, and the local planning organization, developed a curriculum for a…

  17. Gross national happiness as a framework for health impact assessment

    International Nuclear Information System (INIS)

    Pennock, Michael; Ura, Karma

    2011-01-01

    The incorporation of population health concepts and health determinants into Health Impact Assessments has created a number of challenges. The need for intersectoral collaboration has increased; the meaning of 'health' has become less clear; and the distinctions between health impacts, environmental impacts, social impacts and economic impacts have become increasingly blurred. The Bhutanese concept of Gross National Happiness may address these issues by providing an over-arching evidence-based framework which incorporates health, social, environmental and economic contributors as well as a number of other key contributors to wellbeing such as culture and governance. It has the potential to foster intersectoral collaboration by incorporating a more limited definition of health which places the health sector as one of a number of contributors to wellbeing. It also allows for the examination of the opportunity costs of health investments on wellbeing, is consistent with whole-of-government approaches to public policy and emerging models of social progress.

  18. Assessment of the health impact of an environmental pollution and quantitative assessment of health risks

    International Nuclear Information System (INIS)

    2005-09-01

    The report made by a working group is written for experts in health risk assessment or for professionals involved in risk management. It proposes a methodological and conceptual framework which could build a unified approach to a quantitative assessment of health risks. In the first part, under the form of questions and answers, it defines the health impact, describes how to assess the excess of individual risk and the related hypothesis, how to pass from the excess of individual risk to the health impact, how to express the results of an health impact calculation, how to take the lack of knowledge into account at the different steps of this calculation, what is the significance of the result of such a calculation, and how useful an health impact assessment can be. The second part proposes a more detailed presentation of the scientific background for the health impact calculation with its indicators, its uncertainties, its practice in other countries, its relevance, and its fields of application. Then, after a comment of the dose-response relationship, it reports the scientific validity of the assessment of a number of cases

  19. [Health impact assessment of building and investment projects].

    Science.gov (United States)

    Thriene, B

    2003-02-01

    For regional planning and approval procedures for building projects of a certain order of magnitude and power rating according to the German Federal Act on the Prevention of Emissions with Integrated Environmental Impact Assessment (EIA), the German public health departments, acting as public authorities, increasingly perform health impact assessments (HIA). The amended Act on Environmental Impact Assessment, the Decree on industrial plants which require approval (4th Federal Decree on Emission Prevention) and the Health Service Acts of the Federal States of Germany form the legal basis for the assessment of health issues with regard to approval procedures for building and investment projects. In the framework of the "Action Programme for the Environment and Health", the present article aims at making this process binding and to ensure responsibility and general involvement of the Public Health departments in all German Federal States. Future criteria, basic principles and procedures for single-case testing as well as assessment standards should meet these requirements. The Federal Ministry for the Environment and the Federal Ministry for Health should agree on Health Impact Assessment (HIA ) as well as on the relaxant stipulations in their procedures and general administrative regulations for implementing the Environmental Impact Assessment Act (EIA). Current EIA procedures focus on urban development and road construction, industrial investment projects, intensive animal husbandry plants, waste incineration plants, and wind energy farms. This paper illustrates examples meeting with varying degrees of public acceptance. However, being involved in the regional planning procedure for the project "Extension of the federal motorway A 14 from Magdeburg to Schwerin", the Public Health Service also shares global responsibility for health and climate protection. Demands for shortest routing conflict with objectives of environmental protection which should be given long

  20. Implementation of health impact assessment in Danish municipal context

    DEFF Research Database (Denmark)

    Kraemer, Stella R. J.; Nikolajsen, Louise Theilgaard; Gulis, Gabriel

    2014-01-01

    Aims: Implementation of Health Impact Assessment (HIA) in Danish municipalities has been analyzed using the Roger's Diffusion of Innovation Theory. Municipalities were chosen from among those who presented their health policies on websites according to the status of inclusion of HIA into health p...

  1. Health impact assessment – A survey on quantifying tools

    Energy Technology Data Exchange (ETDEWEB)

    Fehr, Rainer, E-mail: rainer.fehr@uni-bielefeld.de [Fakultaet fuer Gesundheitswissenschaften, Universitaet Bielefeld, Universitaetsstr. 25, 33615 Bielefeld (Germany); Mekel, Odile C.L., E-mail: odile.mekel@lzg.nrw.de [Gesundheitsdaten und analysen, Versorgungsstrukturen, Landeszentrum Gesundheit Nordrhein-Westfalen (LZG.NRW), Westerfeldstr. 35-37, 33611 Bielefeld (Germany); Fintan Hurley, J., E-mail: fintan.hurley@iom-world.org [Institute of Occupational Medicine (IOM), Research Avenue North, Riccarton, Edinburgh EH14 4AP, Scotland (United Kingdom); Mackenbach, Johan P., E-mail: j.mackenbach@erasmusmc.nl [Department of Public Health, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam (Netherlands)

    2016-02-15

    Integrating human health into prospective impact assessments is known to be challenging. This is true for both approaches: dedicated health impact assessments (HIA) as well as inclusion of health into more general impact assessments. Acknowledging the full range of participatory, qualitative, and quantitative approaches, this study focuses on the latter, especially on computational tools for quantitative health modelling. We conducted a survey among tool developers concerning the status quo of development and availability of such tools; experiences made with model usage in real-life situations; and priorities for further development. Responding toolmaker groups described 17 such tools, most of them being maintained and reported as ready for use and covering a wide range of topics, including risk & protective factors, exposures, policies, and health outcomes. In recent years, existing models have been improved and were applied in new ways, and completely new models emerged. There was high agreement among respondents on the need to further develop methods for assessment of inequalities and uncertainty. The contribution of quantitative modeling to health foresight would benefit from building joint strategies of further tool development, improving the visibility of quantitative tools and methods, and engaging continuously with actual and potential users. - Highlights: • A survey investigated computational tools for health impact quantification. • Formal evaluation of such tools has been rare. • Handling inequalities and uncertainties are priority areas for further development. • Health foresight would benefit from tool developers and users forming a community. • Joint development strategies across computational tools are needed.

  2. Health impact assessment – A survey on quantifying tools

    International Nuclear Information System (INIS)

    Fehr, Rainer; Mekel, Odile C.L.; Fintan Hurley, J.; Mackenbach, Johan P.

    2016-01-01

    Integrating human health into prospective impact assessments is known to be challenging. This is true for both approaches: dedicated health impact assessments (HIA) as well as inclusion of health into more general impact assessments. Acknowledging the full range of participatory, qualitative, and quantitative approaches, this study focuses on the latter, especially on computational tools for quantitative health modelling. We conducted a survey among tool developers concerning the status quo of development and availability of such tools; experiences made with model usage in real-life situations; and priorities for further development. Responding toolmaker groups described 17 such tools, most of them being maintained and reported as ready for use and covering a wide range of topics, including risk & protective factors, exposures, policies, and health outcomes. In recent years, existing models have been improved and were applied in new ways, and completely new models emerged. There was high agreement among respondents on the need to further develop methods for assessment of inequalities and uncertainty. The contribution of quantitative modeling to health foresight would benefit from building joint strategies of further tool development, improving the visibility of quantitative tools and methods, and engaging continuously with actual and potential users. - Highlights: • A survey investigated computational tools for health impact quantification. • Formal evaluation of such tools has been rare. • Handling inequalities and uncertainties are priority areas for further development. • Health foresight would benefit from tool developers and users forming a community. • Joint development strategies across computational tools are needed.

  3. Health Impact Assessment of an oil drilling project in California

    OpenAIRE

    Lindsay C. McCallum; Kathleen Souweine; Mary McDaniel; Bart Koppe; Christine McFarland; Katherine Butler; Christopher A. Ollson

    2016-01-01

    Objectives: The Health Impact Assessment (HIA) was conducted to evaluate the potential community health implications of a proposed oil drilling and production project in Hermosa Beach, California. The HIA considered 17 determinants of health that fell under 6 major categories (i.e., air quality, water and soil quality, upset conditions, noise and light emissions, traffic, and community livability). Material and Methods: This paper attempts to address some of the gaps within the HIA practice b...

  4. Assessment of the Health Impacts of Climate Change in Kiribati

    Directory of Open Access Journals (Sweden)

    Lachlan McIver

    2014-05-01

    Full Text Available Kiribati—a low-lying, resource-poor Pacific atoll nation—is one of the most vulnerable countries in the World to the impacts of climate change, including the likely detrimental effects on human health. We describe the preparation of a climate change and health adaptation plan for Kiribati carried out by the World Health Organization and the Kiribati Ministry of Health and Medical Services, including an assessment of risks to health, sources of vulnerability and suggestions for highest priority adaptation responses. This paper identifies advantages and disadvantages in the process that was followed, lays out a future direction of climate change and health adaptation work in Kiribati, and proposes lessons that may be applicable to other small, developing island nations as they prepare for and adapt to the impacts of climate change on health.

  5. Assessment of the Health Impacts of Climate Change in Kiribati

    Science.gov (United States)

    McIver, Lachlan; Woodward, Alistair; Davies, Seren; Tibwe, Tebikau; Iddings, Steven

    2014-01-01

    Kiribati—a low-lying, resource-poor Pacific atoll nation—is one of the most vulnerable countries in the World to the impacts of climate change, including the likely detrimental effects on human health. We describe the preparation of a climate change and health adaptation plan for Kiribati carried out by the World Health Organization and the Kiribati Ministry of Health and Medical Services, including an assessment of risks to health, sources of vulnerability and suggestions for highest priority adaptation responses. This paper identifies advantages and disadvantages in the process that was followed, lays out a future direction of climate change and health adaptation work in Kiribati, and proposes lessons that may be applicable to other small, developing island nations as they prepare for and adapt to the impacts of climate change on health. PMID:24830452

  6. Health Impact Assessment, Physical Activity and Federal Lands Trail Policy.

    Science.gov (United States)

    Davis, Sally M; Cruz, Theresa H; Kozoll, Richard L

    2014-01-01

    The objectives of this paper are to describe the application of Health Impact Assessment (HIA) to inform trail decisions affecting a rural, under-resourced community and propose the routine integration of HIAs to enhance NEPA environmental assessments and environmental impact statements for trail decisions on federal lands. Screening, scoping, assessment, recommendations, reporting, monitoring and evaluation are being used to examine the health impact of trail location and design. HIA recommendations are being integrated into the public lands National Environmental Protection Act process for planning access to a new segment of the Continental Divide National Scenic Trail. Potential users from a nearby rural New Mexico community and a region of almost one million may benefit from this HIA-informed planning. HIA can be integrated into the policy and decision-making process for trails on public lands.

  7. [Health impact assessment: one way to introduce health in all policies. SESPAS Report 2010].

    Science.gov (United States)

    Esnaola, Santiago; Bacigalupe, Amaia; Sanz, Elvira; Aldasoro, Elena; Calderón, Carlos; Zuazagoitia, Juan; Cambra, Koldo

    2010-12-01

    Health impact assessment is a predictive tool to support decisions in policy-making. Current experience shows that health impact assessment could play an important role in the development of the Health in All Policies strategy. This strategy has been extensively used in other European countries and in a wide range of policy and administrative sectors. Health impact assessment is hardly ever mandatory and is frequently carried out separately from other impact assessments. The use of this process in Spain is relatively new, limited and fundamentally based on local level experiences and the screening of regional interventions. The current normative and organizational reform of public health in Spain provides an excellent opportunity to promote the development of health impact assessment. Some of the barriers to the development of this process are related to the biomedical model of health prevailing among health professionals, politicians, and the general population, political disaffection, lack of assessment culture, underdevelopment of community participation processes, and insufficient intersectoral work. Health impact assessment provides an opportunity to move toward improving the population's health and reducing inequalities in health. Consequently, political commitment, as well as investment in education and research, is needed to introduce and develop health impact assessment in all administrative settings and policy sectors. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  8. Radiological and related chemical health impact assessments of ...

    African Journals Online (AJOL)

    There had been no serious radiological and related chemical health impact assessments of pipe borne water in the country. Water samples were collected from five waterworks across Lagos Metropolis and a single crystal NaI (Tl) detector was used to determine the activity concentration of 238U radionuclide in the water.

  9. Health impact assessment of mangrove vegetation in an oil spilled ...

    African Journals Online (AJOL)

    post-impact health assessment of the mangrove vegetation of Bodo West Field in Rivers State of Nigeria where three oil spillages occurred was carried out to determine any major changes from the baseline profile of the area 10 yrs after spillage. The accidents resulted in the discharge of a total of 1860 barrels of crude oil, ...

  10. Health impact assessment of climate change in Bangladesh

    International Nuclear Information System (INIS)

    Nelson, Deborah Imel

    2003-01-01

    Global climate change (GCC) may have serious and irreversible impacts. Improved methods are needed to predict and quantify health impacts, so that appropriate risk management strategies can be focused on vulnerable areas. The disability-adjusted life year (DALY) is proposed as an effective tool in environmental health impact assessment (HIA). The DALY accounts for years of life lost to premature death and/or morbidity. Both the DALY and the determinants-of-health approach are applied to HIA of GCC in Bangladesh. Based on historical data, a major storm event may result in approximately 290 DALY per 1000 population, including both deaths and injuries, compared to a current all-cause rate of about 280 per 1000 in the region. A more precise result would require a large input of data; however, this level of analysis may be sufficient to rank risks, and to motivate and target risk management efforts

  11. Health impact assessment of the Atlanta BeltLine.

    Science.gov (United States)

    Ross, Catherine L; Leone de Nie, Karen; Dannenberg, Andrew L; Beck, Laurie F; Marcus, Michelle J; Barringer, Jason

    2012-03-01

    Although a health impact assessment (HIA) is a tool that can provide decision makers with recommendations to promote positive health impacts and mitigate adverse health impacts of proposed projects and policies, it is not routinely conducted on most major projects or policies. To make health a decision criterion for the Atlanta BeltLine, a multibillion-dollar transit, trails, parks, and redevelopment project. An HIA was conducted in 2005-2007 to anticipate and influence the BeltLine's effect on health determinants. Changes in access and equity, environmental quality, safety, social capital, and physical activity were forecast, and steps to maximize health benefits and reduce negative effects were recommended. Key recommendations included giving priority to the construction of trails and greenspace rather than residential and retail construction, making health an explicit goal in project priority setting, adding a public health professional to decision-making boards, increasing the connectivity between the BeltLine and civic spaces, and ensuring that affordable housing is built. BeltLine project decision makers have incorporated most of the HIA recommendations into the planning process. The HIA was cited in the awarding of additional funds of $7,000,000 for brownfield clean-up and greenspace development. The project is expected to promote the health of local residents more than in the absence of the HIA. This report is one of the first HIAs to tie specific assessment findings to specific recommendations and to identifiable impacts from those recommendations. The lessons learned from this project may help others engaged in similar efforts. Copyright © 2012. Published by Elsevier Inc.

  12. Promoting social responsibility for health: health impact assessment and healthy public policy at the community level.

    Science.gov (United States)

    Mittelmark, M B

    2001-09-01

    The 1997 Jakarta Declaration on Health Promotion into the 21st Century called for new responses to address the emerging threats to health. The declaration placed a high priority on promoting social responsibility for health, and it identified equity-focused health impact assessment as a high priority for action. This theme was among the foci at the 2000 Fifth Global Conference on Health Promotion held in Mexico. This paper, which is an abbreviation of a technical report prepared for the Mexico conference, advances arguments for focusing on health impact assessment at the local level. Health impact assessment identifies negative health impacts that call for policy responses, and identifies and encourages practices and policies that promote health. Health impact assessment may be highly technical and require sophisticated technology and expertise. But it can also be a simple, highly practical process, accessible to ordinary people, and one that helps a community come to grips with local circumstances that need changing for better health. To illustrate the possibilities, this paper presents a case study, the People Assessing Their Health (PATH) project from Eastern Nova Scotia, Canada. It places ordinary citizens, rather than community elites, at the very heart of local decision-making. Evidence from PATH demonstrates that low technology health impact assessment, done by and for local people, can shift thinking beyond the illness problems of individuals. It can bring into consideration, instead, how programmes and policies support or weaken community health, and illuminate a community's capacity to improve local circumstances for better health. This stands in contrast to evidence that highly technological approaches to community-level health impact assessment can be self-defeating. Further development of simple, people-centred, low technology approaches to health impact assessment at the local level is called for.

  13. The Contribution of Health Technology Assessment, Health Needs Assessment, and Health Impact Assessment to the Assessment and Translation of Technologies in the Field of Public Health Genomics

    DEFF Research Database (Denmark)

    Rosenkotter, N.; Vondeling, H.; Blancquaert, I.

    2011-01-01

    or to identify infrastructural needs. HIA delivers information on the impact of technologies in a wider scope and promotes informed decision making. HTA, HNA and HIA provide a partly overlapping and partly unique set of methodologies and infrastructure for the translation and assessment of genomic health...

  14. Integrating a quantitative risk appraisal in a health impact assessment

    DEFF Research Database (Denmark)

    Adám, Balázs; Molnár, Agnes; Gulis, Gabriel

    2013-01-01

    BACKGROUND: Although the quantification of health outcomes in a health impact assessment (HIA) is scarce in practice, it is preferred by policymakers, as it assists various aspects of the decision-making process. This article provides an example of integrating a quantitative risk appraisal...... in an HIA performed for the recently adopted Hungarian anti-smoking policy which introduced a smoking ban in closed public places, workplaces and public transport vehicles, and is one of the most effective measures to decrease smoking-related ill health. METHODS: A comprehensive, prospective HIA...

  15. Mutagenesis and teratogenesis as end points in health impact assessment

    International Nuclear Information System (INIS)

    Bender, M.A.

    1976-01-01

    The genetic and teratogenic effects of agents released to the environment as a consequence of energy production are exceedingly difficult to evaluate. Nevertheless, these effects on human health may be very costly in the context of cost-benefit analysis. In fact, the procedures required to limit mutagenic or teratogenic agents to the levels considered acceptable by regulatory bodies may constitute a major fraction of the cost of energy, especially where prudence dictates that a lack of empirical data requires extremely conservative regulations. Experience with ionizing radiation and with regulation of nuclear power installations illustrates the difficulty of genetic and teratogenic health impact assessment and the great uncertainties involved, as well as the influence of these impacts on the regulatory process and the consequent increased cost of power from this source. Data on genetic and teratogenic impacts on human health from chemical agents released to the environment by other energy technologies are much less complete, and, because of the large number of potentially active agents involved, it is evident that generic solutions to health impact assessment will be required to evaluate these energy alternatives

  16. Population Dynamics and Air Pollution: The Impact of Demographics on Health Impact Assessment of Air Pollution

    OpenAIRE

    Flachs, Esben Meulengracht; S?rensen, Jan; B?nl?kke, Jakob; Br?nnum-Hansen, Henrik

    2013-01-01

    Objective. To explore how three different assumptions on demographics affect the health impact of Danish emitted air pollution in Denmark from 2005 to 2030, with health impact modeled from 2005 to 2050. Methods. Modeled air pollution from Danish sources was used as exposure in a newly developed health impact assessment model, which models four major diseases and mortality causes in addition to all-cause mortality. The modeling was at the municipal level, which divides the approximately 5.5 M ...

  17. Health Impact Assessment: a useful tool for decision makers

    Directory of Open Access Journals (Sweden)

    Livia Turco

    2007-09-01

    Full Text Available Health Impact Assessment is defined as ‘the combination of procedures, methods and tools through which it is possible to evaluate a policy, a program or a development plan concerning possible effects on public health and their distribution in the general population’. In a constructive debate this definition points out some interesting observations: - health is not the result of health policies alone, but it is often defined by the attention given to it in other contexts; - health is however the result of policies and it therefore must deserve the attention of Decision Makers; - health must not be taken into consideration without taking into account an evaluation of its distribution and its determinants within a population. Particular attention must therefore be paid into inequalities; - following the Council of the European Union recent conclusions on Health in All Policies we have to consider that everyday environments such as day-care centers, schools,workplaces,neighborhoods and the commute between them have significant effects on health and that health, in turn, has an effect on the economy by enabling active and productive participation in working life. In the past 20 years huge progress has been achieved in the epidemiological contest to define risks. Nowadays, it is known that a low cultural level lowers the capacity to respond to prevention, that elevated pollution levels do represent a health risk, and that the scarce social relationships that elderly people have in our society have strong consequences on their health and their quality of life.

  18. Differing forms, differing purposes: A typology of health impact assessment

    International Nuclear Information System (INIS)

    Harris-Roxas, Ben; Harris, Elizabeth

    2011-01-01

    There is currently considerable diversity in health impact assessment (HIA) practice internationally. Historically this diversity has been described as simple dichotomies, for example the differences between HIAs of projects and policies. However these distinctions have failed to adequately describe the differences that can be observed between different forms of HIAs. This paper describes the three historical and disciplinary fields from which HIA has emerged - environmental health, a social view of health, and health equity. It also puts forward a typology of four different forms of HIA that can be observed in current HIA practice: mandated, decision-support, advocacy, and community-led HIAs. This paper argues that these different forms of HIA serve different purposes and are not necessarily in competition; rather they allow HIA to be responsive to a range of population health concerns and purposes.

  19. Health impact assessment: where does the law come in?

    International Nuclear Information System (INIS)

    Hart, David Q.C.

    2004-01-01

    The European Convention on Human Rights has profound implications for HIA. Public authorities have a positive obligation to stop others from infringing citizens' rights to life and to respect for private and family life. These rights are qualified and have now been interpreted in many thousands of cases. Authorities must, as best they reasonably can, secure the safety of citizens and inform the citizens about the safety or otherwise of any development. Authorities have to strike a balance between the individuals rights and the public benefit. Any public authority before approving a scheme or reaching a regulatory decision which may impact on human rights must consider the nature of that impact, its seriousness and whether it can be justified on public interest grounds. A number of court judgements in cases concerning these issues are discussed. This article is not about how certain of the ideas underlying Health Impact Assessment, in certain circumstances, are or can be incorporated in existing legally recognised instruments such as Environmental Impact Assessments. Nor is it about the statutory powers which authorities--local and national--could, if so inclined, exercise, to further the health and well-being of their constituents. It is about something rather more general, important and yet rather formless, namely the duties identified by the European Court of Human Rights as resting upon public authorities to take steps to safeguard the public health rights of their citizens

  20. [Health impact assessment of "white-collar exemption" in Japan].

    Science.gov (United States)

    Fujino, Yoshihisa; Matsuda, Shinya

    2007-03-01

    This work conducted a health impact assessment (HIA) of the Japanese Government's proposal concerning the introduction of so called "white-collar exemption" into the Japanese labor market. We adopted the Merseyside model and performed a rapid health impact assessment to assess the potential health effects of white-collar exemption. In this HIA, several health determinants which may possibly be affected, both positively and negatively, were identified based on experts' judgments. Literature evidence was assessed using PubMed and other databases. In addition, we searched for the opinions of those affected by white-collar exemption from internet web sites, and six concerns were identified. Long working hours were identified as the most serious concern by both experts and those affected. White-collar exemption may increase irregular working patterns which may be related to sleep disorder, stress, and cardiovascular disease. Family function and social participation will also be affected by irregular working patterns. On the other hand, in terms of stress, white-collar exemption may benefit from a higher degree of job control. There are possibilities that white-collar exemption may enable an improved work-life balance and enable access of some groups of the population, such as people with disabilities or parents looking after children, greater access to the labour market. However, it is uncertain whether the benefits of white-collar exemption would overcome those of the current free-time or flex-time systems. The present work provides a wide range of health impacts of white-collar exemption, and will hopefully attract the attentions of decision-makers and those likely to be affected in order to contribute to policy-making.

  1. Assessing Health Impacts within Environmental Impact Assessments: An Opportunity for Public Health Globally Which Must Not Remain Missed

    Directory of Open Access Journals (Sweden)

    Patrick Harris

    2015-01-01

    Full Text Available Within the member states of the United Nations 190 of 193 have regulated Environmental Impact Assessments (EIA which is a systematic process to prevent and mitigate the potential environmental impacts of industry development projects before these occur. However, the routine and comprehensive assessment of health impacts within EIAs remains underdeveloped. Focusing, as an example, on the risks to global health from the global shift in the mining industry towards Low and Middle Income Countries LMIC, this viewpoint details why connecting with EIA is an essential task for the health system. Although existing knowledge is out of date in relation to global practice we identify how health has been included, to some extent, in High Income Country EIAs and the institutional requirements for doing so. Using arguments identified by industry themselves about requiring a ‘social license to operate’, we conclude that EIA regulations provide the best current mechanism to ensure health protection is a core aspect in the decision making process  to approve projects.

  2. Approaches to integrated monitoring for environmental health impact assessment.

    Science.gov (United States)

    Liu, Hai-Ying; Bartonova, Alena; Pascal, Mathilde; Smolders, Roel; Skjetne, Erik; Dusinska, Maria

    2012-11-21

    Although Integrated Environmental Health Monitoring (IEHM) is considered an essential tool to better understand complex environmental health issues, there is no consensus on how to develop such a programme. We reviewed four existing frameworks and eight monitoring programmes in the area of environmental health. We identified the DPSEEA (Driving Force-Pressure-State-Exposure-Effect-Action) framework as most suitable for developing an IEHM programme for environmental health impact assessment. Our review showed that most of the existing monitoring programmes have been designed for specific purposes, resulting in narrow scope and limited number of parameters. This therefore limits their relevance for studying complex environmental health topics. Other challenges include limited spatial and temporal data availability, limited development of data sharing mechanisms, heterogeneous data quality, a lack of adequate methodologies to link disparate data sources, and low level of interdisciplinary cooperation. To overcome some of these challenges, we propose a DPSEEA-based conceptual framework for an IEHM programme that would enable monitoring and measuring the impact of environmental changes on human health. We define IEHM as 'a systemic process to measure, analyse and interpret the state and changes of natural-eco-anthropogenic systems and its related health impact over time at the same location with causative explanations across the various compartments of the cause-effect chain'. We develop a structural work process to integrate information that is based on existing environmental health monitoring programmes. Such a framework allows the development of combined monitoring systems that exhibit a large degree of compatibility between countries and regions.

  3. Approaches to integrated monitoring for environmental health impact assessment

    Directory of Open Access Journals (Sweden)

    Liu Hai-Ying

    2012-11-01

    Full Text Available Abstract Although Integrated Environmental Health Monitoring (IEHM is considered an essential tool to better understand complex environmental health issues, there is no consensus on how to develop such a programme. We reviewed four existing frameworks and eight monitoring programmes in the area of environmental health. We identified the DPSEEA (Driving Force-Pressure-State-Exposure-Effect-Action framework as most suitable for developing an IEHM programme for environmental health impact assessment. Our review showed that most of the existing monitoring programmes have been designed for specific purposes, resulting in narrow scope and limited number of parameters. This therefore limits their relevance for studying complex environmental health topics. Other challenges include limited spatial and temporal data availability, limited development of data sharing mechanisms, heterogeneous data quality, a lack of adequate methodologies to link disparate data sources, and low level of interdisciplinary cooperation. To overcome some of these challenges, we propose a DPSEEA-based conceptual framework for an IEHM programme that would enable monitoring and measuring the impact of environmental changes on human health. We define IEHM as ‘a systemic process to measure, analyse and interpret the state and changes of natural-eco-anthropogenic systems and its related health impact over time at the same location with causative explanations across the various compartments of the cause-effect chain’. We develop a structural work process to integrate information that is based on existing environmental health monitoring programmes. Such a framework allows the development of combined monitoring systems that exhibit a large degree of compatibility between countries and regions.

  4. Health Impact Assessment of an oil drilling project in California.

    Science.gov (United States)

    McCallum, Lindsay C; Souweine, Kathleen; McDaniel, Mary; Koppe, Bart; McFarland, Christine; Butler, Katherine; Ollson, Christopher A

    2016-01-01

    The Health Impact Assessment (HIA) was conducted to evaluate the potential community health implications of a proposed oil drilling and production project in Hermosa Beach, California. The HIA considered 17 determinants of health that fell under 6 major categories (i.e., air quality, water and soil quality, upset conditions, noise and light emissions, traffic, and community livability). This paper attempts to address some of the gaps within the HIA practice by presenting the methodological approach and results of this transparent, comprehensive HIA; specifically, the evaluation matrix and decision-making framework that have been developed for this HIA and form the basis of the evaluation and allow for a clear conclusion to be reached in respect of any given health determinant (i.e., positive, negative, neutral). There is a number of aspects of the project that may positively influence health (e.g., increased education funding, ability to enhance green space), and at the same time there have been potential negative effects identified (e.g., odor, blowouts, property values). Except for upset conditions, the negative health outcomes have been largely nuisance-related (e.g., odor, aesthetics) without irreversible health impacts. The majority of the health determinants, that had been examined, have revealed that the project would have no substantial effect on the health of the community. Using the newly developed methodology and based on established mitigation measures and additional recommendations provided in the HIA, the authors have concluded that the project will have no substantial effect on community health. This approach and methodology will assist practitioners, stakeholders and decision-makers in advancing the HIA as a useful, reproducible, and informative tool. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  5. Health Impact Assessment of an oil drilling project in California

    Directory of Open Access Journals (Sweden)

    Lindsay C. McCallum

    2016-04-01

    Full Text Available Objectives: The Health Impact Assessment (HIA was conducted to evaluate the potential community health implications of a proposed oil drilling and production project in Hermosa Beach, California. The HIA considered 17 determinants of health that fell under 6 major categories (i.e., air quality, water and soil quality, upset conditions, noise and light emissions, traffic, and community livability. Material and Methods: This paper attempts to address some of the gaps within the HIA practice by presenting the methodological approach and results of this transparent, comprehensive HIA; specifically, the evaluation matrix and decision-making framework that have been developed for this HIA and form the basis of the evaluation and allow for a clear conclusion to be reached in respect of any given health determinant (i.e., positive, negative, neutral. Results: There is a number of aspects of the project that may positively influence health (e.g., increased education funding, ability to enhance green space, and at the same time there have been potential negative effects identified (e.g., odor, blowouts, property values. Except for upset conditions, the negative health outcomes have been largely nuisance-related (e.g., odor, aesthetics without irreversible health impacts. The majority of the health determinants, that had been examined, have revealed that the project would have no substantial effect on the health of the community. Conclusions: Using the newly developed methodology and based on established mitigation measures and additional recommendations provided in the HIA, the authors have concluded that the project will have no substantial effect on community health. This approach and methodology will assist practitioners, stakeholders and decision-makers in advancing the HIA as a useful, reproducible, and informative tool.

  6. Health impact assessment of cycling network expansions in European cities.

    Science.gov (United States)

    Mueller, Natalie; Rojas-Rueda, David; Salmon, Maëlle; Martinez, David; Ambros, Albert; Brand, Christian; de Nazelle, Audrey; Dons, Evi; Gaupp-Berghausen, Mailin; Gerike, Regine; Götschi, Thomas; Iacorossi, Francesco; Int Panis, Luc; Kahlmeier, Sonja; Raser, Elisabeth; Nieuwenhuijsen, Mark

    2018-01-09

    We conducted a health impact assessment (HIA) of cycling network expansions in seven European cities. We modeled the association between cycling network length and cycling mode share and estimated health impacts of the expansion of cycling networks. First, we performed a non-linear least square regression to assess the relationship between cycling network length and cycling mode share for 167 European cities. Second, we conducted a quantitative HIA for the seven cities of different scenarios (S) assessing how an expansion of the cycling network [i.e. 10% (S1); 50% (S2); 100% (S3), and all-streets (S4)] would lead to an increase in cycling mode share and estimated mortality impacts thereof. We quantified mortality impacts for changes in physical activity, air pollution and traffic incidents. Third, we conducted a cost-benefit analysis. The cycling network length was associated with a cycling mode share of up to 24.7% in European cities. The all-streets scenario (S4) produced greatest benefits through increases in cycling for London with 1,210 premature deaths (95% CI: 447-1,972) avoidable annually, followed by Rome (433; 95% CI: 170-695), Barcelona (248; 95% CI: 86-410), Vienna (146; 95% CI: 40-252), Zurich (58; 95% CI: 16-100) and Antwerp (7; 95% CI: 3-11). The largest cost-benefit ratios were found for the 10% increase in cycling networks (S1). If all 167 European cities achieved a cycling mode share of 24.7% over 10,000 premature deaths could be avoided annually. In European cities, expansions of cycling networks were associated with increases in cycling and estimated to provide health and economic benefits. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. Transportation Matters: A Health Impact Assessment in Rural New Mexico

    Directory of Open Access Journals (Sweden)

    Michelle Del Rio

    2017-06-01

    Full Text Available This Health Impact Assessment (HIA informed the decision of expanding public transportation services to rural, low income communities of southern Doña Ana County, New Mexico on the U.S./Mexico border. The HIA focused on impacts of access to health care services, education, and economic development opportunities. Qualitative and quantitative data were collected from surveys of community members, key informant interviews, a focus group with community health workers, and passenger surveys during an initial introduction of the transit system. Results from the survey showed that a high percentage of respondents would use the bus system to access the following: (1 84% for health services; (2 83% for formal and informal education opportunities; and (3 81% for economic opportunities. Results from interviews and the focus group supported the benefits of access to services but many were concerned with the high costs of providing bus service in a rural area. We conclude that implementing the bus system would have major impacts on resident’s health through improved access to: (1 health services, and fresh foods, especially for older adults; (2 education opportunities, such as community colleges, universities, and adult learning, especially for young adults; and (3 economic opportunities, especially jobs, job training, and consumer goods and services. We highlight the challenges associated with public transportation in rural areas where there are: (1 long distances to travel; (2 difficulties in scheduling to meet all needs; and (3 poor road and walking conditions for bus stops. The results are applicable to low income and fairly disconnected rural areas, where access to health, education, and economic opportunities are limited.

  8. Transportation Matters: A Health Impact Assessment in Rural New Mexico.

    Science.gov (United States)

    Del Rio, Michelle; Hargrove, William L; Tomaka, Joe; Korc, Marcelo

    2017-06-13

    This Health Impact Assessment (HIA) informed the decision of expanding public transportation services to rural, low income communities of southern Doña Ana County, New Mexico on the U.S./Mexico border. The HIA focused on impacts of access to health care services, education, and economic development opportunities. Qualitative and quantitative data were collected from surveys of community members, key informant interviews, a focus group with community health workers, and passenger surveys during an initial introduction of the transit system. Results from the survey showed that a high percentage of respondents would use the bus system to access the following: (1) 84% for health services; (2) 83% for formal and informal education opportunities; and (3) 81% for economic opportunities. Results from interviews and the focus group supported the benefits of access to services but many were concerned with the high costs of providing bus service in a rural area. We conclude that implementing the bus system would have major impacts on resident's health through improved access to: (1) health services, and fresh foods, especially for older adults; (2) education opportunities, such as community colleges, universities, and adult learning, especially for young adults; and (3) economic opportunities, especially jobs, job training, and consumer goods and services. We highlight the challenges associated with public transportation in rural areas where there are: (1) long distances to travel; (2) difficulties in scheduling to meet all needs; and (3) poor road and walking conditions for bus stops. The results are applicable to low income and fairly disconnected rural areas, where access to health, education, and economic opportunities are limited.

  9. Health impact assessment of traffic noise in Madrid (Spain).

    Science.gov (United States)

    Tobías, Aurelio; Recio, Alberto; Díaz, Julio; Linares, Cristina

    2015-02-01

    The relationship between environmental noise and health has been examined in depth. In view of the sheer number of persons exposed, attention should be focused on road traffic noise. The city of Madrid (Spain) is a densely populated metropolitan area in which 80% of all environmental noise exposure is attributed to traffic. The aim of this study was to quantify avoidable deaths resulting from reducing the impact of equivalent diurnal noise levels (LeqD) on daily cardiovascular and respiratory mortality among people aged ≥65 years in Madrid. A health impact assessment of (average 24h) LeqD and PM2.5 levels was conducted by using previously reported risk estimates of mortality rates for the period 2003-2005: For cardiovascular causes: LeqD 1.048 (1.005, 1.092) and PM2.5 1.041(1.020, 1.062) and for respiratory causes: LeqD 1.060 (1.000, 1.123) and PM2.5 1.030 (1.000, 1.062). The association found between LeqD exposure and mortality for both causes suggests an important health effect. A reduction of 1dB(A) in LeqD implies an avoidable annual mortality of 284 (31, 523) cardiovascular- and 184 (0, 190) respiratory-related deaths in the study population. The magnitude of the health impact is similar to reducing average PM2.5 levels by 10µg/m(3). Regardless of air pollution, exposure to traffic noise should be considered an important environmental factor having a significant impact on health. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. The Value of Mainstreaming Human Rights into Health Impact Assessment

    Science.gov (United States)

    MacNaughton, Gillian; Forman, Lisa

    2014-01-01

    Health impact assessment (HIA) is increasingly being used to predict the health and social impacts of domestic and global laws, policies and programs. In a comprehensive review of HIA practice in 2012, the authors indicated that, given the diverse range of HIA practice, there is an immediate need to reconsider the governing values and standards for HIA implementation [1]. This article responds to this call for governing values and standards for HIA. It proposes that international human rights standards be integrated into HIA to provide a universal value system backed up by international and domestic laws and mechanisms of accountability. The idea of mainstreaming human rights into HIA is illustrated with the example of impact assessments that have been carried out to predict the potential effects of intellectual property rights in international trade agreements on the availability and affordability of medicines. The article concludes by recommending international human rights standards as a legal and ethical framework for HIA that will enhance the universal values of nondiscrimination, participation, transparency and accountability and bring legitimacy and coherence to HIA practice as well. PMID:25264683

  11. The value of mainstreaming human rights into health impact assessment.

    Science.gov (United States)

    MacNaughton, Gillian; Forman, Lisa

    2014-09-26

    Health impact assessment (HIA) is increasingly being used to predict the health and social impacts of domestic and global laws, policies and programs. In a comprehensive review of HIA practice in 2012, the authors indicated that, given the diverse range of HIA practice, there is an immediate need to reconsider the governing values and standards for HIA implementation [1]. This article responds to this call for governing values and standards for HIA. It proposes that international human rights standards be integrated into HIA to provide a universal value system backed up by international and domestic laws and mechanisms of accountability. The idea of mainstreaming human rights into HIA is illustrated with the example of impact assessments that have been carried out to predict the potential effects of intellectual property rights in international trade agreements on the availability and affordability of medicines. The article concludes by recommending international human rights standards as a legal and ethical framework for HIA that will enhance the universal values of nondiscrimination, participation, transparency and accountability and bring legitimacy and coherence to HIA practice as well.

  12. Health consequence scales for use in health impact assessments of climate change.

    Science.gov (United States)

    Brown, Helen; Spickett, Jeffery

    2014-09-16

    While health impact assessment (HIA) has typically been applied to projects, plans or policies, it has significant potential with regard to strategic considerations of major health issues facing society such as climate change. Given the complexity of climate change, assessing health impacts presents new challenges that may require different approaches compared to traditional applications of HIA. This research focuses on the development of health consequence scales suited to assessing and comparing health effects associated with climate change and applied within a HIA framework. This assists in setting priorities for adaptation plans to minimize the public health impacts of climate change. The scales presented in this paper were initially developed for a HIA of climate change in Perth in 2050, but they can be applied across spatial and temporal scales. The design is based on a health effects pyramid with health measures expressed in orders of magnitude and linked to baseline population and health data. The health consequence measures are combined with a measure of likelihood to determine the level of risk associated with each health potential health impact. In addition, a simple visual framework that can be used to collate, compare and communicate the level of health risks associated with climate change has been developed.

  13. Stakeholder participation in health impact assessment: A multicultural approach

    International Nuclear Information System (INIS)

    Negev, Maya; Davidovitch, Nadav; Garb, Yaakov; Tal, Alon

    2013-01-01

    The literature on impact assessment (HIA) registers the importance of stakeholder participation in the assessment process, but still lacks a model for engaging stakeholders of diverse ethnic, professional and sectorial backgrounds. This paper suggests that the multicultural approach can contribute to HIA through a revision of the generic 5-step HIA model, and its implementation in a metropolitan plan in Southern Israel. The health issue scoped by the stakeholders in the HIA is related to land uses in the vicinity of the national hazardous industry and hazardous waste site. The stakeholders were representatives of the diverse populations at stake, including rural Bedouins and Jewish city dwellers, as well as representatives from the public sector, private sector, non-governmental organizations and academia. The case study revealed that a multicultural stakeholder participation process helps to uncover health issues known to the community which were not addressed in the original plan, and provides local knowledge regarding health conditions that is especially valuable when scientific data is uncertain or absent. It enables diverse stakeholders to prioritize the health issues that will be assessed. The case study also reveals ways in which the model needs revisions and improvements such as in recruitment of diverse participants. This paper presents a multicultural model of HIA and discusses some of the challenges that are faced when HIA is implemented in the context of current decision-making culture. -- Highlights: • We revised the generic HIA model in light of the multicultural approach. • We tested the model in a case study of zoning a hazardous industry site. • Multicultural stakeholder participation uncovers health issues known to communities. • It enables community prioritization of health issues. • We present a model for multicultural stakeholder participation in HIA

  14. Assessing ecosystem impacts on health: A tool review

    NARCIS (Netherlands)

    Oosterbroek, Bram; de Kraker, Joop; Huynen, Maud M T E; Martens, Pim

    2016-01-01

    In the past decade, interest in the impacts of ecosystem change on human health has strongly increased. The ecosystem-health relationship, however, is characterized by several complexity aspects, such as multiple and diverse health impacts - both positive and negative - and a strong interaction with

  15. Environmental and health impact assessment for ports in Thailand.

    Science.gov (United States)

    Chanchang, Chamchan; Sithisarankul, Pornchai; Supanitayanon, Thanawat

    2016-01-01

    Port development in Thailand is an essential part of the national maritime interest in connection with ship and shore activities. The growth of maritime industry and transportation has led to the expansion of ports' areas and capacity. Each port type causes different environmental impacts. Therefore, the Port Authority of Thailand has set up guidelines on ports' environmental management. This is divided into 3 major phases; namely, planning, construction and operation commencement periods. The Report of Environmental and Health Impact Assessment (EIA, HIA and EHIA) is regarded as the environmental management process in the planning period. It is a key tool to anticipate and prevent any adverse effects that might occur on the environment as well as community health resulting from the project implementation. This measure, in turn, creates advance preparation on both the preventive and problem-solving means before the project gets off the ground. At present, the majority of new projects on port development have still been in the process of information gathering for EHIA submission. Some cannot start to operate due to their EHIA failure. For example, the Tha-sala port which did not pass EHIA, mainly because emphasis had been focused on adhering to legal regulations without taking into consideration the in-depth analysis of data being conducted by community entities in the area. Thus caused the project to be finally abolished. Impact assessment on environment and health should be aimed at detailed understanding of the community in each particular area so that effective data of objective achievement in preventing environmental problems could actually be carried out and welcomed by the concerned society.

  16. Adaptation strategies for health impacts of climate change in Western Australia: Application of a Health Impact Assessment framework

    International Nuclear Information System (INIS)

    Spickett, Jeffery T.; Brown, Helen L.; Katscherian, Dianne

    2011-01-01

    Climate change is one of the greatest challenges facing the globe and there is substantial evidence that this will result in a number of health impacts, regardless of the level of greenhouse gas mitigation. It is therefore apparent that a combined approach of mitigation and adaptation will be required to protect public health. While the importance of mitigation is recognised, this project focused on the role of adaptation strategies in addressing the potential health impacts of climate change. The nature and magnitude of these health impacts will be determined by a number of parameters that are dependent upon the location. Firstly, climate change will vary between regions. Secondly, the characteristics of each region in terms of population and the ability to adapt to changes will greatly influence the extent of the health impacts that are experienced now and into the future. Effective adaptation measures therefore need to be developed with these differences in mind. A Health Impact Assessment (HIA) framework was used to consider the implications of climate change on the health of the population of Western Australia (WA) and to develop a range of adaptive responses suited to WA. A broad range of stakeholders participated in the HIA process, providing informed input into developing an understanding of the potential health impacts and potential adaptation strategies from a diverse sector perspective. Potential health impacts were identified in relation to climate change predictions in WA in the year 2030. The risk associated with each of these impacts was assessed using a qualitative process that considered the consequences and the likelihood of the health impact occurring. Adaptations were then developed which could be used to mitigate the identified health impacts and provide responses which could be used by Government for future decision making. The periodic application of a HIA framework is seen as an ideal tool to develop appropriate adaptation strategies to

  17. Health impact assessment of air pollution using a dynamic exposure profile: Implications for exposure and health impact estimates

    International Nuclear Information System (INIS)

    Dhondt, Stijn; Beckx, Carolien; Degraeuwe, Bart; Lefebvre, Wouter; Kochan, Bruno; Bellemans, Tom; Int Panis, Luc; Macharis, Cathy; Putman, Koen

    2012-01-01

    In both ambient air pollution epidemiology and health impact assessment an accurate assessment of the population exposure is crucial. Although considerable advances have been made in assessing human exposure outdoors, the assessments often do not consider the impact of individual travel behavior on such exposures. Population-based exposures to NO 2 and O 3 using only home addresses were compared with models that integrate all time-activity patterns—including time in commute—for Flanders and Brussels. The exposure estimates were used to estimate the air pollution impact on years of life lost due to respiratory mortality. Health impact of NO 2 using an exposure that integrates time-activity information was on average 1.2% higher than when assuming that people are always at their home address. For ozone the overall estimated health impact was 0.8% lower. Local differences could be much larger, with estimates that differ up to 12% from the exposure using residential addresses only. Depending on age and gender, deviations from the population average were seen. Our results showed modest differences on a regional level. At the local level, however, time-activity patterns indicated larger differences in exposure and health impact estimates, mainly for people living in more rural areas. These results suggest that for local analyses the dynamic approach can contribute to an improved assessment of the health impact of various types of pollution and to the understanding of exposure differences between population groups. - Highlights: ► Exposure to ambient air pollution was assessed integrating population mobility. ► This dynamic exposure was integrated into a health impact assessment. ► Differences between the dynamic and residential exposure were quantified. ► Modest differences in health impact were found at a regional level. ► At municipal level larger differences were found, influenced by gender and age.

  18. Investigating underlying principles to guide health impact assessment.

    Science.gov (United States)

    Fakhri, Ali; Maleki, Mohammadreza; Gohari, Mahmoodreza; Harris, Patrick

    2014-06-01

    Many countries conduct Health Impact Assessment (HIA) of their projects and policies to predict their positive and negative health impacts. In recent years many guides have been developed to inform HIA practice, largely reflecting local developments in HIA. These guides have often been designed for specific contexts and specific need, making the choice between guides difficult. The objective of the current study is to identify underlying principles in order to guide HIA practice in Iran. This study was conducted in three stages: 1) Studies comparing HIA guidelines were reviewed to identify criteria used for comparison seeking emphasized principles. 2) The HIA characteristics extracted from published papers were categorized in order to determine the principles that could guide HIA practice. 3) Finally, these principles were agreed by experts using nominal group technique. The review of the studies comparing HIA guides demonstrated there are no clear comparison criteria for reviewing HIA guides and no study mentioned HIA principles. Investigating the HIA principles from peer-reviewed papers, we found 14 issues. These were, considering of general features in planning and conducting HIAs such as HIA stream, level, timing and type, considering of the wider socio-political and economic context, considering of economic, technical and legal aspects of HIA and capacities for HIA, rationality and comprehensiveness, using appropriate evidence, elaborating on HIA relation to other forms of Impact Assessment, considering of equity, and encouraging intersectoral and interdisciplinary cooperation, involvement of stakeholders and transparency as underlying principles to guide HIA practice. The results emphasize how critical these technical as well as tactical considerations are in the early scoping step of an HIA which plans the conduct of the HIA in reponse to local contextual issues. Determining the principles of HIA from peer-reviewed papers provides an opportunity for guiding

  19. Investigating Underlying Principles to Guide Health Impact Assessment

    Directory of Open Access Journals (Sweden)

    Ali Fakhri

    2014-06-01

    Full Text Available Background Many countries conduct Health Impact Assessment (HIA of their projects and policies to predict their positive and negative health impacts. In recent years many guides have been developed to inform HIA practice, largely reflecting local developments in HIA. These guides have often been designed for specific contexts and specific need, making the choice between guides difficult. The objective of the current study is to identify underlying principles in order to guide HIA practice in Iran. Methods This study was conducted in three stages: 1 Studies comparing HIA guidelines were reviewed to identify criteria used for comparison seeking emphasized principles. 2 The HIA characteristics extracted from published papers were categorized in order to determine the principles that could guide HIA practice. 3 Finally, these principles were agreed by experts using nominal group technique. Results The review of the studies comparing HIA guides demonstrated there are no clear comparison criteria for reviewing HIA guides and no study mentioned HIA principles. Investigating the HIA principles from peer-reviewed papers, we found 14 issues. These were, considering of general features in planning and conducting HIAs such as HIA stream, level, timing and type, considering of the wider socio-political and economic context, considering of economic, technical and legal aspects of HIA and capacities for HIA, rationality and comprehensiveness, using appropriate evidence, elaborating on HIA relation to other forms of Impact Assessment, considering of equity, and encouraging intersectoral and interdisciplinary cooperation, involvement of stakeholders and transparency as underlying principles to guide HIA practice. The results emphasize how critical these technical as well as tactical considerations are in the early scoping step of an HIA which plans the conduct of the HIA in reponse to local contextual issues. Conclusion Determining the principles of HIA from

  20. Contamination of Sachet Water in Nigeria: Assessment and Health Impact

    Directory of Open Access Journals (Sweden)

    Omalu ICJ

    2011-01-01

    Full Text Available Adequate supply of fresh and clean drinking water is a basic need for all human beings. Water consumers are frequently unaware of the potential health risks associated with exposure to water borne contaminants which have often led to diseases like diarrhoea, cholera, dysentery, typhoid fever, legionnaire’s disease and parasitic diseases. The inadequacy of pipe borne water-supply in Nigeria is a growing problem; as a result people resort to buying water from vendors, and sachet or bottled water became a major source of drinking water. Although, portable and affordable, the problems of its purity and other health concerns have begun to manifest. Sachet water have been reported to contain bacteria such as Bacillus sp., Pseudomonas sp., Klebsiella sp., Streptococcus sp., and oocysts of Cryptosporidia sp. Apart from environmental contaminants, improper storage and handling by vendors also poses a serious threat to the health of the ignorant consumers. This paper tends to review the quality of these ‘pure water’; its physical examination, microbial assessments, its impacts on health, and the various strategies adopted by the concerned authorities to regulate this thriving industry.

  1. Population Dynamics and Air Pollution: The Impact of Demographics on Health Impact Assessment of Air Pollution

    Directory of Open Access Journals (Sweden)

    Esben Meulengracht Flachs

    2013-01-01

    Full Text Available Objective. To explore how three different assumptions on demographics affect the health impact of Danish emitted air pollution in Denmark from 2005 to 2030, with health impact modeled from 2005 to 2050. Methods. Modeled air pollution from Danish sources was used as exposure in a newly developed health impact assessment model, which models four major diseases and mortality causes in addition to all-cause mortality. The modeling was at the municipal level, which divides the approximately 5.5 M residents in Denmark into 99 municipalities. Three sets of demographic assumptions were used: (1 a static year 2005 population, (2 morbidity and mortality fixed at the year 2005 level, or (3 an expected development. Results. The health impact of air pollution was estimated at 672,000, 290,000, and 280,000 lost life years depending on demographic assumptions and the corresponding social costs at 430.4 M€, 317.5 M€, and 261.6 M€ through the modeled years 2005–2050. Conclusion. The modeled health impact of air pollution differed widely with the demographic assumptions, and thus demographics and assumptions on demographics played a key role in making health impact assessments on air pollution.

  2. Motivators and barriers to incorporating climate change-related health risks in environmental health impact assessment.

    Science.gov (United States)

    Turner, Lyle R; Alderman, Katarzyna; Connell, Des; Tong, Shilu

    2013-03-22

    Climate change presents risks to health that must be addressed by both decision-makers and public health researchers. Within the application of Environmental Health Impact Assessment (EHIA), there have been few attempts to incorporate climate change-related health risks as an input to the framework. This study used a focus group design to examine the perceptions of government, industry and academic specialists about the suitability of assessing the health consequences of climate change within an EHIA framework. Practitioners expressed concern over a number of factors relating to the current EHIA methodology and the inclusion of climate change-related health risks. These concerns related to the broad scope of issues that would need to be considered, problems with identifying appropriate health indicators, the lack of relevant qualitative information that is currently incorporated in assessment and persistent issues surrounding stakeholder participation. It was suggested that improvements are needed in data collection processes, particularly in terms of adequate communication between environmental and health practitioners. Concerns were raised surrounding data privacy and usage, and how these could impact on the assessment process. These findings may provide guidance for government and industry bodies to improve the assessment of climate change-related health risks.

  3. Comparative Human Health Impact Assessment of Engineered Nanomaterials in the Framework of Life Cycle Assessment.

    Science.gov (United States)

    Fransman, Wouter; Buist, Harrie; Kuijpers, Eelco; Walser, Tobias; Meyer, David; Zondervan-van den Beuken, Esther; Westerhout, Joost; Klein Entink, Rinke H; Brouwer, Derk H

    2017-07-01

    For safe innovation, knowledge on potential human health impacts is essential. Ideally, these impacts are considered within a larger life-cycle-based context to support sustainable development of new applications and products. A methodological framework that accounts for human health impacts caused by inhalation of engineered nanomaterials (ENMs) in an indoor air environment has been previously developed. The objectives of this study are as follows: (i) evaluate the feasibility of applying the CF framework for NP exposure in the workplace based on currently available data; and (ii) supplement any resulting knowledge gaps with methods and data from the life cycle approach and human risk assessment (LICARA) project to develop a modified case-specific version of the framework that will enable near-term inclusion of NP human health impacts in life cycle assessment (LCA) using a case study involving nanoscale titanium dioxide (nanoTiO 2 ). The intent is to enhance typical LCA with elements of regulatory risk assessment, including its more detailed measure of uncertainty. The proof-of-principle demonstration of the framework highlighted the lack of available data for both the workplace emissions and human health effects of ENMs that is needed to calculate generalizable characterization factors using common human health impact assessment practices in LCA. The alternative approach of using intake fractions derived from workplace air concentration measurements and effect factors based on best-available toxicity data supported the current case-by-case approach for assessing the human health life cycle impacts of ENMs. Ultimately, the proposed framework and calculations demonstrate the potential utility of integrating elements of risk assessment with LCA for ENMs once the data are available. © 2016 Society for Risk Analysis.

  4. National Built Environment Health Impact Assessment Model: Creation and Application

    Science.gov (United States)

    Behavioral (activity, diet, social interaction) and exposure (air pollution, traffic injury, and noise) related health impacts of land use and transportation investment decisions are becoming better understood and quantified. Research has shown relationships between density, mix,...

  5. Equity-focused health impact assessment: A tool to assist policy makers in addressing health inequalities

    International Nuclear Information System (INIS)

    Simpson, Sarah; Mahoney, Mary; Harris, Elizabeth; Aldrich, Rosemary; Stewart-Williams, Jenny

    2005-01-01

    In Australasia (Australia and New Zealand) the use of health impact assessment (HIA) as a tool for improved policy development is comparatively new. The public health workforce do not routinely assess the potential health and equity impacts of proposed policies or programs. The Australasian Collaboration for Health Equity Impact Assessment was funded to develop a strategic framework for equity-focused HIA (EFHIA) with the intent of strengthening the ways in which equity is addressed in each step of HIA. The collaboration developed a draft framework for EFHIA that mirrored, but modified the commonly accepted steps of HIA; tested the draft framework in six different health service delivery settings; analysed the feedback about application of the draft EFHIA framework and modified it accordingly. The strategic framework shows promise in providing a systematic process for identifying potential differential health impacts and assessing the extent to which these are avoidable and unfair. This paper presents the EFHIA framework and discusses some of the issues that arose in the case study sites undertaking equity-focused HIA

  6. Effectiveness of Health Impact Assessments: A Synthesis of Data From Five Impact Evaluation Reports.

    Science.gov (United States)

    Dannenberg, Andrew L

    2016-06-30

    Since the 1990s, the use of health impact assessments (HIAs) has grown for considering the potential health impacts of proposed policies, plans, programs, and projects in various sectors. Evaluation of HIA impacts is needed for understanding the value of HIAs, improving the methods involved in HIAs, and potentially expanding their application. Impact evaluations examine whether HIAs affect decisions and lead to other effects. I reviewed HIA impact evaluations identified by literature review and professional networking. I abstracted and synthesized data on key findings, success factors, and challenges from 5 large evaluations conducted in the United States, Europe, Australia, and New Zealand and published from 2006 through 2015. These studies analyzed impacts of approximately 200 individual HIAs. Major impacts of HIAs were directly influencing some decisions, improving collaboration among stakeholders, increasing awareness of health issues among decision makers, and giving community members a stronger voice in local decisions. Factors that contributed to successful HIAs included engaging stakeholders, timeliness, policy and systems support for conducting HIAs, having people with appropriate skills on the HIA team, obtaining the support of decision makers, and providing clearly articulated, feasible recommendations. Challenges that may have reduced HIA success were poor timeliness, underestimation of time and resources needed, difficulty in accessing relevant data, use of jargon in HIA reports, difficulty in involving decision makers in the HIA process, and absence of a requirement to conduct HIAs. HIAs can be useful to promote health and mitigate adverse impacts of decisions made outside of the health sector. Stakeholder interactions and community engagement may be as important as direct impacts of HIAs. Multiple factors are required for HIA success. Further work could strengthen the role of HIAs in promoting equity, examine HIA impacts in specific sectors, and

  7. HEALTH IMPACT ASSESSMENT BY INGESTION OF POLLUTED SOIL/SEDIMENT

    Directory of Open Access Journals (Sweden)

    Ines Tomašek

    2016-06-01

    Full Text Available Potentially toxic elements (PTEs pose a threat to human health as they can easily enter human body via ingestion of polluted soil/sediment. In order to estimate bioavailability and access health impact on people, measurement of the oral bioaccessibility of a contaminant is crucial. Various laboratory based in vitro tests which mimic human gastrointestinal tract conditions can be used. In order to set up the method for analysing bioaccessibility of contaminants in soil samples in Laboratory for the analysis of geological materials at Department of Mineralogy, Petrology and Mineral resources (Faculty of Mining, Geology and Petroleum Engineering, University of Zagreb - RGNF, with regards to the available equipment, an orientation survey was carried out in collaboration with the Department of Biochemical Engineering (Faculty of Food Technology and Biotechnology, University of Zagreb - PBF. The digestion of two different samples in synthetic fluids (gastric and intestinal fluid was performed simultaneously at RGNF laboratory and PBF laboratory under different extraction conditions according to each laboratory’s ability. Prior to analysis of bioaccessibility, detailed mineralogical and chemical characterization of samples was performed. The comparison of two experiments showed that there is a relatively good correlation between concentrations obtained after digestion of samples in different labs, under different conditions. As a result of this study, an efficient and relatively inexpensive method for determining the bioaccessibility was set up at Faculty of Mining, Geology and Petroleum Engineering, which makes this kind of tests more accessible and enables new approach in risk assessment studies.

  8. An assessment of health research impact in Iran.

    Science.gov (United States)

    Yazdizadeh, Bahareh; Majdzadeh, Reza; Janani, Leila; Mohtasham, Farideh; Nikooee, Sima; Mousavi, Abdmohammad; Najafi, Farid; Atabakzadeh, Maryam; Bazrafshan, Azam; Zare, Morteza; Karami, Manoochehr

    2016-07-26

    In recent years, Iran has made significant developments in the field of health sciences. However, the question is whether this considerable increase has affected public health. The research budget has always been negligible and unsustainable in developing countries. Hence, using the Payback Framework, we conducted this study to evaluate the impact of health research in Iran. By using a cross-sectional method and two-stage stratified cluster sampling, the projects were randomly selected from six medical universities. A questionnaire was designed according to the Payback Framework and completed by the principle investigators of the randomly selected projects. The response rate was 70.4%. Ten point twenty-four percent (10.24%) of the studies had been ordered by a knowledge user organization. The average number of articles published in journals per project was 0.96, and half of the studies had no articles published in Scopus. The results of 12% of the studies had been used in systematic review articles and the same proportion had been utilized in clinical or public health guidelines. The results of 5.3% of the studies had been implemented in the Health Ministry's policymaking. 62% of the studies were expected to affect health directly, 38% of them had been implemented, and among the latter 60% had achieved the expected results. Concerning the economic impacts, the most common expected impact was the reduction of 'days of work missed because of illness or disability' and impact on personal and health system costs. About 36% of these studies had been implemented, and 61% had achieved the expected impact. In most aspects, the status of research impact needs improvement. A comparison of Iran's ranking of knowledge creation and knowledge impact in the Global Innovation Index confirms these findings. The most important problems identified were, not conducting research based on national needs, and the lack of implementation of research results.

  9. Health impact assessment in China: Emergence, progress and challenges

    Energy Technology Data Exchange (ETDEWEB)

    Huang Zheng, E-mail: huangzhg@mails.tjmu.edu.cn

    2012-01-15

    The values, concepts and approaches of health impact assessment (HIA) were outlined in the Gothenburg consensus paper and some industrialized countries have implemented HIA for many years. HIA has played an important role in environmental protection in China, however, the emergence, progress and challenges of HIA in China have not been well described. In this paper, the evolution of HIA in China was analyzed and the challenges of HIA were presented based on the author's experiences. HIA contributed to decision-making for large capital construction projects, such as the Three Gorges Dam project, in its emergence stage. Increasing attention has been given to HIA in recent years due to supportive policies underpinning development of the draft HIA guidelines in 2008. However enormous challenges lie ahead in ensuring the institutionalization of HIA into project, program and policy decision-making process due to limited scope, immature tools and insufficient professionals in HIA practice. HIA should broaden its horizons by encompassing physical, chemical, biological and socio-economic aspects and constant attempts should be made to integrate HIA into the decision-making process, not only for projects and programs but also for policies as well.

  10. Health impact assessment as an instrument to examine the health implications of education policies.

    Science.gov (United States)

    Pharr, J; Gakh, M; Coughenour, C; Clark, S

    2017-04-01

    Health impact assessment (HIA) is a systematic process that can be used by public health professionals to examine the potential health effects of a policy, plan, program, or project that originates outside of the health sector. This article presents a case study of how an interdisciplinary team utilized an HIA to analyze the potential health impact of full-day kindergarten (FDK) on communities in Nevada. Case study. With stakeholder and community engagement, we conducted a multistage HIA that included qualitative and quantitative data collection and analysis, a review of existing literature, and projections. The team considered several pathways through which FDK could impact health in Nevada: (1) school performance; (2) physical development (physical activity and nutrition education); and (3) access to school-based meals and health screenings. Findings indicated that access to FDK could enhance opportunities for Nevada's children to harness school-based services, increase physical activity, and promote nutrition education. In addition, based on existing research that suggests relationships between (1) FDK attendance and 3rd and 5th grade math and reading standardized test scores and (2) 3rd and 5th grade test scores and high school graduation, as well as available state and national data, we estimated that access to FDK could increase high school graduation in Nevada by 499-820 students per year. This HIA demonstrated that access to FDK could impact both student and adult health in Nevada. Our engagement of public health professionals along with stakeholders and the community in the HIA process demonstrated that HIAs can be an important tool for public health professionals to examine the effects on community health of policies, programs, plans or projects that arise outside of the health sector. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  11. Radiological and related Chemical Health Impact Assessments of ...

    African Journals Online (AJOL)

    Ogunjo Samuel

    concentrations obtained and the relation from United State Environmental Protection Agency (USEPA), the chemical health impact such as life average daily dose (LADD) ... about 1,386 million cubic kilometers [1]. Only 3 percent of the world's .... Using Equation 2, the elemental concentrations in pipe born water samples ...

  12. Process and impact evaluation of the Greater Christchurch Urban Development Strategy Health Impact Assessment

    Science.gov (United States)

    Mathias, Kaaren R; Harris-Roxas, Ben

    2009-01-01

    Background despite health impact assessment (HIA) being increasingly widely used internationally, fundamental questions about its impact on decision-making, implementation and practices remain. In 2005 a collaboration between public health and local government authorities performed an HIA on the Christchurch Urban Development Strategy Options paper in New Zealand. The findings of this were incorporated into the Greater Christchurch Urban Development Strategy; Methods using multiple qualitative methodologies including key informant interviews, focus groups and questionnaires, this study performs process and impact evaluations of the Christchurch HIA including evaluation of costs and resource use; Results the evaluation found that the HIA had demonstrable direct impacts on planning and implementation of the final Urban Development Strategy as well as indirect impacts on understandings and ways of working within and between organisations. It also points out future directions and ways of working in this successful collaboration between public health and local government authorities. It summarises the modest resource use and discusses the important role HIA can play in urban planning with intersectoral collaboration and enhanced relationships as both catalysts and outcomes of the HIA process; Conclusion as one of the few evaluations of HIA that have been published to date, this paper makes a substantial contribution to the literature on the impact, utility and effectiveness of HIA. PMID:19344529

  13. A health impact assessment framework for assessing vulnerability and adaptation planning for climate change.

    Science.gov (United States)

    Brown, Helen; Spickett, Jeffery; Katscherian, Dianne

    2014-12-01

    This paper presents a detailed description of an approach designed to investigate the application of the Health Impact Assessment (HIA) framework to assess the potential health impacts of climate change. A HIA framework has been combined with key climate change terminology and concepts. The fundamental premise of this framework is an understanding of the interactions between people, the environment and climate. The diversity and complexity of these interactions can hinder much needed action on the critical health issue of climate change. The objectives of the framework are to improve the methodology for understanding and assessing the risks associated with potential health impacts of climate change, and to provide decision-makers with information that can facilitate the development of effective adaptation plans. While the process presented here provides guidance with respect to this task it is not intended to be prescriptive. As such, aspects of the process can be amended to suit the scope and available resources of each project. A series of working tables has been developed to assist in the collation of evidence throughout the process. The framework has been tested in a number of locations including Western Australia, Solomon Islands, Vanuatu and Nauru.

  14. Health Impact Assessment Practice and Potential for Integration within Environmental Impact and Strategic Environmental Assessments in Italy

    Science.gov (United States)

    Linzalone, Nunzia; Assennato, Giorgio; Ballarini, Adele; Cadum, Ennio; Cirillo, Mario; Cori, Liliana; De Maio, Francesca; Musmeci, Loredana; Natali, Marinella; Rieti, Sabrina; Soggiu, Maria Eleonora; Bianchi, Fabrizio

    2014-01-01

    Avoiding or minimizing potential environmental impact is the driving idea behind protecting a population’s health via Environmental Impact Assessments (EIAs) and Strategic Environmental Assessments (SEAs). However, both are often carried out without any systematic approach. This paper describes the findings of a review of HIA, EIA and SEA experiences carried out by the authors, who act as institutional competent subjects at the national and regional levels in Italy. The analysis of how health is tackled in EIA and SEA procedures could support the definition of a protocol for the integration of HIA with EIA and SEA. Although EIA and SEA approaches include the aim of protecting health, significant technical and methodological gaps are present when assessing health systematically, and their basic principles regarding assessment are unsatisfactory for promoting and addressing healthcare concepts stated by the WHO. HIA is still poorly integrated into the decision-making process, screening and monitoring phases are only occasionally implemented, and operational details are not well-defined. The collaborative approach of institutions involved in environment and health is a core element in a systematic advancement toward supporting effective decisions and effective protection of the environment and health. At the Italian national level, the definition of guidelines and tools for HIA, also in relation with EIA and SEA, is of great interest. PMID:25493391

  15. Assessing the Anthropogenic Impact on Environment by Health Soil Card

    Directory of Open Access Journals (Sweden)

    Geanina Bireescu

    2014-12-01

    Full Text Available Deterioration of soil health due to the current intensive agricultural practices for increasing the level of food production, in terms of both quality and quantity, should be a concern of major interest to the health of plants, animals, humans and environment. Soil health is the net result of the processes of preservation and degradation, depending on the biological component of soil ecosystem that affects plant and environmental health, food safety and quality. This research aimed to assess the main physical, chemical and biological indicators of soil health and the indicators of soil residual pollution in the intensive olericultural systems in transition to organic systems for ensuring a sustainable management. Our research was carried out in conventional olecultural systems of North-Eastern Romania in conversion to organic systems.The conversion intoorganic systems has reduced the effects of intensive practices, creating the premises for an optimal biological activity and production of healthier vegetables.

  16. Place shaping to create health and wellbeing using health impact assessment: health geography applied to develop evidence-based practice.

    Science.gov (United States)

    Learmonth, Alyson; Curtis, Sarah

    2013-11-01

    In a political milieu where there is pressure towards localised and participative decisionmaking, and an environment of global recession and environmental degradation, it is crucial that population health considerations inform strategic decisions. The paper puts forward 'place shaping to create health and wellbeing' as a strategic tool, drawing on ideas that are fundamental in health geography, and argues that this is an important emerging application of Health Impact Assessment (HIA), as part of evidence-based practice. These views developed primarily from case study work in the North East of England aiming to enhance health and wellbeing in a population with significant health disadvantages. © 2013 Elsevier Ltd. All rights reserved.

  17. Integrating health impact assessment into the triple bottom line concept

    International Nuclear Information System (INIS)

    Mahoney, Mary; Potter, Jenny-Lynn

    2004-01-01

    This theoretical study explores the links between the Triple Bottom Line (TBL) concept and the principles of HIA and considers the potential role of HIA to provide a mechanism for integrating health concerns within a broader agenda of government and business. TBL is a framework linked to the broader sustainability agenda that underpins and reviews environmental, economic and social performance of organizations. In its simplest form, TBL acts as a tool for reporting to stakeholders/shareholders organizational performance and the nature of the impacts on the community. The links to HIA are clear as both seek to determine the impact (potential and actual) on the health and well-being of the population. The study found that TBL can operate at four levels within organizations ranging from reporting through to full integration with the organization's goals and practices. Health is narrowly defined and there are tensions about how to undertake the social accountability functions. The study shows the potential role for HIA within the broader policy and accountability agenda. As health is one of the main outcomes of an organization's activities it needs to be taken into account at all levels of activity

  18. Assessing the impact of health technology assessment on the Austrian healthcare system.

    Science.gov (United States)

    Schumacher, Ines; Zechmeister, Ingrid

    2013-01-01

    In Austria, research in health technology assessment (HTA) has been conducted since the 1990s. The aim of this study is to analyze whether the HTA research program of the Institute of Technology Assessment (ITA) and the Ludwig Boltzmann Institute for HTA (LBI-HTA) have had an impact on the Austrian healthcare system. We applied qualitative and quantitative empirical research methods, such as interviewing, download analysis, questionnaire, retrospective routine data analysis, and media analysis. Data were analyzed according to a conceptual framework, considering seven impact categories (awareness, acceptance, process, decision, practice, final outcomes, enlightenment) and different target groups. A rising number of downloads and single HTA reports with high media interest were identified. Interviews showed that HTA reports have increasingly been used for investment and reimbursement decisions, as well as for the preparation of negotiations. Economic impact was indicated by decreased expenditures due to HTA recommendations. Overall, knowledge about evidence-based medicine increased and, in places, an "HTA culture" can be recognized. Yet, several decision-making processes occur at all levels without the use of HTA. The analysis demonstrated an impact within all predefined categories; however, it depends on the system level and its target groups. HTA reports are primarily used by hospital management, (social) insurances, and the Austrian Ministry of Health. Nevertheless, there is still potential to increase the impact of HTA. Therefore, the inclusion of HTA in decision-making processes in Austria needs to move from a voluntary basis to a mandatory one.

  19. Assessing framing assumptions in quantitative health impact assessments: a housing intervention example.

    Science.gov (United States)

    Mesa-Frias, Marco; Chalabi, Zaid; Foss, Anna M

    2013-09-01

    Health impact assessment (HIA) is often used to determine ex ante the health impact of an environmental policy or an environmental intervention. Underpinning any HIA is the framing assumption, which defines the causal pathways mapping environmental exposures to health outcomes. The sensitivity of the HIA to the framing assumptions is often ignored. A novel method based on fuzzy cognitive map (FCM) is developed to quantify the framing assumptions in the assessment stage of a HIA, and is then applied to a housing intervention (tightening insulation) as a case-study. Framing assumptions of the case-study were identified through a literature search of Ovid Medline (1948-2011). The FCM approach was used to identify the key variables that have the most influence in a HIA. Changes in air-tightness, ventilation, indoor air quality and mould/humidity have been identified as having the most influence on health. The FCM approach is widely applicable and can be used to inform the formulation of the framing assumptions in any quantitative HIA of environmental interventions. We argue that it is necessary to explore and quantify framing assumptions prior to conducting a detailed quantitative HIA during the assessment stage. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Advancing efforts to achieve health equity: equity metrics for health impact assessment practice.

    Science.gov (United States)

    Heller, Jonathan; Givens, Marjory L; Yuen, Tina K; Gould, Solange; Jandu, Maria Benkhalti; Bourcier, Emily; Choi, Tim

    2014-10-24

    Equity is a core value of Health Impact Assessment (HIA). Many compelling moral, economic, and health arguments exist for prioritizing and incorporating equity considerations in HIA practice. Decision-makers, stakeholders, and HIA practitioners see the value of HIAs in uncovering the impacts of policy and planning decisions on various population subgroups, developing and prioritizing specific actions that promote or protect health equity, and using the process to empower marginalized communities. There have been several HIA frameworks developed to guide the inclusion of equity considerations. However, the field lacks clear indicators for measuring whether an HIA advanced equity. This article describes the development of a set of equity metrics that aim to guide and evaluate progress toward equity in HIA practice. These metrics also intend to further push the field to deepen its practice and commitment to equity in each phase of an HIA. Over the course of a year, the Society of Practitioners of Health Impact Assessment (SOPHIA) Equity Working Group took part in a consensus process to develop these process and outcome metrics. The metrics were piloted, reviewed, and refined based on feedback from reviewers. The Equity Metrics are comprised of 23 measures of equity organized into four outcomes: (1) the HIA process and products focused on equity; (2) the HIA process built the capacity and ability of communities facing health inequities to engage in future HIAs and in decision-making more generally; (3) the HIA resulted in a shift in power benefiting communities facing inequities; and (4) the HIA contributed to changes that reduced health inequities and inequities in the social and environmental determinants of health. The metrics are comprised of a measurement scale, examples of high scoring activities, potential data sources, and example interview questions to gather data and guide evaluators on scoring each metric.

  1. A joint urban planning and public health framework: contributions to health impact assessment.

    Science.gov (United States)

    Northridge, Mary E; Sclar, Elliott

    2003-01-01

    A joint urban planning and public health perspective is articulated here for use, in health impact assessment. Absent a blueprint for a coherent and supportive structure on which to test our thinking, we are bound to fall flat. Such a perspective is made necessary by the sheer number of people living in cities throughout the world, the need for explicit attention to land use and transportation systems as determinants of population health, and the dearth of useful indicators of the built environment for monitoring progress. If explicit attention is not paid to the overarching goals of equality and democracy, they have little if any chance of being realized in projects, programs, and policies that shape the built environment and therefore the public's health.

  2. A Joint Urban Planning and Public Health Framework: Contributions to Health Impact Assessment

    Science.gov (United States)

    Northridge, Mary E.; Sclar, Elliott

    2003-01-01

    A joint urban planning and public health perspective is articulated here for use, in health impact assessment. Absent a blueprint for a coherent and supportive structure on which to test our thinking, we are bound to fall flat. Such a perspective is made necessary by the sheer number of people living in cities throughout the world, the need for explicit attention to land use and transportation systems as determinants of population health, and the dearth of useful indicators of the built environment for monitoring progress. If explicit attention is not paid to the overarching goals of equality and democracy, they have little if any chance of being realized in projects, programs, and policies that shape the built environment and therefore the public’s health. PMID:12511400

  3. Assessing the public health impact of using poison center data for public health surveillance.

    Science.gov (United States)

    Wang, Alice; Law, Royal; Lyons, Rebecca; Choudhary, Ekta; Wolkin, Amy; Schier, Joshua

    2017-12-13

    The National Poison Data System (NPDS) is a database and surveillance system for US poison centers (PCs) call data. The Centers for Disease Control and Prevention (CDC) and American Association of Poison Control Centers (AAPCC) use NPDS to identify incidents of potential public health significance. State health departments are notified by CDC of incidents identified by NPDS to be of potential public health significance. Our objective was to describe the public health impact of CDC's notifications and the use of NPDS data for surveillance. We described how NPDS data informed three public health responses: the Deepwater Horizon incident, national exposures to laundry detergent pods, and national exposures to e-cigarettes. Additionally, we extracted survey results of state epidemiologists regarding NPDS incident notification follow-up from 1 January 2015 to 31 December 2016 to assess current public health application of NPDS data using Epi Info 7.2 and analyzed data using SAS 9.3. We assessed whether state health departments were aware of incidents before notification, what actions were taken, and whether CDC notifications contributed to actions. NPDS data provided evidence for industry changes to improve laundry detergent pod containers safety and highlighted the need to regulate e-cigarette sale and manufacturing. NPDS data were used to improve situational awareness during the 2010 Deepwater Horizon oil spill. Of 59 health departments and PCs who responded to CDC notifications about anomalies (response rate = 49.2%), 27 (46%) reported no previous awareness of the incident, and 20 (34%) said that notifications contributed to public health action. Monitoring NPDS data for anomalies can identify emerging public health threats and provide evidence-based science to support public health action and policy changes.

  4. Assessing the impact of England's National Health Service R&D Health Technology Assessment program using the "payback" approach.

    Science.gov (United States)

    Raftery, James; Hanney, Stephen; Green, Colin; Buxton, Martin

    2009-01-01

    This study assesses the impact of the English National Health Service (NHS) Health Technology Assessment (HTA) program using the "payback" framework. A survey of lead investigators of all research projects funded by the HTA program 1993--2003 supplemented by more detailed case studies of sixteen projects. Of 204 eligible projects, replies were received from 133 or 65 percent. The mean number of peer-reviewed publications per project was 2.9. Seventy-three percent of projects claimed to have had had an impact on policy and 42 percent on behavior. Technology Assessment Reports for the National Institute for Health and Clinical Excellence (NICE) had fewer than average publications but greater impact on policy. Half of all projects went on to secure further funding. The case studies confirmed the survey findings and indicated factors associated with impact. The HTA program performed relatively well in terms of "payback." Facilitating factors included the program's emphasis on topics that matter to the NHS, rigorous methods and the existence of "policy customers" such as NICE.

  5. Human health and wellbeing in environmental impact assessment in New South Wales, Australia: Auditing health impacts within environmental assessments of major projects

    International Nuclear Information System (INIS)

    Harris, Patrick J.; Harris, Elizabeth; Thompson, Susan; Harris-Roxas, Ben; Kemp, Lynn

    2009-01-01

    Internationally the inclusion of health within environmental impact assessment (EIA) has been shown to be limited. While Australian EIA documentation has not been studied empirically to date, deficiencies in practice have been documented. This research developed an audit tool to undertake a qualitative descriptive analysis of 22 Major Project EAs in New South Wales, Australia. Results showed that health and wellbeing impacts were not considered explicitly. They were, however, included indirectly in the identification of traditional public health exposures associated with the physical environment and to a lesser extent the inclusion of social and economic impacts. However, no health data was used to inform any of the assessments, there was no reference to causal pathways between exposures or determinants and physical or mental health effects, and there was no inclusion of the differential distribution of exposures or health impacts on different populations. The results add conceptually and practically to the long standing integration debate, showing that health is in a position to add value to the EIA process as an explicit part of standard environmental, social and economic considerations. However, to overcome the consistently documented barriers to integrating health in EIA, capacity must be developed amongst EIA professionals, led by the health sector, to progress health related knowledge and tools.

  6. Prioritizing health: a systematic approach to scoping determinants in health impact assessment

    Directory of Open Access Journals (Sweden)

    Lindsay McCallum

    2016-08-01

    Full Text Available The determinants of health are those factors that have the potential to affect health, either positively or negatively, and include a range of personal, social, economic, and environmental factors. In the practice of Health Impact Assessment (HIA, the stage at which the determinants of health are considered for inclusion is during the scoping step. The scoping step is intended to identify how the HIA will be carried out and to set the boundaries (e.g., temporal and geographical for the assessment. There are several factors that can help to inform the scoping process, many of which are considered in existing HIA tools and guidance; however, a systematic method of prioritizing determinants was found to be lacking. In order to analyze existing HIA scoping tools that are available, a systematic literature review was conducted including both primary and grey literature. A total of 10 HIA Scoping tools met the inclusion/exclusion criteria and were carried forward for comparative analysis. The analysis focused on minimum elements and practice standards of HIA scoping that have been established in the field. The analysis determined that existing approaches lack a clear, systematic method of prioritization of health determinants for inclusion in HIA. This finding led to the development of a Systematic HIA Scoping tool that addressed this gap. The decision matrix tool uses factors such as impact, public concern and data availability to prioritize health determinants. Additionally, the tool allows for identification of data gaps and provides a transparent method for budget allocation and assessment planning. In order to increase efficiency and improve utility, the tool was programmed into Microsoft Excel. Future work in the area of HIA methodology development is vital to the ongoing success of the practice and utilization of HIA as a reliable decision-making tool.

  7. A Health Impact Assessment of California’s Proposed Cap-and-Trade Regulations

    Science.gov (United States)

    English, Paul; Rudolph, Linda

    2012-01-01

    Objectives. To identify unintended health effects of California’s controversial cap-and-trade regulations and establish health-promoting policy recommendations, we performed a health impact assessment. Methods. We used literature reviews, public data, and local health surveys to qualitatively assess potential health risks and benefits related to changes in employment and income, energy costs, effects of emission offset projects, and cobenefits from the allocation of program revenue. We examined case studies from various communities to find existing social, economic, and environmental health conditions. Results. We found that policy implementation will minimally impact job creation (strategies and cap-and-trade policy at the federal level. PMID:22742062

  8. A model for probabilistic health impact assessment of exposure to food chemicals.

    Science.gov (United States)

    van der Voet, Hilko; van der Heijden, Gerie W A M; Bos, Peter M J; Bosgra, Sieto; Boon, Polly E; Muri, Stefan D; Brüschweiler, Beat J

    2009-12-01

    A statistical model is presented extending the integrated probabilistic risk assessment (IPRA) model of van der Voet and Slob [van der Voet, H., Slob, W., 2007. Integration of probabilistic exposure assessment and probabilistic hazard characterisation. Risk Analysis, 27, 351-371]. The aim is to characterise the health impact due to one or more chemicals present in food causing one or more health effects. For chemicals with hardly any measurable safety problems we propose health impact characterisation by margins of exposure. In this probabilistic model not one margin of exposure is calculated, but rather a distribution of individual margins of exposure (IMoE) which allows quantifying the health impact for small parts of the population. A simple bar chart is proposed to represent the IMoE distribution and a lower bound (IMoEL) quantifies uncertainties in this distribution. It is described how IMoE distributions can be combined for dose-additive compounds and for different health effects. Health impact assessment critically depends on a subjective valuation of the health impact of a given health effect, and possibilities to implement this health impact valuation step are discussed. Examples show the possibilities of health impact characterisation and of integrating IMoE distributions. The paper also includes new proposals for modelling variable and uncertain factors describing food processing effects and intraspecies variation in sensitivity.

  9. Making effective links to decision-making: Key challenges for health impact assessment

    International Nuclear Information System (INIS)

    Elliott, Eva; Francis, Sarah

    2005-01-01

    This paper draws on an exploratory research study to examine the effectiveness of health impact assessments in Wales. Through the review of five case study health impact assessments the research identified a number of benefits of the process in terms of skills and knowledge development amongst participants. The indirect contributions to decision-making were also evident including the way in which health impact assessment provided useful insights into the local community's perspective and raised awareness about the wider determinants of health. The process was also useful in establishing a dialogue between different stakeholders, which indirectly assisted decision-making and implementation. The direct links between health impact assessment and decision-making were more difficult to trace and this paper puts forward a number of suggestions for making those links more transparent. Suggestions include integrating decision-makers and clarifying the intended links to decision-making at the start of the health impact assessment process. Mainstreaming health impact assessment so that it is triggered as a routine part of all decision-making would help ensure it stands the best chance of informing decisions

  10. The use of expert elicitation in environmental health impact assessment: a seven step procedure.

    NARCIS (Netherlands)

    Knol, A.B.; Slottje, P.; van der Sluijs, J.P.; Lebret, E.

    2010-01-01

    BACKGROUND: Environmental health impact assessments often have to deal with substantial uncertainties. Typically, the knowledge-base is limited with incomplete, or inconsistent evidence and missing or ambiguous data. Consulting experts can help to identify and address uncertainties. METHODS: Formal

  11. [Assessing the impact of the environment on human health].

    Science.gov (United States)

    Locatelli, Marine

    2016-05-01

    In public health, nurses are concerned with the global health of populations. A recently qualified nurse, interested in this area of health, enhanced her skills with a master's degree specialising in the links between the environment and health. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  12. Assessment of urban air pollution and it's probable health impact.

    Science.gov (United States)

    Barman, S C; Kumar, N; Singh, R; Kisku, G C; Khan, A H; Kidwai, M M; Murthy, R C; Negi, M P S; Pandey, P; Verma, A K; Jain, G; Bhargava, S K

    2010-11-01

    The present study deals with the quantitative effect of vehicular emission on ambient air quality during May 2006 in urban area of Lucknow city. In this study SPM, RSPM, SO2, NOx and 7 trace metals associated with RSPM were estimated at 10 representative locations in urban area and one village area for control. Beside this, air quality index (AQI), health effects of different metals and mortality were assessed. The 24 hr average concentration of SPM, RSPM, SO2 and NOx was found to be 382.3, 171.5, 24.3 and 33.8 microg m(-3) respectively in urban area and these concentrations were found to be significantly (p urban area were found to be higher than prescribed limit of National Ambient Air Quality Standard (NAAQS) except SPM for industrial area. The 24 hr mean concentration of metals associated with RSPM was found to be higher than the control site by 52.3, 271.8, 408.9, 75.81, 62.7, 487.54 and 189.5% for Fe, Cu, Pb, Zn, Ni, Mn and Cr respectively. The inter correlation of metals Pb with Mn, Fe and Cr; Zn with Ni and Cr; Ni with Cr; Mn with Fe and Cu with Cr showed significant positive relation either at p air quality in the urban area is affected adversely due to emission and accumulation of SPM, RSPM, SO2, NOx and trace metals. These pollutants may pose detrimental effect on human health, as exposure of these are associated with cardiovascular and respiratory diseases, neurological impairments, increased risk of preterm birth and even mortality and morbidity.

  13. Predicting the health impact of lowering salt consumption in Turkey using the DYNAMO health impact assessment tool.

    Science.gov (United States)

    Erkoyun, E; Sözmen, K; Bennett, K; Unal, B; Boshuizen, H C

    2016-11-01

    To estimate the impact of three daily salt consumption scenarios on the prevalence and incidence of ischaemic heart disease (IHD) and cerebrovascular disease in 2025 in the Turkish population aged ≥30 years using the DYNAMO Health Impact Assessment tool. Statistical disease modelling study. DYNAMO health impact assessment was populated using data from Turkey to estimate the prevalence and incidence of IHD and cerebrovascular disease in 2025. TurkSTAT data were used for demographic data, and national surveys were used for salt consumption and disease-specific burden. Three salt consumption scenarios were modelled: (1) reference scenario: mean salt consumption stays the same from 2012-2013 until 2025; (2) gradual decline: daily salt intake reduces steadily by 0.47 g per year by lowering salt intake from bread by 50% and from table salt by 40% by 2025; and (3) World Health Organization (WHO) advice: daily salt intake of 5 g per day from 2013 until 2025. The gradual decline scenario would lead to a decrease in the prevalence of IHD and cerebrovascular disease by 0.3% and 0.2%, respectively, and a decrease in the incidence by 0.6 and 0.4 per 1000, respectively. Following WHO's advice would lead to a decrease in the prevalence of IHD and cerebrovascular disease by 0.8% and 0.5%, respectively, and a decrease in the incidence by 1.0 and 0.7 per 1000, respectively. This model indicates that Turkey can lower its future cardiovascular disease burden by following the gradual decline scenario. Following WHO's advice would achieve an even greater benefit. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  14. The impact and effectiveness of health impact assessment: A conceptual framework

    International Nuclear Information System (INIS)

    Harris-Roxas, Ben; Harris, Elizabeth

    2013-01-01

    The use of health impact assessment (HIA) has expanded rapidly and there are increasing demands for it to demonstrate its effectiveness. This paper presents a conceptual framework for evaluating HIA and describes its development through (i) a review of the literature, (ii) a review of work undertaken as part of a major HIA capacity building project and (iii) an in-depth study of seven completed HIAs. The framework emphasises context, process and impacts as key domains in understanding and evaluating the effectiveness of an HIA. This new framework builds upon the existing approaches to evaluating HIA and extends them to reflect the broad range of factors that comprise and influence the effectiveness of HIAs. It may be of use in evaluating completed HIAs and in planning HIAs that are yet to be undertaken. -- Highlights: ► The first empirically-derived conceptual framework for evaluating HIA ► It may also be useful for planning and reporting on HIAs. ► The framework emphasises context, process and impacts as key domains. ► A broad range of factors influence the effectiveness of HIAs

  15. Urgency to Assess the Health Impact of Ambient Air Pollution in China.

    Science.gov (United States)

    Yang, Bo-Yi; Liu, Yimin; Hu, Li-Wen; Zeng, Xiao-Wen; Dong, Guang-Hui

    2017-01-01

    As the world's second-largest economy, China is going on suffering from environmental pollution, especially for ambient air pollution, which has become a major threat to public health; public awareness of the detrimental effects of air pollution on health is increasing-particularly in relation to haze days. Considering the nonlinear relationship of ambient air pollution exposure and health impacts, and the differences in specific sources of air pollution with those in North America and Europe, conducting health impact assessments of ambient air pollution in China has thus become an urgent task for public health practitioners. Systematic review of the health effects of exposure to ambient air pollution from quantitative studies conducted in Chinese could provide vital information for epidemiology-based health impact assessments and the implementation of a national environmental protection policy.

  16. Facilitating communities in designing and using their own community health impact assessment tool

    International Nuclear Information System (INIS)

    Cameron, Colleen; Ghosh, Sebanti; Eaton, Susan L.

    2011-01-01

    Reducing health inequities and improving the health of communities require an informed public that is aware of the social determinants of health and how policies and programs have an impact on the health of their communities. People Assessing Their Health (PATH) is a process that uses community-driven health impact assessment to build the capacity of people to become active participants in the decisions that affect the well-being of their community. The PATH process is both a health promotion and a community development approach that builds people's ability to bring critical analysis to a situation and to engage in effective social action to bring about desired change. Because it increases analytical skills and provides communities with their own unique tool to assess the potential impact of projects, programs or policies on the health and well-being of their community it is an empowering process. PATH was originally used in three communities in northeastern Nova Scotia, Canada in 1996 when the Canadian health care system was being restructured to a more decentralized system. Since then it has been used in other communities in Nova Scotia and India. This paper will describe the PATH process and the use of the community health impact assessment as well as the methodology used in the PATH process. The lessons learned from PATH's experiences of building capacity among the community in Canada and India will be presented.

  17. Quantifying uncertainty in health impact assessment: a case-study example on indoor housing ventilation.

    Science.gov (United States)

    Mesa-Frias, Marco; Chalabi, Zaid; Foss, Anna M

    2014-01-01

    Quantitative health impact assessment (HIA) is increasingly being used to assess the health impacts attributable to an environmental policy or intervention. As a consequence, there is a need to assess uncertainties in the assessments because of the uncertainty in the HIA models. In this paper, a framework is developed to quantify the uncertainty in the health impacts of environmental interventions and is applied to evaluate the impacts of poor housing ventilation. The paper describes the development of the framework through three steps: (i) selecting the relevant exposure metric and quantifying the evidence of potential health effects of the exposure; (ii) estimating the size of the population affected by the exposure and selecting the associated outcome measure; (iii) quantifying the health impact and its uncertainty. The framework introduces a novel application for the propagation of uncertainty in HIA, based on fuzzy set theory. Fuzzy sets are used to propagate parametric uncertainty in a non-probabilistic space and are applied to calculate the uncertainty in the morbidity burdens associated with three indoor ventilation exposure scenarios: poor, fair and adequate. The case-study example demonstrates how the framework can be used in practice, to quantify the uncertainty in health impact assessment where there is insufficient information to carry out a probabilistic uncertainty analysis. © 2013.

  18. Methods and challenges for the health impact assessment of vaccination programs in Latin America.

    Science.gov (United States)

    Sartori, Ana Marli Christovam; Nascimento, Andréia de Fátima; Yuba, Tânia Yuka; Soárez, Patrícia Coelho de; Novaes, Hillegonda Maria Dutilh

    2015-01-01

    To describe methods and challenges faced in the health impact assessment of vaccination programs, focusing on the pneumococcal conjugate and rotavirus vaccines in Latin America and the Caribbean. For this narrative review, we searched for the terms "rotavirus", "pneumococcal", "conjugate vaccine", "vaccination", "program", and "impact" in the databases Medline and LILACS. The search was extended to the grey literature in Google Scholar. No limits were defined for publication year. Original articles on the health impact assessment of pneumococcal and rotavirus vaccination programs in Latin America and the Caribbean in English, Spanish or Portuguese were included. We identified 207 articles. After removing duplicates and assessing eligibility, we reviewed 33 studies, 25 focusing on rotavirus and eight on pneumococcal vaccination programs. The most frequent studies were ecological, with time series analysis or comparing pre- and post-vaccination periods. The main data sources were: health information systems; population-, sentinel- or laboratory-based surveillance systems; statistics reports; and medical records from one or few health care services. Few studies used primary data. Hospitalization and death were the main outcomes assessed. Over the last years, a significant number of health impact assessments of pneumococcal and rotavirus vaccination programs have been conducted in Latin America and the Caribbean. These studies were carried out few years after the programs were implemented, meet the basic methodological requirements and suggest positive health impact. Future assessments should consider methodological issues and challenges arisen in these first studies conducted in the region.

  19. Methods and challenges for the health impact assessment of vaccination programs in Latin America

    Directory of Open Access Journals (Sweden)

    Ana Marli Christovam Sartori

    2015-01-01

    Full Text Available ABSTRACT OBJECTIVE To describe methods and challenges faced in the health impact assessment of vaccination programs, focusing on the pneumococcal conjugate and rotavirus vaccines in Latin America and the Caribbean. METHODS For this narrative review, we searched for the terms "rotavirus", "pneumococcal", "conjugate vaccine", "vaccination", "program", and "impact" in the databases Medline and LILACS. The search was extended to the grey literature in Google Scholar. No limits were defined for publication year. Original articles on the health impact assessment of pneumococcal and rotavirus vaccination programs in Latin America and the Caribbean in English, Spanish or Portuguese were included. RESULTS We identified 207 articles. After removing duplicates and assessing eligibility, we reviewed 33 studies, 25 focusing on rotavirus and eight on pneumococcal vaccination programs. The most frequent studies were ecological, with time series analysis or comparing pre- and post-vaccination periods. The main data sources were: health information systems; population-, sentinel- or laboratory-based surveillance systems; statistics reports; and medical records from one or few health care services. Few studies used primary data. Hospitalization and death were the main outcomes assessed. CONCLUSIONS Over the last years, a significant number of health impact assessments of pneumococcal and rotavirus vaccination programs have been conducted in Latin America and the Caribbean. These studies were carried out few years after the programs were implemented, meet the basic methodological requirements and suggest positive health impact. Future assessments should consider methodological issues and challenges arisen in these first studies conducted in the region.

  20. Assessing Health, Economic, and Social Equity Impacts of Graphic ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The provisions include a requirement for graphic health warnings (GHWs) to take up at least 50% of the front and back of tobacco product packaging starting in ... A new funding opportunity on Zika virus is responding to the virus outbreak and the health threat it represents for the affected populations in the hardest hit ...

  1. Review and assessments of potential environmental, health and safety impacts of MHD technology. Final draft

    Energy Technology Data Exchange (ETDEWEB)

    1978-01-01

    The purpose of this document is to develop an environmental, health and safety (EH and S) assessment and begin a site - specific assessment of these and socio - economic impacts for the magnetohydrodynamics program of the United States Department of Energy. This assessment includes detailed scientific and technical information on the specific EH and S issues mentioned in the MHD Environmental Development Plan. A review of current literature on impact-related subjects is also included. This document addresses the coal-fired, open-cycle MHD technology and reviews and assesses potential EH and S impacts resulting from operation of commercially-installed technology.

  2. Health and the environment : assessing the impacts, addressing the uncertainties

    NARCIS (Netherlands)

    Knol, A.B.

    2010-01-01

    Environmental health problems have become increasingly complex. Climate change, increased urbanization or exposure to electromagnetic fields are highly divergent examples of issues about which no scientific consensus exists, for which no straightforward solutions are available and which are embedded

  3. Gerena School Health Impact Assessment (HIA) Final Report

    Science.gov (United States)

    This is the final report of the EPA-led Gerena Community School HIA, which aims to provide valuable health-focused information to help the City of Springfield narrow down and prioritize renovation actions at the school.

  4. Assessment of health impacts of decreased smoking prevalence in Copenhagen

    DEFF Research Database (Denmark)

    Holm, Astrid Ledgaard; Brønnum-Hansen, Henrik; Robinson, Kirstine Magtengaard

    2014-01-01

    Tobacco smoking is among the leading risk factors for chronic disease and early death in developed countries, including Denmark, where smoking causes 14% of the disease burden. In Denmark, many public health interventions, including smoking prevention, are undertaken by the municipalities......, but models to estimate potential health effects of local interventions are lacking. The aim of the current study was to model the effects of decreased smoking prevalence in Copenhagen, Denmark. Methods: The DYNAMO-HIA model was applied to the population of Copenhagen, by using health survey data and data......, and cessation and re-initiation rates among adults, which reduced the smoking prevalence to 4% by 2025, would have large beneficial effects on incidence and prevalence of smoking-related diseases and mortality. Health benefits could also be obtained through interventions targeting only cessation or re...

  5. Systematic Review on Evaluation of Health Impact Assessments in Iran: Evolution, Studies and Areas for Improvement

    Directory of Open Access Journals (Sweden)

    Edris Hoseinzadeh

    2017-06-01

    Conclusion: Health Impact Assessment (HIA has been required for large development projects by the fifth development plan, however, there is a need to HIA by another fields such as air pollution and urban subjects as they have effects on human health. Presenting such assessment before presentation national health standards requirement of Iran indicates this fact. Thus, we expect from politicians and decision makers to address these issues and apply HIA by other fields alongside assessment of national development projects and plans. By doing so, we can bridge the gap between knowledge and action which may result in health promotion in the society.

  6. Impacts of “metals” on human health: uncertainties in using different Life Cycle Impact Assessment (LCIA) methodologies

    DEFF Research Database (Denmark)

    Pizzol, Massimo; Christensen, Per; Schmidt, Jannick Højrup

    This study looks into the uncertainties in determining the impact of “metals” emissions to human health, in Life Cycle Impact Assessment (LCIA). Metals are diverse substances, with different proprieties and characteristics, considered important in LCIA because of their toxicity to humans...... be considered in an impact assessment focused on human health, and defined a list of 14 metals. We performed a contribution analysis in order to compare methods in relative terms; an approach successfully used in other studies. Various processes have been analyzed with 8 different LCIA methods in order...... to assess both how much each metal contributes to the total impact on human health, when only metal emissions are present, and how much metals in total contribute when also other toxic substances are included in the inventory of emissions. Differences between the methods are great and due...

  7. Health impacts of climate change in Vanuatu: an assessment and adaptation action plan.

    Science.gov (United States)

    Spickett, Jeffery T; Katscherian, Dianne; McIver, Lachlan

    2013-01-30

    Climate change is one of the greatest global challenges and Pacific island countries are particularly vulnerable due to, among other factors, their geography, demography and level of economic development. A Health Impact Assessment (HIA) framework was used as a basis for the consideration of the potential health impacts of changes in the climate on the population of Vanuatu, to assess the risks and propose a range of potential adaptive responses appropriate for Vanuatu. The HIA process involved the participation of a broad range of stakeholders including expert sector representatives in the areas of bio-physical, socio-economic, infrastructure, environmental diseases and food, who provided informed comment and input into the understanding of the potential health impacts and development of adaptation strategies. The risk associated with each of these impacts was assessed with the application of a qualitative process that considered both the consequences and the likelihood of each of the potential health impacts occurring. Potential adaptation strategies and actions were developed which could be used to mitigate the identified health impacts and provide responses which could be used by the various sectors in Vanuatu to contribute to future decision making processes associated with the health impacts of climate change.

  8. Integrated Environmental Health Impact Assessment for Risk Governance Purposes; Across What Do We Integrate?

    NARCIS (Netherlands)

    Lebret, Erik

    Integrated Environmental Health Impact Assessment (IEHIA) can be considered as an element in the third phase of environmental risk management. Its focus is on providing inclusive descriptions of multiple impacts from multiple stressors in such a way that they can be evaluated against the potential

  9. Dynamo-HIA-a dynamic modeling tool for generic health impact assessments

    NARCIS (Netherlands)

    S.K. Lhachimi (Stefan); W.J. Nusselder (Wilma); H.A. Smit (Henriëtte); P.H.M. Van Baal (Pieter); P. Baili (Paolo); K. Bennett (Kathleen); E. Fernández (Esteve); M.C. Kulik (Margarete); T. Lobstein (Tim); J. Pomerleau (Joceline); J.P. Mackenbach (Johan); H.C. Boshuizen (Hendriek)

    2012-01-01

    textabstractBackground: Currently, no standard tool is publicly available that allows researchers or policy-makers to quantify the impact of policies using epidemiological evidence within the causal framework of Health Impact Assessment (HIA). A standard tool should comply with three technical

  10. DYNAMO-HIA - A Dynamic Modelling tool for generic Health Impact Assessments

    NARCIS (Netherlands)

    Lhachimi, S.K.; Nusselder, W.J.; Smit, H.A.; Baal, van P.; Bailli, P.; Bennett, K.; Fernández, E.; Kulik, M.C.; Lobstein, T.; Pomerleau, J.; Mackenbach, J.P.; Boshuizen, H.C.

    2012-01-01

    Background Currently, no standard tool is publicly available that allows researchers or policy-makers to quantify the impact of policies using epidemiological evidence within the causal framework of Health Impact Assessment (HIA). A standard tool should comply with three technical criteria

  11. A review on the practical application of human biomonitoring in integrated environmental health impact assessment

    Czech Academy of Sciences Publication Activity Database

    Smolders, R.; Schramm, K.W.; Stenius, U.; Grellier, J.; Kahn, A.; Trnovec, T.; Šrám, Radim; Schoeters, G.

    2009-01-01

    Roč. 12, č. 2 (2009), s. 107-123 ISSN 1093-7404 R&D Projects: GA MŽP(CZ) SP/1B3/8/08 Institutional research plan: CEZ:AV0Z50390512 Keywords : human biomonitoring * environmental pollution * risk assessment Subject RIV: DN - Health Impact of the Environment Quality Impact factor: 3.617, year: 2009

  12. Indigenous community based participatory research and health impact assessment: A Canadian example

    International Nuclear Information System (INIS)

    Kwiatkowski, Roy E.

    2011-01-01

    The Environmental Health Research Division (EHRD) of the First Nations and Inuit Health Branch, Health Canada conducts science-based activities and research with Canadian Indigenous communities in areas such as climate change adaptation, environmental contaminants, water quality, biomonitoring, risk assessment, health impact assessment, and food safety and nutrition. EHRD's research activities have been specifically designed to not only inform Health Canada's policy decision-makers but as well, Indigenous community decision-makers. This paper will discuss the reasons why Indigenous community engagement is important, what are some of the barriers preventing community engagement; and the efforts by EHRD to carry out community-based participatory research activities with Indigenous peoples.

  13. Assessing the health impact of transnational corporations: a case study on McDonald's Australia.

    Science.gov (United States)

    Anaf, Julia; Baum, Frances E; Fisher, Matt; Harris, Elizabeth; Friel, Sharon

    2017-02-06

    The practices of transnational corporations affect population health through production methods, shaping social determinants of health, or influencing the regulatory structures governing their activities. There has been limited research on community exposures to TNC policies and practices. Our pilot research used McDonald's Australia to test methods for assessing the health impacts of one TNC within Australia. We adapted existing Health Impact Assessment methods to assess McDonald's activities. Data identifying potential impacts were sourced through document analysis, including McDonald's corporate literature; media analysis and semi-structured interviews. We commissioned a spatial and socioeconomic analysis of McDonald's restaurants in Australia through Geographic Information System technology. The data was mapped against a corporate health impact assessment framework which included McDonald's Australia's political and business practices; products and marketing; workforce, social, environmental and economic conditions; and consumers' health related behaviours. We identified both positive and detrimental aspects of McDonald's Australian operations across the scope of the CHIA framework. We found that McDonald's outlets were slightly more likely to be located in areas of lower socioeconomic status. McDonald's workplace conditions were found to be more favourable than those in many other countries which reflects compliance with Australian employment regulations. The breadth of findings revealed the need for governments to strengthen regulatory mechanisms that are conducive to health; the opportunity for McDonald's to augment their corporate social responsibility initiatives and bolster reputational endorsement; and civil society actors to inform their advocacy towards health and equity outcomes from TNC operations. Our study indicates that undertaking a corporate health impact assessment is possible, with the different methods revealing sufficient information to

  14. Assessing the health workforce implications of health policy and programming: how a review of grey literature informed the development of a new impact assessment tool.

    Science.gov (United States)

    Nove, Andrea; Cometto, Giorgio; Campbell, James

    2017-11-09

    In their adoption of WHA resolution 69.19, World Health Organization Member States requested all bilateral and multilateral initiatives to conduct impact assessments of their funding to human resources for health. The High-Level Commission for Health Employment and Economic Growth similarly proposed that official development assistance for health, education, employment and gender are best aligned to creating decent jobs in the health and social workforce. No standard tools exist for assessing the impact of global health initiatives on the health workforce, but tools exist from other fields. The objectives of this paper are to describe how a review of grey literature informed the development of a draft health workforce impact assessment tool and to introduce the tool. A search of grey literature yielded 72 examples of impact assessment tools and guidance from a wide variety of fields including gender, health and human rights. These examples were reviewed, and information relevant to the development of a health workforce impact assessment was extracted from them using an inductive process. A number of good practice principles were identified from the review. These informed the development of a draft health workforce impact assessment tool, based on an established health labour market framework. The tool is designed to be applied before implementation. It consists of a relatively short and focused screening module to be applied to all relevant initiatives, followed by a more in-depth assessment to be applied only to initiatives for which the screening module indicates that significant implications for HRH are anticipated. It thus aims to strike a balance between maximising rigour and minimising administrative burden. The application of the new tool will help to ensure that health workforce implications are incorporated into global health decision-making processes from the outset and to enhance positive HRH impacts and avoid, minimise or offset negative impacts.

  15. Assessing Health, Economic, and Social Equity Impacts of Graphic ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The provisions include a requirement for graphic health warnings (GHWs) to take up at least 50% of the front and back of tobacco product packaging starting in November 2013. The law also prohibits misleading terms suggesting that one tobacco product is less harmful than another. While the law marks a significant step to ...

  16. [Methods for health impact assessment of policies for municipal solid waste management: the SESPIR Project].

    Science.gov (United States)

    Parmagnani, Federica; Ranzi, Andrea; Ancona, Carla; Angelini, Paola; Chiusolo, Monica; Cadum, Ennio; Lauriola, Paolo; Forastiere, Francesco

    2014-01-01

    The Project Epidemiological Surveillance of Health Status of Resident Population Around the Waste Treatment Plants (SESPIR) included five Italian regions (Emilia-Romagna, Piedmont, Lazio, Campania, and Sicily) and the National Institute of Health in the period 2010-2013. SESPIR was funded by the Ministry of Health as part of the National centre for diseases prevention and control (CCM) programme of 2010 with the general objective to provide methods and operational tools for the implementation of surveillance systems for waste and health, aimed at assessing the impact of the municipal solid waste (MSW) treatment cycle on the health of the population. The specific objective was to assess health impacts resulting from the presence of disposal facilities related to different regional scenarios of waste management. Suitable tools for analysis of integrated assessment of environmental and health impact were developed and applied, using current demographic, environmental and health data. In this article, the methodology used for the quantitative estimation of the impact on the health of populations living nearby incinerators, landfills and mechanical biological treatment plants is showed, as well as the analysis of three different temporal scenarios: the first related to the existing plants in the period 2008-2009 (baseline), the second based on regional plans, the latter referring to MSW virtuous policy management based on reduction of produced waste and an intense recovery policy.

  17. A review package for health impact assessment reports on development projects

    DEFF Research Database (Denmark)

    Cave, Ben; Jakobsen, Mette Winge

    2017-01-01

    A review package for assessing the quality of health impact assessment (HIA) reports of development projects in UK was developed in 2009 as a contribution to the improvement of the output of HIAs being conducted in the UK on large development projects. Since its publication, the review package ha...

  18. Policy health impact assessment of the EU Health Strategy (2008-2013). Fostering good health in an aging Europe – tackling tobacco consumption

    DEFF Research Database (Denmark)

    Ádám, Balázs; Molnár, Ágnes; Ádány, Róza

    2012-01-01

    smoking by incorporating the issue into its 1st objective “Fostering good health in an aging Europe”. The aim of the study was to assess the health impact of the most effective tobacco control policy, taxation, on the EU level. Methods: The assessment was based on the mapping of the whole impact scheme...

  19. Assessing the population health impact of market interventions to improve access to antiretroviral treatment.

    Science.gov (United States)

    Bärnighausen, Till; Kyle, Margaret; Salomon, Joshua A; Waning, Brenda

    2012-09-01

    Despite extraordinary global progress in increasing coverage of antiretroviral treatment (ART), the majority of people needing ART currently are not receiving treatment. Both the number of people needing ART and the average ART price per patient-year are expected to increase in coming years, which will dramatically raise funding needs for ART. Several international organizations are using interventions in ART markets to decrease ART price or to improve ART quality, delivery and innovation, with the ultimate goal of improving population health. These organizations need to select those market interventions that are most likely to substantially affect population health outcomes (ex ante assessment) and to evaluate whether implemented interventions have improved health outcomes (ex post assessment). We develop a framework to structure ex ante and ex post assessment of the population health impact of market interventions, which is transmitted through effects in markets and health systems. Ex ante assessment should include evaluation of the safety and efficacy of the ART products whose markets will be affected by the intervention; theoretical consideration of the mechanisms through which the intervention will affect population health; and predictive modelling to estimate the potential population health impact of the intervention. For ex post assessment, analysts need to consider which outcomes to estimate empirically and which to model based on empirical findings and understanding of the economic and biological mechanisms along the causal pathway from market intervention to population health. We discuss methods for ex post assessment and analyse assessment issues (unintended intervention effects, interaction effects between different interventions, and assessment impartiality and cost). We offer seven recommendations for ex ante and ex post assessment of population health impact of market interventions.

  20. Indicators for planning of health services: assessing impacts of social and health care factors on population health.

    Science.gov (United States)

    Wan, T T; Broida, J H

    1983-01-01

    Community health planning requires identification of the level of access to care and factors which affect the differentials in use of health services. In formulating strategies or alternatives for planning, some assessment of the current level or patterns of health services must be made. It is this element of the planning process that is addressed in this paper. In this study sixty-five specifically designated areas (medical market areas) in the Province of Quebec, Canada were selected. The analysis was performed using data obtained from a large scale study of physicians' responses to the introduction of universal medical care insurance in Quebec. Our analysis offered an opportunity to observe the impact of Medicare on access to care for those thought to be underserved.

  1. Selection and evaluation of exposure-effect-relationships for health impact assessment in the field of noise and health

    NARCIS (Netherlands)

    Kempen EEMM van; Staatsen BAM; Kamp I van; MGO

    2005-01-01

    This report is a background document that can be used to assess the health impact attributable to noise in the Netherlands. To this end the available exposure-effect-relationships in the field of noise and health are reviewed and evaluated, using data published in the epidemiological literature as

  2. Carcinogenesis as an end point in health impact assessment

    International Nuclear Information System (INIS)

    Schneiderman, M.A.

    1976-01-01

    All sources of energy production, with perhaps the exception of falling water, wind, and geothermal sources, appear to have associated carcinogenic hazards. Epidemiological information does not allow us to pinpoint single ''causes,'' but urban dwellers, coal miners, and petroleum refinery workers all appear to be at increased risk of cancer. Radiation--cancer relationships have been shown in exposed populations, and work is currently under way assessing the risks of former Atomic Energy Commission workers. With the exception of radiation exposure, there are few human data for estimating dose--response relationships to environmental carcinogens. At very low doses for add-on type exposures, safety-oriented behavior leads us to assume no thresholds and to operate as if the dose--response curve in man is likely to be linear

  3. Health impact assessment of proposal to burn tyres in a cement plant

    International Nuclear Information System (INIS)

    Cook, Andrew; Kemm, John

    2004-01-01

    A cement plant located in a small English town applied for a variation in its license to allow it to use chopped tyres as fuel in the cement kiln in part replacement for coal. The local health authority (PCT), a statutory consultee in the Integrated Pollution Prevention and Control (IPPC) process, requested an Health Impact Assessment (HIA) of the proposal to inform its response. A combination of interviews with key informants, literature search and participatory methods was used. The HIA broadly concluded that the proposal was unlikely to cause adverse impacts. The attempt to be impartial and the failure to confirm health fears disappointed many residents. The HIA had to be completed very quickly and it proved impossible to produce meaningful participation within this time scale. It is also suggested that very few PCTs have adequate resources to make the assessment of health impacts necessary for them to properly fulfil their role in the IPPC process

  4. The Contribution of Health Technology Assessment, Health Needs Assessment, and Health Impact Assessment to the Assessment and Translation of Technologies in the Field of Public Health Genomics

    NARCIS (Netherlands)

    Rosenköttera, N.; Vondeling, Hindrik; Blancquaert, I.; Mekel, O.C.L.; Kristensen, F.B.; Brand, A.

    2011-01-01

    The European Union has named genomics as one of the promising research fields for the development of new health technologies. Major concerns with regard to these fields are, on the one hand, the rather slow and limited translation of new knowledge and, on the other hand, missing insights into the

  5. Assessing potential health impacts of waste recovery and reuse business models in Hanoi, Vietnam.

    Science.gov (United States)

    Winkler, Mirko S; Fuhrimann, Samuel; Pham-Duc, Phuc; Cissé, Guéladio; Utzinger, Jürg; Nguyen-Viet, Hung

    2017-02-01

    In resource-constrained settings, the recovery of nutrients and the production of energy from liquid and solid waste are important. We determined the range and magnitude of potential community health impacts of six solid and liquid waste recovery and reuse business models in Hanoi, Vietnam. We employed a health impact assessment (HIA) approach using secondary data obtained from various sources supplemented with primary data collection. For determining the direction (positive or negative) and magnitude of potential health impacts in the population, a semiquantitative impact assessment was pursued. From a public health perspective, wastewater reuse for inland fish farming, coupled with on-site water treatment has considerable potential for individual and community-level health benefits. One of the business models investigated (i.e. dry fuel manufacturing with agro-waste) resulted in net negative health impacts. In Hanoi, the reuse of liquid and solid waste-as a mean to recover water and nutrients and to produce energy-has considerable potential for health benefits if appropriately managed and tailored to local contexts. Our HIA methodology provides an evidence-based decision-support tool for identification and promotion of business models for implementation in Hanoi.

  6. Towards Integration of Environmental and Health Impact Assessments for Wild Capture Fishing and Farmed Fish with Particular Reference to Public Health and Occupational Health Dimensions

    Directory of Open Access Journals (Sweden)

    Andrew Watterson

    2008-12-01

    Full Text Available The paper offers a review and commentary, with particular reference to the production of fish from wild capture fisheries and aquaculture, on neglected aspects of health impact assessments which are viewed by a range of international and national health bodies and development agencies as valuable and necessary project tools. Assessments sometimes include environmental health impact assessments but rarely include specific occupational health and safety impact assessments especially integrated into a wider public health assessment. This is in contrast to the extensive application of environmental impact assessments to fishing and the comparatively large body of research now generated on the public health effects of eating fish. The value of expanding and applying the broader assessments would be considerable because in 2004 the United Nations Food and Agriculture Organization reports there were 41,408,000 people in the total ‘fishing’ sector including 11,289,000 in aquaculture. The paper explores some of the complex interactions that occur with regard to fishing activities and proposes the wider adoption of health impact assessment tools in these neglected sectors through an integrated public health impact assessment tool.

  7. Air Pollution and Climate Change Health Impact Assessment. The ACHIA Project

    International Nuclear Information System (INIS)

    Kinney, P.L.

    2013-01-01

    Climate change may affect human health via interactions with air pollutants such as ozone and PM 2.5 . These air pollutants are linked to climate because they can be both affected by and have effects on climate. In coming decades, substantial, cost-effective improvements in public health may be achieved with well-planned strategies to mitigate climate impacts while also reducing health effects of ozone and PM 2.5 . Climate mitigation actions affect greenhouse pollutant emissions, including methane and black carbon, but also may affect other key air pollution precursors such as NOx, CO, and SOx. To better understand the potential of such strategies, studies are needed that assess possible future health impacts under alternative assumptions about future emissions and climate across multiple spatial scales. The overall objective of this project is to apply state of the art climate, air quality, and health modelling tools to assess future health impacts of ozone and PM 2.5 under different IPCCs scenario of climate change, focusing specifically on pollution-related health co-benefits which could be achieved under alternative climate mitigation pathways in the period 2030-2050. This question will be explored at three spatial scales: global, regional (Europe), and urban (Paris). ACHIA is comprised of an integrated set of four work packages: WP1. Global Climate and Air Pollution Impacts of Alternative Emissions Pathways; WP2. Climate and Air Quality at Regional and Urban Scales: Results for Europe and Paris; WP3. Health Impact Assessment; WP4. Dissemination, Evaluation, Management. ACHIA is designed to create an interdisciplinary approach to the impacts of climate change on health through air quality changes, and to start longer-term collaborations between communities. We expect the project to advance state of art across all WPs, with important implications for research groups around the world. A particular innovation of the project is the multi-scale aspect, i.e., the

  8. Integrating human health into environmental impact assessment: case studies of Canada's Northern mining resource sector

    International Nuclear Information System (INIS)

    Noble, B.F.; Bronson, J.E.

    2005-01-01

    This paper examines the integration of human health considerations into environmental impact assessment (EIA) in the Canadian North. Emphasis is placed on the northern mining sector, where more land has been staked in the past decade than in the previous 50 years combined. Using information from interviews with northern EIA and health practitioners and reviews of selected project documents, we examined three principal mining case studies, northern Saskatchewan uranium mining operations, the Ekati diamond project, and the Voisey's Bay mine/mill project, to determine whether and how health considerations in EIA have evolved and the current nature and scope of health integration. Results suggest that despite the recognized link between environment and health and the number of high-profile megaprojects in Canada's North, human health, particularly social health, has not been given adequate treatment in northern EIA. Health considerations in EIA have typically been limited to physical health impacts triggered directly by project-induced environmental change, while social and other health determinants have been either not considered at all, or limited to those aspects of health and well-being that the project proponent directly controlled, namely employment opportunities and worker health and safety. In recent years, we have been seeing improvements in the scope of health in EIA to reflect a broader range of health determinants, including traditional land use and culture. However, there is still a need to adopt impact mitigation and enhancement measures that are sensitive to northern society, to monitor and follow up actual health impacts after project approval, and to ensure that mitigation and enhancement measures are effective. (author)

  9. Methods and challenges for the health impact assessment of vaccination programs in Latin America

    OpenAIRE

    Sartori, Ana Marli Christovam; Nascimento, Andr?ia de F?tima; Yuba, T?nia Yuka; de So?rez, Patr?cia Coelho; Novaes, Hillegonda Maria Dutilh

    2015-01-01

    ABSTRACT OBJECTIVE To describe methods and challenges faced in the health impact assessment of vaccination programs, focusing on the pneumococcal conjugate and rotavirus vaccines in Latin America and the Caribbean. METHODS For this narrative review, we searched for the terms "rotavirus", "pneumococcal", "conjugate vaccine", "vaccination", "program", and "impact" in the databases Medline and LILACS. The search was extended to the grey literature in Google Scholar. No limits were defined for pu...

  10. [Exploring models for the assessment of the economic, social, political, and scientific impact of health research].

    Science.gov (United States)

    Macías-Angel, Beatriz; Agudelo-Calderón, Carlos A

    2015-05-01

    Health research produces effects on the health of populations. This document approaches the frameworks and the models used by developed countries to assess the impact of health research through documentary analysis of research with the highest impact. With this, it was possible to identify two guiding axes of analysis: one having to do with focus, and the other having to do with emphasis. With these, the published models, their uses, their reach, and their origins are related. Our study brings awareness to the features they have and the areas in which Colombia could implement them. We found that the framework for evaluating health research known as the "payback model" is a model for monitoring research that tracks the process and research results with multidimensional categorization of the impacts of research.

  11. [Health impact assessment methodology for urban planning projects in Andalusia (Spain)].

    Science.gov (United States)

    Moya-Ruano, Luis A; Candau-Bejarano, Ana; Rodríguez-Rasero, Francisco J; Ruiz-Fernández, Josefa; Vela-Ríos, José

    To describe the tool developed in Andalusia (Spain) to conduct an analysis and prospective assessment of health impacts from urban planning projects as well as the process followed to design it. On the one hand, direct and indirect relationships between urban setting and health were identified in light of the best scientific evidence available; and, on the other hand, methods and tools in impact assessment were reviewed. After the design of the tool, it was tested via both internal and external validation processes (meetings, workshops and interviews with key informants). The tool consists of seven phases, structured in two stages. A first descriptive stage shows how to obtain information about goals, objectives and general points pertaining the project and also to characterise the potentially affected population. The second one indicates, in several phases, how to identify and sort out potential impacts from the project using different supporting tools. Both in the testing phase and through its implementation since the entry into force of Andalusian Decree 169/2014 (16 June 2015) and forced all urban planning projects to be subjected to an Health Impact Assessment, this methodology has proved responsive, identifying major potential health impacts from the measures included in those projects. However, the tool has been shaped as a living tool and will be adapted in line with the experience acquired in its use. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  12. Assessment of the health impacts of the 2011 summer floods in Brisbane.

    Science.gov (United States)

    Alderman, Katarzyna; Turner, Lyle R; Tong, Shilu

    2013-08-01

    To assess the effects of the 2011 floods in Brisbane, Australia, on residents' physical and mental health. Residents who had been affected by the floods completed a community-based survey that examined the direct impact of flooding on households and their perceived physical and mental health. Outcome variables included overall and respiratory health and mental health outcomes related to psychological distress, sleep quality, and posttraumatic stress disorder (PTSD). Multivariable logistic regression was used to examine the association between flooding and perceived health outcome variables, adjusted for current health status and sociodemographic factors. Residents whose households were directly affected by flooding were more likely to report poor overall (Odds Ratio [OR] 5.3; 95% CI, 2.8-10.1) and respiratory (OR 2.3; 95% CI, 1.1-4.6) health, psychological distress (OR 1.9; 95% CI, 1.1-3.5), poor sleep quality (OR 2.3; 95% CI, 1.2-4.4), and probable PTSD (OR 2.3; 95% CI, 1.2-4.5). The 2011 Brisbane floods had significant impact on the physical and psychosocial health of residents. Improved support strategies may need to be integrated into existing disaster management programs to reduce flood-related health impacts, particularly those related to mental health.

  13. Community participation in Health Impact Assessment. A scoping review of the literature

    NARCIS (Netherlands)

    Broeder, den Lea; Uiters, Ellen; Have, ten Wim; Wagemakers, Annemarie; Schuit, Albertine Jantine

    2017-01-01

    Currently, the engagement of local communities in Health Impact Assessment is becoming more and more important. A scoping review was performed to take stock of visions, methods and experiences in this field. A combined Scopus and Medline search yielded 100 articles in scientific journals. The

  14. Community participation in Health Impact Assessment. A scoping review of the literature

    NARCIS (Netherlands)

    den Broeder, Lea; Uiters, Ellen; ten Have, Wim; Wagemakers, Annemarie; Schuit, Albertine Jantine

    2017-01-01

    Currently, the engagement of local communities in Health Impact Assessment is becoming more and more important. A scoping review was performed to take stock of visions, methods and experiences in this field. A combined Scopus and Medline search yielded 100 articles in scientific journals. The final

  15. Assessing health impacts in complex eco-epidemiological settings in the humid tropics: Modular baseline health surveys

    International Nuclear Information System (INIS)

    Winkler, Mirko S.; Divall, Mark J.; Krieger, Gary R.; Schmidlin, Sandro; Magassouba, Mohamed L.; Knoblauch, Astrid M.; Singer, Burton H.; Utzinger, Jürg

    2012-01-01

    The quantitative assessment of health impacts has been identified as a crucial feature for realising the full potential of health impact assessment (HIA). In settings where demographic and health data are notoriously scarce, but there is a broad range of ascertainable ecological, environmental, epidemiological and socioeconomic information, a diverse toolkit of data collection strategies becomes relevant for the mainly small-area impacts of interest. We present a modular, cross-sectional baseline health survey study design, which has been developed for HIA of industrial development projects in the humid tropics. The modular nature of our toolkit allows our methodology to be readily adapted to the prevailing eco-epidemiological characteristics of a given project setting. Central to our design is a broad set of key performance indicators, covering a multiplicity of health outcomes and determinants at different levels and scales. We present experience and key findings from our modular baseline health survey methodology employed in 14 selected sentinel sites within an iron ore mining project in the Republic of Guinea. We argue that our methodology is a generic example of rapid evidence assembly in difficult-to-reach localities, where improvement of the predictive validity of the assessment and establishment of a benchmark for longitudinal monitoring of project impacts and mitigation efforts is needed.

  16. Participatory health impact assessment for the development of local government regulation on hazard control

    International Nuclear Information System (INIS)

    Inmuong, Uraiwan; Rithmak, Panee; Srisookwatana, Soomol; Traithin, Nathathai; Maisuporn, Pornpun

    2011-01-01

    The Thai Public Health Act 1992 required the Thai local governments to issue respective regulations to take control of any possible health-hazard related activities, both from commercial and noncommercial sources. Since 1999, there has been centrally decentralized of power to a new form of local government establishment, namely Sub-district Administrative Organization (SAO). The SAO is asmall-scale local governing structure while its legitimate function is for community services, including control of health impact related activities. Most elected SAO administrators and officers are new and less experience with any of public health code of practice, particularly on health-hazard control. This action research attempted to introduce and apply a participatory health impact assessment (HIA) tool for the development of SAO health-hazard control regulation. The study sites were at Ban Meang and Kok See SAOs, Khon Kaen Province, Thailand, while all intervention activities conducted during May 2005-April 2006. A set of cooperative activities between researchers and community representatives were planned and organized by; surveying and identifying place and service base locally causing local environmental health problems, organizing community participatory workshops for drafting and proposing the health-hazard control regulation, and appropriate practices for health-hazard controlling measures. This action research eventually could successfully enable the SAO administrators and officers understanding of local environmental-related health problem, as well as development of imposed health-hazard control regulation for local community.

  17. Integration of quantitative risk assessment in the health impact assessment of the recently amended Hungarian anti-smoking policy

    DEFF Research Database (Denmark)

    Ádám, Balázs; Molnár, Ágnes; Gulis, Gabriel

    2011-01-01

    -smokers to introduce smoking ban in closed public places, workplaces and public transport vehicles. Full chain approach was used to identify basic rules for prioritizing the major impact pathways with special attention to the feasibility of quantifying exposure and outcome. Exposure assessment relied on international...... experiences, while outcome assessment calculated measures of disease burden, like attributable death and disability adjusted life years, for a baseline and a predicted situation after the proposed changes take place. The major impact of the proposal was identified to decreases prevalence of active and passive...... population of Hungary. As demonstrated by the results, providing smoke-free public places has an unambiguous positive impact on the health of the public that has been confirmed by the quantified health gain. The demonstrated methodology offers a practicable example for applying quantitative risk assessment...

  18. DYNAMO-HIA--a Dynamic Modeling tool for generic Health Impact Assessments.

    Directory of Open Access Journals (Sweden)

    Stefan K Lhachimi

    Full Text Available BACKGROUND: Currently, no standard tool is publicly available that allows researchers or policy-makers to quantify the impact of policies using epidemiological evidence within the causal framework of Health Impact Assessment (HIA. A standard tool should comply with three technical criteria (real-life population, dynamic projection, explicit risk-factor states and three usability criteria (modest data requirements, rich model output, generally accessible to be useful in the applied setting of HIA. With DYNAMO-HIA (Dynamic Modeling for Health Impact Assessment, we introduce such a generic software tool specifically designed to facilitate quantification in the assessment of the health impacts of policies. METHODS AND RESULTS: DYNAMO-HIA quantifies the impact of user-specified risk-factor changes on multiple diseases and in turn on overall population health, comparing one reference scenario with one or more intervention scenarios. The Markov-based modeling approach allows for explicit risk-factor states and simulation of a real-life population. A built-in parameter estimation module ensures that only standard population-level epidemiological evidence is required, i.e. data on incidence, prevalence, relative risks, and mortality. DYNAMO-HIA provides a rich output of summary measures--e.g. life expectancy and disease-free life expectancy--and detailed data--e.g. prevalences and mortality/survival rates--by age, sex, and risk-factor status over time. DYNAMO-HIA is controlled via a graphical user interface and is publicly available from the internet, ensuring general accessibility. We illustrate the use of DYNAMO-HIA with two example applications: a policy causing an overall increase in alcohol consumption and quantifying the disease-burden of smoking. CONCLUSION: By combining modest data needs with general accessibility and user friendliness within the causal framework of HIA, DYNAMO-HIA is a potential standard tool for health impact assessment based

  19. Policy health impact assessment of the EU Health Strategy (2008-2013). Fostering good health in an aging Europe – tackling tobacco consumption

    DEFF Research Database (Denmark)

    Ádám, Balázs; Molnár, Ágnes; Ádány, Róza

    2012-01-01

    smoking by incorporating the issue into its 1st objective “Fostering good health in an aging Europe”. The aim of the study was to assess the health impact of the most effective tobacco control policy, taxation, on the EU level. Methods: The assessment was based on the mapping of the whole impact scheme...... from which one priority causal pathway was selected for detailed quantitative evaluation. The analysis was carried out on each impact level using the top-down risk assessment tool developed in the Risk Assessment from Policy to Impact Dimension EU project. Health outcome was quantified as the change...... in the number of death attributable to smoking. Results: Tobacco taxation policy affects two health determinants directly and several others indirectly. It influences state income due to changing prices and substance use which has been chosen for detailed assessment. In the model, the scenario of 10% price...

  20. The Health Impacts of Climate Change: A Continuing Medical Education Needs Assessment Framework.

    Science.gov (United States)

    Valois, Pierre; Blouin, Patrick; Ouellet, Claudine; Renaud, Jean-Sébastien; Bélanger, Diane; Gosselin, Pierre

    2016-01-01

    As the health consequences of climate change (CC) will likely become more manifest in the future, family physicians have to be knowledgeable about these impacts and the ways in which they can affect their patients. The main aim of this study was to propose a competency framework and questionnaire used to conduct a needs analysis to identify and prioritize family physicians' real educational needs regarding the health impacts of CC. A mixed method combining a qualitative interview and a quantitative online questionnaire was used (n = 24 physicians). The interview assessed key beliefs related to participating in an online continuing medical education (eCME) activity on the health impacts of climate change, and the perception of the key factors or conditions required to ensure the family physicians' satisfaction with this eCME activity. The questionnaire assessed the current and desired levels of competency on five general training themes: general knowledge about CC; heat-related illnesses; CC, extreme weather events and modification of vector-borne and zoonotic diseases; CC, extreme weather events and modification of water-borne diseases; and mental health impacts of natural disasters. Results revealed the need for improved medical education on climate change and health. Results also add to the literature by showing that a 3-hour eCME activity covering these topics would be useful and would allow family physicians to use this knowledge in their daily practice, notably through prevention and counseling. Introducing a CME needs assessment framework and a generic instrument that reflects family physicians' needs regarding the health impacts of CC has the added advantage of standardizing the assessment procedure.

  1. The search for underlying principles of health impact assessment: progress and prospects: Comment on "Investigating underlying principles to guide health impact assessment".

    Science.gov (United States)

    Winkler, Mirko S; Utzinger, Jürg

    2014-07-01

    Health Impact Assessment (HIA) is a relatively young field of endeavour, and hence, future progress will depend on the planning, implementation and rigorous evaluation of additional HIAs of projects, programmes and policies the world over. In the June 2014 issue of the International Journal of Health Policy and Management, Fakhri and colleagues investigated underlying principles of HIA through a comprehensive review of the literature and expert consultation. With an emphasis on the Islamic Republic of Iran, the authors identified multiple issues that are relevant for guiding HIA practice. At the same time, the study unravelled current shortcomings in the understanding and definition of HIA principles and best practice at national, regional, and global levels. In this commentary we scrutinise the research presented, highlight strengths and limitations, and discuss the findings in the context of other recent attempts to guide HIA.

  2. Affordable housing and health: a health impact assessment on physical inspection frequency.

    Science.gov (United States)

    Klein, Elizabeth G; Keller, Brittney; Hood, Nancy; Holtzen, Holly

    2015-01-01

    To characterize the prevalence of health-related housing quality exposure for the vulnerable populations that live in affordable housing. Retrospective cross-sectional study. Affordable housing properties in Ohio inspected between 2007 and 2011. Stratified random sample of physical inspection reports (n = 370), including a case study of properties receiving multiple inspections (n = 35). Health-related housing factors, including mold, fire hazard, and others. The majority of affordable housing property inspections (85.1%) included at least 1 health-related housing quality issue. The prevalence of specific health-related violations was varied, with appliance and plumbing issues being the most common, followed by fire, mold, and pest violations. Across funding agencies, the actual implementation of inspection protocols differed. The majority of physical inspections identified housing quality issues that have the potential to impact human health. If the frequency of physical inspections is reduced as a result of inspection alignment, the most health protective inspection protocol should be selected for funding agency inspections; a standardized physical inspection tool is recommended to improve the consistency of inspection findings between mandatory physical inspections in order to promote optimum tenant health.

  3. Building-related health impacts in European and Chinese cities: a scalable assessment method.

    Science.gov (United States)

    Tuomisto, Jouni T; Niittynen, Marjo; Pärjälä, Erkki; Asikainen, Arja; Perez, Laura; Trüeb, Stephan; Jantunen, Matti; Künzli, Nino; Sabel, Clive E

    2015-12-14

    Public health is often affected by societal decisions that are not primarily about health. Climate change mitigation requires intensive actions to minimise greenhouse gas emissions in the future. Many of these actions take place in cities due to their traffic, buildings, and energy consumption. Active climate mitigation policies will also, aside of their long term global impacts, have short term local impacts, both positive and negative, on public health. Our main objective was to develop a generic open impact model to estimate health impacts of emissions due to heat and power consumption of buildings. In addition, the model should be usable for policy comparisons by non-health experts on city level with city-specific data, it should give guidance on the particular climate mitigation questions but at the same time increase understanding on the related health impacts and the model should follow the building stock in time, make comparisons between scenarios, propagate uncertainties, and scale to different levels of detail. We tested The functionalities of the model in two case cities, namely Kuopio and Basel. We estimated the health and climate impacts of two actual policies planned or implemented in the cities. The assessed policies were replacement of peat with wood chips in co-generation of district heat and power, and improved energy efficiency of buildings achieved by renovations. Health impacts were not large in the two cities, but also clear differences in implementation and predictability between the two tested policies were seen. Renovation policies can improve the energy efficiency of buildings and reduce greenhouse gas emissions significantly, but this requires systematic policy sustained for decades. In contrast, fuel changes in large district heating facilities may have rapid and large impacts on emissions. However, the life cycle impacts of different fuels is somewhat an open question. In conclusion, we were able to develop a practical model for city

  4. Bias in retrospective assessment of perceived dental treatment effects when using the Oral Health Impact Profile.

    Science.gov (United States)

    Reissmann, Daniel R; Erler, Antje; Hirsch, Christian; Sierwald, Ira; Machuca, Carolina; Schierz, Oliver

    2017-10-23

    Aim of this exploratory study was to investigate whether a retrospective assessment of oral health-related quality of life (OHRQoL) using the Oral Health Impact Profile (OHIP) is susceptible to bias such as implicit theory of change and cognitive dissonance. In this prospective clinical study, a sample of 126 adult patients (age 17-83 years, 49% women) requiring prosthodontic treatment was consecutively recruited. The OHRQoL was assessed using the 49-item OHIP at baseline and at follow-up. Additionally, patients were asked at follow-up to retrospectively rate their oral health status at baseline (retrospective pretest or then-test) and the change in oral health status using a global transition question. Furthermore, patients' ratings of overall oral health and general health were used as validity criteria for the OHRQoL assessments. Response shift was calculated as the difference between the initial and retrospective baseline assessments. Baseline and retrospective pretest did not differ substantially in terms of internal consistency and convergent validity. Response shift was more pronounced when patients perceived a large change in OHRQoL during treatment. Retrospective pretests were more highly correlated with the baseline than with the follow-up assessment. Findings suggest that retrospective assessments of OHRQoL using the OHIP-49 are susceptible to bias. Cognitive dissonance is more likely to appear as a source of bias than implicit theory of change.

  5. Assessing the health equity impacts of regional land-use plan making: An equity focussed health impact assessment of alternative patterns of development of the Whitsunday Hinterland and Mackay Regional Plan, Australia (Short report)

    International Nuclear Information System (INIS)

    Gunning, Colleen; Harris, Patrick; Mallett, John

    2011-01-01

    Health service and partners completed an equity focussed health impact assessment to influence the consideration of health and equity within regional land-use planning in Queensland, Australia. This project demonstrated how an equity oriented assessment matrix can assist in testing regional planning scenarios. It is hoped that this HIA will contribute to the emerging interest in ensuring that potential differential health impacts continue to be considered as part of land-use planning processes.

  6. Building health impact assessment capacity as a lever for healthy public policy in urban planning.

    Science.gov (United States)

    Hughes, Jenny L; Kemp, Lynn A

    2007-01-01

    Building capacity to improve health through applying health impact assessment (HIA) increases the range of people, organisations and communities who are able to address health problems and, in particular, the problems that arise out of social inequity and social exclusion. To achieve this, a range of strategies is required across the areas of organisational development, workforce development, resource allocation, leadership and partnerships. A conceptual framework to guide understanding of capacity building evolved during a three-year capacity building project that supported the implementation of HIA. This is also applicable to the broader agenda of healthy public policy.

  7. Multimedia Environmental Pollutant Assessment System (MEPAS{reg_sign}): Exposure pathway and human health impact assessment models

    Energy Technology Data Exchange (ETDEWEB)

    Strenge, D.L.; Chamberlain, P.J.

    1995-05-01

    The Multimedia Environmental Pollutant Assessment System (MEPAS) provides physics-based models for human health risk assessment for radioactive and hazardous pollutants. MEPAS analyzes pollutant behavior in various media (air, soil, groundwater and surface water) and estimates transport through and between media and exposure and impacts to the environment, to the maximum individual, and to populations. MEPAS includes 25 exposure pathway models, a database with information on more than 650 contaminants, and a sensitivity module that allows for uncertainty analysis. Four major transport pathways are considered in MEPAS: groundwater, overland, surface water, and atmospheric. This report describes the exposure pathway and health impact assessment component of MEPAS, which provides an estimate of health impacts to selected individuals and populations from exposure to pollutants. The exposure pathway analysis starts with pollutant concentration in a transport medium and estimates the average daily dose to exposed individuals from contact with the transport medium or a secondary medium contaminated by the transport medium. The average daily dose is then used to estimate a measure of health impact appropriate to the type of pollutant considered. Discussions of the exposure pathway models include the assumptions and equations used to convert the transport medium concentrations to exposure medium concentrations. The discussion for a given exposure pathway defines the transport pathways leading to the exposure, the special processes considered in determining the pollutant concentration in the exposure medium, and the exposure model used to estimate the average daily dose. Models for the exposure pathway and health impact assessments require definition of several parameters. A summary of the notation used for these parameters is provided.

  8. Health Impact Assessment of air Pollution in Megacity of Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Kazem Naddafi

    2012-12-01

    Full Text Available The aims of the present study were to provide quantitative data on the impact of air pollution on the health of people living in Tehran city, the most populated city of Iran. The approach proposed by the World Health Organization (WHO was applied using the AirQ 2.2.3 software developed by the WHO European Centre for Environment and Health, Bilthoven Division. Concentrations of ozone, nitrogen dioxide, sulfur dioxide and particulate matter of aerodynamic diameter ≤ 10 μm (PM10 were used to assess human exposure and healthimpacts in terms of attributable proportion of the health outcome, annual number of excess cases of mortality for all causes, and cardiovascular and respiratory diseases. The annual average of PM10, SO2, NO2 and O3 in Tehran were 90.58, 89.16, 85 and 68.82 μg/m3, respectively. Considering short-term effects, PM10 had the highest health impact on the 8,700,000 inhabitants of Tehran city, causing an excess of total mortality of 2194 out of 47284 in a year. Sulfur dioxide, nitrogen dioxide and ozone caused about, respectively, 1458, 1050 and 819 excess cases of total mortality. Results indicate that the magnitude of the health impact estimated for the city of Tehranunderscores the need for urgent action to reduce the health burden of air pollution.

  9. Short-Term Health Impact Assessment of Urban PM10 in Bejaia City (Algeria

    Directory of Open Access Journals (Sweden)

    Fatima Benaissa

    2016-01-01

    Full Text Available We used Health Impact Assessment (HIA to analyze the impact on a given population’s health outcomes in terms of all-causes mortality and respiratory and cardiovascular hospitalizations attributable to short-term exposure to particulate matter less than 10 μm diameter (PM10 in Bejaia city, for which health effects of air pollution have never been investigated. Two scenarios of PM10 reduction were considered: first, a scenario where the PM10 annual mean is decreased by 5 µg/m3, and then a scenario where this PM10 mean is decreased to 20 µg/m3 (World Health Organization annual air quality guideline (WHO-AQG. Annual mean level of PM10 (81.7 µg/m3 was calculated from objective measurements assessed in situ. Each year, about 4 and 55 deaths could be postponed with the first and the second scenarios successfully. Furthermore, decreasing PM10 annual mean by 5 µg/m3 would avoid 5 and 3 respiratory and cardiac hospitalizations, respectively, and not exceeding the PM10 WHO-AQG (20 µg/m3 would result in a potential gain of 36 and 23 per 100000 respiratory and cardiac hospitalizations, respectively. Lowering in current levels of PM10 has a nonnegligible impact in terms of public health that it is expected to be higher in the case of long-term effects.

  10. Comprehensive Assessment of Human Health Impacts and Benefits of Fruits and Vegetables in a LCA Context

    DEFF Research Database (Denmark)

    Stylianou, Katerina S.; Fantke, Peter; Fulgoni, Victor L.

    2017-01-01

    following a traditional LCA approach. For PM, we couple emissions with an epidemiology-based dose-response to estimate impacts. For pesticide residues exposure, we use publically available health impacts derived by combining exposure modelling of pesticide residue with toxicological studies for numerous...... pesticide active ingredients. The nutritional assessment is based on effect factors estimated using the 2010 health burden attributable to corresponding dietary risk factors in DALY from the global burden of disease (GBD) and daily consumption food consumption based on the National Health and Nutrition...... Examination Survey (NHANES) 2009-2012.One fruits serving is linked to 0.07 g PM2.5-eq (0.03 g PM2.5-eq/servingvegetables, Figure 1), 40% due to NH3 as PM precursor, corresponding to 0.08 mu DALY (0.03 mu DALY/servingvegetables). From a nutritional perspective, adding one serving of fruits to the average US...

  11. Evaluating the balanced scorecard at the University Health Network: an impact assessment.

    Science.gov (United States)

    Young, Justin; Bell, Robert; Khalfan, Adil; Lindquist, Evert

    2008-01-01

    The balanced scorecard (BSC) has become increasing popular in healthcare organizations. A recent study conducted at the University Health Network in Toronto explored the extent to which the BSC has focused and aligned various organizational units and departments around shared goals and objectives. The evaluation also assessed the BSC's impact on front-line staff and how the development and rollout of the BSC should be modified in the next planning iteration.

  12. Health impact assessment in the United States: Has practice followed standards?

    International Nuclear Information System (INIS)

    Schuchter, Joseph; Bhatia, Rajiv; Corburn, Jason; Seto, Edmund

    2014-01-01

    As an emerging practice, Health Impact Assessment is heterogeneous in purpose, form, and scope and applied in a wide range of decision contexts. This heterogeneity challenges efforts to evaluate the quality and impact of practice. We examined whether information in completed HIA reports reflected objectively-evaluable criteria proposed by the North American HIA Practice Standards Working Group in 2009. From publically-available reports of HIAs conducted in the U.S. and published from 2009 to 2011, we excluded those that were components of, or comment letters on, Environmental Impact Assessments (5) or were demonstration projects or student exercises (8). For the remaining 23 reports, we used practice standards as a template to abstract data on the steps of HIA, including details on the rationale, authorship, funding, decision and decision-makers, participation, pathways and methods, quality of evidence, and recommendations. Most reports described screening, scoping, and assessment processes, but there was substantial variation in the extent of these processes and the degree of stakeholder participation. Community stakeholders participated in screening or scoping in just two-thirds of the HIAs (16). On average, these HIAs analyzed 5.5 determinants related to 10.6 health impacts. Most HIA reports did not include evaluation or monitoring plans. This study identifies issues for field development and improvement. The standards might be adapted to better account for variability in resources, produce fit-for-purpose HIAs, and facilitate innovation guided by the principles. - Highlights: • Our study examined reported HIAs in the U.S. against published practice standards. • Most HIAs used some screening, scoping and assessment elements from the standards. • The extent of these processes and stakeholder participation varied widely. • The average HIA considered multiple health determinants and impacts. • Evaluation or monitoring plans were generally not included in

  13. Health effects from indoor and outdoor exposure to fine particulate matter in life cycle impact assessment

    DEFF Research Database (Denmark)

    Fantke, Peter; McKone, T.E.; Jolliet, Olivier

    2016-01-01

    Exposure to fine particulate matter (PM2.5) pollution is a major contributor to human disease burden as continuously shown in the Global Burden of Disease study series. Exposures to PM2.5 concentration outdoors and indoors contribute almost equally to this burden. Despite the importance, health...... impacts from exposure to PM2.5 are often excluded from life cycle impact assessment (LCIA) characterization profiles. This is in large part because of the lack of well-vetted harmonized guidance about how to consistently assess the exposures and impacts of indoor and outdoor emissions of PM2.5 and its...... precursors. We present a framework for calculating characterization factors for indoor and outdoor emissions of primary PM2.5 and secondary PM2.5 precursors, and a roadmap for further refining this modelling framework for operational use in LCIA. The framework was developed over the last three years...

  14. Understanding relevance of health research: considerations in the context of research impact assessment.

    Science.gov (United States)

    Dobrow, Mark J; Miller, Fiona A; Frank, Cy; Brown, Adalsteinn D

    2017-04-17

    With massive investment in health-related research, above and beyond investments in the management and delivery of healthcare and public health services, there has been increasing focus on the impact of health research to explore and explain the consequences of these investments and inform strategic planning. Relevance is reflected by increased attention to the usability and impact of health research, with research funders increasingly engaging in relevance assessment as an input to decision processes. Yet, it is unclear whether relevance is a synonym for or predictor of impact, a necessary condition or stage in achieving it, or a distinct aim of the research enterprise. The main aim of this paper is to improve our understanding of research relevance, with specific objectives to (1) unpack research relevance from both theoretical and practical perspectives, and (2) outline key considerations for its assessment. Our approach involved the scholarly strategy of review and reflection. We prepared a draft paper based on an exploratory review of literature from various fields, and gained from detailed and insightful analysis and critique at a roundtable discussion with a group of key health research stakeholders. We also solicited review and feedback from a small sample of expert reviewers. Research relevance seems increasingly important in justifying research investments and guiding strategic research planning. However, consideration of relevance has been largely tacit in the health research community, often depending on unexplained interpretations of value, fit and potential for impact. While research relevance seems a necessary condition for impact - a process or component of efforts to make rigorous research usable - ultimately, relevance stands apart from research impact. Careful and explicit consideration of research relevance is vital to gauge the overall value and impact of a wide range of individual and collective research efforts and investments. To improve

  15. The impact of health technology assessment reports on decision making in Austria.

    Science.gov (United States)

    Zechmeister, Ingrid; Schumacher, Ines

    2012-01-01

    Health technology assessment (HTA) was established in Austria in the 1990s and, since then, it has gained considerable importance. In this study, we aim to analyze whether the HTA reports that have been produced at the Institute for Technology Assessment (ITA) and at the Ludwig Boltzmann Institute for HTA (LBI-HTA) have had an impact on decision making within the Austrian health care system. We selected all reports that were intended for supporting (i) reimbursement/investment or (ii) disinvestment decisions. Eleven full HTA reports and fifty-eight rapid assessments fulfilled the inclusion criteria. We used interview data and administrative data on volumes, tariffs and expenditure of products/services to analyze whether and how reports were in reality used in decision making and what the consequences for health care expenditure and resource distribution have been. Five full HTA reports and fifty-six rapid technology assessments were used for reimbursement decisions. Four full HTA reports and two rapid assessments were used for disinvestment decisions and resulted in reduced volumes and expenditure. Two full HTA reports showed no impact on decision making. Impact was most evident for hospital technologies. HTA has played some role in reducing volumes of over-supplied hospital technologies, resulting in reduced expenditure for several hospital providers. Additionally, it has been increasingly included in prospective planning and reimbursement decisions of late, indicating re-distribution of resources toward evidence-based technologies. However, further factors may have influenced the decisions, and the impact could be considerably increased by systematically incorporating HTA into the decision-making process in Austria.

  16. The potential role of health impact assessment in tackling the complexity of climate change adaptation for health.

    Science.gov (United States)

    Brown, Helen L; Proust, Katrina; Spickett, Jeffery; Capon, Anthony

    2011-12-01

    Managing an issue of the magnitude, scope and complexity of climate change is a daunting prospect, yet one which nations around the world must face. Climate change is an issue without boundaries--impacts will cut across administrative and geographical borders and be felt by every sector of society. Responses to climate change will need to employ system approaches that take into account the relationships that cross organisational and sectoral boundaries. Solutions designed in isolation from these interdependencies will be unlikely to succeed, squandering opportunities for long-term effective adaptation. Health Impact Assessment (HIA) provides a structural approach to identify, evaluate and manage health impacts of climate change that is inclusive of a wide range of stakeholders. Climate change will affect decision-making across every government level and sector and the health implications of these decisions can also be addressed with HIA. Given the nature of the issue, HIA of climate change will identify a large number of variables that influence the type and extent of health impacts and the management of these impacts. In order to implement the most effective adaptation measures, it is critica that an understanding of the interactions between these variables is developed. The outcome of HIA of climate change can therefore be strengthened by the introduction of system dynamics tools, such as causal loop diagrams, that are designed to examine interactions between variables and the resulting behaviour of complex systems.

  17. IMPACT OF HEALTH TECHNOLOGY ASSESSMENT IN LITIGATION CONCERNING ACCESS TO HIGH-COST DRUGS.

    Science.gov (United States)

    Aleman, Alicia; Perez Galan, Ana

    2017-01-01

    The impact of health technology assessment (HTA) in the judicialization of the right of health has not been deeply studied in Latin American countries. The purpose of this study is to review the process of judicialization of the access to high cost drugs in Uruguay and assess the impact HTAs have had on this process. The methodology used for this study included a comprehensive literature search in electronic databases, local journals, internal documents developed in the Ministry of Health, as well as conducting interviews with key informants. Judicialization of the access of high cost drugs has been increasing since 2010. The strategy of the Ministry of Health of Uruguay to decrease this problem included the organization of roundtables with judges and other stakeholders on the basis of HTA, the training of defense lawyers in the use and interpretation of HTA, and the participation of a professional who develops HTA in the preparation of the defense arguments. A year after the implementation of this strategy, 25 percent of writs of protection were won by the Ministry of Health. Even though the strategy implemented was effective in reducing the loss of litigations, it was not effective in reducing the growing number of writs of protection. It is essential to address this problem in a broad debate and to promote understanding between the parties.

  18. Screening tool development for health impact assessment of large administrative structural changes

    DEFF Research Database (Denmark)

    Ravn, Anne Katrine; Nicolaisen, Henriette; Linnrose, Karina

    2008-01-01

    available on the Internet and in the scientific literature, in many cases lack of access to those tools creates a barrier to the use of HIA. RESULTS: Denmark is undergoing a major structural change in state administration, moving many responsibilities from the state to the local level. Newly constructed......AIMS: Screening is the first, extremely important step of health impact assessment (HIA) methodology. It contributes to the decision to conduct or not conduct a full assessment, and predefines the main fields of interest of the assessment. METHODS: Although there are examples of screening tools...... councils are faced with challenges regarding their responsibilities in health promotion and other fields, and this has opened a window for the introduction of HIA at a local level. Owing to the lack of experience with HIA in Denmark, screening tools are lacking and are frequently requested by councils...

  19. Book Review: Guide to Health Impact Assessment (HIA in petroleum industry

    Directory of Open Access Journals (Sweden)

    Iraj Nabipour

    2013-04-01

    Full Text Available Rapid growing industry in combination with physical, social and environmental life has raised concerns about social and environmental consequences of different industries. Therfore, Social Impact Assessment (SIA and Environmental Impact Assessment (EIA are included in health projects, policies and programs. HIA has been implemented in industrial projects since 1990. Several countries incuding European countries, Canada, Nezealand, USA had great developments regarding HIA in their industries. Moreover, World Health Organization has played an important role in developing HIA policy in industries. Different processes and procedures are applied for HIA but there are common points. Some of these points are as follows: -Focusing on community policies and health consequences throughout the public -Structurized format based on a health model Different HIA’s with different standards could be developed considering their common elements. It must be noted that HIA is not a part of EIA. EIA’s nature, procedures and methodology is different from HIA. However, as EIA focuses in some parts on public health, HIA could be included in EIA partially. Furhurmore, Local community around the industry is considered as HIA target point. So HIA’s essentials are considered to be beyond industrial medicine. Knowledge based economy requirements for successful technology and economy in petroleum industry are consisted of healthy workforce and community. These requirements are going to become a belief in petroleum industry because health issues guarantee economical and social developments in future. The book Reviews HIA in petroleum industry, health consequences of this industry on workforce and community. It takes the reader through a structural format towards multiple steps of HIA and enables him to have an integrated view. Establishment, development and implementation of such processes in petroleum industry will ensure economical and also health future of the

  20. The role of health impact assessment in Phase V of the Healthy Cities European Network.

    Science.gov (United States)

    Simos, Jean; Spanswick, Lucy; Palmer, Nicola; Christie, Derek

    2015-06-01

    Health impact assessment (HIA) is a prospective decision-making aid tool that aims to improve the quality of policies, programmes or projects through recommendations that promote health. It identifies how and through which pathways a decision can impact a wide range of health determinants and seeks to define the distribution of effects within populations, thereby raising the issue of equity. HIA was introduced to the WHO European Healthy Cities Network as one of its four core themes during the Phase IV (2004-08). Here we present an evaluation of the use of HIA during Phase V (2009-13), where HIA was linked with the overarching theme of health and health equity in all local policies and a requirement regarding capacity building. The evaluation was based on 10 case studies contributed by 9 Healthy Cities in five countries (France, Hungary, Italy, Spain and the UK). A Realist Evaluation framework was used to collect and aggregate data obtained through three methods: an HIA factors analysis, a case-study template analysis using Nvivo software and a detailed questionnaire. The main conclusion is that HIA significantly helps promote Health in All Policies (HiAP) and sustainability in Healthy Cities. It is recommended that all Healthy City candidates to Phase VI (2014-18) of the WHO Healthy Cities European Network effectively adopt HIA and HiAP. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. The impact of the National Institute for Health Research Health Technology Assessment programme, 2003-13: a multimethod evaluation.

    Science.gov (United States)

    Guthrie, Susan; Bienkowska-Gibbs, Teresa; Manville, Catriona; Pollitt, Alexandra; Kirtley, Anne; Wooding, Steven

    2015-08-01

    The National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme supports research tailored to the needs of NHS decision-makers, patients and clinicians. This study reviewed the impact of the programme, from 2003 to 2013, on health, clinical practice, health policy, the economy and academia. It also considered how HTA could maintain and increase its impact. Interviews (n = 20): senior stakeholders from academia, policy-making organisations and the HTA programme. Bibliometric analysis: citation analysis of publications arising from HTA programme-funded research. Researchfish survey: electronic survey of all HTA grant holders. Payback case studies (n = 12): in-depth case studies of HTA programme-funded research. We make the following observations about the impact, and routes to impact, of the HTA programme: it has had an impact on patients, primarily through changes in guidelines, but also directly (e.g. changing clinical practice); it has had an impact on UK health policy, through providing high-quality scientific evidence - its close relationships with the National Institute for Health and Care Excellence (NICE) and the National Screening Committee (NSC) contributed to the observed impact on health policy, although in some instances other organisations may better facilitate impact; HTA research is used outside the UK by other HTA organisations and systematic reviewers - the programme has an impact on HTA practice internationally as a leader in HTA research methods and the funding of HTA research; the work of the programme is of high academic quality - the Health Technology Assessment journal ensures that the vast majority of HTA programme-funded research is published in full, while the HTA programme still encourages publication in other peer-reviewed journals; academics agree that the programme has played an important role in building and retaining HTA research capacity in the UK; the HTA programme has played a role in

  2. [Health impact assessment of policies for municipal solid waste management: findings of the SESPIR Project].

    Science.gov (United States)

    Ranzi, Andrea; Ancona, Carla; Angelini, Paola; Badaloni, Chiara; Cernigliaro, Achille; Chiusolo, Monica; Parmagnani, Federica; Pizzuti, Renato; Scondotto, Salvatore; Cadum, Ennio; Forastiere, Francesco; Lauriola, Paolo

    2014-01-01

    The SESPIR Project (Epidemiological Surveillance of Health Status of Resident Population Around the Waste Treatment Plants) assessed the impact on health of residents nearby incinerators, landfills and mechanical biological treatment plants in five Italian regions (Emilia-Romagna, Piedmont, Lazio, Campania, and Sicily). The assessment procedure took into account the available knowledge on health effects of waste disposal facilities. Analyses were related to three different scenarios: a Baseline scenario, referred to plants active in 2008-2009; the regional future scenario, with plants expected in the waste regional plans; a virtuous scenario (Green 2020), based on a policy management of municipal solid waste (MSW) through the reduction of production and an intense recovery policy. Facing with a total population of around 24 million for the 5 regions, the residents nearby the plants were more than 380,000 people at Baseline. Such a population is reduced to approximately 330.000 inhabitants and 170.000 inhabitants in the regional and Green 2020 scenarios, respectively. The health impact was assessed for the period 2008-2040. At Baseline, 1-2 cases per year of cancer attributable to MSW plants were estimated, as well as 26 cases per year of adverse pregnancy outcomes (including low birth weight and birth defects), 102 persons with respiratory symptoms, and about a thousand affected from annoyance caused by odours. These annual estimates are translated into 2,725 years of life with disability (DALYs) estimated for the entire period. The DALYs are reduced by approximately 20% and 80% in the two future scenarios. Even in these cases, health impact is given by the greater effects on pregnancy and the annoyance associated with the odours of plants. In spite of the limitations due to the inevitable assumptions required by the present exercise, the proposed methodology is suitable for a first approach to assess different policies that can be adopted in regional planning in

  3. Improving health through policies that promote active travel: a review of evidence to support integrated health impact assessment.

    Science.gov (United States)

    de Nazelle, Audrey; Nieuwenhuijsen, Mark J; Antó, Josep M; Brauer, Michael; Briggs, David; Braun-Fahrlander, Charlotte; Cavill, Nick; Cooper, Ashley R; Desqueyroux, Hélène; Fruin, Scott; Hoek, Gerard; Panis, Luc Int; Janssen, Nicole; Jerrett, Michael; Joffe, Michael; Andersen, Zorana Jovanovic; van Kempen, Elise; Kingham, Simon; Kubesch, Nadine; Leyden, Kevin M; Marshall, Julian D; Matamala, Jaume; Mellios, Giorgos; Mendez, Michelle; Nassif, Hala; Ogilvie, David; Peiró, Rosana; Pérez, Katherine; Rabl, Ari; Ragettli, Martina; Rodríguez, Daniel; Rojas, David; Ruiz, Pablo; Sallis, James F; Terwoert, Jeroen; Toussaint, Jean-François; Tuomisto, Jouni; Zuurbier, Moniek; Lebret, Erik

    2011-05-01

    Substantial policy changes to control obesity, limit chronic disease, and reduce air pollution emissions, including greenhouse gasses, have been recommended. Transportation and planning policies that promote active travel by walking and cycling can contribute to these goals, potentially yielding further co-benefits. Little is known, however, about the interconnections among effects of policies considered, including potential unintended consequences. We review available literature regarding health impacts from policies that encourage active travel in the context of developing health impact assessment (HIA) models to help decision-makers propose better solutions for healthy environments. We identify important components of HIA models of modal shifts in active travel in response to transport policies and interventions. Policies that increase active travel are likely to generate large individual health benefits through increases in physical activity for active travelers. Smaller, but population-wide benefits could accrue through reductions in air and noise pollution. Depending on conditions of policy implementations, risk tradeoffs are possible for some individuals who shift to active travel and consequently increase inhalation of air pollutants and exposure to traffic injuries. Well-designed policies may enhance health benefits through indirect outcomes such as improved social capital and diet, but these synergies are not sufficiently well understood to allow quantification at this time. Evaluating impacts of active travel policies is highly complex; however, many associations can be quantified. Identifying health-maximizing policies and conditions requires integrated HIAs. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Health impact assessment on urban development projects in France: finding pathways to fit practice to context.

    Science.gov (United States)

    Roué-Le Gall, Anne; Jabot, Françoise

    2017-06-01

    In France, there is increasing interest in health impact assessments (HIAs) and most are performed on urban projects. The field of expertise is still under development and mostly established within the public health sector. To date, in France, all HIAs conducted in urban planning are stand-alone HIAs disconnected from the required environmental impact assessment (EIA). The paper opens with an introduction of the close and complex relationship between health and urban planning, HIA and a description of key elements needed for understanding the French context. Then, the paper analyses the context and the implementation process for four HIAs in progress in order to understand the specific characteristics of urban development, identify the key stages for introducing a health perspective into urban projects, and extract avenues to be explored when adapting HIAs applied to urban planning in France. Using a qualitative multiple case study design, an analysis framework was built to compare several aspects of the four HIAs and made it possible to highlight three pathways for adapting HIA to the urban planning sector: the schedule, links between the EIA and HIA, and the complementarity of the initiatives to involve residents. Legal measures enable a point of contact that brings health institutions and cities closer together. HIA is yet another tool that public authorities now have at their fingertips to work together in strengthening democracy and in reducing social, geographical and environmental health inequalities. More research must be undertaken to develop an understanding of the practice-related context; to judge HIA's capacity to draw on existing approaches in different fields; and to explore the different avenues leading to increased health, wellbeing and equity.

  5. Health effects from indoor and outdoor exposure to fine particulate matter in life cycle impact assessment

    DEFF Research Database (Denmark)

    McKone, T.E.; Fantke, Peter

    2016-01-01

    Fine particulate matter (PM2.5) pollution has been estimated to contribute more than 7% to the total global human disease burden from 1990 to 2013 (http://healthdata.org/gbd). Ambient (outdoor) and household indoor PM2.5 exposures are reported to account for 41% and 58% of this impact, respectively......, emphasizing the need to include both, outdoor and indoor exposure into overall estimates of healt h burdens in life cycle impact assessment. However, lacking clear guidance on how to consistently include health effects from exposure to PM2.5 in life cycle perspective, practitioners fail to report related life...... cycle impacts. To address this gap, a global initiative has worked on building a coupled indoor-outdoor intake fraction framework combining exposure to PM2.5 emitted indoors and outdoors with exposure to PM2.5 formed indoors and outdoors from chemical reactions. An exposure-response model derived from...

  6. Assessment of impact on health of children working in the garbage dumping site in Dhaka, Bangladesh.

    Science.gov (United States)

    Lahiry, Gargy; Rahman, Tania; Hasan, A K M Mahbub; Dutta, Alak K; Arif, Md; Howlader, Zakir H

    2011-12-01

    Waste dumping is one of the major causes of environment pollution in Bangladesh. This study was designed to assess the impact on health of children working in one of the garbage dumping sites in Dhaka. Blood samples were collected from exposed (n = 20, aged: 8-15 years, exposed to dumped garbage from 6 months to 6 years) and control subjects (n = 15, age matched and never worked in the garbage dumping site). Oxidative stress markers like lipid hydroperoxides, thiobarbituric acid reactive substances and protein carbonyl content were measured. Alkaline comet assay was performed to assess the possible damage in DNA. To check the consequences of possible toxic exposure, we performed liver function tests of the study subjects. Oxidative stress-mediated damage of macromolecules was found to be significantly increased in the exposed children. Liver function tests were found normal. Thus, the children working in garbage dumping site are in severe health risk.

  7. Health impact assessment of waste management facilities in three European countries

    Directory of Open Access Journals (Sweden)

    Preiss Philipp

    2011-06-01

    Full Text Available Abstract Background Policies on waste disposal in Europe are heterogeneous and rapidly changing, with potential health implications that are largely unknown. We conducted a health impact assessment of landfilling and incineration in three European countries: Italy, Slovakia and England. Methods A total of 49 (Italy, 2 (Slovakia, and 11 (England incinerators were operating in 2001 while for landfills the figures were 619, 121 and 232, respectively. The study population consisted of residents living within 3 km of an incinerator and 2 km of a landfill. Excess risk estimates from epidemiological studies were used, combined with air pollution dispersion modelling for particulate matter (PM10 and nitrogen dioxide (NO2. For incinerators, we estimated attributable cancer incidence and years of life lost (YoLL, while for landfills we estimated attributable cases of congenital anomalies and low birth weight infants. Results About 1,000,000, 16,000, and 1,200,000 subjects lived close to incinerators in Italy, Slovakia and England, respectively. The additional contribution to NO2 levels within a 3 km radius was 0.23, 0.15, and 0.14 μg/m3, respectively. Lower values were found for PM10. Assuming that the incinerators continue to operate until 2020, we are moderately confident that the annual number of cancer cases due to exposure in 2001-2020 will reach 11, 0, and 7 in 2020 and then decline to 0 in the three countries in 2050. We are moderately confident that by 2050, the attributable impact on the 2001 cohort of residents will be 3,621 (Italy, 37 (Slovakia and 3,966 (England YoLL. The total exposed population to landfills was 1,350,000, 329,000, and 1,425,000 subjects, respectively. We are moderately confident that the annual additional cases of congenital anomalies up to 2030 will be approximately 2, 2, and 3 whereas there will be 42, 13, and 59 additional low-birth weight newborns, respectively. Conclusions The current health impacts of landfilling and

  8. Health impact assessment of waste management facilities in three European countries

    Science.gov (United States)

    2011-01-01

    Background Policies on waste disposal in Europe are heterogeneous and rapidly changing, with potential health implications that are largely unknown. We conducted a health impact assessment of landfilling and incineration in three European countries: Italy, Slovakia and England. Methods A total of 49 (Italy), 2 (Slovakia), and 11 (England) incinerators were operating in 2001 while for landfills the figures were 619, 121 and 232, respectively. The study population consisted of residents living within 3 km of an incinerator and 2 km of a landfill. Excess risk estimates from epidemiological studies were used, combined with air pollution dispersion modelling for particulate matter (PM10) and nitrogen dioxide (NO2). For incinerators, we estimated attributable cancer incidence and years of life lost (YoLL), while for landfills we estimated attributable cases of congenital anomalies and low birth weight infants. Results About 1,000,000, 16,000, and 1,200,000 subjects lived close to incinerators in Italy, Slovakia and England, respectively. The additional contribution to NO2 levels within a 3 km radius was 0.23, 0.15, and 0.14 μg/m3, respectively. Lower values were found for PM10. Assuming that the incinerators continue to operate until 2020, we are moderately confident that the annual number of cancer cases due to exposure in 2001-2020 will reach 11, 0, and 7 in 2020 and then decline to 0 in the three countries in 2050. We are moderately confident that by 2050, the attributable impact on the 2001 cohort of residents will be 3,621 (Italy), 37 (Slovakia) and 3,966 (England) YoLL. The total exposed population to landfills was 1,350,000, 329,000, and 1,425,000 subjects, respectively. We are moderately confident that the annual additional cases of congenital anomalies up to 2030 will be approximately 2, 2, and 3 whereas there will be 42, 13, and 59 additional low-birth weight newborns, respectively. Conclusions The current health impacts of landfilling and incineration can be

  9. The role of Health Impact Assessment in the setting of air quality standards: An Australian perspective

    Energy Technology Data Exchange (ETDEWEB)

    Spickett, Jeffery, E-mail: J.Spickett@curtin.edu.au [WHO Collaborating Centre for Environmental Health Impact Assessment (Australia); Faculty of Health Sciences, School of Public Health, Curtin University, Perth, Western Australia (Australia); Katscherian, Dianne [WHO Collaborating Centre for Environmental Health Impact Assessment (Australia); Faculty of Health Sciences, School of Public Health, Curtin University, Perth, Western Australia (Australia); Harris, Patrick [CHETRE — UNSW Research Centre for Primary Health Care and Equity, University of New South Wales (Australia)

    2013-11-15

    The approaches used for setting or reviewing air quality standards vary from country to country. The purpose of this research was to consider the potential to improve decision-making through integration of HIA into the processes to review and set air quality standards used in Australia. To assess the value of HIA in this policy process, its strengths and weaknesses were evaluated aligned with review of international processes for setting air quality standards. Air quality standard setting programmes elsewhere have either used HIA or have amalgamated and incorporated factors normally found within HIA frameworks. They clearly demonstrate the value of a formalised HIA process for setting air quality standards in Australia. The following elements should be taken into consideration when using HIA in standard setting. (a) The adequacy of a mainly technical approach in current standard setting procedures to consider social determinants of health. (b) The importance of risk assessment criteria and information within the HIA process. The assessment of risk should consider equity, the distribution of variations in air quality in different locations and the potential impacts on health. (c) The uncertainties in extrapolating evidence from one population to another or to subpopulations, especially the more vulnerable, due to differing environmental factors and population variables. (d) The significance of communication with all potential stakeholders on issues associated with the management of air quality. In Australia there is also an opportunity for HIA to be used in conjunction with the NEPM to develop local air quality standard measures. The outcomes of this research indicated that the use of HIA for air quality standard setting at the national and local levels would prove advantageous. -- Highlights: • Health Impact Assessment framework has been applied to a policy development process. • HIA process was evaluated for application in air quality standard setting.

  10. Radiation environment assessment, measurement and its impact on health and sustainable development

    International Nuclear Information System (INIS)

    Kumar, Pradeep; Panwar, Brijandra Singh

    2012-01-01

    Present paper deals with Radiation Environment Assessment, Measurement and its Impact on Health, its meaning and in particular with sustainable development perspective. Health and Environment appears to be different subjects and concepts, but in reality they are interrelated and interdependent. One cannot exist without the other. For good health hygienic environment is a sine qua non. Article 3 of Universal Declaration of Human Right 1948 incorporates the right to life. It has been interpreted by the international court that the word life does not means simply to live but it means to live with dignity and in well and pollution and radiation free environment which is a gift of nature on this universe. There is no doubt about the nuclear revolution that has taken place and has made life of human beings worth living on this earth with comfort. It is growing development of the nation. But in the process the development that has been done at the cost of human life, public health and environment which will prove fatal in the long run. So there is a need for Sustainable Development of the human and environment of the world. Precisely and concisely, the sustainable development is a process that meets the needs of the present without compromising ability of future generations to meet their own needs. A hygienic and redaction free environment will ensure the better Health of the people. Environment and nuclear power plant can coexist. The harmonization of the two needs has led to the concept of Radiation Environment Assessment and sustainable development, so much so that it has become the most significant and focal point of environmental legislation relating to the same. Sustainable development, simply put, is a process in which development can be sustained over generations effects of radiation on humans and on the environment. Finally, this paper deals with the impact of radiation on environment and the need of sustainable development for achieving a better human. (author)

  11. The State of Alaska's early experience with institutionalization of health impact assessment.

    Science.gov (United States)

    Anderson, Paul J; Yoder, Sarah; Fogels, Ed; Krieger, Gary; McLaughlin, Joseph

    2013-01-01

    Many nations routinely include health impact assessments (HIA) in public policy decisions. Institutionalization of HIA formally integrates health considerations into a governmental decision-making process. We describe an example of institutionalization in the United States through Alaska's early experience with institutionalization of HIA. HIA arose from a series of health conferences in the 1970s that affirmed the importance of "health for all." A number of key milestones eventually defined HIA as a unique field of impact assessment. There are several approaches to institutionalization, and one common approach in the United States is through the National Environmental Policy Act (NEPA). NEPA formed the basis for the earliest HIAs in Alaska. Early HIAs in Alaska led to conferences, working groups, a state guidance document and the institutionalization of a HIA program within the Department of Health and Social Services in 2010. A medical epidemiologist staffs the program, which utilizes contractors to meet rising demand for HIA. The HIA program has sustainable funding from the state budget and from the state's natural resource permitting process. The HIA document is the main deliverable, but the program performs other tasks, including fieldwork and technical reviews. The HIA program works closely with a host of collaborative partners. Alaska's institutionalized HIA program benefits from sustainable funding that promotes continuous quality improvement and involves the program in the entire life cycle of a development project. The program structure adapts well to variations in workflow and supports a host of quality control activities. Currently, the program focuses on HIAs for natural resource development projects.

  12. The State of Alaska's early experience with institutionalization of health impact assessment

    Directory of Open Access Journals (Sweden)

    Paul J. Anderson

    2013-08-01

    Full Text Available Background . Many nations routinely include health impact assessments (HIA in public policy decisions. Institutionalization of HIA formally integrates health considerations into a governmental decision-making process. We describe an example of institutionalization in the United States through Alaska's early experience with institutionalization of HIA. Literature review . HIA arose from a series of health conferences in the 1970s that affirmed the importance of “health for all.” A number of key milestones eventually defined HIA as a unique field of impact assessment. There are several approaches to institutionalization, and one common approach in the United States is through the National Environmental Policy Act (NEPA. NEPA formed the basis for the earliest HIAs in Alaska. Program description . Early HIAs in Alaska led to conferences, working groups, a state guidance document and the institutionalization of a HIA program within the Department of Health and Social Services in 2010. A medical epidemiologist staffs the program, which utilizes contractors to meet rising demand for HIA. The HIA program has sustainable funding from the state budget and from the state's natural resource permitting process. The HIA document is the main deliverable, but the program performs other tasks, including fieldwork and technical reviews. The HIA program works closely with a host of collaborative partners. Conclusion . Alaska's institutionalized HIA program benefits from sustainable funding that promotes continuous quality improvement and involves the program in the entire life cycle of a development project. The program structure adapts well to variations in workflow and supports a host of quality control activities. Currently, the program focuses on HIAs for natural resource development projects.

  13. [Health and environmental licensing: a methodological proposal for assessment of the impact of the oil and gas industry].

    Science.gov (United States)

    Barbosa, Eduardo Macedo; Barata, Matha Macedo de Lima; Hacon, Sandra de Souza

    2012-02-01

    Bearing in mind the importance of the impacts of the oil industry on human health, this article seeks to present a methodological proposal for analysis of these aspects in environmental impact assessment studies, based on the established legal parameters and a validated matrix for the hydroelectric sector. The lack of health considerations in the environmental impact assessment was detected in most of the 21 oil production enterprises analyzed, that were licensed in the period from January 1, 2004 through October 30, 2009. The health matrix proved to be an appropriate methodological approach to analyze these aspects in the environmental licensing process, guiding decisions and interventions in socio-environmental management.

  14. Environmental Modeling and Bayesian Analysis for Assessing Human Health Impacts from Radioactive Waste Disposal

    Science.gov (United States)

    Stockton, T.; Black, P.; Tauxe, J.; Catlett, K.

    2004-12-01

    Bayesian decision analysis provides a unified framework for coherent decision-making. Two key components of Bayesian decision analysis are probability distributions and utility functions. Calculating posterior distributions and performing decision analysis can be computationally challenging, especially for complex environmental models. In addition, probability distributions and utility functions for environmental models must be specified through expert elicitation, stakeholder consensus, or data collection, all of which have their own set of technical and political challenges. Nevertheless, a grand appeal of the Bayesian approach for environmental decision- making is the explicit treatment of uncertainty, including expert judgment. The impact of expert judgment on the environmental decision process, though integral, goes largely unassessed. Regulations and orders of the Environmental Protection Agency, Department Of Energy, and Nuclear Regulatory Agency orders require assessing the impact on human health of radioactive waste contamination over periods of up to ten thousand years. Towards this end complex environmental simulation models are used to assess "risk" to human and ecological health from migration of radioactive waste. As the computational burden of environmental modeling is continually reduced probabilistic process modeling using Monte Carlo simulation is becoming routinely used to propagate uncertainty from model inputs through model predictions. The utility of a Bayesian approach to environmental decision-making is discussed within the context of a buried radioactive waste example. This example highlights the desirability and difficulties of merging the cost of monitoring, the cost of the decision analysis, the cost and viability of clean up, and the probability of human health impacts within a rigorous decision framework.

  15. The use of expert elicitation in environmental health impact assessment: a seven step procedure

    Directory of Open Access Journals (Sweden)

    van der Sluijs Jeroen P

    2010-04-01

    Full Text Available Abstract Background Environmental health impact assessments often have to deal with substantial uncertainties. Typically, the knowledge-base is limited with incomplete, or inconsistent evidence and missing or ambiguous data. Consulting experts can help to identify and address uncertainties. Methods Formal expert elicitation is a structured approach to systematically consult experts on uncertain issues. It is most often used to quantify ranges for poorly known parameters, but may also be useful to further develop qualitative issues such as definitions, assumptions or conceptual (causal models. A thorough preparation and systematic design and execution of an expert elicitation process may increase the validity of its outcomes and transparency and trustworthiness of its conclusions. Various expert elicitation protocols and methods exist. However, these are often not universally applicable, and need customization to suite the needs of a specific study. In this paper, we set out to develop a widely applicable method for the use of expert elicitation in environmental health impact assessment. Results We present a practical yet flexible seven step procedure towards organising expert elicitation in the context of environmental health impact assessment, based on existing protocols. We describe how customization for specific applications is always necessary. In particular, three issues affect the choice of methods for a particular application: the types of uncertainties considered, the intended use of the elicited information, and the available resources. We outline how these three considerations guide choices regarding the design and execution of expert elicitation. We present signposts to sources where the issues are discussed in more depth to give the newcomer the insights needed to make the protocol work. The seven step procedure is illustrated using examples from earlier published elicitations in the field of environmental health research

  16. Assessing the impact of hazardous waste on children's health: The exposome paradigm.

    Science.gov (United States)

    Sarigiannis, D A

    2017-10-01

    Assessment of the health impacts related to hazardous waste is a major scientific challenge with multiple societal implications. Most studies related to associations between hazardous waste and public health do not provide established of mechanistic links between environmental exposure and disease burden, resulting in ineffective waste management options. The exposome concept comes to overhaul the nature vs. nurture paradigm and embraces a world of dynamic interactions between environmental exposures, endogenous exposures and genetic expression in humans. In this context, the exposome paradigm provides a novel tool for holistic hazardous waste management. Waste streams and the related contamination of environmental media are not viewed in isolation, but rather as components of the expotype, the vector of exposures an individual is exposed to over time. Thus, a multi-route and multi-pathway exposure estimation can be performed setting a realistic basis for integrated health risk assessment. Waste management practices are thus assessed not only regarding their technological edge and efficacy but also their effects on human health at the individual and community level, considering intra-subject variability in the affected population. The effectiveness of the exposome approach is demonstrated in the case of Athens, the capital of Greece, where the health effects associated to long term and short term exposure to two major waste management facilities (landfill and plastic recycling) are presented. Using the exposome analysis tools, we confirmed that proximity to a landfill is critical for children neurodevelopment. However, this effect is significantly modified by parameters such as parental education level, socioeconomic status and nutrition. Proximity to a plastics recycling plant does not pose significant threats under normal operating conditions; yet, in the case of an accidental fire, release of persistent carcinogenic compounds (dioxins and furans) even for a

  17. Advancing the practice of health impact assessment in Canada: Obstacles and opportunities

    International Nuclear Information System (INIS)

    McCallum, Lindsay C.; Ollson, Christopher A.; Stefanovic, Ingrid L.

    2015-01-01

    Health Impact Assessment (HIA) is recognized as a useful tool that can identify potential health impacts resulting from projects or policy initiatives. Although HIA has become an established practice in some countries, it is not yet an established practice in Canada. In order to enable broader support for HIA, this study provides a comprehensive review and analysis of the peer-reviewed and gray literature on the state of HIA practice. The results of this review revealed that, although there is an abundance of publications relating to HIA, there remains a lack of transparent, consistent and reproducible approaches and methods throughout the process. Findings indicate a need for further research and development on a number of fronts, including: 1) the nature of HIA triggers; 2) consistent scoping and stakeholder engagement approaches; 3) use of evidence and transparency of decision-making; 4) reproducibility of assessment methods; 5) monitoring and evaluation protocols; and, 6) integration within existing regulatory frameworks. Addressing these issues will aid in advancing the more widespread use of HIA in Canada. - Highlights: • Reviewed current state of practice in the field of HIA • Identified key obstacles and opportunities for HIA advancement • Major issues include lack of consistent approach and methodology. • No national regulatory driver hinders opportunity for widespread use of HIA. • Identified research opportunities vital to developing HIA practice in Canada

  18. The first three years of the Journal of Global Health: Assessing the impact

    Directory of Open Access Journals (Sweden)

    Igor Rudan

    2014-06-01

    Full Text Available The Journal of Global Health (JoGH is three years old. To assess its impact, we analysed online access to JoGH’s articles using PubMed Central and Google Analytics tools. Moreover, we tracked citations that JoGH received in 2013 using ISI Web of KnowledgeSM and Google Scholar® tools. The 66 items (articles, viewpoints and editorials published between June 2011 and December 2013 were accessed more than 50 000 times during 2013, from more than 160 countries of the world. Seven among the 13 most accessed papers were focused on global, regional and national epidemiological estimates of important infectious diseases. JoGH articles published in 2011 and 2012 received 77 citations in Journal Citation Reports® (JCR–indexed journals in 2013 to 24 original research articles, setting our first, unofficial impact factor at 3.208. In addition, JoGH received 11 citations during 2013 to its 12 original research papers published during 2013, resulting in an immediacy index of 0.917. The number of external, non–commissioned submissions that we consider to be of high quality is continuously increasing, leading to current JoGH’s rejection rate of about 80%. The current citation analysis raises favourable expectations for the JoGH’s overall impact on the global health community in future years.

  19. The Politics of Healthy Policies: Redesigning health impact assessment to integrate health in public policy

    NARCIS (Netherlands)

    M.P.M. Bekker (Marleen)

    2007-01-01

    textabstractPublic health issues, such as obesity, lung disease from air pollution or mental health complaints from living in an unsafe neighbourhood, are complex, intractable policy problems. The causes are dispersed at the individual and the collective level among different societal

  20. Government use licenses in Thailand: an assessment of the health and economic impacts

    Directory of Open Access Journals (Sweden)

    Chaisiri Kakanang

    2011-08-01

    Full Text Available Abstract Background Between 2006 and 2008, Thailand's Ministry of Public Health (MOPH granted government use licenses for seven patented drugs in order to improve access to these essential treatments. The decision to grant the government use licenses was contentious both within and beyond the country. In particular, concerns were highlighted that the negative consequences might outweigh the expected benefits of the policy. This study conducted assessments of the health and economic implications of these government use licenses. Methods The health and health-related economic impacts were quantified in terms of i Quality Adjusted Life Years (QALYs gained and ii increased productivity in US dollars (USD as a result of the increased access to drugs. The study adopted a five-year timeframe for the assessment, commencing from the time of the grant of the government use licenses. Empirical evidence gathered from national databases was used to assess the changes in volume of exports after US Generalized System of Preferences (GSP withdrawal and level of foreign direct investment (FDI. Results As a result of the granting of the government use licenses, an additional 84,158 patients were estimated to have received access to the seven drugs over five years. Health gains from the use of the seven drugs compared to their best alternative accounted for 12,493 QALYs gained, which translates into quantifiable incremental benefits to society of USD132.4 million. The government use license on efavirenze was found to have the greatest benefit. In respect of the country's economy, the study found that Thailand's overall exports increased overtime, although exports of the three US GSP withdrawal products to the US did decline. There was also found to be no relationship between the government use licenses and the level of foreign investment over the period 2002 to 2008. Conclusions The public health benefits of the government use licenses were generally positive

  1. What is the impact of disease prevalence upon health technology assessment?

    Science.gov (United States)

    Rotily, Michel; Roze, Stéphane

    2013-12-01

    As national budgets for health care will remain under stress for the foreseeable future, health technology assessment (HTA) aimed at offering guidance to policy-making will have an increasing role to play in optimizing resources. The emergence of new treatment paradigms and health technologies, and the prevalence studies which determine when a disease is a current or future burden for patients and the community are in the roots of the HTA process. Analysing studies on screening test strategies and health care policy, this paper revisits two key concepts in epidemiology, prevalence and incidence, in order to show their major impact upon HTA. Utilization of the predictive values of screening tests that include prevalence in their calculations, and analysing all options for screening strategies are necessary in HTA. Cost-effectiveness analyses and statistical models should include potential externalities, especially the impact of prevention and treatment on infectious disease prevalence. Beyond estimates of cost-effectiveness ratios, decision makers also need to know by how much their annual health care budget is likely to increase or decrease in the years following the emergence of new technologies: hence the importance of incidence- or prevalence-based economic evaluations. As new paradigms are occurring, especially in the field of oncology, with treatments targeted to 'small' groups of patients identified through genetic testing, prevalence data are strongly needed. Precise estimates of disease prevalence, in general populations as well as in risk or targeted groups, will therefore be necessary to improve HTA process. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Assessing concentrations and health impacts of air quality management strategies: Framework for Rapid Emissions Scenario and Health impact ESTimation (FRESH-EST).

    Science.gov (United States)

    Milando, Chad W; Martenies, Sheena E; Batterman, Stuart A

    2016-09-01

    In air quality management, reducing emissions from pollutant sources often forms the primary response to attaining air quality standards and guidelines. Despite the broad success of air quality management in the US, challenges remain. As examples: allocating emissions reductions among multiple sources is complex and can require many rounds of negotiation; health impacts associated with emissions, the ultimate driver for the standards, are not explicitly assessed; and long dispersion model run-times, which result from the increasing size and complexity of model inputs, limit the number of scenarios that can be evaluated, thus increasing the likelihood of missing an optimal strategy. A new modeling framework, called the "Framework for Rapid Emissions Scenario and Health impact ESTimation" (FRESH-EST), is presented to respond to these challenges. FRESH-EST estimates concentrations and health impacts of alternative emissions scenarios at the urban scale, providing efficient computations from emissions to health impacts at the Census block or other desired spatial scale. In addition, FRESH-EST can optimize emission reductions to meet specified environmental and health constraints, and a convenient user interface and graphical displays are provided to facilitate scenario evaluation. The new framework is demonstrated in an SO2 non-attainment area in southeast Michigan with two optimization strategies: the first minimizes emission reductions needed to achieve a target concentration; the second minimizes concentrations while holding constant the cumulative emissions across local sources (e.g., an emissions floor). The optimized strategies match outcomes in the proposed SO2 State Implementation Plan without the proposed stack parameter modifications or shutdowns. In addition, the lower health impacts estimated for these strategies suggest that FRESH-EST could be used to identify potentially more desirable pollution control alternatives in air quality management planning

  3. Educational impact of an assessment of medical students' collaboration in health care teams.

    Science.gov (United States)

    Olupeliyawa, Asela; Balasooriya, Chinthaka; Hughes, Chris; O'Sullivan, Anthony

    2014-02-01

    This paper explores how structured feedback and other features of workplace-based assessment (WBA) impact on medical students' learning in the context of an evaluation of a workplace-based performance assessment: the teamwork mini-clinical evaluation exercise (T-MEX). The T-MEX enables observation-based measurement of and feedback on the behaviours required to collaborate effectively as a junior doctor within the health care team. The instrument is based on the mini-clinical evaluation exercise (mini-CEX) format and focuses on clinical encounters such as consultations with medical and allied health professionals, discharge plan preparation, handovers and team meetings. The assessment was implemented during a 6-week period in 2010 with 25 medical students during their final clinical rotation. Content analysis was conducted on the written feedback provided by 23 assessors and the written reflections and action plans proposed by the 25 student participants (in 88 T-MEX forms). Semi-structured interviews with seven assessors and three focus groups with 14 student participants were conducted and the educational impact was explored through thematic analysis. The study enabled the identification of features of WBA that promote the development of collaborative competencies. The focus of the assessment on clinical encounters and behaviours important for collaboration provided opportunities for students to engage with the health care team and highlighted the role of teamwork in these encounters. The focus on specific behaviours and a stage-appropriate response scale helped students identify learning goals and facilitated the provision of focused feedback. Incorporating these features within an established format helped students and supervisors to engage with the instrument. Extending the format to include structured reflection enabled students to self-evaluate and develop plans for improvement. The findings illuminate the mechanisms by which WBA facilitates learning. The

  4. Air pollution as a risk factor in health impact assessments of a travel mode shift towards cycling.

    Science.gov (United States)

    Raza, Wasif; Forsberg, Bertil; Johansson, Christer; Sommar, Johan Nilsson

    2018-01-01

    Promotion of active commuting provides substantial health and environmental benefits by influencing air pollution, physical activity, accidents, and noise. However, studies evaluating intervention and policies on a mode shift from motorized transport to cycling have estimated health impacts with varying validity and precision. To review and discuss the estimation of air pollution exposure and its impacts in health impact assessment studies of a shift in transport from cars to bicycles in order to guide future assessments. A systematic database search of PubMed was done primarily for articles published from January 2000 to May 2016 according to PRISMA guidelines. We identified 18 studies of health impact assessment of change in transport mode. Most studies investigated future hypothetical scenarios of increased cycling. The impact on the general population was estimated using a comparative risk assessment approach in the majority of these studies, whereas some used previously published cost estimates. Air pollution exposure during cycling was estimated based on the ventilation rate, the pollutant concentration, and the trip duration. Most studies employed exposure-response functions from studies comparing background levels of fine particles between cities to estimate the health impacts of local traffic emissions. The effect of air pollution associated with increased cycling contributed small health benefits for the general population, and also only slightly increased risks associated with fine particle exposure among those who shifted to cycling. However, studies calculating health impacts based on exposure-response functions for ozone, black carbon or nitrogen oxides found larger effects attributed to changes in air pollution exposure. A large discrepancy between studies was observed due to different health impact assessment approaches, different assumptions for calculation of inhaled dose and different selection of dose-response functions. This kind of assessments

  5. Air pollution as a risk factor in health impact assessments of a travel mode shift towards cycling

    Science.gov (United States)

    Raza, Wasif; Forsberg, Bertil; Johansson, Christer; Sommar, Johan Nilsson

    2018-01-01

    ABSTRACT Background: Promotion of active commuting provides substantial health and environmental benefits by influencing air pollution, physical activity, accidents, and noise. However, studies evaluating intervention and policies on a mode shift from motorized transport to cycling have estimated health impacts with varying validity and precision. Objective: To review and discuss the estimation of air pollution exposure and its impacts in health impact assessment studies of a shift in transport from cars to bicycles in order to guide future assessments. Methods: A systematic database search of PubMed was done primarily for articles published from January 2000 to May 2016 according to PRISMA guidelines. Results: We identified 18 studies of health impact assessment of change in transport mode. Most studies investigated future hypothetical scenarios of increased cycling. The impact on the general population was estimated using a comparative risk assessment approach in the majority of these studies, whereas some used previously published cost estimates. Air pollution exposure during cycling was estimated based on the ventilation rate, the pollutant concentration, and the trip duration. Most studies employed exposure-response functions from studies comparing background levels of fine particles between cities to estimate the health impacts of local traffic emissions. The effect of air pollution associated with increased cycling contributed small health benefits for the general population, and also only slightly increased risks associated with fine particle exposure among those who shifted to cycling. However, studies calculating health impacts based on exposure-response functions for ozone, black carbon or nitrogen oxides found larger effects attributed to changes in air pollution exposure. Conclusion: A large discrepancy between studies was observed due to different health impact assessment approaches, different assumptions for calculation of inhaled dose and different

  6. Medico-ecological study and health impact assessment of hydro-electric projects in Malaysia

    International Nuclear Information System (INIS)

    Karen Lai

    1996-01-01

    The objectives of this studies were to determine i) if there was any potential health risks in terms of spread of vector-borne and other communicable diseases resulting from the changes in the environment due to creation of large bodies of water as consequence of the construction of dams, ii) diseases of public health importance in populations affected by such projects. Nine pre-impoundment studies had been carried out and potential impact of the change in environment on discases and health of the affected populations in each areas was evaluated. Risk of infections to the dam construction workers also assessed. Recommendations on mitigation measures were made for each situation so that adequate provisions could be made to improve the health conditions of these populations especially those who would be resettled as a result of impoundment . Prevention and control measures on transmission of infection, including vector control were proposed. The potential medico-ecological hazards encountered by immigrants and visitors to the area on completion of the hydro project were also envisaged

  7. Implementing Health Impact Assessment Programs in State Health Agencies: Lessons Learned From Pilot Programs, 2009-2011.

    Science.gov (United States)

    Goff, Nancy; Wyss, Kerry; Wendel, Arthur; Jarris, Paul

    2016-01-01

    Health Impact Assessment (HIA) has emerged as a promising tool to integrate health considerations into decision making. The growth and success of HIA practice in the United States will be dependent on building the capacity of practitioners. This article seeks to identify the role of state health agencies (SHAs) in building capacity for conducting HIAs and the key components of initiatives that produced effective HIAs and HIA programs. The authors proposed to answer 3 research questions: (1) What can be the role of the SHA in HIA? (2) What are the characteristics of successful state HIA programs? and (3) What are some effective strategies for building capacity for HIA in SHAs and local health departments? The authors reviewed program reports from the ASTHO's pilot state health agencies (California, Minnesota, Oregon, and Wisconsin) that, between 2009 and 2011, created HIA programs to provide HIA training, conduct HIAs, and build practitioner networks. Program reports were examined for shared themes on the role of SHAs in a statewide HIA initiative, the characteristics of successful programs, and effective strategies for building capacity. Despite differences among the programs, many shared themes existed. These include stressing the importance of a basic, sustained infrastructure for HIA practice; leveraging existing programs and networks; and working in partnership with diverse stakeholders. SHAs can build capacity for HIA, and SHAs can both lead and support the completion of individual HIAs. States and territories interested in starting comprehensive statewide HIA initiatives could consider implementing the strategies identified by the pilot programs.

  8. CONTRIBUTION OF STAKEHOLDER ENGAGEMENT TO THE IMPACT OF A HEALTH TECHNOLOGY ASSESSMENT: AN IRISH CASE STUDY.

    Science.gov (United States)

    Ryan, Máirín; Moran, Patrick S; Harrington, Patricia; Murphy, Linda; O'Neill, Michelle; Whelan, Marty; Teljeur, Conor

    2017-01-01

    The aim of this study was to illustrate the contribution of stakeholder engagement to the impact of health technology assessment (HTA) using an Irish HTA of a national public access defibrillation (PAD) program. In response to draft legislation that proposed a PAD program, the Minister for Health requested that Health Information and Quality Authority undertake an HTA to inform the design and implementation of a national PAD program and the necessary underpinning legislation. The draft legislation outlined a program requiring widespread installation and maintenance of automatic external defibrillators in specified premises. Stakeholder engagement to optimize the impact of the HTA included one-to-one interviews with politicians, engagement with an Expert Advisory Group, public and targeted consultation, and positive media management. The HTA quantified the clinical benefits of the proposed PAD program as modest, identified that substantial costs would fall on small/medium businesses at a time of economic recession, and that none of the programs modeled were cost-effective. The Senator who proposed the Bill actively publicized the HTA process and its findings and encouraged participation in the public consultation. Participation of key stakeholders was important for the quality and acceptability of the HTA findings and advice. Media management promoted public engagement and understanding. The Bill did not progress. The HTA informed the decision not to progress with legislation for a national PAD program. Engagement was tailored to ensure that key stakeholders including politicians and the public were informed of the HTA process, the findings, and the advice, thereby maximizing acceptance. Appropriate stakeholder engagement optimizes the impact of HTA.

  9. The fit between health impact assessment and public policy: practice meets theory.

    Science.gov (United States)

    Harris, Patrick; Sainsbury, Peter; Kemp, Lynn

    2014-05-01

    The last decade has seen increased use of health impact assessment (HIA) to influence public policies developed outside the Health sector. HIA has developed as a structured, linear and technical process to incorporate health, broadly defined, into policy. This is potentially incongruent with complex, non-linear and tactical policy making which does not necessarily consider health. HIA research has however not incorporated existing public policy theory to explain practitioners' experiences with HIA and policy. This research, therefore, used public policy theory to explain HIA practitioners' experiences and investigate 'What is the fit between HIA and public policy?' Empirical findings from nine in-depth interviews with international HIA practitioners were re-analysed against public policy theory. We reviewed the HIA literature for inclusion of public policy theories then compared these for compatibility with our critical realist methodology and the empirical data. The theory 'Policy Cycles and Subsystems' (Howlett et al., 2009) was used to re-analyse the empirical data. HIAs for policy are necessarily both tactical and technical. Within policy subsystems using HIA to influence public policy requires tactically positioning health as a relevant public policy issue and, to facilitate this, institutional support for collaboration between Public Health and other sectors. HIA fits best within the often non-linear public policy cycle as a policy formulation instrument. HIA provides, tactically and technically, a space for practical reasoning to navigate facts, values and processes underlying the substantive and procedural dimensions of policy. Re-analysing empirical experiential data using existing public policy theory provided valuable explanations for future research, policy and practice concerning why and how HIA fits tactically and technically with the world of public policy development. The use of theory and empiricism opens up important possibilities for future

  10. Urban and Transport Planning Related Exposures and Mortality: A Health Impact Assessment for Cities.

    Science.gov (United States)

    Mueller, Natalie; Rojas-Rueda, David; Basagaña, Xavier; Cirach, Marta; Cole-Hunter, Tom; Dadvand, Payam; Donaire-Gonzalez, David; Foraster, Maria; Gascon, Mireia; Martinez, David; Tonne, Cathryn; Triguero-Mas, Margarita; Valentín, Antònia; Nieuwenhuijsen, Mark

    2017-01-01

    By 2050, nearly 70% of the global population is projected to live in urban areas. Because the environments we inhabit affect our health, urban and transport designs that promote healthy living are needed. We estimated the number of premature deaths preventable under compliance with international exposure recommendations for physical activity (PA), air pollution, noise, heat, and access to green spaces. We developed and applied the Urban and TranspOrt Planning Health Impact Assessment (UTOPHIA) tool to Barcelona, Spain. Exposure estimates and mortality data were available for 1,357,361 residents. We compared recommended with current exposure levels. We quantified the associations between exposures and mortality and calculated population attributable fractions to estimate the number of premature deaths preventable. We also modeled life-expectancy and economic impacts. We estimated that annually, nearly 20% of mortality could be prevented if international recommendations for performance of PA; exposure to air pollution, noise, and heat; and access to green space were followed. Estimations showed that the greatest portion of preventable deaths was attributable to increases in PA, followed by reductions of exposure to air pollution, traffic noise, and heat. Access to green spaces had smaller effects on mortality. Compliance was estimated to increase the average life expectancy by 360 (95% CI: 219, 493) days and result in economic savings of 9.3 (95% CI: 4.9, 13.2) billion EUR/year. PA factors and environmental exposures can be modified by changes in urban and transport planning. We emphasize the need for a) the reduction of motorized traffic through the promotion of active and public transport and b) the provision of green infrastructure, both of which are suggested to provide opportunities for PA and for mitigation of air pollution, noise, and heat. Citation: Mueller N, Rojas-Rueda D, Basagaña X, Cirach M, Cole-Hunter T, Dadvand P, Donaire-Gonzalez D, Foraster M

  11. Human health impact assessment of exposure to particulate matter: an AirQ software modeling.

    Science.gov (United States)

    Miri, Mohammad; Ebrahimi Aval, Hamideh; Ehrampoush, Mohammad Hassan; Mohammadi, Amir; Toolabi, Ali; Nikonahad, Ali; Derakhshan, Zahra; Abdollahnejad, Ali

    2017-07-01

    The aim of this study was to assess the health impacts related to particulate matter less than 10 μm (PM 10 ) exposure in the city of Yazd, Iran. For this aim, AirQ 2.2.3 software was used to model relationship between short-term exposure to PM 10 and disease cases proposed by the World Health Organization (WHO). The annual mean concentration of PM 10 was 97 μg/m 3 . The maximum concentration value of PM 10 was measured during the summer (731 μg/m 3 ). 4.988% (95%CI: 3.381-6.542%) of the total mortality, 7.3% (95%CI; 4.19-10.21%) of cardiovascular mortality, and 10.21% (95%CI; 4.19-14.89%) of respiratory mortality were related to the PM 10 concentrations. Consequently, the AirQ software can provide valuable information about the importance of air pollution and the substantial impacts of PM 10 on the society for policymakers.

  12. Assessing the impact of nurse and allied health professional consultants: developing an activity diary.

    Science.gov (United States)

    Humphreys, Ann; Richardson, Janet; Stenhouse, Elizabeth; Watkins, Mary

    2010-09-01

    To construct and test an activity diary designed to measure the impact and explore the activities of nurse and allied health professional consultants in relation to each speciality and function of the role. This was part of a funded feasibility study to assess the contribution of nurse and allied health professional consultants. This was an exploratory study. Thematic analysis of guided discussions with five nurse consultants and one physiotherapy consultant identified activities which were used to construct an activity diary. The activities were grouped under the four pillars or functions of the consultant role; expert practice, leadership, research and education. Participants recorded their activities in a diary over a one-week period. Results suggest that with some modification, this activity diary could be used to capture the impact, complexity and diversity of activities of the consultant role. Advanced practice roles are essential to the healthcare workforce of the future. This tool provides a method for measuring the contribution and complexity of the consultant role. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

  13. Assessing the impact of a new health sector pay system upon NHS staff in England

    Directory of Open Access Journals (Sweden)

    Buchan James

    2008-06-01

    Full Text Available Abstract Background Pay and pay systems are a critical element in any health sector human resource strategy. Changing a pay system can be one strategy to achieve or sustain organizational change. This paper reports on the design and implementation of a completely new pay system in the National Health Service (NHS in England. 'Agenda for Change' constituted the largest-ever attempt to introduce a new pay system in the UK public services, covering more than one million staff. Its objectives were to improve the delivery of patient care as well as enhance staff recruitment, retention and motivation, and to facilitate new ways of working. Methods This study was the first independent assessment of the impact of Agenda for Change at a local and national level. The methods used in the research were a literature review; review of 'grey' unpublished documentation provided by key stakeholders in the process; analysis of available data; interviews with key national informants (representing government, employers and trade unions, and case studies conducted with senior human resource managers in ten NHS hospitals in England Results Most of the NHS trust managers interviewed were in favour of Agenda for Change, believing it would assist in delivering improvements in patient care and staff experience. The main benefits highlighted were: 'fairness', moving different staff groups on to harmonized conditions; equal pay claim 'protection'; and scope to introduce new roles and working practices. Conclusion Agenda for Change took several years to design, and has only recently been implemented. Its very scale and central importance to NHS costs and delivery of care argues for a full assessment at an early stage so that lessons can be learned and any necessary changes made. This paper highlights weaknesses in evaluation and limitations in progress. The absence of systematically derived and applied impact indicators makes it difficult to assess impact and impact

  14. Oral health impact on quality of life assessment among dental patients in Bangalore city

    Directory of Open Access Journals (Sweden)

    Y Pradeep

    2014-01-01

    Full Text Available Introduction: Over the past few decades mankind has been mainly affected with chronic noncommunicable diseases, which led to compromised quality of life. Common dental diseases come under same categories that are largely social and behavioral in origin. Health-related quality of life helps us address the limitations of traditional clinical indicators of health. Aim: To measure the impact of oral health on quality of life among patients visiting dental teaching hospitals and private clinics in Bangalore city using oral health-related quality of life (OHQoL - U.K index. Materials and Methods: A total of 1200 individuals who are above 16-year of age were selected through stratified cluster random sampling technique for this study. Data were collected using OHQoL-U.K instrument. Results: Most of the subjects (78% perceived their oral health as impacting their quality of life. Many participants perceived their oral health had positive impact on life quality through enhancing their smile, appearance, speech. But 44.9% and 28.5% of respondents said their oral health has a negative impact on quality of life because of breath odor and finance respectively. Subjects are belonging to lower socioeconomic background, women and older adults (>45 years perceived their oral health has a negative impact on quality of life compared to subjects from higher social class, men and young adults. Conclusion: Oral health has more impact on physical and functional aspects rather than on social and psychological domains.

  15. Choices Behind Numbers: a Review of the Major Air Pollution Health Impact Assessments in Europe.

    Science.gov (United States)

    Malmqvist, E; Oudin, A; Pascal, M; Medina, S

    2018-03-01

    The aim of this review is to identify the key contextual and methodological differences in health impact assessments (HIA) of ambient air pollution performed for Europe. We limited our review to multi-country reviews. An additional aim is to quantify some of these differences by applying them in a HIA template in three European cities. Several HIAs of ambient air pollution have been performed for Europe, and their key results have been largely disseminated. Different studies have, however, come up with substantial differences in attributed health effects. It is of importance to review the background contributing to these differences and to quantify their importance for decision makers who will use them. We identified several methodological differences that could explain the discrepancy behind the number of attributable deaths or years of life lost. The main differences are due to the exposure-response functions chosen, the ways of assessing air pollution levels, the air pollution scenarios and the study population. In the quantification part, we found that using risk estimates from the European Study of Cohorts for Air Pollution Effects (ESCAPE) instead of the American Cancer Society (ACS) study could nearly double the attributable burden of ambient air pollution. This study provides some insights into the differential results in previously published HIAs on air pollution in Europe. These results are important for stakeholders in order to make informed decisions.

  16. Health impact assessment of transport policies in Rotterdam: Decrease of total traffic and increase of electric car use

    NARCIS (Netherlands)

    Tobollik, M.; Keuken, M.; Sabel, C.; Cowie, H.; Tuomisto, J.; Sarigiannis, D.; Künzli, N.; Perez, L.; Mudu, P.

    2016-01-01

    Background: Green house gas (GHG) mitigation policies can be evaluated by showing their co-benefits to health. Method: Health Impact Assessment (HIA) was used to quantify co-benefits of GHG mitigation policies in Rotterdam. The effects of two separate interventions (10% reduction of private vehicle

  17. Assessing health impacts of the Chad-Cameroon petroleum development and pipeline project: challenges and a way forward

    International Nuclear Information System (INIS)

    Utzinger, Juerg; Wyss, Kaspar; Moto, Daugla D.; Yemadji, N'Diekhor; Tanner, Marcel; Singer, Burton H.

    2005-01-01

    Health impact assessment (HIA) of projects, programmes and policies is increasingly recognized as a powerful methodology for mitigating negative health impacts and enhancing equitable and sustainable development, yet applications in the developing world are sparse. Here, we focus on a large infrastructure development in sub-Saharan Africa, namely the Chad-Cameroon petroleum development and pipeline project. We adapted a five-step process for HIA, consisting of (1) screening of project documents, (2) profiling of affected communities, (3) identifying priority health areas, predicting potential impacts, and proposing mitigation measures, (4) implementing interventions, and (5) monitoring and evaluation of health impacts. We found that project scoping was broad, including extensive environmental and social assessments. Innovative features of the project include the high degree of public-private partnerships, and the management of oil revenues for purposes of poverty reduction. The project also addressed occupational and public health issues, and developed and implemented measures to prevent or mitigate potential health impacts. However, there was a disproportionate emphasis on workers' health, particularly on the prevention/mitigation of construction-related injuries, sexually transmitted infections (STIs; mainly HIV/AIDS), and malaria. Health impacts among surrounding communities, and cumulative health impacts in the larger region were not considered in a comprehensive way. Concluding, there is a need for a more systemic approach to HIA and its incorporation within 'Equator Principles', which are increasingly adopted by the international financial community. This process would include clarification of corporate social responsibility beyond the project fence line in the mitigation of health problems at regional levels. Finally, we propose the establishment and running of a longitudinal demographic surveillance system, which--coupled with regular household surveys

  18. Health impact assessment of Roma housing policies in Central and Eastern Europe: A comparative analysis

    International Nuclear Information System (INIS)

    Molnár, Ágnes; Ádám, Balázs; Antova, Temenujka; Bosak, Lubos; Dimitrov, Plamen; Mileva, Hristina; Pekarcikova, Jarmila; Zurlyte, Ingrida; Gulis, Gabriel; Ádány, Róza; Kósa, Karolina

    2012-01-01

    Marginalised Roma communities in European countries live in substandard housing conditions the improvement of which has been one of the major issues of the Decade of Roma Inclusion, the ongoing intergovernmental European Roma programme. The paper presents EU-funded health impact assessments of national Roma housing policies and programmes in 3 Central and Eastern European countries in light of the evaluation of a completed local project in a fourth CEE country so as to compare predicted effects to observed ones. Housing was predicted to have beneficial health effects by improving indoor and outdoor conditions, access to services, and socioeconomic conditions. Negative impacts were predicted only in terms of maintenance expenses and housing tenure. However, observed impacts of the completed local project did not fully support predictions especially in terms of social networks, satisfaction with housing and neighbourhood, and inhabitant safety. In order to improve the predictive value of HIA, more evidence should be produced by the careful evaluation of locally implemented housing projects. In addition, current evidence is in favour of planning Roma housing projects at the local rather than at the national level in alignment with the principle of subsidiarity. - Highlights: ► Predictive validity of HIA of national Roma housing policies – in light of current evidence – is low. ► Implemented housing projects should be comprehensively evaluated to improve reliability of HIA. ► Roma housing projects should be planned at the local rather than at the national level. ► HIA should be used to plan Roma housing projects at the local level.

  19. Assessing health impacts of the December 2013 Ice storm in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Nikhil Rajaram

    2016-07-01

    Full Text Available Abstract Background Ice, or freezing rain storms have the potential to affect human health and disrupt normal functioning of a community. The purpose of this study was to assess acute health impacts of an ice storm that occurred in December 2013 in Toronto, Ontario, Canada. Methods Data on emergency department visits were obtained from the National Ambulatory Care Reporting System. Rates of visits in Toronto during the storm period (December 21, 2013 – January 1, 2014 were compared to rates occurring on the same dates in the previous five years (historical comparison and compared to those in a major unaffected city, Ottawa, Ontario (geographic comparison. Overall visits and rates for three categories of interest (cardiac conditions, environmental causes and injuries were assessed. Rate ratios were calculated using Poisson regression with population counts as an offset. Absolute counts of carbon monoxide poisoning were compared descriptively in a sub-analysis. Results During the 2013 storm period, there were 34 549 visits to EDs in Toronto (12.46 per 1000 population compared with 10 794 visits in Ottawa (11.55 per 1000 population. When considering year and geography separately, rates of several types of ED visits were higher in the storm year than in previous years in both Toronto and Ottawa. Considering year and geography together, rates in the storm year were higher for overall ED visits (RR: 1.10, 95 % CI: 1.09-1.11 and for visits due to environmental causes (RR: 2.52, 95 % CI: 2.21-2.87 compared to previous years regardless of city. For injuries, visit rates were higher in the storm year in both Toronto and Ottawa, but the increase in Toronto was significantly greater than the increase in Ottawa, indicating a significant interaction between geography and year (RR: 1.23, 95 % CI: 1.16-1.30. Conclusions This suggests that the main health impact of the 2013 Ice Storm was an increase in ED visits for injuries, while other increases could

  20. Assessing health impacts of the December 2013 Ice storm in Ontario, Canada.

    Science.gov (United States)

    Rajaram, Nikhil; Hohenadel, Karin; Gattoni, Laera; Khan, Yasmin; Birk-Urovitz, Elizabeth; Li, Lennon; Schwartz, Brian

    2016-07-11

    Ice, or freezing rain storms have the potential to affect human health and disrupt normal functioning of a community. The purpose of this study was to assess acute health impacts of an ice storm that occurred in December 2013 in Toronto, Ontario, Canada. Data on emergency department visits were obtained from the National Ambulatory Care Reporting System. Rates of visits in Toronto during the storm period (December 21, 2013 - January 1, 2014) were compared to rates occurring on the same dates in the previous five years (historical comparison) and compared to those in a major unaffected city, Ottawa, Ontario (geographic comparison). Overall visits and rates for three categories of interest (cardiac conditions, environmental causes and injuries) were assessed. Rate ratios were calculated using Poisson regression with population counts as an offset. Absolute counts of carbon monoxide poisoning were compared descriptively in a sub-analysis. During the 2013 storm period, there were 34 549 visits to EDs in Toronto (12.46 per 1000 population) compared with 10 794 visits in Ottawa (11.55 per 1000 population). When considering year and geography separately, rates of several types of ED visits were higher in the storm year than in previous years in both Toronto and Ottawa. Considering year and geography together, rates in the storm year were higher for overall ED visits (RR: 1.10, 95 % CI: 1.09-1.11) and for visits due to environmental causes (RR: 2.52, 95 % CI: 2.21-2.87) compared to previous years regardless of city. For injuries, visit rates were higher in the storm year in both Toronto and Ottawa, but the increase in Toronto was significantly greater than the increase in Ottawa, indicating a significant interaction between geography and year (RR: 1.23, 95 % CI: 1.16-1.30). This suggests that the main health impact of the 2013 Ice Storm was an increase in ED visits for injuries, while other increases could have been due to severe weather across Ontario at that time

  1. Concerted action on assessment of health and environmental impacts. Modeller and experimentalists' forum: final report

    International Nuclear Information System (INIS)

    Simmonds, J.

    2000-07-01

    and experimental work in relation to assessing the health impacts on man. The forum did not consider the effects on the environment as a whole

  2. Health Impact Assessment (HIA) in Ireland and the role of local government

    Energy Technology Data Exchange (ETDEWEB)

    O' Mullane, Monica, E-mail: Monica.omullane@truni.sk [Department of Public Health, Faculty of Health Care and Social Work/Fakulta Zdravotnictva a Socialnej Prace, Trnavska univerzita, Univerzitne namestie 1, 917 01 Trnava (Slovakia); Quinlivan, Aodh, E-mail: A.quinlivan@ucc.ie [Department of Government, College of Business and Law, 2nd Floor O' Rahilly Building, University College Cork (Ireland)

    2012-01-15

    Background: Health Impact Assessment (HIA) in Ireland has developed significantly since its endorsement in the health strategies of the Republic of Ireland (2001) and Northern Ireland (2002). Throughout 2007 and 2008, research was conducted to examine HIA as a policy-informing tool throughout both jurisdictions. One aspect of this research investigated the role of local government and its relationship in advancing HIA practise and use in Ireland. Methods: A case study research design was used which employed qualitative research methods, including semistructured interviewing and participant observation. In total 48 interviews were conducted with members of the HIA steering committees and individuals closely involved in the HIAs. Results: The relationship between local government and HIA in Northern Ireland is a positive one given the strong tradition of local government in the jurisdiction. The Review of Public Administration (RPA) negatively influenced the integration of HIA into local authority procedures. In the Republic of Ireland, the influence of social values and political will was found to be negatively present with the HIA on Traveller accommodation. Evidence from the HIA conducted on traffic and transport in Dublin was used to plan further health promotion and community planning activities in the area. Conclusion: Local government plays a vital role in HIA practise and development in both jurisdictions. The willingness to work with external partners (such as the health care services) was an important enabler or barrier to HIA operation. This will remain the case in the foreseeable future. - Highlights: Black-Right-Pointing-Pointer We investigated influences on the use of HIA knowledge of four cases from Northern Ireland and the Republic of Ireland. Black-Right-Pointing-Pointer The engagement of the public authorities assists implementation of the findings of the HIA. Black-Right-Pointing-Pointer Tension continues between positivist and incrementalist

  3. Health Impact Assessment (HIA) in Ireland and the role of local government

    International Nuclear Information System (INIS)

    O'Mullane, Monica; Quinlivan, Aodh

    2012-01-01

    Background: Health Impact Assessment (HIA) in Ireland has developed significantly since its endorsement in the health strategies of the Republic of Ireland (2001) and Northern Ireland (2002). Throughout 2007 and 2008, research was conducted to examine HIA as a policy-informing tool throughout both jurisdictions. One aspect of this research investigated the role of local government and its relationship in advancing HIA practise and use in Ireland. Methods: A case study research design was used which employed qualitative research methods, including semistructured interviewing and participant observation. In total 48 interviews were conducted with members of the HIA steering committees and individuals closely involved in the HIAs. Results: The relationship between local government and HIA in Northern Ireland is a positive one given the strong tradition of local government in the jurisdiction. The Review of Public Administration (RPA) negatively influenced the integration of HIA into local authority procedures. In the Republic of Ireland, the influence of social values and political will was found to be negatively present with the HIA on Traveller accommodation. Evidence from the HIA conducted on traffic and transport in Dublin was used to plan further health promotion and community planning activities in the area. Conclusion: Local government plays a vital role in HIA practise and development in both jurisdictions. The willingness to work with external partners (such as the health care services) was an important enabler or barrier to HIA operation. This will remain the case in the foreseeable future. - Highlights: ► We investigated influences on the use of HIA knowledge of four cases from Northern Ireland and the Republic of Ireland. ► The engagement of the public authorities assists implementation of the findings of the HIA. ► Tension continues between positivist and incrementalist approaches towards HIA.

  4. Pricing implications of non-marginal budgetary impacts in health technology assessment : a conceptual model

    NARCIS (Netherlands)

    Howdon, Daniel David Henry; Lomas, James Richard Scott

    2017-01-01

    This paper introduces a framework by which to conceptualise the decision-making process in health technology assessment when the quantity of health forgone by acceptance is high enough such that the use of a single threshold based on the marginal productivity of the health care system is

  5. A life cycle assessment framework combining nutritional and environmental health impacts of diet: a case study on milk

    DEFF Research Database (Denmark)

    Stylianou, Katerina S.; Heller, Martin C.; Fulgoni III, Victor L.

    2016-01-01

    human health effects associated with the addition of one serving of fluid milk to the present average adult US diet. Epidemiology-based nutritional impacts and benefits linked to milk intake, such as colorectal cancer, stroke, and prostate cancer, were compared to selected environmental impacts......-LCA) framework that evaluates and compares in parallel the environmental and nutritional effects of foods or diets. We applied this framework to assess human health impacts, expressed in Disability Adjusted Life Years (DALYs), in a proof-of conceptcase study that investigated the environmental and nutritional......Purpose While there has been considerable effort to understand the environmental impact of a food or diet, nutritional effects are not usually included in food-related life cycle assessment (LCA). Methods We developed a novel Combined Nutritional and Environmental Life Cycle Assessment (CONE...

  6. Pesticides and health in highland Ecuadorian potato production: assessing impacts and developing responses

    NARCIS (Netherlands)

    Cole, D.; Sherwood, S.G.; Crissman, C.; Barrera, V.H.; Espinosa, E.

    2002-01-01

    Pesticide use in highland Ecuador is concentrated in the high-risk, commercial production of potatoes. Small farm families experience considerable exposure and adverse health consequences. The authors describe a three-pronged strategy to reduce health impacts: 1) a community-based process of

  7. Is health impact assessment useful in the context of trade negotiations? A case study of the Trans Pacific Partnership Agreement.

    Science.gov (United States)

    Hirono, Katherine; Haigh, Fiona; Gleeson, Deborah; Harris, Patrick; Thow, Anne Marie; Friel, Sharon

    2016-04-04

    The Trans Pacific Partnership Agreement (TPP) is a recently concluded free trade agreement involving Australia and 11 other Pacific-rim nations, which has the potential for far-reaching impacts on public health. A health impact assessment (HIA) was carried out during the negotiations to determine the potential future public health impact in Australia and to provide recommendations to mitigate potential harms. This paper explores the findings and outcomes of the HIA, and how this approach can be used to provide evidence for public health advocacy. A modified version of the standard HIA process was followed. The HIA was led by technical experts in HIA, trade policy, and health policy, in collaboration with advocacy organisations concerned with the TPP and health. The HIA reviewed the provisions in leaked TPP text in order to determine their potential impact on future health policy. As part of this process, researchers developed policy scenarios in order to examine how TPP provisions may affect health policies and their subsequent impact to health for both the general and vulnerable populations. The four policy areas assessed were the cost of medicines, tobacco control, alcohol control and food labelling. In all areas assessed, the HIA found that proposed TPP provisions were likely to adversely affect health. These provisions are also likely to more adversely affect the health of vulnerable populations. The HIA produced relevant evidence that was useful in advocacy efforts by stakeholders, and engaging the public through various media platforms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Assessing the Health Impact of Phosphorus in the Food Supply: Issues and Considerations123

    Science.gov (United States)

    Calvo, Mona S.; Moshfegh, Alanna J.; Tucker, Katherine L.

    2014-01-01

    The Western dietary pattern of intake common to many Americans is high in fat, refined carbohydrates, sodium, and phosphorus, all of which are associated with processed food consumption and higher risk of life-threatening chronic diseases. In this review, we focus on the available information on current phosphorus intake with this Western dietary pattern, and new knowledge of how the disruption of phosphorus homeostasis can occur when intake of phosphorus far exceeds nutrient needs and calcium intake is limited. Elevation of extracellular phosphorus, even when phosphorus intake is seemingly modest, but excessive relative to need and calcium intake, may disrupt the endocrine regulation of phosphorus balance in healthy individuals, as it is known to do in renal disease. This elevation in serum phosphate, whether episodic or chronically sustained, may trigger the secretion of regulatory hormones, whose actions can damage tissue, leading to the development of cardiovascular disease, renal impairment, and bone loss. Therefore, we assessed the health impact of excess phosphorus intake in the context of specific issues that reflect changes over time in the U.S. food supply and patterns of intake. Important issues include food processing and food preferences, the need to evaluate phosphorus intake in relation to calcium intake and phosphorus bioavailability, the accuracy of various approaches used to assess phosphorus intake, and the difficulties encountered in evaluating the relations of phosphorus intake to chronic disease markers or incident disease. PMID:24425729

  9. Health impact assessment research and practice: A place for paradigm positioning?

    International Nuclear Information System (INIS)

    Haigh, Fiona; Harris, Patrick; Haigh, Neil

    2012-01-01

    In this article, we provide a critical review of the place of paradigm in health impact assessment (HIA) research and practice. We contend that most HIA practitioners have given insufficient attention to paradigm positioning when developing and applying HIA methodologies and that some concerns about current HIA practice can be attributed to this. We review HIA literature to assess the extent and nature of attention given to paradigm positioning and these related concerns. We then respond to our critique by exploring the implications, opportunities and challenges of adopting a critical realist paradigm, which we believe has the potential to help HIA practitioners to develop HIA methodology in a way that addresses these issues. - Highlights: ► We provide a critical review of the place of paradigm in HIA. ► We demonstrate that HIA practitioners give insufficient attention to paradigm. ► The implications, opportunities and challenges of adopting a critical realist paradigm are explored. ► This is the first paper, to our knowledge, that discusses a critical realist approach to HIA.

  10. Direct method for impact assessment of environmental pollutants and toxicants causing health hazards

    International Nuclear Information System (INIS)

    Fazal-ur-Rehman; Adil, A.; Abdullah, A.; Masood, S.R.; Agha, A.

    1997-01-01

    Industrial waste pollutants and toxicants are released in three forms i.e. gas, liquid, solid or their admixtures, causing atmospheric , hydro spheric and lithospheric pollutions. Gaseous wastes pollute the surrounding air before entering the waste-cycle and bio-cycle through vegetation/ forestation(i.e., plant kingdom). Liquid wastes enter the water-cycle directly and speedily whereas solid wastes enter the water-cycle indirectly and slowly. All these wastes, as it is well known later on enter plant and animal kingdoms which ultimately effect the human health and make different body parts sick/malignant. Therefore, the regular monitoring of elemental composition of these body parts becomes imperative. The above mentioned format of impact assessment has been followed during different joint studies (carried out in collaboration with university of the Punjab, INMOL and other Departments) which are based on the analytical data collected during the period of last five years. These samples include specimens of blood serum, cancer tissues, drinking and running water, industrial wastes and effluents etc. The comparison, of analysis of samples of unaffected (healthy) and malignant body parts, leads to the direct assessment of environmental pollutants and the inhabitants. (author)

  11. Estimating Active Transportation Behaviors to Support Health Impact Assessment in the United States.

    Science.gov (United States)

    Mansfield, Theodore J; Gibson, Jacqueline MacDonald

    2016-01-01

    Health impact assessment (HIA) has been promoted as a means to encourage transportation and city planners to incorporate health considerations into their decision-making. Ideally, HIAs would include quantitative estimates of the population health effects of alternative planning scenarios, such as scenarios with and without infrastructure to support walking and cycling. However, the lack of baseline estimates of time spent walking or biking for transportation (together known as "active transportation"), which are critically related to health, often prevents planners from developing such quantitative estimates. To address this gap, we use data from the 2009 US National Household Travel Survey to develop a statistical model that estimates baseline time spent walking and biking as a function of the type of transportation used to commute to work along with demographic and built environment variables. We validate the model using survey data from the Raleigh-Durham-Chapel Hill, NC, USA, metropolitan area. We illustrate how the validated model could be used to support transportation-related HIAs by estimating the potential health benefits of built environment modifications that support walking and cycling. Our statistical model estimates that on average, individuals who commute on foot spend an additional 19.8 (95% CI 16.9-23.2) minutes per day walking compared to automobile commuters. Public transit riders walk an additional 5.0 (95% CI 3.5-6.4) minutes per day compared to automobile commuters. Bicycle commuters cycle for an additional 28.0 (95% CI 17.5-38.1) minutes per day compared to automobile commuters. The statistical model was able to predict observed transportation physical activity in the Raleigh-Durham-Chapel Hill region to within 0.5 MET-hours per day (equivalent to about 9 min of daily walking time) for 83% of observations. Across the Raleigh-Durham-Chapel Hill region, an estimated 38 (95% CI 15-59) premature deaths potentially could be avoided if the entire

  12. Estimating active transportation behaviors to support health impact assessment in the United States

    Directory of Open Access Journals (Sweden)

    Theodore J Mansfield

    2016-05-01

    Full Text Available Health impact assessment (HIA has been promoted as a means to encourage transportation and city planners to incorporate health considerations into their decision-making. Ideally, HIAs would include quantitative estimates of the population health effects of alternative planning scenarios, such as scenarios with and without infrastructure to support walking and cycling. However, the lack of baseline estimates of time spent walking or biking for transportation (together known as active transportation, which are critically related to health, often prevents planners from developing such quantitative estimates. To address this gap, we use data from the 2009 US National Household Travel Survey to develop a statistical model that estimates baseline time spent walking and biking as a function of the type of transportation used to commute to work along with demographic and built environment variables. We validate the model using survey data from the Raleigh-Durham-Chapel Hill, NC, metropolitan area. We illustrate how the validated model could be used to support transportation-related HIAs by estimating the potential health benefits of built environment modifications that support walking and cycling. Our statistical model estimates that on average, individuals who commute on foot spend an additional 19.8 (95% CI 16.9–23.2 minutes per day walking compared to automobile commuters. Public transit riders walk an additional 5.0 (95% CI 3.5–6.4 minutes per day compared to automobile commuters. Bicycle commuters cycle for an additional 28.0 (95% CI 17.5–38.1 minutes per day compared to automobile commuters. The statistical model was able to predict observed transportation physical activity in the Raleigh-Durham-Chapel Hill region to within 0.5 MET-hours per day (equivalent to about 9 minutes of daily walking time for 83% of observations. Across the Raleigh-Durham-Chapel Hill region, an estimated 38 (95% CI 15–59 premature deaths potentially could be

  13. Integration of health into urban spatial planning through impact assessment: Identifying governance and policy barriers and facilitators

    International Nuclear Information System (INIS)

    Carmichael, Laurence; Barton, Hugh; Gray, Selena; Lease, Helen; Pilkington, Paul

    2012-01-01

    This article presents the results of a review of literature examining the barriers and facilitators in integrating health in spatial planning at the local, mainly urban level, through appraisals. Our literature review covered the UK and non UK experiences of appraisals used to consider health issues in the planning process. We were able to identify four main categories of obstacles and facilitators including first the different knowledge and conceptual understanding of health by different actors/stakeholders, second the types of governance arrangements, in particular partnerships, in place and the political context, third the way institutions work, the responsibilities they have and their capacity and resources and fourth the timeliness, comprehensiveness and inclusiveness of the appraisal process. The findings allowed us to draw some lessons on the governance and policy framework regarding the integration of health impact into spatial planning, in particular considering the pros and cons of integrating health impact assessment (HIA) into other forms of impact assessment of spatial planning decisions such as environmental impact assessment (EIA) and strategic environment assessment (SEA). In addition, the research uncovered a gap in the literature that tends to focus on the mainly voluntary HIA to assess health outcomes of planning decisions and neglect the analysis of regulatory mechanisms such as EIA and SEA. - Highlights: ► Governance and policy barriers and facilitators to the integration of health into urban planning. ► Review of literature on impact assessment methods used across the world. ► Knowledge, partnerships, management/resources and processes can impede integration. ► HIA evaluations prevail uncovering research opportunities for evaluating other techniques.

  14. Climate change and plant health; Development of a conceptual frame-work for impact assessment

    NARCIS (Netherlands)

    Breukers, M.L.H.

    2010-01-01

    This report presents a conceptual framework for systematic assessment of direct economic impacts of climate change on pest and disease management at the crop level. The framework evaluates and aggregates the effects, and subsequently impacts, of climate change on selected pests and diseases and

  15. Health impacts related to urban and transport planning: A burden of disease assessment.

    Science.gov (United States)

    Mueller, Natalie; Rojas-Rueda, David; Basagaña, Xavier; Cirach, Marta; Cole-Hunter, Tom; Dadvand, Payam; Donaire-Gonzalez, David; Foraster, Maria; Gascon, Mireia; Martinez, David; Tonne, Cathryn; Triguero-Mas, Margarita; Valentín, Antònia; Nieuwenhuijsen, Mark

    2017-10-01

    Until now, estimates of the Global Burden of Disease (GBD) have mainly been produced on national or regional levels. These general estimates, however, are less useful for city governments who have to take decisions on local scales. To address this gap, we focused on the city-level burden of disease (BD) due to exposures affected by urban and transport planning. We conducted a BD assessment using the Urban and Transport Planning Health Impact Assessment (UTOPHIA) tool to estimate annual preventable morbidity and disability-adjusted life-years (DALYs) under compliance with international exposure recommendations for physical activity (PA), exposure to air pollution, noise, heat, and access to green spaces in Barcelona, Spain. Exposure estimates and morbidity data were available for 1,357,361 Barcelona residents ≥20years (2012). We compared recommended with current exposure levels to estimate the associated BD. We quantified associations between exposures and morbidities and calculated population attributable fractions to estimate the number of attributable cases. We calculated DALYs using GBD Study 2015 background DALY estimates for Spain, which were scaled to Barcelona considering differences in population size, age and sex structures. We also estimated annual health costs that could be avoided under compliance with exposure recommendations. Not complying with recommended levels for PA, air pollution, noise, heat and access to green spaces was estimated to generate a large morbidity burden and resulted in 52,001 DALYs (95% CI: 42,866-61,136) in Barcelona each year (13% of all annual DALYs). From this BD 36% (i.e. 18,951 DALYs) was due to traffic noise with sleep disturbance and annoyance contributing largely (i.e. 10,548 DALYs). Non-compliance was estimated to result in direct health costs of 20.10 million € (95% CI: 15.36-24.83) annually. Non-compliance of international exposure recommendations was estimated to result in a considerable BD and in substantial

  16. The Search for Underlying Principles of Health Impact Assessment: Progress and Prospects; Comment on “Investigating Underlying Principles to Guide Health Impact Assessment”

    Directory of Open Access Journals (Sweden)

    Mirko S. Winkler

    2014-07-01

    Full Text Available Health Impact Assessment (HIA is a relatively young field of endeavour, and hence, future progress will depend on the planning, implementation and rigorous evaluation of additional HIAs of projects, programmes and policies the world over. In the June 2014 issue of the International Journal of Health Policy and Management, Fakhri and colleagues investigated underlying principles of HIA through a comprehensive review of the literature and expert consultation. With an emphasis on the Islamic Republic of Iran, the authors identified multiple issues that are relevant for guiding HIA practice. At the same time, the study unravelled current shortcomings in the understanding and definition of HIA principles and best practice at national, regional, and global levels. In this commentary we scrutinise the research presented, highlight strengths and limitations, and discuss the findings in the context of other recent attempts to guide HIA.

  17. Health impact assessment of particulate pollution in Tallinn using fine spatial resolution and modeling techniques

    Directory of Open Access Journals (Sweden)

    Kimmel Veljo

    2009-03-01

    Full Text Available Abstract Background Health impact assessments (HIA use information on exposure, baseline mortality/morbidity and exposure-response functions from epidemiological studies in order to quantify the health impacts of existing situations and/or alternative scenarios. The aim of this study was to improve HIA methods for air pollution studies in situations where exposures can be estimated using GIS with high spatial resolution and dispersion modeling approaches. Methods Tallinn was divided into 84 sections according to neighborhoods, with a total population of approx. 390 000 persons. Actual baseline rates for total mortality and hospitalization with cardiovascular and respiratory diagnosis were identified. The exposure to fine particles (PM2.5 from local emissions was defined as the modeled annual levels. The model validation and morbidity assessment were based on 2006 PM10 or PM2.5 levels at 3 monitoring stations. The exposure-response coefficients used were for total mortality 6.2% (95% CI 1.6–11% per 10 μg/m3 increase of annual mean PM2.5 concentration and for the assessment of respiratory and cardiovascular hospitalizations 1.14% (95% CI 0.62–1.67% and 0.73% (95% CI 0.47–0.93% per 10 μg/m3 increase of PM10. The direct costs related to morbidity were calculated according to hospital treatment expenses in 2005 and the cost of premature deaths using the concept of Value of Life Year (VOLY. Results The annual population-weighted-modeled exposure to locally emitted PM2.5 in Tallinn was 11.6 μg/m3. Our analysis showed that it corresponds to 296 (95% CI 76528 premature deaths resulting in 3859 (95% CI 10236636 Years of Life Lost (YLL per year. The average decrease in life-expectancy at birth per resident of Tallinn was estimated to be 0.64 (95% CI 0.17–1.10 years. While in the polluted city centre this may reach 1.17 years, in the least polluted neighborhoods it remains between 0.1 and 0.3 years. When dividing the YLL by the number of

  18. Building capacity for Health Impact Assessment: Training outcomes from the United States

    Energy Technology Data Exchange (ETDEWEB)

    Schuchter, Joseph [Berkeley, CA (United States); Rutt, Candace, E-mail: awr8@cdc.gov [Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity and Obesity, 4770 Buford Highway MS/F-77, Atlanta, GA 30341 (United States); Satariano, William A. [University of California Berkeley, School of Public Health, Division of Community Health and Human Development, Berkeley, CA (United States); Seto, Edmund [University of Washington, Department of Environmental and Occupational Health Sciences, Seattle, WA (United States)

    2015-01-15

    Background: Despite the continued growth of Health Impact Assessment (HIA) in the US, there is little research on HIA capacity-building. A comprehensive study of longer-term training outcomes may reveal opportunities for improving capacity building activities and HIA practice. Methods: We conducted in-depth interviews with HIA trainees in the United States to assess their outcomes and needs. Using a training evaluation framework, we measured outcomes across a spectrum of reaction, learning, behavior and results. Results: From 2006 to 2012, four organizations trained over 2200 people in at least 75 in-person HIA trainings in 29 states. We interviewed 48 trainees, selected both randomly and purposefully. The mean duration between training and interview was 3.4 years. Trainees reported that their training objectives were met, especially when relevant case-studies were used. They established new collaborations at the trainings and maintained them. Training appeared to catalyze more holistic thinking and practice, including a range of HIA-related activities. Many trainees disseminated what they learned and engaged in components of HIA, even without dedicated funding. Going forward, trainees need assistance with quantitative methods, project management, community engagement, framing recommendations, and evaluation. Conclusions: The research revealed opportunities for a range of HIA stakeholders to refine and coordinate training resources, apply a competency framework and leverage complimentary workforce development efforts, and sensitize and build the capacity of communities. - Highlights: • We interviewed HIA trainees in the United States to assess longer-term outcomes. • Training appeared to catalyze a range of beneficial partnerships and activities. • Trainees reported outstanding needs for specific skills and competencies. • There are various opportunities to improve training and capacity-building.

  19. Disaster Metrics: A Proposed Quantitative Assessment Tool in Complex Humanitarian Emergencies - The Public Health Impact Severity Scale (PHISS).

    Science.gov (United States)

    Bayram, Jamil D; Kysia, Rashid; Kirsch, Thomas D

    2012-08-21

    Complex Humanitarian Emergencies (CHE) result in rapid degradation of population health and quickly overwhelm indigenous health resources. Numerous governmental, non-governmental, national and international organizations and agencies are involved in the assessment of post-CHE affected populations. To date, there is no entirely quantitative assessment tool conceptualized to measure the public health impact of CHE. Essential public health parameters in CHE were identified based on the Sphere Project "Minimum Standards", and scoring rubrics were proposed based on the prevailing evidence when applicable. 12 quantitative parameters were identified, representing the four categories of "Minimum Standards for Disaster Response" according to the Sphere Project; health, shelter, food and nutrition, in addition to water and sanitation. The cumulative tool constitutes a quantitative scale, referred to as the Public Health Impact Severity Scale (PHISS), and the score on this scale ranges from a minimum of 0 to a maximum of 100. Quantitative measurement of the public health impact of CHE is germane to accurate assessment, in order to identify the scale and scope of the critical response required for the relief efforts of the affected populations. PHISS is a new conceptual metric tool, proposed to add an objective quantitative dimension to the post-CHE assessment arsenal. PHISS has not yet been validated, and studies are needed with prospective data collection to test its validity, feasibility and reliability. Bayram JD, Kysia R, Kirsch TD. Disaster Metrics: A Proposed Quantitative Assessment Tool in Complex Humanitarian Emergencies - The Public Health Impact Severity Scale (PHISS). PLOS Currents Disasters. 2012 Aug 21. doi: 10.1371/4f7b4bab0d1a3.

  20. Full-chain health impact assessment of traffic-related air pollution and childhood asthma.

    Science.gov (United States)

    Khreis, Haneen; de Hoogh, Kees; Nieuwenhuijsen, Mark J

    2018-05-01

    Asthma is the most common chronic disease in children. Traffic-related air pollution (TRAP) may be an important exposure contributing to its development. In the UK, Bradford is a deprived city suffering from childhood asthma rates higher than national and regional averages and TRAP is of particular concern to the local communities. We estimated the burden of childhood asthma attributable to air pollution and specifically TRAP in Bradford. Air pollution exposures were estimated using a newly developed full-chain exposure assessment model and an existing land-use regression model (LUR). We estimated childhood population exposure to NO x and, by conversion, NO 2 at the smallest census area level using a newly developed full-chain model knitting together distinct traffic (SATURN), vehicle emission (COPERT) and atmospheric dispersion (ADMS-Urban) models. We compared these estimates with measurements and estimates from ESCAPE's LUR model. Using the UK incidence rate for childhood asthma, meta-analytical exposure-response functions, and estimates from the two exposure models, we estimated annual number of asthma cases attributable to NO 2 and NO x in Bradford, and annual number of asthma cases specifically attributable to traffic. The annual average census tract levels of NO 2 and NO x estimated using the full-chain model were 15.41 and 25.68 μg/m 3 , respectively. On average, 2.75 μg/m 3 NO 2 and 4.59 μg/m 3 NO x were specifically contributed by traffic, without minor roads and cold starts. The annual average census tract levels of NO 2 and NO x estimated using the LUR model were 21.93 and 35.60 μg/m 3 , respectively. The results indicated that up to 687 (or 38% of all) annual childhood asthma cases in Bradford may be attributable to air pollution. Up to 109 cases (6%) and 219 cases (12%) may be specifically attributable to TRAP, with and without minor roads and cold starts, respectively. This is the first study undertaking full-chain health impact assessment

  1. [Assessement of combined impact of hazards on petrochemical and chemical workers' health].

    Science.gov (United States)

    Badamshina, G G; Karimova, L K; Tkacheva, T A; Mavrina, L N; Bakirova, A É

    2013-01-01

    We have conducted a study on working conditions and health status of petrochemical workers. The main hazardous factor of work environment and manufacture process has been found to be work environment air pollution caused by Class 2-3 hazards. Depending on the composition of the current complex of hazards, the manufacture workers comprise three groups determined by the impact of aromatic hydrocarbons, olefin oxides and their combinations. It has been shown that the combined impact of aromatic hydrocarbons and olefin oxides combination may produce a more pronounced hazardous impact on workers' health compared with the impact of aromatic hydrocarbons or olefin oxides taken separately. This may be due to the summing up of biological effects.

  2. Health effects of fine particulate matter in life cycle impact assessment: findings from the Basel Guidance Workshop

    DEFF Research Database (Denmark)

    Fantke, Peter; Jolliet, Olivier; Evans, John S.

    2015-01-01

    to consistently include health effects from PM2.5 exposure in LCA practice. As a consequence, different models are currently used to assess life cycle impacts for PM2.5, sometimes leading to inconsistent results. In a global effort initiated by the United Nations Environment Programme (UNEP......Purpose Fine particulate matter (PM2.5) is considered to be one of the most important environmental factors contributing to the global human disease burden. However, due to the lack of broad consensus and harmonization in the life cycle assessment (LCA) community, there is no clear guidance on how......)/Society for Environmental Toxicology and Chemistry(SETAC) Life Cycle Initiative, respiratory inorganics’ impacts expressed as health effects from PM2.5 exposure were selected as one of the initial impact categories to undergo review with the goal of providing global guidance for implementation in life cycle impact...

  3. Nuclear Power and Environment Comparative Assessment of Environmental and Health Impacts of Electricity Generating Systems

    International Nuclear Information System (INIS)

    Rashed, S.M.

    1999-01-01

    This paper deals with comparative assessment of the environmental and health impacts of nuclear and other electricity generation systems. The study including normal operations and accidents in full energy chain analysis. The comparison of the environmental impacts arising from the waste management cycles associated with non emission waste are also discussed. Nuclear Power while economically feasible and meeting 17% of the world,s demand for electricity is almost free of the air polluting gases that threaten the global climate. Comparing nuclear power with other sources for electricity generation in terms of their associated environmental releases of pollutant such as SO 2 , NOX, CO 2 , CH 4 and radioisotopes, taking into account the full fuel chains chains of supply option, nuclear power will help to reduce environmental degradation due to electricity generation activities. In view of CO 2 emission, the ranking order commences with hydro, followed by nuclear, wind and photovoltaic Power Plants. CO 2 emissions from a nuclear power plant are by two orders of magnitude lower than those of fossil fueled power plants. A consequent risk comparison between different energy sources has to include al phases of the whole energy cycle. Coal mines accidents have resulted in several 1000 acute deaths over the years. Later fatalities have never been estimated. Then came hydropower, also resulting in many catastrophes and losses of human lives. Followed oil and gas energy industry, its tribute in acute fatalities is expressed in more than 1000 life lost. No estimate is available concerning later fatalities. latest in the list is commercial nuclear energy, badly illustrated by the Chernobyl accident resulting officially in 31 acute fatalities, 145 latent fatalities, and 135000 evacuated individuals. The paper offers some findings and conclusions on the role of nuclear power in protecting the global environment

  4. Indoor Air Pollutant Exposure for Life Cycle Assessment: Regional Health Impact Factors for Households

    DEFF Research Database (Denmark)

    Rosenbaum, Ralph K.; Meijer, Arjen; Demou, Evangelia

    2015-01-01

    of magnitude, due to the variability of ventilation rate, building occupation, and volume. To compare health impacts as a result of indoor exposure with those from outdoor exposure, the indoor exposure characterization factors determined with the modified USEtox model were applied in a case study on cooking...... in non-OECD countries. This study demonstrates the appropriateness and significance of integrating indoor environments into LCA, which ensures a more holistic account of all exposure environments and allows for a better accountability of health impacts. The model, intake fractions, and characterization...... factors are made available for use in standard LCA studies via www.usetox.org and in standard LCA software....

  5. Assessing the impact of natural policy experiments on socioeconomic inequalities in health: how to apply commonly used quantitative analytical methods?

    Science.gov (United States)

    Hu, Yannan; van Lenthe, Frank J; Hoffmann, Rasmus; van Hedel, Karen; Mackenbach, Johan P

    2017-04-20

    The scientific evidence-base for policies to tackle health inequalities is limited. Natural policy experiments (NPE) have drawn increasing attention as a means to evaluating the effects of policies on health. Several analytical methods can be used to evaluate the outcomes of NPEs in terms of average population health, but it is unclear whether they can also be used to assess the outcomes of NPEs in terms of health inequalities. The aim of this study therefore was to assess whether, and to demonstrate how, a number of commonly used analytical methods for the evaluation of NPEs can be applied to quantify the effect of policies on health inequalities. We identified seven quantitative analytical methods for the evaluation of NPEs: regression adjustment, propensity score matching, difference-in-differences analysis, fixed effects analysis, instrumental variable analysis, regression discontinuity and interrupted time-series. We assessed whether these methods can be used to quantify the effect of policies on the magnitude of health inequalities either by conducting a stratified analysis or by including an interaction term, and illustrated both approaches in a fictitious numerical example. All seven methods can be used to quantify the equity impact of policies on absolute and relative inequalities in health by conducting an analysis stratified by socioeconomic position, and all but one (propensity score matching) can be used to quantify equity impacts by inclusion of an interaction term between socioeconomic position and policy exposure. Methods commonly used in economics and econometrics for the evaluation of NPEs can also be applied to assess the equity impact of policies, and our illustrations provide guidance on how to do this appropriately. The low external validity of results from instrumental variable analysis and regression discontinuity makes these methods less desirable for assessing policy effects on population-level health inequalities. Increased use of the

  6. Assessing the impact of natural policy experiments on socioeconomic inequalities in health: how to apply commonly used quantitative analytical methods?

    Directory of Open Access Journals (Sweden)

    Yannan Hu

    2017-04-01

    Full Text Available Abstract Background The scientific evidence-base for policies to tackle health inequalities is limited. Natural policy experiments (NPE have drawn increasing attention as a means to evaluating the effects of policies on health. Several analytical methods can be used to evaluate the outcomes of NPEs in terms of average population health, but it is unclear whether they can also be used to assess the outcomes of NPEs in terms of health inequalities. The aim of this study therefore was to assess whether, and to demonstrate how, a number of commonly used analytical methods for the evaluation of NPEs can be applied to quantify the effect of policies on health inequalities. Methods We identified seven quantitative analytical methods for the evaluation of NPEs: regression adjustment, propensity score matching, difference-in-differences analysis, fixed effects analysis, instrumental variable analysis, regression discontinuity and interrupted time-series. We assessed whether these methods can be used to quantify the effect of policies on the magnitude of health inequalities either by conducting a stratified analysis or by including an interaction term, and illustrated both approaches in a fictitious numerical example. Results All seven methods can be used to quantify the equity impact of policies on absolute and relative inequalities in health by conducting an analysis stratified by socioeconomic position, and all but one (propensity score matching can be used to quantify equity impacts by inclusion of an interaction term between socioeconomic position and policy exposure. Conclusion Methods commonly used in economics and econometrics for the evaluation of NPEs can also be applied to assess the equity impact of policies, and our illustrations provide guidance on how to do this appropriately. The low external validity of results from instrumental variable analysis and regression discontinuity makes these methods less desirable for assessing policy effects

  7. Human health impact of Salmonella contamination in imported soybean products: A semiquantitative risk assessment

    DEFF Research Database (Denmark)

    Hald, Tine; Wingstrand, Anne; Brondsted, T.

    2006-01-01

    The objectives of our study were to estimate the number of reported cases of human salmonellosis in Denmark that can be attributed to the occurrence of Salmonella in soy-based animal feed and to assess whether certain serotypes can be considered of less importance to human health. The assessment ...

  8. Heat, Human Performance, and Occupational Health: A Key Issue for the Assessment of Global Climate Change Impacts.

    Science.gov (United States)

    Kjellstrom, Tord; Briggs, David; Freyberg, Chris; Lemke, Bruno; Otto, Matthias; Hyatt, Olivia

    2016-01-01

    Ambient heat exposure is a well-known health hazard, which reduces human performance and work capacity at heat levels already common in tropical and subtropical areas. Various health problems have been reported. Increasing heat exposure during the hottest seasons of each year is a key feature of global climate change. Heat exhaustion and reduced human performance are often overlooked in climate change health impact analysis. Later this century, many among the four billion people who live in hot areas worldwide will experience significantly reduced work capacity owing to climate change. In some areas, 30-40% of annual daylight hours will become too hot for work to be carried out. The social and economic impacts will be considerable, with global gross domestic product (GDP) losses greater than 20% by 2100. The analysis to date is piecemeal. More analysis of climate change-related occupational health impact assessments is greatly needed.

  9. Assessing health impacts in complex eco-epidemiological settings in the humid tropics: Advancing tools and methods

    International Nuclear Information System (INIS)

    Winkler, Mirko S.; Divall, Mark J.; Krieger, Gary R.; Balge, Marci Z.; Singer, Burton H.; Utzinger, Juerg

    2010-01-01

    In the developing world, large-scale projects in the extractive industry and natural resources sectors are often controversial and associated with long-term adverse health consequences to local communities. In many industrialised countries, health impact assessment (HIA) has been institutionalized for the mitigation of anticipated negative health effects while enhancing the benefits of projects, programmes and policies. However, in developing country settings, relatively few HIAs have been performed. Hence, more HIAs with a focus on low- and middle-income countries are needed to advance and refine tools and methods for impact assessment and subsequent mitigation measures. We present a promising HIA approach, developed within the frame of a large gold-mining project in the Democratic Republic of the Congo. The articulation of environmental health areas, the spatial delineation of potentially affected communities and the use of a diversity of sources to obtain quality baseline health data are utilized for risk profiling. We demonstrate how these tools and data are fed into a risk analysis matrix, which facilitates ranking of potential health impacts for subsequent prioritization of mitigation strategies. The outcomes encapsulate a multitude of environmental and health determinants in a systematic manner, and will assist decision-makers in the development of mitigation measures that minimize potential adverse health effects and enhance positive ones.

  10. The Health Impacts of Energy Policy Pathways in Ulaanbaatar, Mongolia: A Total Exposure Assessment

    Science.gov (United States)

    Hill, L. A.; Damdinsuren, Y.; Olkhanud, P. B.; Smith, K. R.; Turner, J. R.; Edwards, R.; Odsuren, M.; Ochir, C.

    2015-12-01

    Ulaanbaatar is home to nearly half of Mongolia's 2.8 million residents. The city's rapid growth, frigid winters, valley topography, and reliance on coal-fired stoves have led to some of the worst winter pollution levels in the world. To better understand this issue, we modeled integrated PM2.5exposures and related health impacts for various city-wide heating policies through 2024. This assessment is one of the first to employ a total exposure approach and results of the 2014 Comparative Risk Assessments of the Global Burden of Disease Project (CRA/GBD) in a policy-relevant energy study. Emissions related to heating, traffic, and power generation were considered under Business as Usual, Moderate Improvement, and Max Improvement scenarios. Calibrated outdoor models were combined with indoor models, local infiltration and time activity estimates, and demographic projections to estimate PM2.5exposures in 2014 and 2024. Indoor exposures were assigned by heating type, home type, and smoking status; outdoor exposures were assigned through geocoding. Population average annual exposures were calculated and applied to local disease rates and integrated exposure-response curves (2014 CRA/GBD) to arrive at annual projections of premature deaths and DALYs. We estimate 2014 annual average exposures at 68 μg/m3, dictated almost exclusively by indoor winter exposures. Under current trends, annual exposures increase 10% to 75 μg/m3 in 2024. This is in stark contrast to the moderate and max improvement scenarios, which lead to 2024 annual exposures that are 31%, and 68% lower, respectively. Under the Moderate scenario, 2024 per capita annual DALY and death burdens drop 26% and 22%, respectively, from 2014 levels. Under the Max scenario, 2024 per capita annual DALY and death burdens drop 71% and 66%, respectively, from 2014. SHS becomes a major contributor as emissions from other sectors decrease. Reductions are dominated by cardiovascular and lower respiratory diseases in children.

  11. What makes health impact assessments successful? Factors contributing to effectiveness in Australia and New Zealand.

    Science.gov (United States)

    Haigh, Fiona; Harris, Elizabeth; Harris-Roxas, Ben; Baum, Fran; Dannenberg, Andrew L; Harris, Mark F; Keleher, Helen; Kemp, Lynn; Morgan, Richard; Ng Chok, Harrison; Spickett, Jeff

    2015-10-03

    While many guidelines explain how to conduct Health Impact Assessments (HIAs), less is known about the factors that determine the extent to which HIAs affect health considerations in the decision making process. We investigated which factors are associated with increased or reduced effectiveness of HIAs in changing decisions and in the implementation of policies, programs or projects. This study builds on and tests the Harris and Harris-Roxas' conceptual framework for evaluating HIA effectiveness, which emphasises context, process and output as key domains. We reviewed 55 HIA reports in Australia and New Zealand from 2005 to 2009 and conducted surveys and interviews for 48 of these HIAs. Eleven detailed case studies were undertaken using document review and stakeholder interviews. Case study participants were selected through purposeful and snowball sampling. The data were analysed by thematic content analysis. Findings were synthesised and mapped against the conceptual framework. A stakeholder forum was utilised to test face validity and practical adequacy of the findings. We found that some features of HIA are essential, such as the stepwise but flexible process, and evidence based approach. Non-essential features that can enhance the impact of HIAs include capacity and experience; 'right person right level'; involvement of decision-makers and communities; and relationships and partnerships. There are contextual factors outside of HIA such as fit with planning and decision making context, broader global context and unanticipated events, and shared values and goals that may influence a HIA. Crosscutting factors include proactive positioning, and time and timeliness. These all operate within complex open systems, involving multiple decision-makers, levels of decision-making, and points of influence. The Harris and Harris-Roxas framework was generally supported. We have confirmed previously identified factors influencing effectiveness of HIA and identified new

  12. Climate change and plant health; Development of a conceptual frame-work for impact assessment

    OpenAIRE

    Breukers, M.L.H.

    2010-01-01

    This report presents a conceptual framework for systematic assessment of direct economic impacts of climate change on pest and disease management at the crop level. The framework evaluates and aggregates the effects, and subsequently impacts, of climate change on selected pests and diseases and their control in a particular crop. Application of the framework reveals opportunities and threats in crop protection resulting from climate change, and can direct future adaptation efforts.

  13. Assessing the Health Impact of Trade: A Call for an Expanded Research Agenda

    Science.gov (United States)

    McNamara, Courtney

    2017-01-01

    Labonté et al provide an insightful analysis of the Trans-Pacific Partnership (TPP) and its impact on a selection of important health determinants. Their work confirms concerns raised by previous analyses of leaked drafts and offers governments serious and timely reasons to carefully consider provisions of the agreement prior to moving forward with ratification. It also contributes more generally to a growing literature focused on identifying the health impacts of trade. This commentary uses the authors’ analysis as a starting point to reflect on two interrelated issues relevant both for taking seriously one of the article’s main recommendations and future work in the area of trade and health. PMID:28812818

  14. Assessing health impacts in complex eco-epidemiological settings in the humid tropics: The centrality of scoping

    International Nuclear Information System (INIS)

    Winkler, Mirko S.; Divall, Mark J.; Krieger, Gary R.; Balge, Marci Z.; Singer, Burton H.; Utzinger, Juerg

    2011-01-01

    Natural resources development projects are - and have been for more than 150 years - located in remote rural areas in developing countries, where local level data on community health is notoriously scarce. Health impact assessment (HIA) aims at identifying potential negative health consequences of such projects and providing the initial evidence-base for prevention and mitigation of diseases, injuries and risk factors, as well as promotion of positive effects. An important, but under-systematised early phase of the HIA process is scoping. It aims at organising diverse, often fragmentary, evidence and identifying potential project-related health impacts and underlying data gaps. It is also a key element in defining the terms of reference for the entire assessment. We present novel methodological features for the scoping process, emphasising the evaluation of quality of evidence, and illustrate its use in a contemporary HIA of the Simandou iron ore project in the Republic of Guinea. Assessment of data quality is integrated with specific content information via an analytical framework for the systematic identification of health outcomes and determinants of major concern. A subsequent gap analysis is utilised to assess the need for further baseline data collection and to facilitate the specification of a set of potential key performance indicators and strategies to inform the required evidence-base. We argue that scoping also plays a central role in the design of surveillance systems for longitudinal monitoring of health, equity and wellbeing following project implementation.

  15. Health Impacts of Climate Change in Pacific Island Countries: A Regional Assessment of Vulnerabilities and Adaptation Priorities.

    Science.gov (United States)

    McIver, Lachlan; Kim, Rokho; Woodward, Alistair; Hales, Simon; Spickett, Jeffery; Katscherian, Dianne; Hashizume, Masahiro; Honda, Yasushi; Kim, Ho; Iddings, Steven; Naicker, Jyotishma; Bambrick, Hilary; McMichael, Anthony J; Ebi, Kristie L

    2016-11-01

    Between 2010 and 2012, the World Health Organization Division of Pacific Technical Support led a regional climate change and health vulnerability assessment and adaptation planning project, in collaboration with health sector partners, in 13 Pacific island countries-Cook Islands, Federated States of Micronesia, Fiji, Kiribati, Marshall Islands, Nauru, Niue, Palau, Samoa, Solomon Islands, Tonga, Tuvalu, and Vanuatu. We assessed the vulnerabilities of Pacific island countries to the health impacts of climate change and planned adaptation strategies to minimize such threats to health. This assessment involved a combination of quantitative and qualitative techniques. The former included descriptive epidemiology, time series analyses, Poisson regression, and spatial modeling of climate and climate-sensitive disease data, in the few instances where this was possible; the latter included wide stakeholder consultations, iterative consensus building, and expert opinion. Vulnerabilities were ranked using a "likelihood versus impact" matrix, and adaptation strategies were prioritized and planned accordingly. The highest-priority climate-sensitive health risks in Pacific island countries included trauma from extreme weather events, heat-related illnesses, compromised safety and security of water and food, vector-borne diseases, zoonoses, respiratory illnesses, psychosocial ill-health, non-communicable diseases, population pressures, and health system deficiencies. Adaptation strategies relating to these climate change and health risks could be clustered according to categories common to many countries in the Pacific region. Pacific island countries are among the most vulnerable in the world to the health impacts of climate change. This vulnerability is a function of their unique geographic, demographic, and socioeconomic characteristics combined with their exposure to changing weather patterns associated with climate change, the health risks entailed, and the limited capacity

  16. Ecological and human health sediment risk assessment for a hydrocarbon-impacted site in Lake Athabasca

    International Nuclear Information System (INIS)

    Mcdonald, B.; Wagenaar, A.; LaPorte, J.; Misfeldt, G.; Chatwell, I.

    2009-01-01

    The operation of a public port facility near Uranium City, Saskatchewan has resulted in elevated levels of hydrocarbons in soil, groundwater and sediment. Remedial action in the uplands portion of the site was successful and a risk management approach was initiated for the aquatic portion of the site in order to resolve human health and ecological issues. Ecological risks were assessed using a sediment weight-of-evidence approach involving chemistry, toxicity, bioaccumulation and benthic community structure. Human health risks were assessed via fish consumption, water ingestion and direct contact according to Health Canada guidance. This presentation included an overview of the general risk assessment approach as well as site-specific data and findings. The primary focus was on the challenges confronted during the risk assessment process, such as the need to include alkylated PAHs as a COPC in the human health risk assessment and to evaluate ongoing propeller wash and sediment resuspension for sediment risk management, even though the facility is no longer operational.

  17. Assessment of environmental pollution from brick kilns and their impacts on human health in Bangladesh

    International Nuclear Information System (INIS)

    Azad, A.K.; Iqbal, A.

    2005-01-01

    Bricks are the most essential component for expanding urbanization in Bangladesh. Brick kilns situated all over the country meet the demand of these bricks. But brick fields are causing some environmental problems too. The objective of this study is to identify the pattern of energy consumption in brick fields as well as their impacts on the environment. An attempt has been made to estimate the emission of pollutants (Green house gases and non- green house gases) from brick fields to assess the impacts of the pollutants on human health of the surrounding areas. In Bangladesh, the total number of brick fields is around 6000. Brick fields use coal, wood fuel and crude a mainly for burning bricks in the kiln. Estimation reveals that in Bangladesh for the years 2003-2004, the coal required was 1800 kton while the wood fuel required was 1260 kton. Estimation also reveals that for Bangladesh the annual emission of the pollutants are 7505931.01 tons CO/sub 2/, 943.93 tons CH/sub 4/, 128.40 tons N/sub 2/O, 21763.49 tons NO/sub x/, 40777.21 tons CO, 1698.48 tons NMVOC and 176223.04 tons SO/sub 2/. CO/sub 2/ emission is the most prominent from brick burning. Estimation shows that, for the present level of CO/sub 2/ emission in Bangladesh yearly afforestation required is about 1.4 x 10/sup 9/9 m/sup 2/ area. The emission causes some health problems among both the workers and local inhabitants. The concentration persist around brick fields (200 m) is very high and is 3000 micro g/m/sup 3/ for SO/sub 2/ and 300 micro g/m/sup 3/ for NO/sub x/ and PM-10 during winter, while for summer the concentration is 1000 micro g/m/sup 3/ and 125 micro g/m/sup 3/ respectively. From the high concentration of these pollutants people face some of the health problems. About 30% of the workers suffer from dizziness while 60% feel fatigue. The headache is the most common problem of all the workers and 75% suffer from it. Those working for many years feel fatigue more than the new comers, 55% and 3

  18. The impact of parallel regulatory-health technology assessment scientific advice on clinical development. Assessing the uptake of regulatory and health technology assessment recommendations.

    Science.gov (United States)

    Tafuri, Giovanni; Lucas, Inês; Estevão, Steve; Moseley, Jane; d'Andon, Anne; Bruehl, Hannah; Gajraj, Elangovan; Garcia, Sonia; Hedberg, Niklas; Massari, Marco; Molina, Andrea; Obach, Mercè; Osipenko, Leeza; Petavy, Frank; Petschulies, Marco; Pontes, Caridad; Russo, Pierluigi; Schiel, Anja; Van de Casteele, Marc; Zebedin-Brandl, Eva-Maria; Rasi, Guido; Vamvakas, Spiros

    2018-01-25

    The parallel regulatory-health technology assessment scientific advice (PSA) procedure allows manufacturers to receive simultaneous feedback from both EU regulators and health technology assessment (HTA) bodies on development plans for new medicines. The primary objective of the present study is to investigate whether PSA is integrated in the clinical development programmes for which advice was sought. Contents of PSA provided by regulators and HTA bodies for each procedure between 2010 and 2015 were analysed. The development of all clinical studies for which PSA had been sought was tracked using three different databases. The rate of uptake of the advice provided by regulators and HTA bodies was assessed on two key variables: comparator/s and primary endpoint. In terms of uptake of comparator recommendations at the time of PSA in the actual development, our analysis showed that manufacturers implemented comparators to address both the needs of regulators and of at least one HTA body in 12 of 21 studies. For primary endpoints, in all included studies manufacturers addressed both the needs of the regulators and at least one HTA body. One of the key findings of this analysis is that manufacturers tend to implement changes to the development programme based on both regulatory and HTA advice with regards to the choice of primary endpoint and comparator. It also confirms the challenging choice of the study comparator, for which manufacturers seem to be more inclined to satisfy the regulatory advice. Continuous research efforts in this area are of paramount importance from a public health perspective. © 2018 The British Pharmacological Society.

  19. Health impact assessment of Solar Disinfection (SODIS) of drinking water in three African countries

    CSIR Research Space (South Africa)

    du Preez, M

    2010-09-01

    Full Text Available ...................................................................... 50 2.6.1.2 Anthropometry.................................................................... 51 2.7 PHASE 5: POST-SURVEY COMPLIANCE .................................................... 53 2.8 PHASE 6: DATA ANALYSIS... .......................................................................................... 62 3.8 ASSESSMENT OF HEALTH OUTCOMES ..................................................... 64 3.8.1 Analysis Approach............................................................................. 64 3.8.2 Data summary...

  20. Estuarine fish health assessment: Evidence of wastewater impacts based on nitrogen isotopes and histopathology

    Energy Technology Data Exchange (ETDEWEB)

    Schlacher, Thomas A. [Faculty of Science, Health and Education, University of the Sunshine Coast, Maroochydore DC, QLD 4558 (Australia)], E-mail: tschlach@usc.edu.au; Mondon, Julie A. [School of Life and Environmental Sciences, Deakin University, Warrnambool (Australia)], E-mail: julie.mondon@deakin.edu.au; Connolly, Rod M. [Australian Rivers Institute - Coast and Estuaries and Griffith School of Environment, Griffith University (Australia)], E-mail: r.connolly@griffith.edu.au

    2007-11-15

    Sewage effluent is a powerful agent of ecological change in estuaries. While the effects of sewage pollution on water quality are usually well documented, biological responses of exposed organisms are not. We quantified health impacts in the form of pathological tissue changes across multiple organs in estuarine fish exposed to elevated levels of treated wastewater. Structural pathologies were compared in wild populations of four fish species from two subtropical estuaries on the east coast of Australia that differ substantially in the amount of direct wastewater loadings. Uptake of sewage-derived nitrogen by fish was traced with stable nitrogen isotopes. Pathologies were common in the liver, spleen, gill, kidney and muscle tissues, and included granulomas, melanomacrophage aggregates, and multiple deformities of the gill epithelia. Tissue deformities were more frequent in fish exposed directly to wastewater discharges. Mullet (Valamugil georgii) were most affected, with only a single specimen free of pathologies in the sewage-impacted estuary. Similarly, in those fish that had structural abnormalities, more deformities were generally found in individuals from sites receiving sewage. These spatial contrasts in impaired fish health correspond to significantly enriched {delta}{sup 15}N values in fish muscle as a consequence of fish assimilating sewage-N. Overall, the pattern of lower health and enriched {delta}{sup 15}N values in fish from sewage-impacted areas suggests that organism health is lowered by sewage inputs to estuaries. Measurements of organism health are required to understand the effects of sewage on estuarine ecosystems, and histopathology of fishes is a powerful tool to achieve this.

  1. Health Impacts of Climate Change in Pacific Island Countries: A Regional Assessment of Vulnerabilities and Adaptation Priorities

    Science.gov (United States)

    McIver, Lachlan; Kim, Rokho; Woodward, Alistair; Hales, Simon; Spickett, Jeffery; Katscherian, Dianne; Hashizume, Masahiro; Honda, Yasushi; Kim, Ho; Iddings, Steven; Naicker, Jyotishma; Bambrick, Hilary; McMichael, Anthony J.; Ebi, Kristie L.

    2015-01-01

    Background: Between 2010 and 2012, the World Health Organization Division of Pacific Technical Support led a regional climate change and health vulnerability assessment and adaptation planning project, in collaboration with health sector partners, in 13 Pacific island countries—Cook Islands, Federated States of Micronesia, Fiji, Kiribati, Marshall Islands, Nauru, Niue, Palau, Samoa, Solomon Islands, Tonga, Tuvalu, and Vanuatu. Objective: We assessed the vulnerabilities of Pacific island countries to the health impacts of climate change and planned adaptation strategies to minimize such threats to health. Methods: This assessment involved a combination of quantitative and qualitative techniques. The former included descriptive epidemiology, time series analyses, Poisson regression, and spatial modeling of climate and climate-sensitive disease data, in the few instances where this was possible; the latter included wide stakeholder consultations, iterative consensus building, and expert opinion. Vulnerabilities were ranked using a “likelihood versus impact” matrix, and adaptation strategies were prioritized and planned accordingly. Results: The highest-priority climate-sensitive health risks in Pacific island countries included trauma from extreme weather events, heat-related illnesses, compromised safety and security of water and food, vector-borne diseases, zoonoses, respiratory illnesses, psychosocial ill-health, non-communicable diseases, population pressures, and health system deficiencies. Adaptation strategies relating to these climate change and health risks could be clustered according to categories common to many countries in the Pacific region. Conclusion: Pacific island countries are among the most vulnerable in the world to the health impacts of climate change. This vulnerability is a function of their unique geographic, demographic, and socioeconomic characteristics combined with their exposure to changing weather patterns associated with climate

  2. Intraprocedural contrast-enhanced ultrasound (CEUS) in liver percutaneous radiofrequency ablation: clinical impact and health technology assessment.

    Science.gov (United States)

    Mauri, Giovanni; Porazzi, Emanuele; Cova, Luca; Restelli, Umberto; Tondolo, Tania; Bonfanti, Marzia; Cerri, Anna; Ierace, Tiziana; Croce, Davide; Solbiati, Luigi

    2014-04-01

    To assess the clinical and the economic impacts of intraprocedural use of contrast-enhanced ultrasound (CEUS) in patients undergoing percutaneous radiofrequency ablation for small (impact, cost effectiveness, and budget, organisational and equity impacts were evaluated and compared with standard treatment without intraprocedural CEUS using the health technology assessment approach. Intraprocedural CEUS detected incomplete ablation in 34/93 (36.5 %) patients, who underwent additional treatment during the same session. At 24-h, complete ablation was found in 88/93 (94.6 %) patients. Thus, a second session of treatment was spared in 29/93 (31.1 %) patients. Cost-effectiveness analysis revealed an advantage for the use of intraprocedural CEUS in comparison with standard treatment (4,639 vs 6,592) with a 21.9 % reduction of the costs to treat the whole sample. Cost per patient for complete treatment was  4,609 versus  5,872 respectively. The introduction of intraprocedural CEUS resulted in a low organisational impact, and in a positive impact on equity Intraprocedural use of CEUS has a relevant clinical impact, reducing the number of re-treatments and the related costs per patient. • CEUS allows to immediately asses the result of ablation. • Intraprocedural CEUS decreases the number of second ablative sessions. • Intraprocedural CEUS may reduce cost per patient for complete treatment. • Use of intraprocedural CEUS may reduce hospital budget. • Its introduction has low organisational impact, and relevant impact on equity.

  3. Baseline health conditions in selected communities of northern Sierra Leone as revealed by the health impact assessment of a biofuel project.

    Science.gov (United States)

    Winkler, Mirko S; Knoblauch, Astrid M; Righetti, Aurélie A; Divall, Mark J; Koroma, Manso M; Fofanah, Ibrahim; Turay, Hamid; Hodges, Mary H; Utzinger, Jürg

    2014-09-01

    As biofuel projects may be associated with positive and negative effects on people's health and wellbeing, a health impact assessment was performed for the Addax Bioenergy Sierra Leone (ABSL) project. We present data from the baseline health survey, which will provide a point of departure for future monitoring and evaluation activities. In December 2010, a cross-sectional survey was carried out in eight potentially affected communities. A broad set of clinical and parasitological indicators were assessed using standardised, quality-controlled procedures, including anthropometry and prevalence of anaemia, Plasmodium falciparum and helminth infections. Complete datasets were obtained from 1221 individuals of 194 households and eight schools. Of children aged biofuel project impacts on community health in a rural setting in sub-Saharan Africa. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Assessment of Noise and Associated Health Impacts at Selected Secondary Schools in Ibadan, Nigeria

    International Nuclear Information System (INIS)

    Ana, G.R.E.E.; Brown, G.E.; Sridhar, M.K.C.; Shendell, D.G.; Shendell, D.G.; Shendell, D.G.

    2010-01-01

    Background. Most schools in Ibadan, Nigeria, are located near major roads (mobile line sources). We conducted an initial assessment of noise levels and adverse noise-related health and learning effects. Methods. For this descriptive, cross-sectional study, four schools were selected randomly from eight participating in overall project. We administered 200 questionnaires, 50 per school, assessing health and learning-related outcomes. Noise levels (A-weighted decibels, dBA) were measured with calibrated sound level meters. Traffic density was assessed for school with the highest measured dBA. Observational checklists assessed noise control parameters and building physical attributes. Results. Short-term, cross-sectional school-day noise levels ranged 68.3-84.7 dBA. Over 60% of respondents reported that vehicular traffic was major source of noise, and over 70% complained being disturbed by noise. Three schools reported tiredness, and one school lack of concentration, as the most prevalent noise-related health problems. Conclusion. Secondary school occupants in Ibadan, Nigeria were potentially affected by exposure to noise from mobile line sources.

  5. Health care technology assessment

    Science.gov (United States)

    Goodman, Clifford

    1994-12-01

    The role of technology in the cost of health care is a primary issue in current debates concerning national health care reform. The broad scope of studies for understanding technological impacts is known as technology assessment. Technology policy makers can improve their decision making by becoming more aware, and taking greater advantage, of key trends in health care technology assessment (HCTA). HCTA is the systematic evaluation of the properties, impacts, and other attributes of health care technologies, including: technical performance; clinical safety and efficacy/effectiveness; cost-effectiveness and other economic attributes; appropriate circumstances/indications for use; and social, legal, ethical, and political impacts. The main purpose of HCTA is to inform technology-related policy making in health care. Among the important trends in HCTA are: (1) proliferation of HCTA groups in the public and private sectors; (2) higher standards for scientific evidence concerning technologies; (3) methodological development in cost analyses, health-related quality of life measurement, and consolidation of available scientific evidence (e.g., meta-analysis); (4) emphasis on improved data on how well technologies work in routine practice and for traditionally under-represented patient groups; (5) development of priority-setting methods; (6) greater reliance on medical informatics to support and disseminate HCTA findings.

  6. Regional and urban down scaling of global climate scenarios for health impact assessments

    Energy Technology Data Exchange (ETDEWEB)

    San Jose, R.; Perez, J. L.; Perez, L.; Gonzalez, R. M.; Pecci, J.; Garzon, A.; Palacios, M.

    2015-07-01

    In this contribution we have used global climate RCP IPCC scenarios to produce climate and air pollution maps at regional (25 km resolution) and urban scale with 200 m spatial resolution over Europe and five European cities in order to investigate the impact on meteorological variables and pollutant concentrations . We have used the very well known mesoscale meteorological model WRF-Chem (NOAA, US). We have used 2011 as control past year and two RCP scenarios from CCSM global climate model with 4.5 W/m2 and 8.5 W/m2 for 2030, 2050 and 2100 years. After running WRF-Chem model, using the boundary conditions provided by RCP scenarios with the emissions of 2011, we have performed a detailed down scaling process using CALMET diagnostic model to obtain a full 200 m spatial resolution map of five European cities (London, Antwerp, Madrid, Milan, and Helsinki). We will show the results and the health impacts for future RCP IPCC climate scenarios in comparison with the 2011 control year information for climate and health indicators. Finally, we have also investigated the impact of the aerosol effects in the short wave radiation mean value. Two simulations with the WRF-Chem model have been performed over Europe in 2010. A baseline simulation without any feedback effects and a second simulation including the direct effects affecting the solar radiation reaching the surface as well as the indirect aerosol effect with potential impacts on increasing or decreasing the precipitation rates. Aerosol effects produce an increase of incoming radiation over Atlantic Ocean (up to 70%) because the prescribed aerosol concentrations in the WRF-Chem without feedbacks is substantially higher than the aerosol concentrations produced when we activate the feedback effects. The decrease in solar radiation in the Sahara area (10%) is found to be produced because the prescribed aerosol concentration in the no feedback simulation is lower than when we activate the feedback effects. (Author)

  7. Regional and urban downscaling of global climate scenarios for health impact assessments

    Energy Technology Data Exchange (ETDEWEB)

    San Jose, R.; Perez, J.L.; Perez, L.; Gonzalez, R.M.; Pecci, J.; Garzon, A.; Palacios, M.

    2015-07-01

    In this contribution we have used global climate RCP IPCC scenarios to produce climate and air pollution maps at regional (25 km resolution) and urban scale with 200 m spatial resolution over Europe and five European cities in order to investigate the impact on meteorological variables and pollutant concentrations . We have used the very well known mesoscale meeorological model WRF-Chem (NOAA, US). We have used 2011 as control past year and two RCP scenarios from CCSM global climate model with 4.5 W/m2 and 8.5 W/m2 for 2030, 2050 and 2100 years. After running WRF-Chem model, using the boundary conditions provided by RCP scenarios with the emissions of 2011, we have performed a detailed downscaling process using CALMET diagnostic model to obtain a full 200 m spatial resolution map of five European cities (London, Antwerp, Madrid, Milan, and Helsinki). We will show the results and the health impacts for future RCP IPCC climate scenarios in comparison with the 2011 control year information for climate and health indicators. Finnally, we have also investigated the impact of the aerosol effects in the short wave radiation mean value. Two simulations with the WRF-Chem model have been performed over Europe in 2010. A baseline simulation without any feedback effects and a second simulation including the direct effects affecting the solar radiation reaching the surface as well as the indirect aerosol effect with potential impacts on increasing or decreasing the precipitation rates. Aerosol effects produce an increase of incoming radiation over Atlantic Ocean (up to 70%) because the prescribed aerosol concentrations in the WRF-Chem without feedbacks is substantially higher than the aerosol concentrations produced when we activate the feedback effects. The decrease in solar radiation in the Sahara area (10%) is found to be produced because the prescribed aerosol concentration in the {sup n}o feedback{sup s}imulation is lower than when we activate the feedback effects. (Author)

  8. Regional and urban down scaling of global climate scenarios for health impact assessments

    International Nuclear Information System (INIS)

    San Jose, R.; Perez, J. L.; Perez, L.; Gonzalez, R. M.; Pecci, J.; Garzon, A.; Palacios, M.

    2015-01-01

    In this contribution we have used global climate RCP IPCC scenarios to produce climate and air pollution maps at regional (25 km resolution) and urban scale with 200 m spatial resolution over Europe and five European cities in order to investigate the impact on meteorological variables and pollutant concentrations . We have used the very well known mesoscale meteorological model WRF-Chem (NOAA, US). We have used 2011 as control past year and two RCP scenarios from CCSM global climate model with 4.5 W/m2 and 8.5 W/m2 for 2030, 2050 and 2100 years. After running WRF-Chem model, using the boundary conditions provided by RCP scenarios with the emissions of 2011, we have performed a detailed down scaling process using CALMET diagnostic model to obtain a full 200 m spatial resolution map of five European cities (London, Antwerp, Madrid, Milan, and Helsinki). We will show the results and the health impacts for future RCP IPCC climate scenarios in comparison with the 2011 control year information for climate and health indicators. Finally, we have also investigated the impact of the aerosol effects in the short wave radiation mean value. Two simulations with the WRF-Chem model have been performed over Europe in 2010. A baseline simulation without any feedback effects and a second simulation including the direct effects affecting the solar radiation reaching the surface as well as the indirect aerosol effect with potential impacts on increasing or decreasing the precipitation rates. Aerosol effects produce an increase of incoming radiation over Atlantic Ocean (up to 70%) because the prescribed aerosol concentrations in the WRF-Chem without feedbacks is substantially higher than the aerosol concentrations produced when we activate the feedback effects. The decrease in solar radiation in the Sahara area (10%) is found to be produced because the prescribed aerosol concentration in the no feedback simulation is lower than when we activate the feedback effects. (Author)

  9. The Malay version of the Early Childhood Oral Health Impact Scale (Malay-ECOHIS)--assessing validity and reliability.

    Science.gov (United States)

    Hashim, Azlina N; Yusof, Zamros Y M; Esa, Rashidah

    2015-11-25

    The Early Childhood Oral Health Impact Scale (ECOHIS) is used to assess oral impacts on the quality of life of preschool aged children and their families. The objective of this study was to perform a cross-cultural adaptation of the ECOHIS into Malay and assess its psychometric properties. The cross-cultural adaptation of ECOHIS into Malay comprised of translating the ECOHIS into the Malay language (Malay-ECOHIS) by experts followed by face validation of the Malay-ECOHIS by a group of mothers. The Malay-ECOHIS was back translated into English and this was compared with the original ECOHIS. Minor changes were made to the Malay-ECOHIS before it was finalised. The Malay-ECOHIS' psychometric properties were assessed in terms of construct, convergent and discriminant validity as well as internal and test-retest reliability based on two separate studies involving 127 parents of 4-6 year old preschool children followed by oral examinations of 860 preschool children from 25 kindergartens from two districts in Selangor state, Malaysia. Non-parametric statistics were used to assess the relationships between the Malay-ECOHIS and the subjective and clinical outcome measures. The Cronbach's alpha was 0.83 and the weighted Kappa was 0.95 (intraclass correlation = 0.94). The Malay-ECOHIS demonstrated significant associations with different subjective and normative measures, i.e. levels of oral health satisfaction, perceived oral health status, perceived oral health need, toothache experience, pattern of dental attendance, and caries status of preschool children. These significant associations supported its construct, convergent and discriminant validity as well as internal and test-retest reliability. This study showed that the Malay-ECOHIS is a valid and reliable instrument to assess the negative impacts of oral disorders/conditions on the quality of life of 4-6 year old preschool children and their families in Malaysia.

  10. Formative impact assessment of learning by doing program with health care professionals from Aragón

    Directory of Open Access Journals (Sweden)

    María Luisa Gracia-Pérez

    2017-05-01

    Full Text Available Health professionals require constant learning process that allows them to address current challenges such as technological innovation, organizational changes, the evidence-based medicine, epidemiological changes, participation, etc. Despite the resources and efforts invested, it has not paid enough attention to assessing the training of these professionals. This article analyzes the formative impact assessment based on a learning by doing program conducted in the Aragon Health Service. The training activities were proposed, implemented and evaluated by service professionals in the workplace after a management selection process. We have worked with ad hoc survey designed and sent to participating professionals and students. 182 doctors and nurses responded online. By bivariate regression analysis and analyzed the interaction between learning knowledge and skills, their transfer to the workplace and the quality of care. 94.4% of respondents the relationship between improving professional skills (acquisition of knowledge and skills useful to the profession, application of new knowledge and skills in the workplace, training cascading notes and improving knowledge and skills and improved quality of care (measured by indicators of European Foundation for Quality Management. The design of the impact evaluation of the training should be linked to previous assessments and measure results consequential effects on the organization. This information becomes a key tool to assess the effectiveness of the executed program and programming future actions, to ensure the continued training of health professionals and to improve the quality of their performances.

  11. A Hybrid Fuzzy Inference System Based on Dispersion Model for Quantitative Environmental Health Impact Assessment of Urban Transportation Planning

    Directory of Open Access Journals (Sweden)

    Behnam Tashayo

    2017-01-01

    Full Text Available Characterizing the spatial variation of traffic-related air pollution has been and is a long-standing challenge in quantitative environmental health impact assessment of urban transportation planning. Advanced approaches are required for modeling complex relationships among traffic, air pollution, and adverse health outcomes by considering uncertainties in the available data. A new hybrid fuzzy model is developed and implemented through hierarchical fuzzy inference system (HFIS. This model is integrated with a dispersion model in order to model the effect of transportation system on the PM2.5 concentration. An improved health metric is developed as well based on a HFIS to model the impact of traffic-related PM2.5 on health. Two solutions are applied to improve the performance of both the models: the topologies of HFISs are selected according to the problem and used variables, membership functions, and rule set are determined through learning in a simultaneous manner. The capabilities of this proposed approach is examined by assessing the impacts of three traffic scenarios involved in air pollution in the city of Isfahan, Iran, and the model accuracy compared to the results of available models from literature. The advantages here are modeling the spatial variation of PM2.5 with high resolution, appropriate processing requirements, and considering the interaction between emissions and meteorological processes. These models are capable of using the available qualitative and uncertain data. These models are of appropriate accuracy, and can provide better understanding of the phenomena in addition to assess the impact of each parameter for the planners.

  12. The 'Hothaps' programme for assessing climate change impacts on occupational health and productivity: an invitation to carry out field studies.

    Science.gov (United States)

    Kjellstrom, Tord; Gabrysch, Sabine; Lemke, Bruno; Dear, Keith

    2009-11-11

    The 'high occupational temperature health and productivity suppression' programme (Hothaps) is a multi-centre health research and prevention programme aimed at quantifying the extent to which working people are affected by, or adapt to, heat exposure while working, and how global heating during climate change may increase such effects. The programme will produce essential new evidence for local, national and global assessment of negative impacts of climate change that have largely been overlooked. It will also identify and evaluate preventive interventions in different social and economic settings.Hothaps includes studies in any part of the world where hourly heat exposure exceeds physiological stress limits that may affect workers. This usually happens at temperatures above 25 degrees C, depending on humidity, wind movement and heat radiation. Working people in low and middle-income tropical countries are particularly vulnerable, because many of them are involved in heavy physical work, either outdoors in strong sunlight or indoors without effective cooling. If high work intensity is maintained in workplaces with high heat exposure, serious health effects can occur, including heat stroke and death.Depending on the type of occupation, the required work intensity, and the level of heat stress, working people have to slow down their work in order to reduce internal body heat production and the risk of heat stroke. Thus, unless preventive interventions are used to reduce the heat stress on workers, their individual health and productivity will be affected and economic output per work hour will be reduced. Heat also influences other daily physical activities, unrelated to work, in all age groups. Poorer people without access to household or workplace cooling devices are most likely to be affected.The Hothaps programme includes a pilot study, heat monitoring of selected workplaces, qualitative studies of perceived heat impacts and preventative interventions

  13. A Health Impact Assessment of Proposed Public Transportation Service Cuts and Fare Increases in Boston, Massachusetts (U.S.A.

    Directory of Open Access Journals (Sweden)

    Peter James

    2014-08-01

    Full Text Available Transportation decisions have health consequences that are often not incorporated into policy-making processes. Health Impact Assessment (HIA is a process that can be used to evaluate health effects of transportation policy. We present a rapid HIA, conducted over eight weeks, evaluating health and economic effects of proposed fare increases and service cuts to Boston, Massachusetts’ public transportation system. We used transportation modeling in concert with tools allowing for quantification and monetization of multiple pathways. We estimated health and economic costs of proposed public transportation system changes to be hundreds of millions of dollars per year, exceeding the budget gap the public transportation authority was required to close. Significant health pathways included crashes, air pollution, and physical activity. The HIA enabled stakeholders to advocate for more modest fare increases and service cuts, which were eventually adopted by decision makers. This HIA was among the first to quantify and monetize multiple pathways linking transportation decisions with health and economic outcomes, using approaches that could be applied in different settings. Including health costs in transportation decisions can lead to policy choices with both economic and public health benefits.

  14. Assessment of health benefits related to air quality improvement strategies in urban areas: An Impact Pathway Approach.

    Science.gov (United States)

    Silveira, Carlos; Roebeling, Peter; Lopes, Myriam; Ferreira, Joana; Costa, Solange; Teixeira, João P; Borrego, Carlos; Miranda, Ana I

    2016-12-01

    Air pollution is, increasingly, a concern to our society given the threats to human health and the environment. Concerted actions to improve air quality have been taken at different levels, such as through the development of Air Quality Plans (AQPs). However, air quality impacts associated with the implementation of abatement measures included in AQPs are often neglected. In order to identify the major gaps and strengths in current knowledge, a literature review has been performed on existing methodologies to estimate air pollution-related health impacts and subsequent external costs. Based on this review, the Impact Pathway Approach was adopted and applied within the context of the MAPLIA research project to assess the health impacts and benefits (or avoided external costs) derived from improvements in air quality. Seven emission abatement scenarios, based on individual and combined abatement measures, were tested for the major activity sectors (traffic, residential and industrial combustion and production processes) of a Portuguese urban area (Grande Porto) with severe particular matter (PM10) air pollution problems. Results revealed a strong positive correlation between population density and health benefits obtained from the assessed reduction scenarios. As a consequence, potential health benefits from reduction scenarios are largest in densely populated areas with high anthropic activity and, thus, where air pollution problems are most alarming. Implementation of all measures resulted in a reduction in PM10 emissions by almost 8%, improving air quality by about 1% and contributing to a benefit of 8.8 million €/year for the entire study domain. The introduction of PM10 reduction technologies in industrial units was the most beneficial abatement measure. This study intends to contribute to policy support for decision-making on air quality management. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. New statistical methodology, mathematical models, and data bases relevant to the assessment of health impacts of energy technologies

    International Nuclear Information System (INIS)

    Ginevan, M.E.; Collins, J.J.; Brown, C.D.; Carnes, B.A.; Curtiss, J.B.; Devine, N.

    1981-01-01

    The present research develops new statistical methodology, mathematical models, and data bases of relevance to the assessment of health impacts of energy technologies, and uses these to identify, quantify, and pedict adverse health effects of energy related pollutants. Efforts are in five related areas including: (1) evaluation and development of statistical procedures for the analysis of death rate data, disease incidence data, and large scale data sets; (2) development of dose response and demographic models useful in the prediction of the health effects of energy technologies; (3) application of our method and models to analyses of the health risks of energy production; (4) a reanalysis of the Tri-State leukemia survey data, focusing on the relationship between myelogenous leukemia risk and diagnostic x-ray exposure; and (5) investigation of human birth weights as a possible early warning system for the effects of environmental pollution

  16. Health impact assessment of marine emissions in Pearl River Delta region.

    Science.gov (United States)

    Lai, H K; Tsang, H; Chau, J; Lee, C H; McGhee, S M; Hedley, A J; Wong, C M

    2013-01-15

    Global marine vessels emissions are adversely affecting human health particularly in southeast Asia. But health burdens from both ocean- and river-going vessels in Pearl River Delta (PRD) regions are not quantified. We estimated the potential health impacts using pooled relative risks of mortality and hospital admissions in China, and the model derived concentrations of sulfur dioxide (SO₂), particulate matter (PM₁₀), nitrogen dioxide (NO₂) and ozone (O₃) due to vessels emissions. SO₂ concentrations due to marine emissions in Hong Kong were 13.6 μg m⁻³ compared with 0.7 μg m⁻³ in PRD regions that were far from the marine vessels. In PRD regions, the estimated annual numbers (per million people) of excess deaths from all natural causes and hospital admissions from cardiorespiratory causes attributable to SO₂, NO₂, O₃ and PM₁₀ combined from marine emissions were 45 and 265 respectively. Marine emission control measures could contribute a large reduction in mortality and hospital admissions in PRD regions especially in Hong Kong. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Models and applications for measuring the impact of health research: update of a systematic review for the Health Technology Assessment programme.

    Science.gov (United States)

    Raftery, James; Hanney, Steve; Greenhalgh, Trish; Glover, Matthew; Blatch-Jones, Amanda

    2016-10-01

    This report reviews approaches and tools for measuring the impact of research programmes, building on, and extending, a 2007 review. (1) To identify the range of theoretical models and empirical approaches for measuring the impact of health research programmes; (2) to develop a taxonomy of models and approaches; (3) to summarise the evidence on the application and use of these models; and (4) to evaluate the different options for the Health Technology Assessment (HTA) programme. We searched databases including Ovid MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature and The Cochrane Library from January 2005 to August 2014. This narrative systematic literature review comprised an update, extension and analysis/discussion. We systematically searched eight databases, supplemented by personal knowledge, in August 2014 through to March 2015. The literature on impact assessment has much expanded. The Payback Framework, with adaptations, remains the most widely used approach. It draws on different philosophical traditions, enhancing an underlying logic model with an interpretative case study element and attention to context. Besides the logic model, other ideal type approaches included constructionist, realist, critical and performative. Most models in practice drew pragmatically on elements of several ideal types. Monetisation of impact, an increasingly popular approach, shows a high return from research but relies heavily on assumptions about the extent to which health gains depend on research. Despite usually requiring systematic reviews before funding trials, the HTA programme does not routinely examine the impact of those trials on subsequent systematic reviews. The York/Patient-Centered Outcomes Research Institute and the Grading of Recommendations Assessment, Development and Evaluation toolkits provide ways of assessing such impact, but need to be evaluated. The literature, as reviewed here, provides very few instances of a randomised trial

  18. Assessing environmental and health impact of the nuclear fuel cycle. Methodology and application to prospective actinides recycling options

    International Nuclear Information System (INIS)

    Garzenne, Claude; Grouiller, Jean-Paul; Le Boulch, Denis

    2005-01-01

    French Industrial Companies: EDF, AREVA (COGEMA and FRAMATOME-ANP), associated with ANDRA, the organization in charge of the waste management in France, and Public Research Institute CEA and IRSN, involved in the nuclear waste management, have developed in collaboration a methodology intended to assess the environmental and health impact of the nuclear fuel cycle. This methodology, based on fuel cycle simulation, Life Cycle Analysis, and Impact Studies of each fuel cycle facilities, has been applied to a set of nuclear scenarios covering a very contrasted range of waste management options, in order to characterize the effect of High Level Waste transmutation, and to estimate to what extent it could contribute to reduce their overall impact on health and environment. The main conclusion we could draw from this study is that it is not possible to discriminate, as far as health and environmental impacts are concerned, nuclear scenarios implementing very different levels of HLW transmutation, representative of the whole range of available options. The main limitation of this work is due to the hypothesis of normal behavior of all fuel cycle facilities: main future improvement of the methodology would be to take the accidental risk into account. (author)

  19. Assessing the impact of cigarette package health warning labels: a cross-country comparison in Brazil, Uruguay, and Mexico

    Science.gov (United States)

    Thrasher, James F; Villalobos, Victor; Szklo, André; Fong, Geoffrey T; Pérez, Cristina; Sebrié, Ernesto; Sansone, Natalie; Figueiredo, Valeska; Boado, Marcelo; Arillo-Santillán, Edna; Bianco, Eduardo

    2015-01-01

    Objective To assess the impact of different health warning labels (HWL). Material and Methods Data from the International Tobacco Control Survey (ITC Survey) were analyzed from adult smokers in Brazil, Uruguay and Mexico, each of which used a different HWL strategy (pictures of human suffering and diseased organs; abstract pictorial representations of risk; and text-only messages, respectively). Main outcomes were HWL salience and cognitive impact. Results HWLs in Uruguay (which was the only country with a HWL on the front of the package) had higher salience than either Brazilian or Mexican packs. People at higher levels of educational attainment in Mexico were more likely to read the text-only HWLs whereas education was unassociated with salience in Brazil or Uruguay. Brazilian HWLs had greater cognitive impacts than HWLs in either Uruguay or Mexico. HWLs in Uruguay generated lower cognitive impacts than the text-only HWLs in Mexico. In Brazil, cognitive impacts were strongest among smokers with low educational attainment. Conclusions This study suggests that HWLs have the most impact when they are prominent (i.e., front and back of the package) and include emotionally engaging imagery that illustrates negative bodily impacts or human suffering due to smoking. PMID:21243191

  20. The effectiveness of health impact assessment in influencing decision-making in Australia and New Zealand 2005–2009

    Science.gov (United States)

    2013-01-01

    Background Health Impact Assessment (HIA) involves assessing how proposals may alter the determinants of health prior to implementation and recommends changes to enhance positive and mitigate negative impacts. HIAs growing use needs to be supported by a strong evidence base, both to validate the value of its application and to make its application more robust. We have carried out the first systematic empirical study of the influence of HIA on decision-making and implementation of proposals in Australia and New Zealand. This paper focuses on identifying whether and how HIAs changed decision-making and implementation and impacts that participants report following involvement in HIAs. Methods We used a two-step process first surveying 55 HIAs followed by 11 in-depth case studies. Data gathering methods included questionnaires with follow-up interview, semi-structured interviews and document collation. We carried out deductive and inductive qualitative content analyses of interview transcripts and documents as well as simple descriptive statistics. Results We found that most HIAs are effective in some way. HIAs are often directly effective in changing, influencing, broadening areas considered and in some cases having immediate impact on decisions. Even when HIAs are reported to have no direct effect on a decision they are often still effective in influencing decision-making processes and the stakeholders involved in them. HIA participants identify changes in relationships, improved understanding of the determinants of health and positive working relationships as major and sustainable impacts of their involvement. Conclusions This study clearly demonstrates direct and indirect effectiveness of HIA influencing decision making in Australia and New Zealand. We recommend that public health leaders and policy makers should be confident in promoting the use of HIA and investing in building capacity to undertake high quality HIAs. New findings about the value HIA stakeholders

  1. Welcome to the revolution: integrative biology and assessing the impact of endocrine disruptors on environmental and public health.

    Science.gov (United States)

    Hayes, Tyrone B

    2005-04-01

    Concern continues to grow over the negative impact of endocrine disrupting chemicals on environmental and public health. The number of identified endocrine disrupting chemicals is increasing, but biological endpoints, experimental design, and approaches for examining and assessing the impact of these chemicals are still debated. Although some workers consider endocrine disruption an "emerging science," I argue here that it is equally, a "merging science" developing in the tradition of integrative biology. Understanding the impact of endocrine disruptors on humans and wildlife is an examination of "context dependent development" and one that Scott Gilbert predicted would require a "new synthesis" or a "revolution" in the biological sciences. Here, I use atrazine as an example to demonstrate the importance of an integrative approach in understanding endocrine disruptors.Atrazine is a potent endocrine disruptor that chemically castrates and feminizes amphibians and other wildlife. These effects are the result of the induction of aromatase, the enzyme that converts androgens to estrogens, and this mechanism has been confirmed in all vertebrate classes examined (fish, amphibians, reptiles, birds, and mammals, including humans). To truly assess the impact of atrazine on amphibians in the wild, diverse fields of study including endocrinology, developmental biology, molecular biology, cellular biology, ecology, and evolutionary biology need to be invoked. To understand fully the long-term impacts on the environment, meteorology, geology, hydrology, chemistry, statistics, mathematics and other disciplines well outside of the biological sciences are required.

  2. Monitoring and Assessing Groundwater Impacts on Vegetation Health in Groundwater Dependent Ecosystems

    Science.gov (United States)

    Rohde, M. M.; Ulrich, C.; Howard, J.; Sweet, S.

    2017-12-01

    Sustainable groundwater management is important for preserving our economy, society, and environment. Groundwater supports important habitat throughout California, by providing a reliable source of water for these Groundwater Dependent Ecosystems (GDEs). Groundwater is particularly important in California since it supplies an additional source of water during the dry summer months and periods of drought. The drought and unsustainable pumping practices have, in some areas, lowered groundwater levels causing undesirable results to ecosystems. The Sustainable Groundwater Management Act requires local agencies to avoid undesirable results in the future, but the location and vulnerabilities of the ecosystems that depend on groundwater and interconnected surface water is often poorly understood. This presentation will feature results from a research study conducted by The Nature Conservancy and Lawrence Berkeley National Laboratory that investigated how changes in groundwater availability along an interconnected surface water body can impact the overall health of GDEs. This study was conducted in California's Central Valley along the Cosumnes River, and situated at the boundary of a high and a medium groundwater basin: South American Basin (Sacramento Hydrologic Region) and Cosumnes Basin (San Joaquin Hydrologic Region). By employing geophysical methodology (electrical resistivity tomography) in this study, spatial changes in groundwater availability were determined under groundwater-dependent vegetation. Vegetation survey data were also applied to this study to develop ecosystem health indicators for groundwater-dependent vegetation. Health indicators for groundwater-dependent vegetation were found to directly correlate with groundwater availability, such that greater availability to groundwater resulted in healthier vegetation. This study provides a case study example on how to use hydrological and biological data for setting appropriate minimum thresholds and

  3. Health impact and noise exposure assessment in the cricket bat industry of Kashmir, India.

    Science.gov (United States)

    Manzoor, Javid; Mamta; Jaganadha Rao, Rayavarapu; Wani, Khursheed Ahmad

    2016-12-01

    The aim of the present study was to identify and evaluate predominant noise sources in the cricket bat industry of Kashmir, India. Sound levels were measured at operator's ear level in the working zone of the workers of seven cricket bat factories. The impact assessment was made through personal interviews with each worker separately during their period of rest. On average, 62.5% of the workers reported difficulty in hearing and 24.1% of the workers have become patients for hypertension. Only 58.1% of the workers complained of headache due to high noise level. The workers engaged in the cricket bat industry of Kashmir are exposed to high noise levels. It is suggested that personal protective equipment like ear plugs and ear muffs be used by these workers as a protection against this hazard.

  4. Preliminary assessment of the health and environmental effects of coal utilization in the midwest. Volume I. Energy scenarios, technology characterizations, air and water resource impacts, and health effects

    Energy Technology Data Exchange (ETDEWEB)

    None

    1977-01-01

    An initial evaluation of the major health and environmental issues associated with increased coal use in the six midwestern states of Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin is presented. Using an integrated assessment approach, the evaluation proceeds from a base-line scenario of energy demand and facility siting for the period 1975 to 2020. Emphasis is placed on impacts from coal extraction, land reclamation, coal combustion for electrical generation, and coal gasification. The range of potential impacts and constraints is illustrated by a second scenario that represents an expected upper limit for coal utilization in Illinois. Included are: (1) a characterization of the energy demand and siting scenarios, coal related technologies, and coal resources, and (2) the related impacts on air quality, water availability, water quality, and human health.

  5. Change Agents & Impact Assessment

    DEFF Research Database (Denmark)

    Kørnøv, Lone; Larsen, Sanne Vammen; Hansen, Anne Merrild

    2010-01-01

    One of the challenges facing impact assessment is finding ways to work in research and practice that allow appropriate action and critical interrogation og action to enable and support sustainable change.......One of the challenges facing impact assessment is finding ways to work in research and practice that allow appropriate action and critical interrogation og action to enable and support sustainable change....

  6. Participatory quantitative health impact assessment of urban and transport planning in cities: A review and research needs.

    Science.gov (United States)

    Nieuwenhuijsen, Mark J; Khreis, Haneen; Verlinghieri, Ersilia; Mueller, Natalie; Rojas-Rueda, David

    2017-06-01

    Urban and transport planning have large impacts on public health, but these are generally not explicitly considered and/or quantified, partly because there are no comprehensive models, methods and tools readily available. Air pollution, noise, temperature, green space, motor vehicle crashes and physical activity are important pathways linking urban and transport planning and public health. For policy decision-making, it is important to understand and be able to quantify the full-chain from source through pathways to health effects and impacts to substantiate and effectively target actions. In this paper, we aim to provide an overview of recent studies on the health impacts related to urban and transport planning in cities, describe the need for novel participatory quantitative health impact assessments (HIA) and provide recommendations. To devise our searches and narrative, we were guided by a recent conceptual framework linking urban and transport planning, environmental exposures, behaviour and health. We searched PubMed, Web of Science, Science Direct, and references from relevant articles in English language from January 1, 1980, to November 1, 2016, using pre-defined search terms. The number of HIA studies is increasing rapidly, but there is lack of participatory integrated and full-chain HIA models, methods and tools. These should be based on the use of a systemic multidisciplinary/multisectorial approach and state-of-the-art methods to address questions such as what are the best, most feasible and needed urban and transport planning policy measures to improve public health in cities? Active citizen support and new forms of communication between experts and citizens and the involvement of all major stakeholders are crucial to find and successfully implement health promoting policy measures. We provided an overview of the current state-of-the art of HIA in cities and made recommendations for further work. The process on how to get there is as important and

  7. Health impact assessment of ambient fine particulate matter exposure in impacts by different vehicle control measures in China

    Science.gov (United States)

    LI, S.; Wang, H.; Jiang, F.; Zhang, S.

    2017-12-01

    Road transportation is the one of the largest emission sources contributing to ambient PM2.5 pollution in China. Since the 1990s, China has adopted comprehensive control measures to mitigate vehicle emissions. However, the effects of these measures on reducing emissions, improving air quality and avoiding negative health impacts have not been systematically evaluated. In this study, we combine emissions inventory, air quality modeling, and IER model to evaluate the effect of various vehicle control measures on premature deaths attributable to ambient PM2.5 at a spatial resolution of 36 km × 36 km across China. Our results show that, comparing to no control scenarios, the total vehicular emissions with the actual vehicle emission controls implemented have reduced the emissions of NOX, HC, CO, PM2.5 by 57%, 69%, 75%, 71% respectively; and reduced the national annual mean PM2.5 concentration by 2.5ug/m³ across China by 2010. The number of avoidable deaths associated with reducing PM2.5 level is 150 thousands (95% Confidence interval: 66 thousand - 212 thousand). The geographic distribution of the absolute number of avoidable deaths presents a distinct regional feature and is particularly evident in several regions. The most influential areas are mainly concentrated in Beijing and its south part, which formed a large area of continuous high value. Our results have important policy implications on prioritizing vehicular emission control strategy in China.

  8. Bridging science and traditional knowledge to assess cumulative impacts of stressors on ecosystem health.

    Science.gov (United States)

    Mantyka-Pringle, Chrystal S; Jardine, Timothy D; Bradford, Lori; Bharadwaj, Lalita; Kythreotis, Andrew P; Fresque-Baxter, Jennifer; Kelly, Erin; Somers, Gila; Doig, Lorne E; Jones, Paul D; Lindenschmidt, Karl-Erich

    2017-05-01

    Cumulative environmental impacts driven by anthropogenic stressors lead to disproportionate effects on indigenous communities that are reliant on land and water resources. Understanding and counteracting these effects requires knowledge from multiple sources. Yet the combined use of Traditional Knowledge (TK) and Scientific Knowledge (SK) has both technical and philosophical hurdles to overcome, and suffers from inherently imbalanced power dynamics that can disfavour the very communities it intends to benefit. In this article, we present a 'two-eyed seeing' approach for co-producing and blending knowledge about ecosystem health by using an adapted Bayesian Belief Network for the Slave River and Delta region in Canada's Northwest Territories. We highlight how bridging TK and SK with a combination of field data, interview transcripts, existing models, and expert judgement can address key questions about ecosystem health when considerable uncertainty exists. SK indicators (e.g., bird counts, mercury in fish, water depth) were graded as moderate, whereas TK indicators (e.g., bird usage, fish aesthetics, changes to water flow) were graded as being poor in comparison to the past. SK indicators were predominantly spatial (i.e., comparing to other locations) while the TK indicators were predominantly temporal (i.e., comparing across time). After being populated by 16 experts (local harvesters, Elders, governmental representatives, and scientists) using both TK and SK, the model output reported low probabilities that the social-ecological system is healthy as it used to be. We argue that it is novel and important to bridge TK and SK to address the challenges of environmental change such as the cumulative impacts of multiple stressors on ecosystems and the services they provide. This study presents a critical social-ecological tool for widening the evidence-base to a more holistic understanding of the system dynamics of multiple environmental stressors in ecosystems and for

  9. Conceptual frameworks and empirical approaches used to assess the impact of health research: an overview of reviews

    Directory of Open Access Journals (Sweden)

    Pistotti Vanna

    2011-06-01

    Full Text Available Abstract Background How to assess the impact of research is of growing interest to funders, policy makers and researchers mainly to understand the value of investments and to increase accountability. Broadly speaking the term "research impact" refers to the contribution of research activities to achieve desired societal outcomes. The aim of this overview is to identify the most common approaches to research impact assessment, categories of impact and their respective indicators. Methods We systematically searched the relevant literature (PubMed, The Cochrane Library (1990-2009 and funding agency websites. We included systematic reviews, theoretical and methodological papers, and empirical case-studies on how to evaluate research impact. We qualitatively summarised the included reports, as well the conceptual frameworks. Results We identified twenty-two reports belonging to four systematic reviews and 14 primary studies. These publications reported several theoretical frameworks and methodological approaches (bibliometrics, econometrics, ad hoc case studies. The "payback model" emerged as the most frequently used. Five broad categories of impact were identified: a advancing knowledge, b capacity building, c informing decision-making, d health benefits, e broad socio-economic benefits. For each proposed category of impact we summarized a set of indicators whose pros and cons are presented and briefly discussed. Conclusions This overview is a comprehensive, yet descriptive, contribution to summarize the conceptual framework and taxonomy of an heterogeneous and evolving area of research. A shared and comprehensive conceptual framework does not seem to be available yet and its single components (epidemiologic, economic, and social are often valued differently in different models.

  10. Conceptual frameworks and empirical approaches used to assess the impact of health research: an overview of reviews

    Science.gov (United States)

    2011-01-01

    Background How to assess the impact of research is of growing interest to funders, policy makers and researchers mainly to understand the value of investments and to increase accountability. Broadly speaking the term "research impact" refers to the contribution of research activities to achieve desired societal outcomes. The aim of this overview is to identify the most common approaches to research impact assessment, categories of impact and their respective indicators. Methods We systematically searched the relevant literature (PubMed, The Cochrane Library (1990-2009)) and funding agency websites. We included systematic reviews, theoretical and methodological papers, and empirical case-studies on how to evaluate research impact. We qualitatively summarised the included reports, as well the conceptual frameworks. Results We identified twenty-two reports belonging to four systematic reviews and 14 primary studies. These publications reported several theoretical frameworks and methodological approaches (bibliometrics, econometrics, ad hoc case studies). The "payback model" emerged as the most frequently used. Five broad categories of impact were identified: a) advancing knowledge, b) capacity building, c) informing decision-making, d) health benefits, e) broad socio-economic benefits. For each proposed category of impact we summarized a set of indicators whose pros and cons are presented and briefly discussed. Conclusions This overview is a comprehensive, yet descriptive, contribution to summarize the conceptual framework and taxonomy of an heterogeneous and evolving area of research. A shared and comprehensive conceptual framework does not seem to be available yet and its single components (epidemiologic, economic, and social) are often valued differently in different models. PMID:21702930

  11. Toward the assessment of scientific and public health impacts of the National Institute of Environmental Health Sciences Extramural Asthma Research Program using available data.

    Science.gov (United States)

    Liebow, Edward; Phelps, Jerry; Van Houten, Bennett; Rose, Shyanika; Orians, Carlyn; Cohen, Jennifer; Monroe, Philip; Drew, Christina H

    2009-07-01

    In the past 15 years, asthma prevalence has increased and is disproportionately distributed among children, minorities, and low-income persons. The National Institute of Environmental Health Sciences (NIEHS) Division of Extramural Research and Training developed a framework to measure the scientific and health impacts of its extramural asthma research to improve the scientific basis for reducing the health effects of asthma. Here we apply the framework to characterize the NIEHS asthma portfolio's impact in terms of publications, clinical applications of findings, community interventions, and technology developments. A logic model was tailored to inputs, outputs, and outcomes of the NIEHS asthma portfolio. Data from existing National Institutes of Health (NIH) databases are used, along with publicly available bibliometric data and structured elicitation of expert judgment. NIEHS is the third largest source of asthma-related research grant funding within the NIH between 1975 and 2005, after the National Heart, Lung, and Blood Institute and the National Institute of Allergy and Infectious Diseases. Much of NIEHS-funded asthma research focuses on basic research, but results are often published in journals focused on clinical investigation, increasing the likelihood that the work is moved into practice along the "bench to bedside" continuum. NIEHS support has led to key breakthroughs in scientific research concerning susceptibility to asthma, environmental conditions that heighten asthma symptoms, and cellular mechanisms that may be involved in treating asthma. If gaps and limitations in publicly available data receive adequate attention, further linkages can be demonstrated between research activities and public health improvements. This logic model approach to research impact assessment demonstrates that it is possible to conceptualize program components, mine existing databases, and begin to show longer-term impacts of program results. The next challenges will be to

  12. Health impact assessment of transport policies in Rotterdam: Decrease of total traffic and increase of electric car use.

    Science.gov (United States)

    Tobollik, Myriam; Keuken, Menno; Sabel, Clive; Cowie, Hilary; Tuomisto, Jouni; Sarigiannis, Denis; Künzli, Nino; Perez, Laura; Mudu, Pierpaolo

    2016-04-01

    Green house gas (GHG) mitigation policies can be evaluated by showing their co-benefits to health. Health Impact Assessment (HIA) was used to quantify co-benefits of GHG mitigation policies in Rotterdam. The effects of two separate interventions (10% reduction of private vehicle kilometers and a share of 50% electric-powered private vehicle kilometers) on particulate matter (PM2.5), elemental carbon (EC) and noise (engine noise and tyre noise) were assessed using Years of Life Lost (YLL) and Years Lived with Disability (YLD). The baseline was 2010 and the end of the assessment 2020. The intervention aimed at reducing traffic is associated with a decreased exposure to noise resulting in a reduction of 21 (confidence interval (CI): 11-129) YLDs due to annoyance and 35 (CI: 20-51) YLDs due to sleep disturbance for the population per year. The effects of 50% electric-powered car use are slightly higher with a reduction of 26 (CI: 13-116) and 41 (CI: 24-60) YLDs, respectively. The two interventions have marginal effects on air pollution, because already implemented traffic policies will reduce PM2.5 and EC by around 40% and 60% respectively, from 2010 to 2020. The evaluation of planned interventions, related to climate change policies, targeting only the transport sector can result in small co-benefits for health, if the analysis is limited to air pollution and noise. This urges to expand the analysis by including other impacts, e.g. physical activity and well-being, as a necessary step to better understanding consequences of interventions and carefully orienting resources useful to build knowledge to improve public health. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Drop the Salt! Assessing the impact of a public health advocacy strategy on Australian government policy on salt.

    Science.gov (United States)

    Webster, Jacqui; Dunford, Elizabeth; Kennington, Sarah; Neal, Bruce; Chapman, Simon

    2014-01-01

    In 2007 the Australian Division of World Action on Salt and Health (AWASH) launched a campaign to encourage the Australian government to take action to reduce population salt intake. The objective of the present research was to assess the impact of the Drop the Salt! campaign on government policy. A review of government activities related to salt reduction was conducted and an advocacy strategy implemented to increase government action on salt. Advocacy actions were documented and the resulting outcomes identified. An analysis of stakeholder views on the effectiveness of the advocacy strategy was also undertaken. Settings Advocacy activities were coordinated through AWASH at the George Institute for Global Health in Sydney. All relevant State and Federal government statements and actions were reviewed and thirteen stakeholders with known interests or responsibilities regarding dietary salt, including food industry, government and health organisations, were interviewed. Stakeholder analysis affirmed that AWASH influenced the government's agenda on salt reduction and four key outputs were attributed to the campaign: (i) the Food Regulation Standing Committee discussions on salt, (ii) the Food and Health Dialogue salt targets, (iii) National Health and Medical Research Council partnership funding and (iv) the New South Wales Premier's Forum on Fast Foods. While it is not possible to definitively attribute changes in government policy to one organisation, stakeholder research indicated that the AWASH campaign increased the priority of salt reduction on the government's agenda. However, a coordinated government strategy on salt reduction is still required to ensure that the potential health benefits are fully realised.

  14. Rapid Assessment of Environmental Health Impacts for Policy Support: The Example of Road Transport in New Zealand

    Directory of Open Access Journals (Sweden)

    David Briggs

    2015-12-01

    Full Text Available An integrated environmental health impact assessment of road transport in New Zealand was carried out, using a rapid assessment. The disease and injury burden was assessed from traffic-related accidents, air pollution, noise and physical (inactivity, and impacts attributed back to modal source. In total, road transport was found to be responsible for 650 deaths in 2012 (2.1% of annual mortality: 308 from traffic accidents, 283 as a result of air pollution, and 59 from noise. Together with morbidity, these represent a total burden of disease of 26,610 disability-adjusted life years (DALYs. An estimated 40 deaths and 1874 DALYs were avoided through active transport. Cars are responsible for about 52% of attributable deaths, but heavy goods vehicles (6% of vehicle kilometres travelled, vkt accounted for 21% of deaths. Motorcycles (1 per cent of vkt are implicated in nearly 8% of deaths. Overall, impacts of traffic-related air pollution and noise are low compared to other developed countries, but road accident rates are high. Results highlight the need for policies targeted at road accidents, and especially at heavy goods vehicles and motorcycles, along with more general action to reduce the reliance on private road transport. The study also provides a framework for national indicator development.

  15. Rapid Assessment of Environmental Health Impacts for Policy Support: The Example of Road Transport in New Zealand.

    Science.gov (United States)

    Briggs, David; Mason, Kylie; Borman, Barry

    2015-12-22

    An integrated environmental health impact assessment of road transport in New Zealand was carried out, using a rapid assessment. The disease and injury burden was assessed from traffic-related accidents, air pollution, noise and physical (in)activity, and impacts attributed back to modal source. In total, road transport was found to be responsible for 650 deaths in 2012 (2.1% of annual mortality): 308 from traffic accidents, 283 as a result of air pollution, and 59 from noise. Together with morbidity, these represent a total burden of disease of 26,610 disability-adjusted life years (DALYs). An estimated 40 deaths and 1874 DALYs were avoided through active transport. Cars are responsible for about 52% of attributable deaths, but heavy goods vehicles (6% of vehicle kilometres travelled, vkt) accounted for 21% of deaths. Motorcycles (1 per cent of vkt) are implicated in nearly 8% of deaths. Overall, impacts of traffic-related air pollution and noise are low compared to other developed countries, but road accident rates are high. Results highlight the need for policies targeted at road accidents, and especially at heavy goods vehicles and motorcycles, along with more general action to reduce the reliance on private road transport. The study also provides a framework for national indicator development.

  16. Health impact assessment from building life cycles and trace metals in coarse particulate matter in urban office environments.

    Science.gov (United States)

    Othman, Murnira; Latif, Mohd Talib; Mohamed, Ahmad Fariz

    2018-02-01

    This study intends to determine the health impacts from two office life cycles (St.1 and St.2) using life cycle assessment (LCA) and health risk assessment of indoor metals in coarse particulates (particulate matter with diameters of less than 10µm). The first building (St.1) is located in the city centre and the second building (St.2) is located within a new development 7km away from the city centre. All life cycle stages are considered and was analysed using SimaPro software. The trace metal concentrations were determined by inductively couple plasma-mass spectrometry (ICP-MS). Particle deposition in the human lung was estimated using the multiple-path particle dosimetry model (MPPD). The results showed that the total human health impact for St.1 (0.027 DALY m -2 ) was higher than St.2 (0.005 DALY m -2 ) for a 50-year lifespan, with the highest contribution from the operational phase. The potential health risk to indoor workers was quantified as a hazard quotient (HQ) for non-carcinogenic elements, where the total values for ingestion contact were 4.38E-08 (St.1) and 2.59E-08 (St.2) while for dermal contact the values were 5.12E-09 (St.1) and 2.58E-09 (St.2). For the carcinogenic risk, the values for dermal and ingestion routes for both St.1 and St.2 were lower than the acceptable limit which indicated no carcinogenic risk. Particle deposition for coarse particles in indoor workers was concentrated in the head, followed by the pulmonary region and tracheobronchial tract deposition. The results from this study showed that human health can be significantly affected by all the processes in office building life cycle, thus the minimisation of energy consumption and pollutant exposures are crucially required. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Using risk analysis in Health Impact Assessment: the impact of different relative risks for men and women in different socio-economic groups

    DEFF Research Database (Denmark)

    Nilunger, Louise; Diderichsen, Finn; Burström, Bo

    2004-01-01

    The aim of this study is to contribute to the emerging field of quantification of Health Impact Assessment (HIA), by analysing how different relative risks affect the burden of disease for various socio-economic groups (SES). Risk analysis, utilising attributable and impact fraction, raises several...... methodological considerations. The present study illustrates this by measuring the impact of changed distribution levels of smoking on lung cancer, ischemic heart disease (IHD), chronic obstructive lung disorder (COLD) and stroke for the highest and lowest socio-economic groups measured in disability adjusted...... life years (DALY). The material is based on relative risks obtained from various international studies, smoking prevalence (SP) data and the number of DALY based on data available for Sweden. The results show that if smoking would have been eliminated (attributable fraction, AF), the inequality between...

  18. [How can the impact of Health Technology Assessment (HTA) in the Austrian healthcare system be assessed? Design of a conceptual framework].

    Science.gov (United States)

    Schumacher, I; Zechmeister, I

    2012-04-01

    In Austria research in Health Technology Assessment (HTA) has been conducted since the 1990s. Research in HTA aims at supporting an adequate and efficient use of health care resources in order to sustain a publicly financed and solidary health care system. Ultimately, HTA research should result in better health of the population. Research results should provide independent information for decision makers. For legitimizing further research resources and for prioritizing future HTA research and guaranteeing the value of future research, HTA research needs itself to undergo evaluation. Aim of the study is to design a conceptual framework for evaluating the impact of HTA research in Austria on the basis of the existing literature. An already existing review which presents methods and concepts how to evaluate HTA-impact was updated by a systematic research including literature of the years 2004-January 2010. Results were analysed in regard to 4 categories: definition of the term impact, target groups and system levels, operationalisation of indicators and evaluation methods. Overall, 19 publications were included. Referring to the 4 categories, an explanation of impact has to take into account HTAs multidisciplinary setting and needs a context related definition. Target groups, system levels, indicators and methods depend on the impact defined. Studies investigated direct and indirect impact and were focused on different target groups like physicians, nurses and decision makers on the micro-, and meso level, as well as politicians and reimbursement institutions on the macro level. Except for one reference all studies applied already known and mostly qualitative methods for measuring the impact of HTA research. Thus, an appropriate pool of instruments seems to be available. There is a lack of information about validity of applied methods and indicators. By adapting adequate methods and concepts a conceptual framework for the Austrian HTA-Impact evaluation has been

  19. Health Impact Assessments, Regulation, and the Unconventional Gas Industry in the UK: Exploiting Resources, Ideology, and Expertise?

    Science.gov (United States)

    Watterson, Andrew; Dinan, William

    2016-02-01

    Health impact assessments (HIAs) across the globe may be used by governments and industries to secure approval for unconventional gas extraction developments. HIA is an umbrella term that covers an array of health review and assessment practices, ranging from the very general to quite specific and technical health studies. Our concern in this paper is principally with the specialist end of the HIA continuum and particularly its application to unconventional gas extraction in the UK. We outline the context within which HIAs in unconventional gas extraction may be conducted. We then explain what HIAs may do. HIAs are often commissioned from consultancy companies to assess unconventional gas extraction project risks and benefits and propose mitigation measures. Communities can rarely afford HIAs in the planning process and may consider them biased when commissioned by vested interests. The oil and gas industry uses these techniques for its own ends. Hiring experts, be they specialist consultants, researchers, lobbyists, ex-government officials, or regulators, to influence planning and regulation is a well-tried tactic and structural advantage exploited by industry in seeking license to operate. Equitable and ethical HIA principles are urgently needed in the UK in relation to unconventional gas to secure the integrity and probity of the emerging regulatory system and address concerns regarding unregulated practitioners. © The Author(s) 2016.

  20. Do transition towns have the potential to promote health and well-being? A health impact assessment of a transition town initiative.

    Science.gov (United States)

    Richardson, J; Nichols, A; Henry, T

    2012-11-01

    Climate change and energy vulnerability present significant challenges for the development and sustainability of our communities. The adverse effects will most likely impact on those already experiencing poverty, as energy and food costs will rise, thus increasing inequalities in health. Transition town initiatives seek to build cohesive sustainable communities to prepare for a future with limited oil and a changing climate. Increasingly, public health practitioners are interested in the role of transition towns as a community development initiative, and their potential to support the wider public health agenda. Health impact assessment (HIA) is an evidence-based process that aims to predict the positive and negative impacts of a strategy, proposal or development. The HIA process provides an opportunity to promote sustainable communities by ensuring that new strategies and developments are considered in the context of their contribution to the health and well-being of local populations. The aim of this study was to use an HIA to examine the potential health and well-being benefits of two related transition town initiatives. A rapid HIA to consider the potential lifestyle changes and health and well-being impacts of Transition Together/Transition Streets (TT/TS) projects. An HIA template was used to assess key documents related to the TT/TS initiatives and those related to the characteristics of the community. Additionally, meetings with 12 key informants (four involved in TT/TS and eight purposively selected for their local knowledge) were held using the HIA template to focus the discussion. The findings highlight the associated lifestyle changes such as increased physical activity and healthy eating, and possible social and well-being benefits of engagement in such an initiative. Engagement may be limited to those already concerned about environmental issues. This paper illustrates the important links between transition towns and the wider public health agenda

  1. Health impacts of floods.

    Science.gov (United States)

    Du, Weiwei; FitzGerald, Gerard Joseph; Clark, Michele; Hou, Xiang-Yu

    2010-01-01

    Floods are the most common hazard to cause disasters and have led to extensive morbidity and mortality throughout the world. The impact of floods on the human community is related directly to the location and topography of the area, as well as human demographics and characteristics of the built environment. The aim of this study is to identify the health impacts of disasters and the underlying causes of health impacts associated with floods. A conceptual framework is developed that may assist with the development of a rational and comprehensive approach to prevention, mitigation, and management. This study involved an extensive literature review that located >500 references, which were analyzed to identify common themes, findings, and expert views. The findings then were distilled into common themes. The health impacts of floods are wide ranging, and depend on a number of factors. However, the health impacts of a particular flood are specific to the particular context. The immediate health impacts of floods include drowning, injuries, hypothermia, and animal bites. Health risks also are associated with the evacuation of patients, loss of health workers, and loss of health infrastructure including essential drugs and supplies. In the medium-term, infected wounds, complications of injury, poisoning, poor mental health, communicable diseases, and starvation are indirect effects of flooding. In the long-term, chronic disease, disability, poor mental health, and poverty-related diseases including malnutrition are the potential legacy. This article proposes a structured approach to the classification of the health impacts of floods and a conceptual framework that demonstrates the relationships between floods and the direct and indirect health consequences.

  2. Human health impacts for renewable energy scenarios from the EnerGEO Platform of Integrated Assessment (PIA)

    International Nuclear Information System (INIS)

    Lefevre, Mireille; Gschwind, Benoit; Blanc, Isabelle; Ranchin, Thierry; Cofala, Janusz; Fuss, Sabine

    2013-01-01

    This article reports impact results from running the EnerGEO Platform of Integrated Assessment (PIA) related to human health for different scenarios in Europe. The scenarios were prepared within the EnerGEO project. The idea of this European project is to determine how low carbon scenarios, and in particular scenarios with a high share of renewable energy, affect concentrations of air pollutants and as a consequence affect human health. PM 2.5 concentrations were estimated with the IIASA Greenhouse Gas and Air Pollution Interactions and Synergies (GAINS) model on a time horizon up to the year 2050 for different scenarios. We analyse here the estimation of the Loss of Life Expectancy due to PM 2.5 concentrations for the Baseline scenario taken as a reference and the Maximum renewable power scenario. (orig.)

  3. Assessment of the environmental impacts and health benefits of a nitrogen emission control area in the North Sea

    Energy Technology Data Exchange (ETDEWEB)

    Hammingh, P.; Geilenkirchen, G. [Netherlands Environmental Assessment Agency PBL, Bilthoven (Netherlands); Maas, R. [National Institute of Public Health and Environmental Protection RIVM, Bilthoven (Netherlands); Holland, M.R. [Ecometrics Research and Consulting EMRC, Reading (United Kingdom); Jonson, J.E. [The Meteorological Synthesizing Centre - West MSC-W, Norwegian Meteorological Institute, Oslo (Norway)

    2012-06-15

    In the last five to ten years, concerns about the health and ecosystem effects of air polluting emissions from ships have grown in international policy debate regarding further air pollutant emissions control. As an outcome of the debate, the International Maritime Organisation (IMO) adopted more stringent emission standards in 2008 to further control air pollution from sea shipping. For example, their most stringent nitrogen oxide emission standards are about 75 per cent lower than the standards for current ships. However, these most stringent standards are only mandatory in specific emission control areas designated by the IMO. Such specific areas aim to protect densely populated areas and sensitive ecosystems from air pollution from nearby international shipping. Prior to a possible application for designation of a nitrogen oxide emission control area, the eight North Sea countries commissioned an assessment of the environmental impacts and health benefits (this report) and the economic impacts and costs (Danish EPA, 2012). The main conclusions of this assessment are presented and concisely explained below. A detailed elaboration of the work carried out, the results and the uncertainties can be found in 'Full results'.

  4. Environmental and health impacts of fine and ultrafine metallic particles: Assessment of threat scores

    Energy Technology Data Exchange (ETDEWEB)

    Goix, Sylvaine [Université de Toulouse, INP-ENSAT, Av. Agrobiopôle, 31326 Castanet-Tolosan (France); UMR 5245 CNRS-INP-UPS, EcoLab (Laboratoire d' écologie fonctionnelle), Avenue de l' Agrobiopôle, BP 32607, 31326 Castanet-Tolosan (France); Lévêque, Thibaut [Université de Toulouse, INP-ENSAT, Av. Agrobiopôle, 31326 Castanet-Tolosan (France); UMR 5245 CNRS-INP-UPS, EcoLab (Laboratoire d' écologie fonctionnelle), Avenue de l' Agrobiopôle, BP 32607, 31326 Castanet-Tolosan (France); ADEME (French Agency for Environment and Energy Management), 20 Avenue du Grésillé, BP 90406, 49004 Angers Cedex 01 (France); Xiong, Tian-Tian [Université de Toulouse, INP-ENSAT, Av. Agrobiopôle, 31326 Castanet-Tolosan (France); UMR 5245 CNRS-INP-UPS, EcoLab (Laboratoire d' écologie fonctionnelle), Avenue de l' Agrobiopôle, BP 32607, 31326 Castanet-Tolosan (France); Schreck, Eva [Géosciences Environnement Toulouse (GET), Observatoire Midi Pyrénées, Université de Toulouse, CNRS, IRD, 14 Avenue E. Belin, F-31400 Toulouse (France); and others

    2014-08-15

    This study proposes global threat scores to prioritize the harmfulness of anthropogenic fine and ultrafine metallic particles (FMP) emitted into the atmosphere at the global scale. (Eco)toxicity of physicochemically characterized FMP oxides for metals currently observed in the atmosphere (CdO, CuO, PbO, PbSO{sub 4}, Sb{sub 2}O{sub 3}, and ZnO) was assessed by performing complementary in vitro tests: ecotoxicity, human bioaccessibility, cytotoxicity, and oxidative potential. Using an innovative methodology based on the combination of (eco)toxicity and physicochemical results, the following hazard classification of the particles is proposed: CdCl{sub 2}∼CdO>CuO>PbO>ZnO>PbSO{sub 4}>Sb{sub 2}O{sub 3}. Both cadmium compounds exhibited the highest threat score due to their high cytotoxicity and bioaccessible dose, whatever their solubility and speciation, suggesting that cadmium toxicity is due to its chemical form rather than its physical form. In contrast, the Sb{sub 2}O{sub 3} threat score was the lowest due to particles with low specific area and solubility, with no effects except a slight oxidative stress. As FMP physicochemical properties reveal differences in specific area, crystallization systems, dissolution process, and speciation, various mechanisms may influence their biological impact. Finally, this newly developed and global approach could be widely used in various contexts of pollution by complex metal particles and may improve risk management. - Highlights: • Seven micro- and nano- monometallic characterized particles were studied as references. • Bioaccessibility, eco and cytotoxicity, and oxidative potential assays were performed. • According to calculated threat scores: CdCl{sub 2}∼CdO>CuO>PbO>ZnO>PbSO{sub 4}>Sb{sub 2}O{sub 3}.

  5. Health impact assessment of increasing public transport and cycling use in Barcelona: a morbidity and burden of disease approach.

    Science.gov (United States)

    Rojas-Rueda, D; de Nazelle, A; Teixidó, O; Nieuwenhuijsen, M J

    2013-11-01

    Quantify the health impacts on morbidity of reduced car trips and increased public transport and cycling trips. A health impact assessment study of morbidity outcomes related to replacing car trips in Barcelona metropolitan (3,231,458 inhabitants). Through 8 different transport scenarios, the number of cases of disease or injuries related to physical activity, particulate matter air pollution public transport and cycling trips resulted in annual reductions of 127 cases of diabetes, 44 of cardiovascular diseases, 30 of dementia, 16 minor injuries, 0.14 major injuries, 11 of breast cancer and 3 of colon-cancer, amounting to a total reduction of 302 Disability Adjusted Life Years per year in travelers. The reduction in PM2.5 exposure in the general population resulted in annual reductions of 7 cases of low birth weight, 6 of preterm birth, 1 of cardiovascular disease and 1 of lower respiratory tract infection. Transport policies to reduce car trips could produce important health benefits in terms of reduced morbidity, particularly for those who take up active transportation. © 2013.

  6. An analysis of the benefits of a cross-sectoral approach to a prospective health impact assessment of a container port development

    International Nuclear Information System (INIS)

    Hay, Laura; Kitcher, Chris

    2004-01-01

    This paper discusses the perceived benefits to a local health authority and a district council environmental services department of a joint approach to a health impact assessment (HIA) of a proposed container port development in North Essex, England. The main perceived benefits were: the opening up of contacts within each organisation; the development of local working relationships between the agencies involved; the exchange of knowledge; the sharing of expertise; the opportunity to address a wide range of health impacts; greater credibility of the assessment during discussion with the decision-makers; the pooling of resources; and greater ownership of the assessment

  7. Environmental metal contamination and health impact assessment in two industrial regions of Romania.

    Science.gov (United States)

    Nedelescu, Mirela; Baconi, Daniela; Neagoe, Aurora; Iordache, Virgil; Stan, Miriana; Constantinescu, Paula; Ciobanu, Anne-Marie; Vardavas, Alexander I; Vinceti, Marco; Tsatsakis, Aristidis M

    2017-02-15

    We investigated two Romanian industrial regions- Copşa Mică and Zlatna, to assess the current situation of soil pollution and bioaccumulation of Pb, Cd, Cu and Zn in different vegetable species and possible risks to consumers. Both total and mobile forms of the metals were determined in soil samples, and metal content in the edible parts of root vegetable samples was also assessed. The concentrations of Pb and Zn in soil were higher in Copşa Mică than in Zlatna (566mg/kg vs 271mg/kg for Pb and 1143mg/kg vs 368mg/kg for Zn)·The metal mobility in soil from Copsa Mica decreases in the order Zn>Cu>Cd>Pb (1.88mg/kg, 0.40mg/kg, 0.22mg/kg, 0.16mg/kg, respectively), while in Zlatna, the order was Cu>Zn>Pb>Cd (0.88mg/kg, 0.29mg/kg, 0.04mg/kg, 0.01mg/kg, respectively), apparently depending on metal and soil conditions. In Copsa Mica, the amount of Pb and Cd in vegetable samples exceeded the maximum permissible limits in carrots (median concentration 0.32mg/kg for Pb and Cd) and in yellow onions (median concentration 0.24mg/kg for Cd). In Zlatna region, the content of Cd exceeded the maximum limits in yellow onions (median concentration 0.11mg/kg). The amount of Pb was higher than the maximum acceptable level in carrots from the Zlatna region (median concentration 0.12mg/kg). Cu and Zn levels were within the normal range in all vegetable samples. In the Zlatna region, the transfer factors for Pb and Cd were higher in carrots (median values of 9.9 for Pb and 21.0 for Cd) compared to carrots harvested in Copsa Mica (median values of 4.0 for Pb and 2.0 for Cd). Daily intake rates of metals through local vegetable consumption exceeded the limit values established by the European Food Safety Authority for Pb (1.2 to 2.4 times) and Cd (5.5 to 9.1 times) in both regions, with potential adverse health effects for the local population. The results highlight the need for total soil remediation action before fruit and vegetables produced in these polluted areas can be safely

  8. A system dynamics modelling approach to assess the impact of launching a new nicotine product on population health outcomes.

    Science.gov (United States)

    Hill, Andrew; Camacho, Oscar M

    2017-06-01

    In 2012 the US FDA suggested the use of mathematical models to assess the impact of releasing new nicotine or tobacco products on population health outcomes. A model based on system dynamics methodology was developed to project the potential effects of a new nicotine product at a population level. A model representing traditional smoking populations (never, current and former smokers) and calibrated using historical data was extended to a two-product model by including electronic cigarettes use statuses. Smoking mechanisms, such as product initiation, switching, transition to dual use, and cessation, were represented as flows between smoking statuses (stocks) and the potential effect of smoking renormalisation through a feedback system. Mortality over a 50-year period (2000-2050) was the health outcome of interest, and was compared between two scenarios, with and without e-cigarettes being introduced. The results suggest that by 2050, smoking prevalence in adults was 12.4% in the core model and 9.7% (including dual users) in the counterfactual. Smoking-related mortality was 8.4% and 8.1%, respectively. The results suggested an overall beneficial effect from launching e-cigarettes and that system dynamics could be a useful approach to assess the potential population health effects of nicotine products when epidemiological data are not available. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  9. Learning from a Rapid Health Impact Assessment of a proposed maternity service reconfiguration in the English NHS

    Directory of Open Access Journals (Sweden)

    Haroon Sophie

    2008-04-01

    Full Text Available Abstract Background Within many parts of the country, the NHS is undertaking reconfiguration of services. Such proposals can prove a tipping point and provoke public protest, often with significant involvement of local and national politicians. We undertook a rapid Health Impact Assessment (HIA of a proposed reconfiguration of maternity services in Huddersfield and Halifax in England. The aim of the HIA was to help the PCT Boards to assess the reconfiguration's possible consequences on access to maternity services, and maternal and infant health outcomes across different socio-economic groups in Kirklees. We report on the findings of the HIA and the usefulness of the process to decision making. Methods This HIA used routine maternity data for 2004–2005 in Huddersfield, in addition to published evidence. Standard HIA techniques were used. Results We re-highlighted the socio economic differences in smoking status at booking and quitting during pregnancy. We focused on the key concerns of the public, that of adverse obstetric events on a Midwife Led Unit (MLU with distant obstetric cover. We estimate that twenty percent of women giving birth in a MLU may require urgent transfer to obstetric care during labour. There were no significant socio economic differences. Much of the risk can be mitigated though robust risk management policies. Additional travelling distances and costs could affect lower socio-economic groups the greatest because of lower car ownership and geographical location in relation to the units. There is potential that with improved community antenatal and post natal care, population outcomes could improve significantly, the available evidence supports this view. Conclusion Available evidence suggests that maternity reconfiguration towards enhanced community care could have many potential benefits but carries risk. Investment is needed to realise the former and mitigate the latter. The usefulness of this Health Impact Assessment

  10. Learning from a Rapid Health Impact Assessment of a proposed maternity service reconfiguration in the English NHS.

    Science.gov (United States)

    Fell, Greg; Haroon, Sophie

    2008-04-25

    Within many parts of the country, the NHS is undertaking reconfiguration of services. Such proposals can prove a tipping point and provoke public protest, often with significant involvement of local and national politicians. We undertook a rapid Health Impact Assessment (HIA) of a proposed reconfiguration of maternity services in Huddersfield and Halifax in England. The aim of the HIA was to help the PCT Boards to assess the reconfiguration's possible consequences on access to maternity services, and maternal and infant health outcomes across different socio-economic groups in Kirklees. We report on the findings of the HIA and the usefulness of the process to decision making. This HIA used routine maternity data for 2004-2005 in Huddersfield, in addition to published evidence. Standard HIA techniques were used. We re-highlighted the socio economic differences in smoking status at booking and quitting during pregnancy. We focused on the key concerns of the public, that of adverse obstetric events on a Midwife Led Unit (MLU) with distant obstetric cover. We estimate that twenty percent of women giving birth in a MLU may require urgent transfer to obstetric care during labour. There were no significant socio economic differences. Much of the risk can be mitigated though robust risk management policies. Additional travelling distances and costs could affect lower socio-economic groups the greatest because of lower car ownership and geographical location in relation to the units. There is potential that with improved community antenatal and post natal care, population outcomes could improve significantly, the available evidence supports this view. Available evidence suggests that maternity reconfiguration towards enhanced community care could have many potential benefits but carries risk. Investment is needed to realise the former and mitigate the latter. The usefulness of this Health Impact Assessment may have been impeded by its timing, and the politically charged

  11. The influence of air quality model resolution on health impact assessment for fine particulate matter and its components.

    Science.gov (United States)

    Li, Ying; Henze, Daven K; Jack, Darby; Kinney, Patrick L

    2016-02-01

    Health impact assessments for fine particulate matter (PM2.5) often rely on simulated concentrations generated from air quality models. However, at the global level, these models often run at coarse resolutions, resulting in underestimates of peak concentrations in populated areas. This study aims to quantitatively examine the influence of model resolution on the estimates of mortality attributable to PM 2.5 and its species in the USA. We use GEOS-Chem, a global 3-D model of atmospheric composition, to simulate the 2008 annual average concentrations of PM2.5 and its six species over North America. The model was run at a fine resolution of 0.5 × 0.66° and a coarse resolution of 2 × 2.5°, and mortality was calculated using output at the two resolutions. Using the fine-modeled concentrations, we estimate that 142,000 PM 2.5 -related deaths occurred in the USA in 2008, and the coarse resolution produces a national mortality estimate that is 8 % lower than the fine-model estimate. Our spatial analysis of mortality shows that coarse resolutions tend to substantially underestimate mortality in large urban centers. We also re-grid the fine-modeled concentrations to several coarser resolutions and repeat mortality calculation at these resolutions. We found that model resolution tends to have the greatest influence on mortality estimates associated with primary species and the least impact on dust-related mortality. Our findings provide evidence of possible biases in quantitative PM 2.5 health impact assessments in applications of global atmospheric models at coarse spatial resolutions.

  12. Assessing Opinions in Community Leadership Networks to Address Health Inequalities: A Case Study from Project IMPACT

    Science.gov (United States)

    McCauley, M. P.; Ramanadhan, S.; Viswanath, K.

    2015-01-01

    This study demonstrates a novel approach that those engaged in promoting social change in health can use to analyze community power, mobilize it and enhance community capacity to reduce health inequalities. We used community reconnaissance methods to select and interview 33 participants from six leadership sectors in "Milltown", the New…

  13. Dairy foods and osteoporosis: an example of assessing the health-economic impact of food products

    NARCIS (Netherlands)

    F.J.B. Lötters (Freek); I. Lenoir-Wijnkoop (Irene); P. Fardellone; R. Rizzoli; E. Rocher; M.J. Poley (Marten)

    2013-01-01

    markdownabstract__Abstract__ Osteoporosis has become a major health concern, carrying a substantial burden in terms of health outcomes and costs. We constructed a model to quantify the potential effect of an additional intake of calcium from dairy foods on the risk of osteoporotic fracture,

  14. Adverse childhood experiences: assessing the impact on health and school engagement and the mitigating role of resilience.

    Science.gov (United States)

    Bethell, Christina D; Newacheck, Paul; Hawes, Eva; Halfon, Neal

    2014-12-01

    The ongoing longitudinal Adverse Childhood Experiences Study of adults has found significant associations between chronic conditions; quality of life and life expectancy in adulthood; and the trauma and stress associated with adverse childhood experiences, including physical or emotional abuse or neglect, deprivation, or exposure to violence. Less is known about the population-based epidemiology of adverse childhood experiences among US children. Using the 2011-12 National Survey of Children's Health, we assessed the prevalence of adverse childhood experiences and associations between them and factors affecting children's development and lifelong health. After we adjusted for confounding factors, we found lower rates of school engagement and higher rates of chronic disease among children with adverse childhood experiences. Our findings suggest that building resilience-defined in the survey as "staying calm and in control when faced with a challenge," for children ages 6-17-can ameliorate the negative impact of adverse childhood experiences. We found higher rates of school engagement among children with adverse childhood experiences who demonstrated resilience, as well as higher rates of resilience among children with such experiences who received care in a family-centered medical home. We recommend a coordinated effort to fill knowledge gaps and translate existing knowledge about adverse childhood experiences and resilience into national, state, and local policies, with a focus on addressing childhood trauma in health systems as they evolve during ongoing reform. Project HOPE—The People-to-People Health Foundation, Inc.

  15. Oral Health Promotion Intervention In Rural Contexts: Impact assessment. Córdoba, Argentina.

    Directory of Open Access Journals (Sweden)

    Lila Cornejo

    2014-03-01

    Full Text Available Introduction: The study was carried out in Cruz del Eje Department, Cordoba Province, Argentina. It was based on diagnosis of conceptions of health, concentration of fluoride in drinking water and accessibility to dental coverage in 71 rural schools. Additionally, parents and teachers’ conceptions of general and oral health, dental clinical status and sialochemistry of students from eight schools were considered. Objective: To evaluate a community intervention strategy for promoting oral health in rural contexts. Through the participation of the teacher as a mediator of healthy pattern, this strategy was developed. Methods: In order to elaborate oral health promoting strategies, educational workshops, epistolary communication and on site tutorials meetings were implemented. Specific health projects to be added to the Educational Institutional Programs, as a contextualized mediating strategy for promoting oral health were designed by teachers. The strategy was evaluated comparing dental caries increase (CI detected the previous year and the one following the implementation of the educational plans. Mac Nemar's test was applied, and p<0.05 was set to indicate statistical differences between both periods. Results: A 30.43% CI (p<0.0001 was observed the year before implementing the educational programs as well as a CI reduction to 17.39% (p=0.0002 a year after their application. Conclusion: The drop off in 57.14% of the CI in rural areas, confirms the intervention strategy of designed for this particular context.Keywords: community intervention, oral health promotion, rural communities.

  16. Assessment of the Public Health Risks and Impact of a Tornado in Funing, China, 23 June 2016: A Retrospective Analysis.

    Science.gov (United States)

    Wang, Kaiwen; Zhong, Shuang; Wang, Xiaoye; Wang, Zhe; Yang, Lianping; Wang, Qiong; Wang, Suhan; Sheng, Rongrong; Ma, Rui; Lin, Shao; Liu, Wenyu; Zu, Rongqiang; Huang, Cunrui

    2017-10-10

    (1) Background: Tornadoes are one of the deadliest disasters but their health impacts in China are poorly investigated. This study aimed to assess the public health risks and impact of an EF-4 tornado outbreak in Funing, China; (2) Methods: A retrospective analysis on the characteristics of tornado-related deaths and injuries was conducted based on the database from the Funing's Center for Disease Control and Prevention (CDC) and Funing People's Hospital. A change-point time-series analysis of weekly incidence for the period January 2010 to September 2016 was used to identify sensitive infectious diseases to the tornado; (3) Results: The 75 to 84 years old group was at the highest risk of both death (RR = 82.16; 95% CIs = 19.66, 343.33) and injury (RR = 31.80; 95% CI = 17.26, 58.61), and females were at 53% higher risk of death than males (RR = 1.53; 95% CIs = 1.02, 2.29). Of the 337 injuries, 274 injuries (81%) were minor. Most deaths occurred indoors (87%) and the head (74%) was the most frequent site of trauma during the tornado. Five diseases showed downward change-points; (4) Conclusions: The experience of the Funing tornado underscores the relative danger of being indoors during a tornado and is successful in avoiding epidemics post-tornado. Current international safety guidelines need modification when generalized to China.

  17. Assessment of the Public Health Risks and Impact of a Tornado in Funing, China, 23 June 2016: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Kaiwen Wang

    2017-10-01

    Full Text Available (1 Background: Tornadoes are one of the deadliest disasters but their health impacts in China are poorly investigated. This study aimed to assess the public health risks and impact of an EF-4 tornado outbreak in Funing, China; (2 Methods: A retrospective analysis on the characteristics of tornado-related deaths and injuries was conducted based on the database from the Funing’s Center for Disease Control and Prevention (CDC and Funing People’s Hospital. A change-point time-series analysis of weekly incidence for the period January 2010 to September 2016 was used to identify sensitive infectious diseases to the tornado; (3 Results: The 75 to 84 years old group was at the highest risk of both death (RR = 82.16; 95% CIs = 19.66, 343.33 and injury (RR = 31.80; 95% CI = 17.26, 58.61, and females were at 53% higher risk of death than males (RR = 1.53; 95% CIs = 1.02, 2.29. Of the 337 injuries, 274 injuries (81% were minor. Most deaths occurred indoors (87% and the head (74% was the most frequent site of trauma during the tornado. Five diseases showed downward change-points; (4 Conclusions: The experience of the Funing tornado underscores the relative danger of being indoors during a tornado and is successful in avoiding epidemics post-tornado. Current international safety guidelines need modification when generalized to China.

  18. Impact assessment revisited

    DEFF Research Database (Denmark)

    Thiele, Jan; Kollmann, Johannes Christian; Markussen, Bo

    2010-01-01

    The theoretical underpinnings of the assessment of invasive alien species impacts need to be improved. At present most approaches are unreliable to quantify impact at regional scales and do not allow for comparison of different invasive species. There are four basic problems that need......; and (4) the total invaded range is an inappropriate measure for quantifying regional impact because the habitat area available for invasion can vary markedly among invasive species. Mathematical models and empirical data using an invasive alien plant species (Heracleum mantegazzianum) indicate...... to be addressed: (1) Some impacted ecosystem traits are spatially not additive; (2) invader effects may increase non-linearly with abundance or there may be effect thresholds impairing estimates of linear impact models; (3) the abundance and impact of alien species will often co-vary with environmental variation...

  19. a rapid health impact assessment of the university of ilorin dam

    African Journals Online (AJOL)

    Many Dams have been constructed in different parts of the world and for different purposes. While these dams have in most cases served the reason for their construction, the resultant environmental impact have been a subject of concern. The creation of a reservoir not only changes the ecology and hydrology of the ...

  20. Replacing car trips by increasing bike and public transport in the greater Barcelona metropolitan area: a health impact assessment study.

    Science.gov (United States)

    Rojas-Rueda, D; de Nazelle, A; Teixidó, O; Nieuwenhuijsen, M J

    2012-11-15

    Estimate the health risks and benefits of mode shifts from car to cycling and public transport in the metropolitan area of Barcelona, Spain. We conducted a health impact assessment (HIA), creating 8 different scenarios on the replacement of short and long car trips, by public transport or/and bike. The primary outcome measure was all-cause mortality and change in life expectancy related to two different assessments: A) the exposure of travellers to physical activity, air pollution to particulate matter car trips, starting and ending in Barcelona City, to cycling (n=141,690) would be for the travellers who shift modes 1.15 additional deaths from air pollution, 0.17 additional deaths from road traffic fatality and 67.46 deaths avoided from physical activity resulting in a total of 66.12 deaths avoided. Fewer deaths would be avoided annually if half of the replaced trips were shifted to public transport (43.76 deaths). The annual health impact in the Barcelona City general population (n=1,630,494) of the 40% reduction in car trips would be 10.03 deaths avoided due to the reduction of 0.64% in exposure to PM2.5. The deaths (including travellers and general population) avoided in Barcelona City therefore would be 76.15 annually. Further health benefits would be obtained with a shift of 40% of the car trips from the Greater Barcelona Metropolitan which either start or end in Barcelona City to public transport (40.15 deaths avoided) or public transport and cycling (98.50 deaths avoided).The carbon dioxide reduction for shifting from car to other modes of transport (bike and public transport) in Barcelona metropolitan area was estimated to be 203,251t/CO₂ emissions per year. Interventions to reduce car use and increase cycling and the use of public transport in metropolitan areas, like Barcelona, can produce health benefits for travellers and for the general population of the city. Also these interventions help to reduce green house gas emissions. Copyright © 2012

  1. Health impact assessment and short-term medical missions: A methods study to evaluate quality of care

    Directory of Open Access Journals (Sweden)

    White Benjamin

    2008-06-01

    Full Text Available Abstract Background Short-term medical missions (STMMs are a well-established means of providing health care to the developing world. Despite over 250 million dollars and thousands of volunteer hours dedicated to STMMs, there is a lack of standardized evaluation to assess patient safety, quality control, and mission impact. The objective of this project is to design and implement an assessment tool that defines objective parameters of quality of care as identified by STMMs. Methods The study was conducted in 3 phases: 1 Base-need analysis to determine factors critical to the quality of STMMs, 2 Design of 5 surveys for mission personnel and patients to enable 360-degree evaluation based on factors from phase 1, and 3 Field testing of the surveys with 5 STMMs. Results An evaluation tool was created assessing 6 major and 30 minor factors identified as important to the quality of STMMs. 5 mission directors, 43 personnel, 10 local hosts, and 55 patients completed the surveys. Of the 6 major measures of quality, missions performed best in Cost (mean score 86%, and Impact (84%. The poorest performance was in Education (64%. Efficiency, Sustainability, and Preparedness showed mean scores of 76%, 77%, and 73%, respectively. Conclusion Our study provides a novel standardized tool for STMM evaluation. Use of the assessment instrument identified areas of strength and weakness of a particular mission, and delineated general trends in performance compared to other STMMs. We anticipate that the use of this tool may improve the quality of care provided by missions, and stimulate solution-sharing and scholarly discussion among missions.

  2. Toward the Assessment of Scientific and Public Health Impacts of the National Institute of Environmental Health Sciences Extramural Asthma Research Program Using Available Data

    Science.gov (United States)

    Liebow, Edward; Phelps, Jerry; Van Houten, Bennett; Rose, Shyanika; Orians, Carlyn; Cohen, Jennifer; Monroe, Philip; Drew, Christina H.

    2009-01-01

    Background In the past 15 years, asthma prevalence has increased and is disproportionately distributed among children, minorities, and low-income persons. The National Institute of Environmental Health Sciences (NIEHS) Division of Extramural Research and Training developed a framework to measure the scientific and health impacts of its extramural asthma research to improve the scientific basis for reducing the health effects of asthma. Objectives Here we apply the framework to characterize the NIEHS asthma portfolio’s impact in terms of publications, clinical applications of findings, community interventions, and technology developments. Methods A logic model was tailored to inputs, outputs, and outcomes of the NIEHS asthma portfolio. Data from existing National Institutes of Health (NIH) databases are used, along with publicly available bibliometric data and structured elicitation of expert judgment. Results NIEHS is the third largest source of asthma-related research grant funding within the NIH between 1975 and 2005, after the National Heart, Lung, and Blood Institute and the National Institute of Allergy and Infectious Diseases. Much of NIEHS-funded asthma research focuses on basic research, but results are often published in journals focused on clinical investigation, increasing the likelihood that the work is moved into practice along the “bench to bedside” continuum. NIEHS support has led to key breakthroughs in scientific research concerning susceptibility to asthma, environmental conditions that heighten asthma symptoms, and cellular mechanisms that may be involved in treating asthma. Conclusions If gaps and limitations in publicly available data receive adequate attention, further linkages can be demonstrated between research activities and public health improvements. This logic model approach to research impact assessment demonstrates that it is possible to conceptualize program components, mine existing databases, and begin to show longer

  3. Mortality, greenhouse gas emissions and consumer cost impacts of combined diet and physical activity scenarios: a health impact assessment study.

    Science.gov (United States)

    Tainio, Marko; Monsivais, Pablo; Jones, Nicholas Rv; Brand, Christian; Woodcock, James

    2017-02-22

    To quantify changes in mortality, greenhouse gas (GHG) emissions and consumer costs for physical activity and diet scenarios. For the physical activity scenarios, all car trips from emissions to fuel usage and F&V production. Working age population for England. Data from the Health Survey for England, National Travel Survey and National Diet and Nutrition Survey. Changes in premature deaths, consumer costs and GHG emissions stratified by age, gender and socioeconomic status (SES). Premature deaths were reduced by between 75 and 7648 cases per year for the physical activity scenarios, and 3255 and 6187 cases per year for the diet scenarios. Mortality reductions were greater among people of medium and high SES in the physical activity scenarios, whereas people with lower SES benefited more in the diet scenarios. Similarly, transport fuel costs fell more for people of high SES, whereas diet costs increased most for the lowest SES group. Net GHG emissions decreased by between 0.2 and 10.6 million tons of carbon dioxide equivalent (MtCO 2 e) per year for the physical activity scenarios and increased by between 1.3 and 6.3 MtCO 2 e/year for the diet scenarios. Increasing F&V consumption offers the potential for large health benefits and reduces health inequalities. Replacing short car trips with cycling offers the potential for net benefits for health, GHG emissions and consumer costs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Health Impact Assessment(HIA)of Building Renovations at Gerena Community School, Springfield, Massachusetts

    Science.gov (United States)

    The US Environmental Protection Agency (EPA) has conducted an HIA at the German Gerena Community School in Springfield, MA. HIA is a six-step systematic process that uses an array of data sources, analytic methods and stakeholder input to determine the potential health effects of...

  5. Assessment of the impact of family physicians in the district health system of the Western Cape, South Africa

    Directory of Open Access Journals (Sweden)

    Meyer Swanepoel

    2014-01-01

    Full Text Available Background: In 2007, South Africa made family medicine a new speciality. Family physicians that have trained for this new speciality have been employed in the district health system since 2011. The aim of the present study was to explore the perceptions of district managers on the impact of family physicians on clinical processes, health system performance and health outcomes in the district health system (DHS of the Western Cape.Methods: Nine in-depth interviews were performed: seven with district managers and two with the chief directors of the metropolitan and rural DHS. Interviews were recorded, transcribed and analysed using the ATLAS-ti and the framework method.Results: There was a positive impact on clinical processes for HIV/AIDS, TB, trauma, noncommunicable chronic diseases, mental health, maternal and child health. Health system performance was positively impacted in terms of access, coordination, comprehensiveness and efficiency. An impact on health outcomes was anticipated. The impact was not uniform throughout the province due to different numbers of family physicians and different abilities to function optimally. There was also a perception that the positive impact attributed to family physicians was in the early stages of development. Unanticipated effects included concerns with their roles in management and training of students, as well as tensions with career medical officers.Conclusion: Early feedback from district managers suggests that where family physicians are employed and able to function optimally, they are making a significant impact on health system performance and the quality of clinical processes. In the longer term, this is likely to impact on health outcomes.

  6. Assessment of the impact of family physicians in the district health system of the Western Cape, South Africa

    Directory of Open Access Journals (Sweden)

    Meyer Swanepoel

    2014-12-01

    Full Text Available Background: In 2007, South Africa made family medicine a new speciality. Family physicians that have trained for this new speciality have been employed in the district health system since 2011. The aim of the present study was to explore the perceptions of district managers on the impact of family physicians on clinical processes, health system performance and health outcomes in the district health system (DHS of the Western Cape. Methods: Nine in-depth interviews were performed: seven with district managers and two with the chief directors of the metropolitan and rural DHS. Interviews were recorded, transcribed and analysed using the ATLAS-ti and the framework method. Results: There was a positive impact on clinical processes for HIV/AIDS, TB, trauma, noncommunicable chronic diseases, mental health, maternal and child health. Health system performance was positively impacted in terms of access, coordination, comprehensiveness and efficiency. An impact on health outcomes was anticipated. The impact was not uniform throughout the province due to different numbers of family physicians and different abilities to function optimally. There was also a perception that the positive impact attributed to family physicians was in the early stages of development. Unanticipated effects included concerns with their roles in management and training of students, as well as tensions with career medical officers. Conclusion: Early feedback from district managers suggests that where family physicians are employed and able to function optimally, they are making a significant impact on health system performance and the quality of clinical processes. In the longer term, this is likely to impact on health outcomes.

  7. The Health Deviation of Post-Breast Cancer Lymphedema: Symptom Assessment and Impact on Self-Care Agency.

    Science.gov (United States)

    Armer, Jane M; Henggeler, Mary H; Brooks, Constance W; Zagar, Eris A; Homan, Sherri; Stewart, Bob R

    2008-01-01

    Breast cancer is the leading cancer among women world-wide, affecting 1 of 8 women during their lifetimes. In the US alone, some 2 million breast cancer survivors comprise 20% of all cancer survivors. Conservatively, it is estimated that some 20-40% of all breast cancer survivors will develop the health deviation of lymphedema or treatment-related limb swelling over their lifetimes. This chronic accumulation of protein-rich fluid predisposes to infection, leads to difficulties in fitting clothing and carrying out activities of daily living, and impacts self-esteem, self-concept, and quality of life. Lymphedema is associated with self-care deficits (SCD) and negatively impacts self-care agency (SCA) and physiological and psychosocial well-being. Objectives of this report are two-fold: (1) to explore four approaches of assessing and diagnosing breast cancer lymphedema, including self-report of symptoms and the impact of health deviations on SCA; and (2) to propose the development of a clinical research program for lymphedema based on the concepts of Self-Care Deficit Nursing Theory (SCDNT). Anthropometric and symptom data from a National-Institutes-of-Health-funded prospective longitudinal study were examined using survival analysis to compare four definitions of lymphedema over 24 months post-breast cancer surgery among 140 of 300 participants (all who had passed the 24-month measurement). The four definitions included differences of 200 ml, 10% volume, and 2 cm circumference between pre-op baseline and/or contralateral limbs, and symptom self-report of limb heaviness and swelling. Symptoms, SCA, and SCD were assessed by interviews using a validated tool. Estimates of lymphedema occurrence varied by definition and time since surgery. The 2 cm girth change provided the highest estimation of lymphedema (82% at 24 months), followed by 200 ml volume change (57% at 24 months). The 10% limb volume change converged with symptom report of heaviness and swelling at 24 months

  8. The types of data needed for assessing the environmental and human health impacts of coal

    Science.gov (United States)

    Finkelman, R.B.; Gross, P.M.K.

    1999-01-01

    Coal is one of the most important sources of energy. Its worldwide use will continue to expand during the next several decades, particularly in rapidly developing countries such as China and India. Unfortunately, coal use may bring with it environmental and human health costs. Many of the environmental and health problems attributed to coal combustion are due to mobilization of potentially toxic elements. Some of these problems could be minimized or even avoided if comprehensive databases containing appropriate coal quality information were available to decision makers so that informed decisions could be made regarding coal use. Among the coal quality parameters that should be included in these databases are: C, H, N, O, pyritic sulfur, organic sulfur, major, minor, and trace element concentrations, modes of occurrence of environmentally sensitive elements, cleanability, mineralogy, organic chemistry, petrography, and leachability.Coal is one of the most important sources of energy. Its worldwide use will continue to expand during the next several decades, particularly in rapidly developing countries such as China and India. Unfortunately, coal use may bring with it environmental and human health costs. Many of the environmental and health problems attributed to coal combustion are due to mobilization of potentially toxic elements. Some of these problems could be minimized or even avoided if comprehensive databases containing appropriate coal quality information were available to decision makers so that informed decisions could be made regarding coal use. Among the coal quality parameters that should be included in these databases are: C, H, N, O, pyritic sulfur, organic sulfur, major, minor, and trace element concentrations, modes of occurrence of environmentally sensitive elements, cleanability, mineralogy, organic chemistry, petrography, and leachability.

  9. Assessing the Impact of De Novo Social Ties within Health Intervention Settings: New Questions for Health Behavior Intervention Research.

    Science.gov (United States)

    Tesdahl, Eric; Gesell, Sabina B

    2015-12-01

    Recent developments in the study of health and social networks have focused on linkages between health outcomes and naturally occurring social relations, such as friendship or kinship. Based on findings in this area, a new generation of health behavior intervention programs have been implemented that rely on the formation of new social relations among program participants. However, little is known about the qualities of these de novo social relations. We examined the social networks of 59 participants within a randomized controlled trial of an intervention designed to prevent excessive gestational weight gain. We employed exponential random graph modeling techniques to analyze supportive relationships formed between participants in the intervention arm, to detect unique effects of program participation on the likelihood of forming ties. Program participation had a positive effect on the likelihood of forming supportive social relations, however, in this particular timeframe we did not detect any additional effect of such relations on the health behaviors or outcomes of interest. Our findings raise two critical questions: do short-term group-level programs reliably lead to the formation of new social relations among participants; and do these relations have a unique effect on health outcomes relative to standard methods of health behavior intervention? © 2015 Wiley Periodicals, Inc.

  10. A NEW HEALTH TECHNOLOGY ASSESSMENT SYSTEM FOR JAPAN? SIMULATING THE POTENTIAL IMPACT ON THE PRICE OF SIMEPREVIR.

    Science.gov (United States)

    Mahlich, Jörg; Kamae, Isao; Rossi, Bruno

    2017-01-01

    Japanese authorities have announced a plan to introduce a health technology assessment (HTA) system in 2016. This study assessed the potential impact of such a policy on the price of the antivirologic drug simeprevir. Taking the antivirologic drug simeprevir as an example, we compared the current Japanese price with hypothetical prices that might result if a U.K. (cost-utility) or German (efficiency frontier) style HTA assessment was in place. The simeprevir unit price under the current Japanese pricing scheme is 13,122 Japanese yen (equivalent to 109.35 U.S. dollars as of April 2015). Depending on the selection of comparators and the pricing method, and assuming that HTA will be used as a basis for price setting, the estimated prices of simeprevir vary up to four times higher than under the current Japanese pricing scheme. Although the analysis is based on only one drug, it cannot be taken for granted that a new HTA system would reduce public healthcare expenditure in Japan.

  11. Participants' Assessment of the Impact of Behavioral Health Self-Direction on Recovery.

    Science.gov (United States)

    Croft, Bevin; Parish, Susan

    2016-10-01

    Self-direction involves managing a flexible budget, selecting and purchasing services and supports to meet individual needs and preferences. An emerging practice in the behavioral health field, self-direction is part of a systemic shift toward person-centered approaches to service provision. To understand the relationship between recovery and self-direction, the authors conducted a content analysis of 30 in-depth interviews with individuals from two self-direction programs in one state. A positive relationship between self-direction and recovery was established. Meeting basic needs for food, clothing, and shelter are important first steps in the recovery process for self-directing participants. Recovery domains were dynamic and interrelated, with gains in independence, self-esteem, and self-confidence facilitating achievement of goals in other domains. To maximize the benefits of self-direction, program administrators may need to develop clearer program implementation standards and address poverty and limited access to appropriate behavioral health services and supports.

  12. How do experts define relevance criteria when initiating Health Impact Assessments of national policies?

    DEFF Research Database (Denmark)

    Kraemer, Stella Rj; Gulis, Gabriel

    2014-01-01

    The aim of this article is to present how the Danish Disease Prevention Committee (DDPC) members and HIA-experts understand when HIA is "relevant", which in this context means when there is "presumed to be a direct and documented effect on the health and morbidity of citizens". Method: DDPC members...... between policy and the related risk factors. Both groups favour the use of scientific evidence according to the traditional biomedical evidence hierarchy but HIA-experts also judge that there is value in using evidence that can be considered weak such as local community knowledge. Conclusions: It is clear...... that the DDPC recommendation gives rise to a discussion on differing perceptions of relevance. The same definition can be used for both direct and indirect effects depending on interpretation. Documented evidence for an effect is desirable in the form provided by the traditional biomedical evidence hierarchy...

  13. Future Extreme Heat Scenarios to Enable the Assessment of Climate Impacts on Public Health over the Coterminous U.S

    Science.gov (United States)

    Quattrochi, D. A.; Crosson, W. L.; Al-Hamdan, M. Z.; Estes, M. G., Jr.

    2013-12-01

    In the United States, extreme heat is the most deadly weather-related hazard. In the face of a warming climate and urbanization, which contributes to local-scale urban heat islands, it is very likely that extreme heat events (EHEs) will become more common and more severe in the U.S. This research seeks to provide historical and future measures of climate-driven extreme heat events to enable assessments of the impacts of heat on public health over the coterminous U.S. We use atmospheric temperature and humidity information from meteorological reanalysis and from Global Climate Models (GCMs) to provide data on past and future heat events. The focus of research is on providing assessments of the magnitude, frequency and geographic distribution of extreme heat in the U.S. to facilitate public health studies. In our approach, long-term climate change is captured with GCM outputs, and the temporal and spatial characteristics of short-term extremes are represented by the reanalysis data. Two future time horizons for 2040 and 2090 are compared to the recent past period of 1981-2000. We characterize regional-scale temperature and humidity conditions using GCM outputs for two climate change scenarios (A2 and A1B) defined in the Special Report on Emissions Scenarios (SRES). For each future period, 20 years of multi-model GCM outputs are analyzed to develop a ';heat stress climatology' based on statistics of extreme heat indicators. Differences between the two future and the past period are used to define temperature and humidity changes on a monthly time scale and regional spatial scale. These changes are combined with the historical meteorological data, which is hourly and at a spatial scale (12 km) much finer than that of GCMs, to create future climate realizations. From these realizations, we compute the daily heat stress measures and related spatially-specific climatological fields, such as the mean annual number of days above certain thresholds of maximum and minimum air

  14. Future Extreme Heat Scenarios to Enable the Assessment of Climate Impacts on Public Health over the Coterminous U.S.

    Science.gov (United States)

    Quattrochi, Dale A.; Crosson, William L.; Al-Hamdan, Mohammad Z.; Estes, Maurice G., Jr.

    2013-01-01

    In the United States, extreme heat is the most deadly weather-related hazard. In the face of a warming climate and urbanization, which contributes to local-scale urban heat islands, it is very likely that extreme heat events (EHEs) will become more common and more severe in the U.S. This research seeks to provide historical and future measures of climate-driven extreme heat events to enable assessments of the impacts of heat on public health over the coterminous U.S. We use atmospheric temperature and humidity information from meteorological reanalysis and from Global Climate Models (GCMs) to provide data on past and future heat events. The focus of research is on providing assessments of the magnitude, frequency and geographic distribution of extreme heat in the U.S. to facilitate public health studies. In our approach, long-term climate change is captured with GCM outputs, and the temporal and spatial characteristics of short-term extremes are represented by the reanalysis data. Two future time horizons for 2040 and 2090 are compared to the recent past period of 1981- 2000. We characterize regional-scale temperature and humidity conditions using GCM outputs for two climate change scenarios (A2 and A1B) defined in the Special Report on Emissions Scenarios (SRES). For each future period, 20 years of multi-model GCM outputs are analyzed to develop a 'heat stress climatology' based on statistics of extreme heat indicators. Differences between the two future and the past period are used to define temperature and humidity changes on a monthly time scale and regional spatial scale. These changes are combined with the historical meteorological data, which is hourly and at a spatial scale (12 km), to create future climate realizations. From these realizations, we compute the daily heat stress measures and related spatially-specific climatological fields, such as the mean annual number of days above certain thresholds of maximum and minimum air temperatures, heat indices

  15. Health Impact of Uranium in Phosphate Fertilizers - Assessing the radiological impact of using Israeli phosphate fertilizers: A critical review

    Energy Technology Data Exchange (ETDEWEB)

    Moinester, Murray [Tel Aviv University, School of Physics and Astronomy, 69978 Tel Aviv (Israel); Kronfeld, Joel [Tel Aviv University, Department of Geosciences, 69978 Tel Aviv (Israel)

    2014-07-01

    Of the three main ingredients used in agricultural nitrogen, phosphorous, and potassium (NPK) fertilizers in Israel and elsewhere, two of them, the phosphorous and potassium additions, contain radio-elements. The P is derived from the use of Senonian aged phosphorite. The extensive Israeli phosphorite deposits (averaging approximately 140 ppm uranium) can be considered a potential low grade uranium ore. Sufficient time has passed since the deposits were laid down for secular equilibrium to be achieved in the uranium decay-series. Thus, deposits now include radioactive daughters thorium, radium, radon, polonium and lead. Besides being radioactive, these or their daughters are biologically deleterious elements. The potential dangers of using enriched phosphate derivatives are both that of adding phosphate radio-metals to the agricultural soils, the uptake by crops, their leakage to the underlying aquifers; or contrariwise, their retention and long term residence in the agricultural top soils. The latter needs to be considered over time, as farmlands are increasingly converted to urban housing. Based upon open sourced literature from Israel and other countries where phosphate fertilizers have been employed, the implications of the above potential problems are reviewed and evaluated. It appears at the moment, that for Israel, the use of phosphate fertilization does not present an immediate health hazard by increasing external dose rates or via crop uptake. However, a continuing build-up of radio-metals over the phreatic aquifers may at some point of time in the future warrant a more rigorous monitoring of the water supplies. Various methods of cleaning soils of the radio-metal contamination are available, though cost via conventional methods would be prohibitive. Though, some of the radionuclides congregate in the phosphogypsum phase during the industrial process, it is currently feasible, if not entirely economical at current depressed prices, to efficiently extract

  16. It's the Heat AND the Humidity -- Assessment of Extreme Heat Scenarios to Enable the Assessment of Climate Impacts on Public Health

    Science.gov (United States)

    Crosson, William L; Al-Hamdan, Mohammad Z.; Economou, Sigrid, A.; Estes, Maurice G.; Estes, Sue M.; Puckett, Mark; Quattrochi, Dale A

    2013-01-01

    In the United States, extreme heat is the most deadly weather-related hazard. In the face of a warming climate and urbanization, which contributes to local-scale urban heat islands, it is very likely that extreme heat events (EHEs) will become more common and more severe in the U.S. In a NASA-funded project supporting the National Climate Assessment, we are providing historical and future measures of extreme heat to enable assessments of the impacts of heat on public health over the coterminous U.S. We use atmospheric temperature and humidity information from meteorological reanalysis and from Global Climate Models (GCMs) to provide data on past and future heat events. The project s emphasis is on providing assessments of the magnitude, frequency and geographic distribution of extreme heat in the U.S. to facilitate public health studies. In our approach, long-term climate change is captured with GCM output, and the temporal and spatial characteristics of short-term extremes are represented by the reanalysis data. Two future time horizons, 2040 and 2090, are the focus of future assessments; these are compared to the recent past period of 1981-2000. We are characterizing regional-scale temperature and humidity conditions using GCM output for two climate change scenarios (A2 and A1B) defined in the Special Report on Emissions Scenarios (SRES). For each future period, 20 years of multi-model GCM output have been analyzed to develop a heat stress climatology based on statistics of extreme heat indicators. Differences between the two future and past periods have been used to define temperature and humidity changes on a monthly time scale and regional spatial scale. These changes, combined with hourly historical meteorological data at a spatial scale (12 km) much finer than that of GCMs, enable us to create future climate realizations, from which we compute the daily heat stress measures and related spatially-specific climatological fields. These include the mean annual

  17. Impact assessment and cost-effectiveness of m-health application used by community health workers for maternal, newborn and child health care services in rural Uttar Pradesh, India: a study protocol.

    Science.gov (United States)

    Prinja, Shankar; Nimesh, Ruby; Gupta, Aditi; Bahuguna, Pankaj; Thakur, Jarnail Singh; Gupta, Madhu; Singh, Tarundeep

    2016-01-01

    An m-health application has been developed and implemented with community health workers to improve their counseling in a rural area of India. The ultimate aim was to generate demand and improve utilization of key maternal, neonatal, and child health services. The present study aims to assess the impact and cost-effectiveness of this project. A pre-post quasi-experimental design with a control group will be used to undertake difference in differences analysis for assessing the impact of intervention. The Annual Health Survey (2011) will provide pre-intervention data, and a household survey will be carried out to provide post-intervention data.Two community development blocks where the intervention was introduced will be treated as intervention blocks while two controls blocks are selected after matching with intervention blocks on three indicators: average number of antenatal care checkups, percentage of women receiving three or more antenatal checkups, and percentage of institutional deliveries. Two categories of beneficiaries will be interviewed in both areas: women with a child between 29 days and 6 months and women with a child between 12 and 23 months. Propensity score matched samples from intervention and control areas in pre-post periods will be analyzed using the difference in differences method to estimate the impact of intervention in utilization of key services.Bottom-up costing methods will be used to assess the cost of implementing intervention. A decision model will estimate long-term effects of improved health services utilization on mortality, morbidity, and disability. Cost-effectiveness will be assessed in terms of incremental cost per disability-adjusted life year averted and cost per unit increase in composite service coverage in intervention versus control groups. The study will generate significant evidence on impact of the m-health intervention for maternal, neonatal, and child services and on the cost of scaling up m-health technology for

  18. Assessing the Health Impact of the following Measures in Schools in Maradi (Niger: Construction of Latrines, Clean Water Supply, Establishment of Hand Washing Stations, and Health Education

    Directory of Open Access Journals (Sweden)

    Halima Boubacar Maïnassara

    2014-01-01

    Full Text Available Objective. To assess the effect on health of the following measures in schools in Maradi (Niger: clean water supply, construction of latrines, establishment of hand washing stations, and health education. Methodology. It was a “before and after” intervention study on a sample of school children aged 7 to 12 years in the Maradi region. The interventions included building of latrines, supplying clean water, setting up hand washing stations, and teaching health education lessons. An individual questionnaire, analysis of stool samples, and a group questionnaire were administered to children and teachers, respectively. The threshold for significance was set at P<0.05. Results. A statistically significant reduction in cases of diarrhoea and abdominal pains was noted after the project. Overall, carriage of at least one parasite increased from 7.5% before the project to 10.2% after it (P=0.04. In the programme group schools, there was a statistically significant increase in the prevalence of Hymenolepis nana, from 0 to 1.9 (P=0.02. Pinworm prevalence remained stable in this group but increased significantly in the control group. Conclusions. Putting health infrastructure in place in schools obviously had an impact on hygiene-related habits in the beneficiary schools and communities.

  19. Assessment of the status of urban air pollution and its impact on human health in the city of Kolkata.

    Science.gov (United States)

    Ghose, Mrinal K; Paul, R; Banerjee, R K

    2005-09-01

    Air pollution has significant effects on exacerbation of asthma, allergy and other respiratory diseases. Like many other magacities in the world the ambient air quality of Kolkata is also being deteriorated day by day. Automobile exhausts and certain industrial pollutants produce O(3) by photochemical reactions. The particulate matter, particularly less than 10 microm in size, can pass through the natural protective mechanism of human respiratory system and plays an important role in genesis and augmentation of allergic disorders. Sources of air pollution in the area and the unique problem arising out of the emission from the vehicles, industries, etc. have been described. Ambient air quality was monitored along with micrometeorological data and the results are discussed. The status of air pollution in the area has been evaluated and a questionnaire survey was conducted to estimate the allergic symptoms and exposure to assess the respiratory disorders. The data are analysed to evaluate the critical situation arising out of the emission of air pollutants and the impact on human health due to respirable diseases (RDs) to middle class sub-population (activity-wise) in the area are assessed. A strategic air quality management plan has been proposed. For the mitigation of air pollution problems in the city, the different measures to be adopted to maintain the balance between sustainable development and environmental management have been discussed.

  20. Assessment of potential health impacts on surface water sources in Northern Nigeria

    Directory of Open Access Journals (Sweden)

    ZD Umar

    2014-05-01

    Full Text Available Northern Nigeria represents the most populous region in Nigeria and adequate water supply and sanitation typically leaves a lot to be desired in the region in order to prevent water related diseases to the vulnerable communities of the region. This research work was carried out in Kano state with specific emphasis on Tomas dam which is one of the largest dams established for multipurpose use in Nigeria. The research was aimed at evaluating Physico-chemical and Bacteriological quality of Tomas Dam in Kano State. 240 water samples from 5 sampling stations within eight months were analyzed for bacteriological and physico-chemical quality. The physico-chemical parameters indicated Biochemical Oxygen Demand (BOD and Water Current Speed results were not significantly different (P>0.05, while other physico-chemical parameters analyzed varied significantly (P<0.05. The study also revealed that Dissolved Oxygen (DO, BOD, Turbidity, and Nitrates recorded higher values than WHO and Federal Environmental Protection Agency, Nigeria (FEPA limits. Total aerobic bacterial counts (TBC and total coliform counts (TCC were determined using pour plate and Most Probable Number (MPN techniques. TBC and TCC were high and exceeded acceptable limits. Faecal coliforms, faecal Streptococciand Klebsiella species constituted 25% of the indicator organisms identified.The observed parameters indicated the Dam was contaminated with pathogenic bacteria. Variations in the weather conditions, animal and anthropogenic interferences were all directly or indirectly related to faecal contamination in the dam. Preventing indiscriminate faecal discharge close to the Dam and sufficient water treatment before consumption are of prime importance to public health as the dam was established for agricultural purposes. DOI: http://dx.doi.org/10.3126/ije.v3i2.10523 International Journal of the Environment Vol.3(2 2014: 125-136

  1. Ecological impact assessment

    International Nuclear Information System (INIS)

    Thomas, J.M.; Eberhardt, L.L.

    1975-01-01

    Quantitative problems in accomplishing ecological impact assessment with particular reference to defining population effects are discussed with some comments on the two approaches most commonly used, e.g., the experimental and simulation models. Some alternatives are suggested because both methods will probably fail to detect real population effects mostly due to poor understanding of ecosystems or because of the limitations inherent in field census methods. Most judgments of ecological impact are not quantitatively defensible but are qualitative, subjective, or political in nature. An examination of aggregates of data from various nuclear power plant sites may be one way to obtain enough replication to judge ecological impact. Thus, currently available data from such studies as well as appropriate demographic, vegetation, census, and bibliographic material could offer an interesting challenge to computer professionals if such an undertaking were contemplated. Present research programs at PNL and computer involvement are described. Future possibilities and directions are discussed. (U.S.)

  2. Is HIA the most effective tool to assess the impact on health of climate change mitigation policies at the local level? A case study in Geneva, Switzerland.

    Science.gov (United States)

    Diallo, Thierno; Cantoreggi, Nicola; Simos, Jean; Christie, Derek P T H

    2017-06-01

    This study aims to understand how the health dimension is integrated into four impact assessment tools used in Geneva, Switzerland: environmental impact assessment (EIA), strategic environmental assessment (SEA), sustainability assessment (SA) and health impact assessment (HIA). We have chosen as a case study greenhouse gas (GHG) emissions reduction policies chosen by the city of Geneva. The methodological approach consists in analysing EIA, SEA, SA and HIA conducted on three projects in three topic areas: urban planning, heating and transportation. These projects are: a complex urbanisation plan in an urban neighbourhood in Geneva (the Gare des Eaux-Vives project), a sustainable transportation plan for a central district in Geneva (the St-Gervais transportation project) and a strategy to encourage the City's employees to use sustainable transport for local business travel. The results show some shortcomings in the consideration of health in SEA, EIA and SA. This work highlights a narrow vision of health in SEA and EIA, limiting itself to a review of the effects of projects on the determinants of the physical environment as required by the legislation relating to these tools. EIA does not require the integration of the health dimension. As for SA, our research found that health is treated much more superficially than in HIA and primarily through the analysis of 'health and safety' criteria. It appears from this work that HIA is the tool which provides the most elaborate assessment, compared to SA, SEA or EIA, of the consequences for health of the GHG reduction policies chosen by the local decision-makers of a city. However, our study suggests that the HIA community should identify the situations in which HIA should be carried out and in which cases it is better to include health issues within an integrated analysis.

  3. The urgent need for health impact assessment: proposing a transdisciplinary approach to the e-waste crisis in sub-Saharan Africa.

    Science.gov (United States)

    Tetteh, Dinah; Lengel, Lara

    2017-06-01

    Electronic waste (e-waste) is a growing health and environmental concern in developing countries. In the sub-Saharan African region e-waste is considered a crisis with no end in sight yet; there is lack of structures and regulations to manage the problem. In this article, we discuss the potential of Health Impact Assessment (HIA) in addressing the health, environmental, and social impacts of e-waste in sub-Saharan Africa. We draw from environmental policy, environmental communication, global health policy, and health communication to argue that managing e-waste could be framed as ongoing HIA where all the steps of HIA are performed on a rolling basis with input from local communities. Further, we suggest that HIA should be infused into recycling legislation to help streamline the practice in order to make it safe for health and the environment and to maximize the economic benefits.

  4. Validation of the Spanish version of the oral health impact profile to assess an association between quality of life and oral health of elderly Chileans.

    Science.gov (United States)

    León, Soraya; Bravo-Cavicchioli, Daniel; Giacaman, Rodrigo A; Correa-Beltrán, Gloria; Albala, Cecilia

    2016-03-01

    To validate the Spanish version of the OHIP-49 among elderly population. Oral health, as a predictor of quality of life, can be evaluated using validated instruments. One of the most commonly used instruments worldwide is the Oral Health Impact Profile-49 (OHIP-49). This instrument has not yet been validated in Chilean older adults. Interviews and clinical exams were performed in a convenience sample of eighty-five elderly participants aged 60 or more years (mean 69.02 ± 7.82 years). Socio-demographic and clinical variables were analysed: number of teeth, caries, periodontal and prosthetic treatment needs and prosthetic functionality. High internal consistency values were obtained for both the OHIP-49 Sp instrument (0.990) and all of its dimensions (0.875-0.995). The average score of the OHIP-49 Sp was 62.54 ± 43.73. Significantly higher OHIP-49 Sp scores were observed in participants with caries (p = 0.01), in those needing complex periodontal treatment (p = 0.0001) and those in need of dental prostheses (p ≤ 0.0001). The OHIP-49 Sp proved to be a valid tool to assess oral health-related quality of life, when tested in Chilean older adults. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  5. Impact assessment and cost-effectiveness of m-health application used by community health workers for maternal, newborn and child health care services in rural Uttar Pradesh, India: a study protocol

    OpenAIRE

    Prinja, Shankar; Nimesh, Ruby; Gupta, Aditi; Bahuguna, Pankaj; Thakur, Jarnail Singh; Gupta, Madhu; Singh, Tarundeep

    2016-01-01

    Background: An m-health application has been developed and implemented with community health workers to improve their counseling in a rural area of India. The ultimate aim was to generate demand and improve utilization of key maternal, neonatal, and child health services. The present study aims to assess the impact and cost-effectiveness of this project.Methods/design: A pre–post quasi-experimental design with a control group will be used to undertake difference in differences analysis for as...

  6. Including the temporal change in PM{sub 2.5} concentration in the assessment of human health impact: Illustration with renewable energy scenarios to 2050

    Energy Technology Data Exchange (ETDEWEB)

    Gschwind, Benoit, E-mail: benoit.gschwind@mines-paristech.fr [Centre Observation, Impacts, Energy, MINES ParisTech, 1 rue Claude Daunesse, CS 10207, F-06904 Sophia Antipolis (France); Lefevre, Mireille, E-mail: mireille.lefevre@mines-paristech.fr [Centre Observation, Impacts, Energy, MINES ParisTech, 1 rue Claude Daunesse, CS 10207, F-06904 Sophia Antipolis (France); Blanc, Isabelle, E-mail: isabelle.blanc@mines-paristech.fr [Centre Observation, Impacts, Energy, MINES ParisTech, 1 rue Claude Daunesse, CS 10207, F-06904 Sophia Antipolis (France); Ranchin, Thierry, E-mail: thierry.ranchin@mines-paristech.fr [Centre Observation, Impacts, Energy, MINES ParisTech, 1 rue Claude Daunesse, CS 10207, F-06904 Sophia Antipolis (France); Wyrwa, Artur, E-mail: awyrwa@agh.edu.pl [AGH University of Science and Technology, Al. Mickiewicza 30, Krakow 30-059 (Poland); Drebszok, Kamila [AGH University of Science and Technology, Al. Mickiewicza 30, Krakow 30-059 (Poland); Cofala, Janusz, E-mail: cofala@iiasa.ac.at [International Institute for Applied Systems Analysis, Schlossplatz 1, 2067 Laxenburg (Austria); Fuss, Sabine, E-mail: fuss@mcc-berlin.net [International Institute for Applied Systems Analysis, Schlossplatz 1, 2067 Laxenburg (Austria); Mercator Research Institute on Global Commons and Climate Change, Torgauer Str. 12-15, 10829 Berlin (Germany)

    2015-04-15

    This article proposes a new method to assess the health impact of populations exposed to fine particles (PM{sub 2.5}) during their whole lifetime, which is suitable for comparative analysis of energy scenarios. The method takes into account the variation of particle concentrations over time as well as the evolution of population cohorts. Its capabilities are demonstrated for two pathways of European energy system development up to 2050: the Baseline (BL) and the Low Carbon, Maximum Renewable Power (LC-MRP). These pathways were combined with three sets of assumptions about emission control measures: Current Legislation (CLE), Fixed Emission Factors (FEFs), and the Maximum Technically Feasible Reductions (MTFRs). Analysis was carried out for 45 European countries. Average PM{sub 2.5} concentration over Europe in the LC-MRP/CLE scenario is reduced by 58% compared with the BL/FEF case. Health impacts (expressed in days of loss of life expectancy) decrease by 21%. For the LC-MRP/MTFR scenario the average PM{sub 2.5} concentration is reduced by 85% and the health impact by 34%. The methodology was developed within the framework of the EU's FP7 EnerGEO project and was implemented in the Platform of Integrated Assessment (PIA). The Platform enables performing health impact assessments for various energy scenarios. - Highlights: • A new method to assess health impact of PM{sub 2.5} for energy scenarios is proposed. • An algorithm to compute Loss of Life Expectancy attributable to exposure to PM{sub 2.5} is depicted. • Its capabilities are demonstrated for two pathways of European energy system development up to 2050. • Integrating the temporal evolution of PM{sub 2.5} is of great interest for assessing the potential impacts of energy scenarios.

  7. Including the temporal change in PM2.5 concentration in the assessment of human health impact: Illustration with renewable energy scenarios to 2050

    International Nuclear Information System (INIS)

    Gschwind, Benoit; Lefevre, Mireille; Blanc, Isabelle; Ranchin, Thierry; Wyrwa, Artur; Drebszok, Kamila; Cofala, Janusz; Fuss, Sabine

    2015-01-01

    This article proposes a new method to assess the health impact of populations exposed to fine particles (PM 2.5 ) during their whole lifetime, which is suitable for comparative analysis of energy scenarios. The method takes into account the variation of particle concentrations over time as well as the evolution of population cohorts. Its capabilities are demonstrated for two pathways of European energy system development up to 2050: the Baseline (BL) and the Low Carbon, Maximum Renewable Power (LC-MRP). These pathways were combined with three sets of assumptions about emission control measures: Current Legislation (CLE), Fixed Emission Factors (FEFs), and the Maximum Technically Feasible Reductions (MTFRs). Analysis was carried out for 45 European countries. Average PM 2.5 concentration over Europe in the LC-MRP/CLE scenario is reduced by 58% compared with the BL/FEF case. Health impacts (expressed in days of loss of life expectancy) decrease by 21%. For the LC-MRP/MTFR scenario the average PM 2.5 concentration is reduced by 85% and the health impact by 34%. The methodology was developed within the framework of the EU's FP7 EnerGEO project and was implemented in the Platform of Integrated Assessment (PIA). The Platform enables performing health impact assessments for various energy scenarios. - Highlights: • A new method to assess health impact of PM 2.5 for energy scenarios is proposed. • An algorithm to compute Loss of Life Expectancy attributable to exposure to PM 2.5 is depicted. • Its capabilities are demonstrated for two pathways of European energy system development up to 2050. • Integrating the temporal evolution of PM 2.5 is of great interest for assessing the potential impacts of energy scenarios

  8. Limited evidence to assess the impact of primary health care system or service level attributes on health outcomes of Indigenous people with type 2 diabetes: a systematic review.

    Science.gov (United States)

    Gibson, Odette R; Segal, Leonie

    2015-04-11

    To describe reported studies of the impact on HbA1C levels, diabetes-related hospitalisations, and other primary care health endpoints of initiatives aimed at improving the management of diabetes in Indigenous adult populations of Australia, Canada, New Zealand and the United States. Systematic literature review using data sources of MEDLINE, Embase, the Cochrane Library, CINHAL and PsycInfo from January 1985 to March 2012. Inclusion criteria were a clearly described primary care intervention, model of care or service, delivered to Indigenous adults with type 2 diabetes reporting a program impact on at least one quantitative diabetes-related health outcome, and where results were reported separately for Indigenous persons. Joanna Briggs Institute critical appraisal tools were used to assess the study quality. PRISMA guidelines were used for reporting. The search strategy retrieved 2714 articles. Of these, 13 studies met the review inclusion criteria. Three levels of primary care initiatives were identified: 1) addition of a single service component to the existing service, 2) system-level improvement processes to enhance the quality of diabetes care, 3) change in primary health funding to support better access to care. Initiatives included in the review were diverse and included comprehensive multi-disciplinary diabetes care, specific workforce development, systematic foot care and intensive individual hypertension management. Twelve studies reported HbA1C, of those one also reported hospitalisations and one reported the incidence of lower limb amputation. The methodological quality of the four comparable cohort and seven observational studies was good, and moderate for the two randomised control trials. The current literature provides an inadequate evidence base for making important policy and practice decisions in relation to primary care initiatives for Indigenous persons with type 2 diabetes. This reflects a very small number of published studies, the general

  9. A citizens' jury on regulation of McDonald's products and operations in Australia in response to a corporate health impact assessment.

    Science.gov (United States)

    Anaf, Julia; Baum, Fran; Fisher, Matthew

    2018-01-31

    1) To report outcomes from a citizens' jury examining regulatory responses to the health impacts of McDonald's Australia; 2) To determine the value of using citizens' juries to develop policy recommendations based on the findings of health impact assessment of transnational corporations (TNCs). A citizens' jury engaged 15 randomly selected and demographically representative jurors from metropolitan Adelaide to deliberate on the findings of a Corporate Health Impact Assessment, and to decide on appropriate policy actions. Jurors unanimously called for government regulation to ensure that transnational fast food corporations pay taxes on profits in the country of income. A majority (two-thirds) also recommended government regulation to reduce fast food advertising, and improve standards of consumer information including a star-ratings system. A minority held the view that no further regulation is required of the corporate fast food industry in Australia. The jury's recommendations can help inform policy makers about the importance of ending the legal profit-shifting strategies by TNCs that affect taxation revenue. They also endorse regulating the fast food industry to provide healthier food, and employing forms of community education and awareness-raising. Implications for public health: Citizens' juries can play an important role in providing feedback and policy recommendations in response to the findings of a health impact assessment of transnational corporations. © 2018 The Authors.

  10. Life Cycle Impact Assessment

    DEFF Research Database (Denmark)

    Rosenbaum, Ralph K.; Hauschild, Michael Zwicky; Boulay, Anne-Marie

    2017-01-01

    by LCA software, but the underlying principles, models and factors should still be well understood by practitioners to ensure the insight that is needed for a qualified interpretation of the results. This chapter teaches the fundamentals of LCIA and opens the black box of LCIA with its characterisation...... models and factors to inform the reader about: (1) the main purpose and characteristics of LCIA, (2) the mandatory and optional steps of LCIA according to the ISO standard, and (3) the science and methods underlying the assessment for each environmental impact category . For each impact category......, the reader is taken through (a) the underlying environmental problem, (b) the underlying environmental mechanism and its fundamental modelling principles, (c) the main anthropogenic sources causing the problem and (d) the main methods available in LCIA. An annex to this book offers a comprehensive...

  11. An approach to developing local climate change environmental public health indicators, vulnerability assessments, and projections of future impacts.

    Science.gov (United States)

    Houghton, Adele; English, Paul

    2014-01-01

    Environmental public health indicators (EPHIs) are used by local, state, and federal health agencies to track the status of environmental hazards; exposure to those hazards; health effects of exposure; and public health interventions designed to reduce or prevent the hazard, exposure, or resulting health effect. Climate and health EPHIs have been developed at the state, federal, and international levels. However, they are also needed at the local level to track variations in community vulnerability and to evaluate the effectiveness of interventions designed to enhance community resilience. This review draws on a guidance document developed by the U.S. Council of State and Territorial Epidemiologists' State Environmental Health Indicators Collaborative climate change working group to present a three-tiered approach to develop local climate change EPHIs. Local climate change EPHIs can assist local health departments (LHDs) in implementing key steps of the 10 essential public health services and the U.S. Centers for Disease Control and Prevention's Building Resilience Against Climate Effects framework. They also allow LHDs to incorporate climate-related trends into the larger health department planning process and can be used to perform vulnerability assessments which can be leveraged to ensure that interventions designed to address climate change do not exacerbate existing health disparities.

  12. Exploration of the functions of health impact assessment in real-world policymaking in the field of social health inequality: towards a conception of conceptual learning.

    Science.gov (United States)

    Feyaerts, Gille; Deguerry, Murielle; Deboosere, Patrick; De Spiegelaere, Myriam

    2017-06-01

    With the implementation of health impact assessment (HIA)'s conceptual model into real-world policymaking, a number of fundamental issues arise concerning its decision-support function. Rooted in a rational vision of the decision-making process, focus regarding both conceptualisation and evaluation has been mainly on the function of instrumental policy-learning. However, in the field of social health inequalities, this function is strongly limited by the intrinsic 'wickedness' of the policy issue. Focusing almost exclusively on this instrumental function, the real influence HIA can have on policymaking in the longer term is underestimated and remains largely unexploited. Drawing insights from theoretical models developed in the field of political science and sociology, we explore the different decision-support functions HIA can fulfill and identify conceptual learning as potentially the most important. Accordingly, dominant focus on the technical engineering function, where knowledge is provided in order to 'rationalise' the policy process and to tackle 'tame' problems, should be complemented with an analysis of the conditions for conceptual learning, where knowledge introduces new information and perspectives and, as such, contributes in the longer term to a paradigm change.

  13. Social Impact Assessment for Wetlands

    NARCIS (Netherlands)

    Vanclay, Francis

    2016-01-01

    Social Impact Assessment (SIA) comprises the processes of analyzing, monitoring, and managing the social consequences of planned interventions (Vanclay 2003; Esteves et al. 2012). Planned interventions can be projects, plans, programs, or policies. SIA arose alongside Environmental Impact Assessment

  14. Development of a Standard for the Health Hazard Assessment of Mechanical Shock and Repeated Impact in Army Vehicles, Phase 1.

    Science.gov (United States)

    1995-05-01

    accelerations in such activities can provide useful information in the assessment of acceptable levels of exposure to repeated impact and shock in less familiar ...exposures can be compared with "safe" stress induced in more familiar environments (walking or light physical work) to assess potential for...personnel of a transport company). Medicina de Lv 49:630-634. Barnes, G.R. 1987. Human Factors of helicopter vibration. 1: The physiological effects of

  15. Assessing the impact of dietary habits on health-related quality of life requires contextual measurement tools

    Directory of Open Access Journals (Sweden)

    Cristina eRuano

    2015-05-01

    Full Text Available The increase of non-communicable diseases at all ages has fostered the general concern for sustaining population health worldwide. Unhealthy lifestyles and dietary habits impacting physical and psycho-social health are well known risk factors for developing life threatening diseases. Identifying the determinants of quality of life is an important task from a Public Health perspective. Consumer-Reported Outcome measures of health-related quality of life are becoming increasingly necessary and relevant in the field of nutrition. However, quality of life questionnaires are seldom used in the nutrition field. We conducted a scientific literature search to find out the questionnaires used to determine the association between dietary habits and quality of life. A total of 13 studies were eligible for inclusion. Across these studies the Short Form–36, a generic (nondisease-specific health-related quality of life measurement instrument was the most widely used. However, generic measures may have limited content validity in the context of dietary habits interventions. We recommend additional contextual diet-specific health-related quality of life measures are also needed for evaluating the impact of diet habits on daily life functioning and well-being.

  16. Assessing the scholarly impact of health psychology: a citation analysis of articles published from 1993 to 2003.

    Science.gov (United States)

    Frosch, Dominick L; Saxbe, Darby; Tomiyama, A Janet; Glenn, Beth A; Low, Carissa A; Hanoch, Yaniv; Motivala, Sarosh J; Meeker, Daniella

    2010-09-01

    We conducted a citation analysis to explore the impact of articles published in Health Psychology and determine whether the journal is fulfilling its stated mission. Six years of articles (N = 408) representing three editorial tenures from 1993-2003 were selected for analysis. Articles were coded for several dimensions enabling examination of the relationship of article features to subsequent citations rates. Journals citing articles published in Health Psychology were classified into four categories: (1) psychology, (2) medicine, (3) public health and health policy, and (4) other journals. The majority of citations of Health Psychology articles were in psychology journals, followed closely by medical journals. Studies reporting data collected from college students, and discussing the theoretical implications of findings, were more likely to be cited in psychology journals, whereas studies reporting data from clinical populations, and discussing the practice implications of findings, were more likely to be cited in medical journals. Time since publication and page length were both associated with increased citation counts, and review articles were cited more frequently than observational studies. Articles published in Health Psychology have a wide reach, informing psychology, medicine, public health and health policy. Certain characteristics of articles affect their subsequent pattern of citation. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  17. The Self-Assessment Process and Impacts on the Health Information Management Program Performance: A Case Study

    Science.gov (United States)

    Spohn, Renae

    2015-01-01

    This study examined how health information management (HIM) educational programs can use the Malcolm Baldrige National Quality Award Model (MBNQAM) educational criteria to meet the self-assessment requirement for Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) accreditation. An existing instrument, Quantum Performance Group's Organizational Assessment Survey authored by Dr. Mark Blazey, was used in this study. The instrument was designed to self-assess the entire organization. Results of the study demonstrate how the MBNQAM can be used to successfully self-assess HIM programs. This research adds to the body of literature surrounding the application of the MBNQAM for HIM programs and provides new information to deans, administrators, and educators that may be useful, as an added component, when self-assessing HIM programs. The results of this study will help to establish a foundation for HIM programs to strengthen the self-assessment process, providing a strong starting point for strategic planning prioritization for HIM program improvement initiatives. The improved process will help in maturing the HIM program while fulfilling accreditation requirements for self-assessment. As additional HIM programs formalize the self-assessment process, benchmarking opportunities with other HIM programs will be created. PMID:26755899

  18. Using a One Health approach to assess the impact of parasitic disease in livestock: how does it add value?

    Science.gov (United States)

    Rushton, Jonathan; Bruce, Mieghan

    2017-01-01

    Human population increases, with greater food demands, have resulted in a rapid evolution of livestock food systems, leading to changes in land and water use. The scale of global livestock systems mean that changes in animal health status, particularly in parasite levels, have impacts that go beyond farm and sector levels. To quantify the true impact of parasites in livestock, frameworks that look at both resources and services valued in markets and those that have no true market value are required. Mitigating the effects of parasitic disease in livestock will not only increase productivity, but also improve animal welfare and human health, whilst reducing the environmental burden of livestock production systems. To measure these potential benefits, a One Health approach is needed. This paper discusses the types of methods and the data collection tools needed for a more holistic perspective and provides a framework with its application to coccidiosis in poultry. To build a body of knowledge that allows the ranking of parasite diseases in a wider animal health setting, such One Health frameworks need to be applied more frequently and with rigour. The outcome will improve the allocation of resources to critical constraints on parasite management.

  19. Impact assessment and cost-effectiveness of m-health application used by community health workers for maternal, newborn and child health care services in rural Uttar Pradesh, India: a study protocol

    Directory of Open Access Journals (Sweden)

    Shankar Prinja

    2016-05-01

    Full Text Available Background: An m-health application has been developed and implemented with community health workers to improve their counseling in a rural area of India. The ultimate aim was to generate demand and improve utilization of key maternal, neonatal, and child health services. The present study aims to assess the impact and cost-effectiveness of this project. Methods/design: A pre–post quasi-experimental design with a control group will be used to undertake difference in differences analysis for assessing the impact of intervention. The Annual Health Survey (2011 will provide pre-intervention data, and a household survey will be carried out to provide post-intervention data.Two community development blocks where the intervention was introduced will be treated as intervention blocks while two controls blocks are selected after matching with intervention blocks on three indicators: average number of antenatal care checkups, percentage of women receiving three or more antenatal checkups, and percentage of institutional deliveries. Two categories of beneficiaries will be interviewed in both areas: women with a child between 29 days and 6 months and women with a child between 12 and 23 months. Propensity score matched samples from intervention and control areas in pre–post periods will be analyzed using the difference in differences method to estimate the impact of intervention in utilization of key services.Bottom-up costing methods will be used to assess the cost of implementing intervention. A decision model will estimate long-term effects of improved health services utilization on mortality, morbidity, and disability. Cost-effectiveness will be assessed in terms of incremental cost per disability-adjusted life year averted and cost per unit increase in composite service coverage in intervention versus control groups. Conclusions: The study will generate significant evidence on impact of the m-health intervention for maternal, neonatal, and child

  20. Assessing the short term health impact of the Great Recession in the European Union: a cross-country panel analysis.

    Science.gov (United States)

    Toffolutti, Veronica; Suhrcke, Marc

    2014-07-01

    There are great concerns and some initial country-specific, descriptive evidence about potential adverse health consequences of the recent Great Recession. Using data for 23 European Union countries we examine the short-term impact of macroeconomic decline during the Great Recession on a range of health and health behaviour indicators. We also examine whether the effect differed between countries according to the level of social protection provided. Overall, during the recent recession, an increase of one percentage point in the standardised unemployment rate has been associated with a statistically significant decrease in the following mortality rates: all-cause-mortality (3.4%), cardiovascular diseases (3.7%), cirrhosis- and chronic liver disease-related mortality (9.2%), motor vehicle accident-related mortality (11.5%), parasitic infection-related mortality (4.1%), but an increase in the suicide rate (34.1%). In general, the effects were more marked in countries with lower levels of social protection, compared to those with higher levels. An increase in the unemployment rate during the Great Recession has had a beneficial health effect on average across EU countries, except for suicide mortality. Social protection expenditures appear to help countries "smooth" the health response to a recession, limiting health damage but also forgoing potential health gains that could otherwise result. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Animal welfare impact assessments

    DEFF Research Database (Denmark)

    Sandøe, Peter; Gamborg, Christian

    2017-01-01

    of this paper is to evaluate the potential of AWIA. We begin by showing how ideas akin to AWIA already play a significant role in other animal ethics controversies, particularly those concerning laboratory animal use and livestock production; and we bring in lessons learnt from these controversies. Then we......Control of wild animals may give rise to controversy, as is seen in the case of badger control to manage TB in cattle in the UK. However, it is striking that concerns about the potential suffering of the affected animals themselves are often given little attention or completely ignored in policies...... aimed at dealing with wild animals. McCulloch and Reiss argue that this could be remedied by means of a “mandatory application of formal and systematic Animal Welfare Impact Assessment (AWIA)”. Optimistically, they consider that an AWIA could help to resolve controversies involving wild animals. The aim...

  2. National Coal Utilization Assessment. a preliminary assessment of the health and environmental effects of coal utilization in the Midwest. Volume I. Energy scenarios, technology characterizations, air and water resource impacts, and health effects

    Energy Technology Data Exchange (ETDEWEB)

    1977-01-01

    This report presents an initial evaluation of the major health and environmental issues associated with increased coal use in the six midwestern states of Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin. Using an integrated assessment approach, the evaluation proceeds from a base-line scenario of energy demand and facility siting for 1975-2020. Emphasis is placed on impacts from coal extraction, land reclamation, coal combustion for electrical generation, and coal gasification. The range of potential impacts and constraints is illustrated by a second scenario that represents an expected upper limit for coal utilization in Illinois. The following are among the more significant issues identified and evaluated in this study: If environmental and related issues can be resolved, coal will continue to be a major source of energy for the Midwest; existing sulfur emission constraints will increase use of western coal; the resource requirements and environmental impacts of coal utilization will require major significant environmental and economic tradeoffs in site selection; short-term (24-hr) ambient standards for sulfur dioxide will limit the sizes of coal facilities or require advanced control technologies; an impact on public health may result from long-range transport of airborne sulfur emissions from coal facilities in the Midwest; inadequately controlled effluents from coal gasification may cause violations of water-quality standards; the major ecological effects of coal extraction are from pre-mining and post-reclamation land use; and sulfur dioxide is the major potential contributor to effects on vegetation of atmospheric emissions from coal facilities.

  3. Achieving a healthy zoning policy in Baltimore: results of a health impact assessment of the TransForm Baltimore zoning code rewrite.

    Science.gov (United States)

    Johnson Thornton, Rachel L; Greiner, Amelia; Fichtenberg, Caroline M; Feingold, Beth J; Ellen, Jonathan M; Jennings, Jacky M

    2013-11-01

    The social determinants of health (SDH) include factors apart from genes and biology that affect population health. Zoning is an urban planning tool that influences neighborhood built environments. We describe the methods and results of a health impact assessment (HIA) of a rezoning effort in Baltimore, Maryland, called TransForm Baltimore. We highlight findings specific to physical activity, violent crime, and obesity. We conducted a multistage HIA of TransForm Baltimore using HIA practice guidelines. Key informant interviews identified focus areas for the quantitative assessment. A literature review and a zoning code analysis evaluated potential impacts on neighborhood factors including physical activity, violent crime, and obesity. We estimated potential impacts in high- and low-poverty neighborhoods. The findings resulted in recommendations to improve the health-promoting potential of TransForm Baltimore. Mixed-use and transit-oriented development were key goals of TransForm Baltimore. Health impacts identified by stakeholders included walkability and healthy communities. For Baltimore residents, we estimated that (1) the percentage of people living in districts allowing mixed-use and off-premise alcohol outlets would nearly triple, (2) 18% would live in transit-oriented development zones, and (3) all residents would live in districts with new lighting and landscaping guidelines. Limiting the concentration of off-premise alcohol outlets represented an opportunity to address health promotion. Changes to Baltimore's zoning code could improve population health including decreasing violent crime. HIAs are an important platform for applying SDH to public health practice. This HIA specifically linked municipal zoning policy with promoting healthier neighborhoods.

  4. Towards health impact assessment of drinking-water privatization--the example of waterborne carcinogens in North Rhine-Westphalia (Germany).

    Science.gov (United States)

    Fehr, Rainer; Mekel, Odile; Lacombe, Martin; Wolf, Ulrike

    2003-01-01

    Worldwide there is a tendency towards deregulation in many policy sectors - this, for example, includes liberalization and privatization of drinking-water management. However, concerns about the negative impacts this might have on human health call for prospective health impact assessment (HIA) on the management of drinking-water. On the basis of an established generic 10-step HIA procedure and on risk assessment methodology, this paper aims to produce quantitative estimates concerning health effects from increased exposure to carcinogens in drinking-water. Using data from North Rhine-Westphalia in Germany, probabilistic estimates of excess lifetime cancer risk, as well as estimates of additional cases of cancer from increased carcinogen exposure levels are presented. The results show how exposure to contaminants that are strictly within current limits could increase cancer risks and case-loads substantially. On the basis of the current analysis, we suggest that with uniform increases in pollutant levels, a single chemical (arsenic) is responsible for a large fraction of expected additional risk. The study also illustrates the uncertainty involved in predicting the health impacts of changes in water quality. Future analysis should include additional carcinogens, non-cancer risks including those due to microbial contamination, and the impacts of system failures and of illegal action, which may be increasingly likely to occur under changed management arrangements. If, in spite of concerns, water is privatized, it is particularly important to provide adequate surveillance of water quality.

  5. Social Impact Assessment in Europe

    DEFF Research Database (Denmark)

    Larsen, Sanne Vammen; Hansen, Anne Merrild; Lyhne, Ivar

    2015-01-01

    Social impact assessment (SIA) is applied worldwide to assess social impacts of plans and projects. In Europe, directives on environmental assessment (EA) require attention to social impacts, however, there is a need to investigate the implementation in practise. To this end, we study three Danish...... cases, which are characterised by debates and conflicts on social issues. Analysis of the EA statements shows inclusion of a broad range of social impacts. However, the EAs do not fully match the concerns of the public, and social impacts are not always analysed in depth, mitigation measures...... are not suggested or are postponed and the geographical distribution of impacts assessed is biased towards including negative local impacts. We discuss the scope and handling of social impacts, and possible implications. Based on this, we conclude with the view that EA might do the job of handling social impacts...

  6. Assessment of the Long Term Trends in Extreme Heat Events and the Associated Health Impacts in the United States

    Science.gov (United States)

    Bell, J.; Rennie, J.; Kunkel, K.; Herring, S.; Cullen, H. M.

    2017-12-01

    Land surface air temperature products have been essential for monitoring the evolution of the climate system. Before a temperature dataset is included in such reports, it is important that non-climatic influences be removed or changed so the dataset is considered homogenous. These inhomogeneities include changes in station location, instrumentation and observing practices. While many homogenized products exist on the monthly time scale, few daily products exist, due to the complication of removing breakpoints that are truly inhomogeneous rather than solely by chance (for example, sharp changes due to synoptic conditions). Recently, a sub monthly homogenized dataset has been developed using data and software provided by NOAA's National Centers for Environmental Information (NCEI). Homogeneous daily data are useful for identification and attribution of extreme heat events over a period of time. Projections of increasing temperatures are expected to result in corresponding increases in the frequency, duration, and intensity of extreme heat events. It is also established that extreme heat events can have significant public health impacts, including short-term increases in mortality and morbidity. In addition, it can exacerbate chronic health conditions in vulnerable populations, including renal and cardiovascular issues. To understand how heat events impact a specific population, it will be important to connect observations on the duration and intensity of extreme heat events with health impacts data including insurance claims and hospital admissions data. This presentation will explain the methodology to identify extreme heat events, provide a climatology of heat event onset, length and severity, and explore a case study of an anomalous heat event with available health data.

  7. Do online health communities enhance patient-physician relationship? An assessment of the impact of social support and patient empowerment.

    Science.gov (United States)

    Audrain-Pontevia, Anne-Francoise; Menvielle, Loick

    2017-01-01

    The diffusion of the Web 2.0 has made it possible for patients to exchange on online health communities, defined as computer-mediated communities dedicated to health topics, wherein members can build relationships with other members. It is now acknowledged that online health communities provide users not only with medical information but also with social support with no time or geographical boundaries. However, in spite of their considerable interest, there is still a paucity of research as to how online health communities alter the patient-physician relationship. This research aims at filling this gap and examines how online health communities, while providing users with computer-mediated social support and empowerment, impact the patient-physician relationship. Six hypotheses are proposed and tested. A survey was developed and 328 responses were collected from online patient groups in Canada in 2016. The data were analysed using structural equation modelling. All but one hypothesis are validated. The results show that user computer-mediated social support positively influences user empowerment and participation during the consultation, which in turn determines user commitment to the relationship with the physician. Importantly and contrary to our expectations, user empowerment is found to be significantly but negatively related to user commitment with the physician.

  8. An assessment of students' confidence in performing psychiatric mental health nursing skills: the impact of the clinical practicum experience.

    Science.gov (United States)

    Fiedler, Ruth Anne; Breitenstein, Susie; Delaney, Kathleen

    2012-01-01

    In 2008, the American Psychiatric Nurses Association and the International Society for Psychiatric Nursing jointed developed Psychiatric Mental Health Nursing competencies for BSN students. In the newly created accelerated track of the BSN program, students spend less time than traditional students in psychiatric mental health (PMH) clinical practica. The primary objective was to discover how the PMH practicum experience influences BSN students' perceptions of their confidence in performing PMH clinical skills. An evaluation design was used in this study. There was significant improvement in students' confidence performing PMH clinical competencies after completing the PMH nursing practicum. The current structure of clinical provides students with experiences that promote their confidence. Students self-assessment about learning needs and skill level should be assessed preclinically to allow for practice to gain confidence.

  9. Development of National Future Extreme Heat Scenario to Enable the Assessment of Climate Impacts on Public Health

    Science.gov (United States)

    Quattrochi, Dale A.; Cresson, William L.; Al-Hamdan, Mohammad Z.; Estes, Maurice G.

    2013-01-01

    The project's emphasis is on providing assessments of the magnitude, frequency and geographic distribution of EHEs to facilitate public health studies. We focus on the daily to weekly time scales on which EHEs occur, not on decadal-scale climate changes. There is, however, a very strong connection between air temperature patterns at the two time scales and long-term climatic changes will certainly alter the frequency of EHEs.

  10. An assessment of the impacts of child oral health in Indonesia and associations with self-esteem, school performance and perceived employability.

    Science.gov (United States)

    Maharani, Diah Ayu; Adiatman, Melissa; Rahardjo, Anton; Burnside, Girvan; Pine, Cynthia

    2017-03-21

    Previous surveys have indicated that a majority of Indonesian children have poor oral health. However, little detailed information is available on underlying causation and none that examine impacts of oral health on child self-esteem, school performance and perceived employability. The aim of this study was to determine levels of child oral health in primary school children in Indonesia, the prevalence of key causal factors; and, to determine relationships between oral health, self-esteem and school academic performance. Cross-sectional epidemiological study in a sample (n = 984) of children aged 6-7 and 10-11 years old attending three public schools in Indonesia. A dental visual impact study was conducted, in which teachers reported their perceptions of the impact of child oral health on school academic performance. Oral health behaviors, self-esteem, and school performance were assessed. The children were clinically examined to measure dental caries and oral cleanliness. Teachers believe that children with visually poor oral health and impaired smiles are more likely to perform poorly at school, be socially excluded and have lower job prospects than their peers with visually good oral health and healthy smiles. The percentages of children with decayed teeth were 94 and 90% in the 6-7- and 10-11-year age groups, respectively. Families reported high levels of child consumption of sugar-containing foods and drinks; many had irregular use of fluoride toothpaste. Children with substantial plaque on their teeth achieved significantly lower levels of school performance than their peers with clean teeth. Significant associations were found between school performance and self-esteem for these children. The study findings highlight the need for preventive care programs to improve the oral health of children in Indonesia and prospective determination of associations between child oral health; self-esteem and school academic performance.

  11. Assessment and Evaluation of Quality of Life (OHRQoL) of Patients with Dental Implants Using the Oral Health Impact Profile (OHIP-14) - A Clinical Study.

    Science.gov (United States)

    Alzarea, Bader K

    2016-04-01

    Peri-implant tissue health is a requisite for success of dental implant therapy. Plaque accumulation leads to initiation of gingivitis around natural teeth and peri-implantitis around dental implants. Peri-implantitis around dental implants may result in implant placement failure. For obtaining long-term success, timely assessment of dental implant site is mandatory. To assess and evaluate Quality of Life (OHRQoL) of individuals with dental implants using the Oral Health Impact Profile (OHIP-14). Total 92 patients were evaluated for assessment of the health of peri-implant tissues by recording, Plaque Index (PI), Probing Pocket Depth (PD), Bleeding On Probing (BOP) and Probing Attachment Level (PAL) as compared to contra-lateral natural teeth (control). In the same patients Quality of Life Assessment was done by utilizing Oral Health Impact Profile Index (OHIP-14). The mean plaque index around natural teeth was more compared to implants and it was statistically significant. Other three dimensions mean bleeding on probing; mean probing attachment level and mean pocket depth around both natural teeth and implant surfaces was found to be not statistically significant. OHIP-14 revealed that patients with dental implants were satisfied with their Oral Health-Related Quality of Life (OHRQoL). Similar inflammatory conditions are present around both natural teeth and implant prostheses as suggested by results of mean plaque index, mean bleeding on probing, mean pocket depth and mean probing attachment level, hence reinforcing the periodontal health maintenance both prior to and after incorporation of dental implants. Influence of implant prostheses on patient's oral health related quality of life (as depicted by OHIP-14) and patients' perceptions and expectations may guide the clinician in providing the best implant services.

  12. Assessing U.S. Health Journalists' Beliefs About Medical Overtreatment and the Impact of Related News Coverage.

    Science.gov (United States)

    Walsh-Childers, Kim; Braddock, Jennifer

    2018-02-01

    The United States spends more on health care than any other country in the world, but often experiences poorer health outcomes and lower patient satisfaction than other developed countries. One possible explanation for this paradox is overtreatment, the use of medical tests and treatment for which harms outweigh benefits. Because journalists play a key role in informing people about the health care system, including issues such as overtreatment, it is important to understand how they define the issue and its importance. This qualitative study of health news journalists offers an analysis of journalists' perspectives on overtreatment coverage. The interviews produced four major themes in regard to journalists' beliefs about overtreatment and its coverage: journalists' roles and responsibilities, the medical context, causes of overtreatment, and economics/costs. Journalists view overtreatment as an important but complex issue driven by Americans' faith in medicine and cultural norms that make uncertainty unacceptable. The medical contexts most associated with overtreatment are cancer testing and treatment and overprescribing. Journalists see themselves as providing information to help consumers make personal treatment decisions, rather than helping audiences understand health policy. For decades, the American public has expressed dissatisfaction with the U.S. health system; in one recent assessment, two-thirds of Americans graded the overall quality of health care in the country at a "C" or worse (Blendon, Benson, SteelFisher, & Weldon, 2011; Blendon, Brodie, Benson, Altman, & Buhr, 2006). A study of patient satisfaction in 11 Western countries showed greater dissatisfaction with the U.S. system than with those in any of the comparison countries, with more than one-quarter of Americans saying the U.S. health system needs to be completely rebuilt (Papanicolas, Cylus, & Smith, 2013).

  13. Comprehensive Assessment of New Proppants for Hydraulic Fracturing Utilization under the Consideration of Cost, Environmental & Health Impacts

    Science.gov (United States)

    Adebakin, Mariam Abiodun

    The advancement and increased practice of hydraulic fracturing, a process which involves the drilling of a well and the injection of fracture fluid (water, proppant and various chemicals) under high pressure to stimulate the production of oil and gas, has gradually gained public attention over the past years. This is because of its effectiveness in booming the nation's economy as well as the adverse effects in terms of risks this process poses to all forms of life. Several speculations have been raised about the choice of proppant used as a contributory factor to the risks hydraulic fracturing poses. Frac sand is the most widely used proppant in several wells in the United States but several health and environmental concerns has been raised on its short and long term use. It is therefore imperative to examine the impacts (health and environmental) as well as cost implication, if any, in selecting the most appropriate proppant in other to reduce and or completely eliminate its effect on humans and other forms of life. This study aims to compare other proppants (resin-coated sand and ceramic) with frac sand, focusing on cost, environmental and health implications when used. This study found that sand is the cheapest and most available proppant in terms of production cost compared to resin coated sand and ceramic proppant. However, sand cannot be used in deep wells as it is subjected to more stress leading to its disintegration and crushing in the well which eventually blocks the fissures created and the subsequent flow of oil and gas. In terms of health and environmental impacts, sand should be discouraged as it generates crystalline silica dust known to be injurious if inhaled.

  14. Performance-based financing with GAVI health system strengthening funding in rural Cambodia: a brief assessment of the impact.

    Science.gov (United States)

    Matsuoka, Sadatoshi; Obara, Hiromi; Nagai, Mari; Murakami, Hitoshi; Chan Lon, Rasmey

    2014-07-01

    Though Cambodia made impressive gains in immunization coverage between the years 2000 and 2005, it recognized several health system challenges to greater coverage of immunization and sustainability. The Global Alliance for Vaccines and Immunization (GAVI) opened a Health System Strengthening (HSS) funding window in 2006. To address the health system challenges, Cambodia has been receiving the GAVI HSS fund since October 2007. The major component of the support is performance-based financing (PBF) for maternal, neonatal and child health (MNCH) services. To examine the impact of the PBF scheme on MNCH services and administrative management in rural Cambodia. Quantitative and qualitative studies were conducted in Kroch Chhmar Operational District (OD), Cambodia. Quantitative analyses were conducted on the trends of the numbers of MNCH services. A brief analysis was conducted using qualitative data. After the commencement of the PBF support, the volume of MNCH services was significantly boosted. In addition, strengthened financial and operational management was observed in the study area. However, the quality of the MNCH services was not ensured. Technical assistance, rather than the PBF scheme, was perceived by stakeholders to play a vital role in increasing the quality of the services. To improve the quality of the health services provided, it is better to include indicators on the quality of care in the PBF scheme. Mutual co-operation between PBF models and technical assistance may ensure better service quality while boosting the quantity. A robust but feasible data validation mechanism should be in place, as a PBF could incentivize inaccurate reporting. The capacity for financial management should be strengthened in PBF recipient ODs. To address the broader aspects of MNCH, a balanced input of resources and strengthening of all six building blocks of a health system are necessary. Published by Oxford University Press in association with The London School of Hygiene

  15. Conceptualising the effectiveness of impact assessment processes

    International Nuclear Information System (INIS)

    Chanchitpricha, Chaunjit; Bond, Alan

    2013-01-01

    This paper aims at conceptualising the effectiveness of impact assessment processes through the development of a literature-based framework of criteria to measure impact assessment effectiveness. Four categories of effectiveness were established: procedural, substantive, transactive and normative, each containing a number of criteria; no studies have previously brought together all four of these categories into such a comprehensive, criteria-based framework and undertaken systematic evaluation of practice. The criteria can be mapped within a cycle/or cycles of evaluation, based on the ‘logic model’, at the stages of input, process, output and outcome to enable the identification of connections between the criteria across the categories of effectiveness. This framework is considered to have potential application in measuring the effectiveness of many impact assessment processes, including strategic environmental assessment (SEA), environmental impact assessment (EIA), social impact assessment (SIA) and health impact assessment (HIA). -- Highlights: • Conceptualising effectiveness of impact assessment processes. • Identification of factors influencing effectiveness of impact assessment processes. • Development of criteria within a framework for evaluating IA effectiveness. • Applying the logic model to examine connections between effectiveness criteria

  16. Collaborative Health Impact Assessment and Policy Development to Improve Air Quality in West Yorkshire—A Case Study and Critical Reflection

    Directory of Open Access Journals (Sweden)

    Yannish Naik

    2017-08-01

    Full Text Available Air pollution is increasingly recognised as a significant problem for cities, with wide ranging impacts on health and quality of life. Combined knowledge of the legal context and health impacts led to air pollution becoming a priority in West Yorkshire. A health impact assessment methodology was used to explore the impacts of low emissions zones, demonstrating significant gains from the implementation of such a measure. This fed in to the collaborative development of the West Yorkshire Low Emissions Strategy (WYLES, resulting in policy changes and an incorporation of health and wellbeing concerns into transport and infrastructure planning, amongst other successes. This case study describes the collaborative approach taken to tackle air pollution locally and summarises key outputs and outcomes of work to date, before providing a critical reflection on what can be learnt from the West Yorkshire experience. This paper will thus interest advocates and stakeholders who are facing similar challenges. Key lessons revolve around broad stakeholder engagement and developing shared ambition. We finally discuss air pollution as a wicked problem, applying the lens of transitions management, a multidisciplinary systems change theory and discuss the local experience in relation to the literature on collaborative public management.

  17. Health Impact Assessment of PM10 and PM2.5 in 27 Southeast and East Asian Cities.

    Science.gov (United States)

    Yorifuji, Takashi; Bae, Sanghyuk; Kashima, Saori; Tsuda, Toshihide; Doi, Hiroyuki; Honda, Yasushi; Kim, Ho; Hong, Yun-Chul

    2015-07-01

    We aimed to evaluate the annual health impacts of particulate matter (PM) less than 10 μm diameter (PM10) and less than 2.5-μm diameter (PM2.5) in 27 cities in Southeast and East Asian countries (Japan, the Philippines, the Republic of Korea, Singapore, and Vietnam) for the year 2009 (n = 50,756,699). We estimated the number of cases attributable to long-term exposure. We used a scenario that reduced the annual mean values for PM10 and PM2.5 to 20 and 10 μg/m, respectively. A reduction in long-term exposure to PM10 and PM2.5 would have postponed 8% to 9% of all-cause mortality or about 37,000 deaths. One third of them were associated with cardiopulmonary mortality and one ninth of them were associated with lung cancer mortality. Current air pollution levels in Southeast and East Asian countries have a nonnegligible public health impact.

  18. Health effects of risk-assessment categories

    International Nuclear Information System (INIS)

    Kramer, C.F.; Rybicka, K.; Knutson, A.; Morris, S.C.

    1983-10-01

    Environmental and occupational health effects associated with exposures to various chemicals are a subject of increasing concern. One recently developed methodology for assessing the health impacts of various chemical compounds involves the classification of similar chemicals into risk-assessment categories (RACs). This report reviews documented human health effects for a broad range of pollutants, classified by RACs. It complements other studies that have estimated human health effects by RAC based on analysis and extrapolation of data from animal research

  19. Health effects of risk-assessment categories

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, C.F.; Rybicka, K.; Knutson, A.; Morris, S.C.

    1983-10-01

    Environmental and occupational health effects associated with exposures to various chemicals are a subject of increasing concern. One recently developed methodology for assessing the health impacts of various chemical compounds involves the classification of similar chemicals into risk-assessment categories (RACs). This report reviews documented human health effects for a broad range of pollutants, classified by RACs. It complements other studies that have estimated human health effects by RAC based on analysis and extrapolation of data from animal research.

  20. Risk assessment and subsequent nursing interventions in a forensic mental health inpatient setting: Associations and impact on aggressive behaviour.

    Science.gov (United States)

    Maguire, Tessa; Daffern, Michael; Bowe, Steven J; McKenna, Brian

    2018-03-01

    To examine associations between risk of aggression and nursing interventions designed to prevent aggression. There is scarce empirical research exploring the nature and effectiveness of interventions designed to prevent inpatient aggression. Some strategies may be effective when patients are escalating, whereas others may be effective when aggression is imminent. Research examining level of risk for aggression and selection and effectiveness of interventions and impact on aggression is necessary. Archival case file. Data from clinical files of 30 male and 30 female patients across three forensic acute units for the first 60 days of hospitalisation were collected. Risk for imminent aggression as measured by the Dynamic Appraisal of Situational Aggression, documented nursing interventions following each assessment, and acts of aggression within the 24-hours following assessment were collected. Generalised estimating equations were used to investigate whether intervention strategies were associated with reduction in aggression. When a Dynamic Appraisal of Situational Aggression assessment was completed, nurses intervened more frequently compared to days when no Dynamic Appraisal of Situational Aggression assessment was completed. Higher Dynamic Appraisal of Situational Aggression assessments were associated with a greater number of interventions. The percentage of interventions selected for males differed from females; males received more pro re nata medication and observation, and females received more limit setting, one-to-one nursing and reassurance. Pro re nata medication was the most commonly documented intervention (35.9%) in this study. Pro re nata medication, limit setting and reassurance were associated with an increased likelihood of aggression in some risk bands. Structured risk assessment prompts intervention, and higher risk ratings result in more interventions. Patient gender influences the type of interventions. Some interventions are associated with

  1. Assessing the Impact of a Human Rights-Based Approach across a Spectrum of Change for Women's, Children's, and Adolescents' Health.

    Science.gov (United States)

    Thomas, Rebekah; Kuruvilla, Shyama; Hinton, Rachel; Jensen, Steven L B; Magar, Veronica; Bustreo, Flavia

    2015-12-10

    Global momentum around women's, children's, and adolescents' health, coupled with the ambitious and equalizing agenda of the Sustainable Development Goals (SDGs), has exposed a tension between the need for comprehensive, multi-actor, rights-based approaches that seek to "close the gaps" and a growing economic and political imperative to demonstrate efficiency, effectiveness, and returns on specific investments. To address this challenge, this paper proposes a framework to measure "results" in a way that offers a more nuanced understanding of the impact of human rights-based approaches and their complexity, as well as their contextual, multi-sectoral, and evolving nature. We argue that the impact of human rights-based approaches is best measured across a spectrum of change-at the individual, programmatic, structural, and societal levels. Such an analysis would allow for more accurate assessments of the cumulative effect of these changes. The paper also underscores the long-overdue need to better define the parameters of a human rights-based approach to health. This is an important part of the research agenda on human rights and health in the context of the SDGs and the Global Strategy for Women's, Children's and Adolescents' Health, and amid calls for better measurement and greater accountability for resources, results, and rights at all levels. While this paper focuses on women's, children's, and adolescents' health, the proposed framework can apply as readily to other areas of health and provides a new frame of reference for assessing the impact of human rights-based approaches. Copyright © 2015 Thomas, Kuruvilla, Hinton, Jensen, Magar, Bustreo. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

  2. Impact of family history assessment on communication with family members and health care providers: A report from the Family Healthware™ Impact Trial (FHITr).

    Science.gov (United States)

    Wang, Catharine; Sen, Ananda; Plegue, Melissa; Ruffin, Mack T; O'Neill, Suzanne M; Rubinstein, Wendy S; Acheson, Louise S

    2015-08-01

    This study examines the impact of Family Healthware™ on communication behaviors; specifically, communication with family members and health care providers about family health history. A total of 3786 participants were enrolled in the Family Healthware™ Impact Trial (FHITr) in the United States from 2005-7. The trial employed a two-arm cluster-randomized design, with primary care practices serving as the unit of randomization. Using generalized estimating equations (GEE), analyses focused on communication behaviors at 6month follow-up, adjusting for age, site and practice clustering. A significant interaction was observed between study arm and baseline communication status for the family communication outcomes (p'scommunicating at baseline and those who were not. Among participants who were not communicating at baseline, intervention participants had higher odds of communicating with family members about family history risk (OR=1.24, p=0.042) and actively collecting family history information at follow-up (OR=2.67, p=0.026). Family Healthware™ did not have a significant effect on family communication among those already communicating at baseline, or on provider communication, regardless of baseline communication status. Greater communication was observed among those at increased familial risk for a greater number of diseases. Family Healthware™ prompted more communication about family history with family members, among those who were not previously communicating. Efforts are needed to identify approaches to encourage greater sharing of family history information, particularly with health care providers. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Impact of Family History Assessment on Communication with Family Members and Health Care Providers: A report from the Family Healthware™ Impact Trial (FHITr)

    Science.gov (United States)

    Wang, Catharine; Sen, Ananda; Plegue, Melissa; Ruffin, Mack T.; O'Neill, Suzanne M.; Rubinstein, Wendy S.; Acheson, Louise S.

    2015-01-01

    Objective This study examines the impact of Family Healthware™ on communication behaviors; specifically, communication with family members and health care providers about family health history. Methods A total of 3786 participants were enrolled in the Family Healthware™ Impact Trial (FHITr) in the United States from 2005-7. The trial employed a two-arm cluster-randomized design, with primary care practices serving as the unit of randomization. Using generalized estimating equations (GEE), analyses focused on communication behaviors at 6 month follow-up, adjusting for age, site and practice clustering. Results A significant interaction was observed between study arm and baseline communication status for the family communication outcomes (psfamily members about family history risk (OR=1.24, p=0.042) and actively collecting family history information at follow-up (OR=2.67, p=0.026). Family Healthware™ did not have a significant effect on family communication among those already communicating at baseline, or on provider communication, regardless of baseline communication status. Greater communication was observed among those at increased familial risk for a greater number of diseases. Conclusion Family Healthware™ prompted more communication about family history with family members, among those who were not previously communicating. Efforts are needed to identify approaches to encourage greater sharing of family history information, particularly with health care providers. PMID:25901453

  4. Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana: A Randomized Cluster Trial.

    Directory of Open Access Journals (Sweden)

    Robert Kaba Alhassan

    Full Text Available Health worker density per 1000 population in Ghana is one of the lowest in the world estimated to be 2.3, below the global average of 9.3. Low health worker motivation induced by poor working conditions partly explain this challenge. Albeit the wage bill for public sector health workers is about 90% of domestic government expenditure on health in countries such as Ghana, staff motivation and performance output remain a challenge, suggesting the need to complement financial incentives with non-financial incentives through a community-based approach. In this study, a systematic community engagement (SCE intervention was implemented to engage community groups in healthcare quality assessment to promote mutual collaboration between clients and healthcare providers, and enhance health worker motivation levels. SCE involves structured use of existing community groups and associations to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements made and rewards given to best performing facilities for closing quality care gaps.To evaluate the effect of SCE interventions on health worker motivation and experiences with clients.The study is a cluster randomized trial involving health workers in private (n = 38 and public (n = 26 primary healthcare facilities in two administrative regions in Ghana. Out of 324 clinical and non-clinical staff randomly interviewed at baseline, 234 (72% were successfully followed at end-line and interviewed on workplace motivation factors and personal experiences with clients. Propensity score matching and difference-in-difference estimations were used to estimate treatment effect of the interventions on staff motivation.Intrinsic (non-financial work incentives including cordiality with clients and perceived career prospects appeared to be prime sources of motivation for health staff interviewed in intervention health facilities while financial incentives were

  5. Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana: A Randomized Cluster Trial.

    Science.gov (United States)

    Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F

    2016-01-01

    Health worker density per 1000 population in Ghana is one of the lowest in the world estimated to be 2.3, below the global average of 9.3. Low health worker motivation induced by poor working conditions partly explain this challenge. Albeit the wage bill for public sector health workers is about 90% of domestic government expenditure on health in countries such as Ghana, staff motivation and performance output remain a challenge, suggesting the need to complement financial incentives with non-financial incentives through a community-based approach. In this study, a systematic community engagement (SCE) intervention was implemented to engage community groups in healthcare quality assessment to promote mutual collaboration between clients and healthcare providers, and enhance health worker motivation levels. SCE involves structured use of existing community groups and associations to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements made and rewards given to best performing facilities for closing quality care gaps. To evaluate the effect of SCE interventions on health worker motivation and experiences with clients. The study is a cluster randomized trial involving health workers in private (n = 38) and public (n = 26) primary healthcare facilities in two administrative regions in Ghana. Out of 324 clinical and non-clinical staff randomly interviewed at baseline, 234 (72%) were successfully followed at end-line and interviewed on workplace motivation factors and personal experiences with clients. Propensity score matching and difference-in-difference estimations were used to estimate treatment effect of the interventions on staff motivation. Intrinsic (non-financial) work incentives including cordiality with clients and perceived career prospects appeared to be prime sources of motivation for health staff interviewed in intervention health facilities while financial incentives were ranked

  6. Developments in Social Impact Assessment

    NARCIS (Netherlands)

    Vanclay, Frank

    2014-01-01

    Along with environmental impact assessment, social impact assessment (SIA) has its origins in the 1970s and has developed from being a tool to meet regulatory requirements, to a discipline that seeks to contribute proactively to better project and policy development and to enhance the wellbeing of

  7. Environmental Impact Assessment: A Procedure.

    Science.gov (United States)

    Stover, Lloyd V.

    Prepared by a firm of consulting engineers, this booklet outlines the procedural "whys and hows" of assessing environmental impact, particularly for the construction industry. Section I explores the need for environmental assessment and evaluation to determine environmental impact. It utilizes a review of the National Environmental Policy Act and…

  8. Health Impact Assessment for Second-Hand Smoke Exposure in Germany—Quantifying Estimates for Ischaemic Heart Diseases, COPD, and Stroke

    Directory of Open Access Journals (Sweden)

    Florian Fischer

    2016-02-01

    Full Text Available Evidence of the adverse health effects attributable to second-hand smoke (SHS exposure is available. This study aims to quantify the impact of SHS exposure on ischaemic heart diseases (IHD, chronic obstructive pulmonary diseases (COPD, and stroke in Germany. Therefore, this study estimated and forecasted the morbidity for the three outcomes in the German population. Furthermore, a health impact assessment was performed using DYNAMO-HIA, which is a generic software tool applying a Markov model. Overall 687,254 IHD cases, 231,973 COPD cases, and 288,015 stroke cases were estimated to be attributable to SHS exposure in Germany for 2014. Under the assumption that the population prevalence of these diseases and the prevalence of SHS exposure remain constant, the total number of cases will increase due to demographic aging. Assuming a total eradication of SHS exposure beginning in 2014 leads to an estimated reduction of 50% in cases, compared to the reference scenario in 2040 for all three diseases. The results highlight the relevance of SHS exposure because it affects several chronic disease conditions and has a major impact on the population’s health. Therefore, public health campaigns to protect non-smokers are urgently needed.

  9. Perception and Barriers to Indoor Air Quality and Perceived Impact on Respiratory Health: An Assessment in Rural Honduras

    Directory of Open Access Journals (Sweden)

    Audrey Le

    2014-01-01

    Full Text Available Objective. The aim of this study was to identify household-specific factors associated with respiratory symptoms and to study the perceived impact of indoor air pollution (IAP as a health issue. Methods. An IRB-approved, voluntary, anonymous 23-item survey was conducted in Spanish at a medical outreach clinic in June 2012 and at the homes of survey respondents N=79. Comparative analyses were performed to investigate relationships between specific house characteristics and respiratory complaints. Results. Seventy-nine surveys were completed. Respiratory symptoms were frequently reported by survey respondents: 42% stated that smoke in their household caused them to have watery eyes, 42% reported household members with coughs within the past two weeks, and 25% stated that there were currently household members experiencing difficulty in breathing. Stove location and kitchen roof construction material were significantly associated with frequency of respiratory symptoms. The vast majority used firewood as their major fuel type. Most respondents indicated that neither indoor air quality was a problem nor did it affect their daily life. Conclusions. Respiratory complaints are common in Yoro, Honduras. Stove location and kitchen roof construction material were significantly associated with frequency of respiratory symptoms; this may have implications for efforts to improve respiratory health in the region.

  10. Qualitative assessment of the impact of health care reform on the availability of clinicians for preclinical medical instruction.

    Science.gov (United States)

    Weeks, S; DesCôteaux, J G

    2000-01-01

    %). Nonfaculty members were less aware of the recent curricular changes (73%); however, more family physicians felt that these changes had a positive impact on willingness to teach (10%) compared to surgical (8%) and nonsurgical specialists (9%; chi 2 = 6.07, p = .048). Forty-five percent of respondents agreed that they would be more willing to teach if offered some from of recognition. Two thirds of written comments suggested that recognition should be nonmonetary (e.g., faculty promotion, acknowledgment). The experience at the University of Calgary suggests that availability of teachers for preclinical undergraduate medical education has diminished as a result of health care reform. Family physicians have been affected the most, and the clinical environment will make it even more difficult to involve this important group of teachers in undergraduate medical education.

  11. Health impact assessment of Ontario's green energy and green economy act. The roles of environmental informatics in sustainability

    International Nuclear Information System (INIS)

    Rattle, Robert

    2013-01-01

    Renewable energy received a boost in Ontario, Canada with the Green Energy and Green Economy Act (GEGEA), ushering in a new Feed-in-Tariff (FIT) program modelled on programs from Germany, Spain, Denmark and other jurisdictions. Information about lessons learned elsewhere has clearly benefited the Ontario experience. Part of the Ontario program included streamlining the impact assessment process to facilitate the swift development of provincial renewable energy capacities. In this context, the GEGEA has been remarkably successful, generating renewable energy sector capacities, resources, projects and their spin-off benefits in Ontario, along with more sustainable electricity system. Environmentalists along with industry continue to laud the benefits of renewable energy and the GEGEA, and with good reason. Renewable energy generation in Ontario has grown from to 2 per cent in 2012 and is expected to reach 10 per cent in 2013. (orig.)

  12. Health impacts of wildfires.

    Science.gov (United States)

    Finlay, Sarah Elise; Moffat, Andrew; Gazzard, Rob; Baker, David; Murray, Virginia

    2012-11-02

    Introduction Wildfires are common globally. Although there has been considerable work done on the health effects of wildfires in countries such as the USA where they occur frequently there has been relatively little work to investigate health effects in the United Kingdom. Climate change may increase the risk of increasing wildfire frequency, therefore there is an urgent need to further understand the health effects and public awareness of wildfires. This study was designed to review current evidence about the health effects of wildfires from the UK standpoint. Methods A comprehensive literature review of international evidence regarding wildfire related health effects was conducted in January 2012. Further information was gathered from authors' focus groups. Results A review of the published evidence shows that human health can be severely affected by wildfires. Certain populations are particularly vulnerable. Wood smoke has high levels of particulate matter and toxins. Respiratory morbidity predominates, but cardiovascular, ophthalmic and psychiatric problems can also result. In addition severe burns resulting from direct contact with the fire require care in special units and carry a risk of multi - organ complications. The wider health implications from spreading air, water and land pollution are of concern. Access to affected areas and communication with populations living within them is crucial in mitigating risk. Conclusion This study has identified factors that may reduce public health risk from wildfires. However more research is needed to evaluate longer term health effects from wildfires. An understanding of such factors is vital to ensure preparedness within health care services for such events.

  13. Assessing the Health Impact of Trade: A Call for an Expanded Research Agenda Comment on "The Trans-Pacific Partnership: Is It Everything We Feared for Health?"

    Science.gov (United States)

    McNamara, Courtney

    2016-09-14

    Labonté et al provide an insightful analysis of the Trans-Pacific Partnership (TPP) and its impact on a selection of important health determinants. Their work confirms concerns raised by previous analyses of leaked drafts and offers governments serious and timely reasons to carefully consider provisions of the agreement prior to moving forward with ratification. It also contributes more generally to a growing literature focused on identifying the health impacts of trade. This commentary uses the authors' analysis as a starting point to reflect on two interrelated issues relevant both for taking seriously one of the article's main recommendations and future work in the area of trade and health. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  14. A review of Health Technology Assessment (HTA) recommendations for drug therapies issued between 2007 and 2009 and their impact on policymaking processes in Poland.

    Science.gov (United States)

    Kolasa, Katarzyna; Schubert, Sebastian; Manca, Andrea; Hermanowski, Tadeusz

    2011-10-01

    The primary objective of this study was to critically review and analyze the Polish Health Technology Assessment (AHTAPol) agency's health technology drug recommendations (HTA activity), in order to ascertain to what extent HTA findings have been incorporated into national drug reimbursement decisions (HTA impact). HTA recommendations issued between 2007 and 2009 were studied. Positive recommendations were classified into three categories: recommendations with major restrictions; minor restrictions; and without restrictions. Definitions of clinical and non-clinical reasons were drawn ups for negative recommendations. The study examined how many different drug technologies assessed by AHTAPol were included in reimbursement lists. In terms of HTA activity, 63 negative and 83 positive HTA recommendations were issued. While clinical arguments were the most prevalent reason for negative HTA recommendations, major restrictions were most common in the positive guidance group. In terms of HTA impact, the results revealed 30 drugs with positive HTA recommendations and four with negative HTA recommendations were included on the reimbursement lists. Most of AHTAPol's recommendations have a positive outcome for the drug being appraised. The study revealed room for further enhancement of HTA impact. Three key areas that need future attention were identified: consistency, credibility; and pragmatism. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  15. Describing the impact of health research: a Research Impact Framework

    Directory of Open Access Journals (Sweden)

    Pleasant Andrew

    2006-10-01

    Full Text Available Abstract Background Researchers are increasingly required to describe the impact of their work, e.g. in grant proposals, project reports, press releases and research assessment exercises. Specialised impact assessment studies can be difficult to replicate and may require resources and skills not available to individual researchers. Researchers are often hard-pressed to identify and describe research impacts and ad hoc accounts do not facilitate comparison across time or projects. Methods The Research Impact Framework was developed by identifying potential areas of health research impact from the research impact assessment literature and based on research assessment criteria, for example, as set out by the UK Research Assessment Exercise panels. A prototype of the framework was used to guide an analysis of the impact of selected research projects at the London School of Hygiene and Tropical Medicine. Additional areas of impact were identified in the process and researchers also provided feedback on which descriptive categories they thought were useful and valid vis-à-vis the nature and impact of their work. Results We identified four broad areas of impact: I. Research-related impacts; II. Policy impacts; III. Service impacts: health and intersectoral and IV. Societal impacts. Within each of these areas, further descriptive categories were identified. For example, the nature of research impact on policy can be described using the following categorisation, put forward by Weiss: Instrumental use where research findings drive policy-making; Mobilisation of support where research provides support for policy proposals; Conceptual use where research influences the concepts and language of policy deliberations and Redefining/wider influence where research leads to rethinking and changing established practices and beliefs. Conclusion Researchers, while initially sceptical, found that the Research Impact Framework provided prompts and descriptive

  16. Describing the impact of health research: a Research Impact Framework.

    Science.gov (United States)

    Kuruvilla, Shyama; Mays, Nicholas; Pleasant, Andrew; Walt, Gill

    2006-10-18

    Researchers are increasingly required to describe the impact of their work, e.g. in grant proposals, project reports, press releases and research assessment exercises. Specialised impact assessment studies can be difficult to replicate and may require resources and skills not available to individual researchers. Researchers are often hard-pressed to identify and describe research impacts and ad hoc accounts do not facilitate comparison across time or projects. The Research Impact Framework was developed by identifying potential areas of health research impact from the research impact assessment literature and based on research assessment criteria, for example, as set out by the UK Research Assessment Exercise panels. A prototype of the framework was used to guide an analysis of the impact of selected research projects at the London School of Hygiene and Tropical Medicine. Additional areas of impact were identified in the process and researchers also provided feedback on which descriptive categories they thought were useful and valid vis-à-vis the nature and impact of their work. We identified four broad areas of impact: I. Research-related impacts; II. Policy impacts; III. Service impacts: health and intersectoral and IV. Societal impacts. Within each of these areas, further descriptive categories were identified. For example, the nature of research impact on policy can be described using the following categorisation, put forward by Weiss: Instrumental use where research findings drive policy-making; Mobilisation of support where research provides support for policy proposals; Conceptual use where research influences the concepts and language of policy deliberations and Redefining/wider influence where research leads to rethinking and changing established practices and beliefs. Researchers, while initially sceptical, found that the Research Impact Framework provided prompts and descriptive categories that helped them systematically identify a range of specific and

  17. Assessment of health risks of policies

    International Nuclear Information System (INIS)

    Ádám, Balázs; Molnár, Ágnes; Ádány, Róza; Bianchi, Fabrizio; Bitenc, Katarina; Chereches, Razvan; Cori, Liliana; Fehr, Rainer; Kobza, Joanna; Kollarova, Jana

    2014-01-01

    The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals

  18. Health assessments for health governance-concepts and methodologies.

    Science.gov (United States)

    Fehr, Rainer; Alexanderson, Kristina; Favaretti, Carlo; de Jong, Judith; La Torre, Giuseppe; Lim, Tek-Ang; Martin-Olmedo, Piedad; Mekel, Odile C L; Michelsen, Kai; Rosenkötter, Nicole; Verschuuren, Marieke; de Waure, Chiara; Zeegers Paget, Dineke

    2017-08-01

    For better supporting the science-governance interface, the potential of health assessments appears underrated. To identify what various types of health assessment have in common; how they differ; which assessment(s) to apply for which purpose; and what needs and options there are for future joint development. This review is based on five types of health assessment: monitoring/surveillance/reporting, assessment of health impact, of health technology, of health systems performance, health-related economic assessment. The approach is exploratory and includes: applying an agreed set of comparative criteria; circulating and supplementing synoptic tables; and interpreting the results. Two of the assessments deal with the question 'Where do we stand?', two others with variants of 'What if' questions. Economic Assessment can take place in combination with any of the others. The assessments involve both overall 'procedures' and a variety of 'methods' which inescapably reflect some subjective assumptions and decisions, e.g. on issue framing. Resources and assistance exist for all these assessments. The paper indicates which type of assessment is appropriate for what purpose. Although scientific soundness of health assessments is not trivial to secure, existing types of health assessment can be interpreted as a useful 'toolkit' for supporting governance. If current traces of 'silo' thinking can be overcome, the attainability of a more unified culture of health assessments increases and such assessments might more widely be recognized as a prime, 'tried and tested' way to voice Public Health knowledge and to support rational governance and policy-making. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  19. Chemical Risk Assessment: Traditional vs Public Health ...

    Science.gov (United States)

    Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. When done efficiently and properly, chemical risk assessment enables risk management actions that minimize the incidence and impacts of environmentally-induced diseases related to chemical exposure. However, traditional chemical risk assessment is faced with multiple challenges with respect to predicting and preventing disease in human populations, and epidemiological studies increasingly report observations of adverse health effects at exposure levels predicted from animal studies to be safe for humans. This discordance reinforces concerns about the adequacy of contemporary risk assessment practices (Birnbaum, Burke, & Jones, 2016) for protecting public health. It is becoming clear that to protect public health more effectively, future risk assessments will need to use the full range of available data, draw on innovative methods to integrate diverse data streams, and consider health endpoints that also reflect the range of subtle effects and morbidities observed in human populations. Given these factors, there is a need to reframe chemical risk assessment to be more clearly aligned with the public health goal of minimizing environmental exposures associated with disease. Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. Chemical risk assessments

  20. Expanding Health Technology Assessments to Include Effects on the Environment

    DEFF Research Database (Denmark)

    Marsh, Kevin; Ganz, Michael Lee; Hsu, John

    2016-01-01

    for incorporating environmental impacts into the health technology assessment (HTA) process and discusses the associated challenges. Two arguments favor incorporating environmental impacts into HTA: 1) environmental changes could directly affect people's health and 2) policy decision makers have broad mandates...

  1. Preliminary assessment of the health and environmental impacts of fluidized-bed combustion of coal as applied to electrical utility systems

    Energy Technology Data Exchange (ETDEWEB)

    None

    1977-02-01

    The objective of this study was to assess the health and environmental impacts of fluidized-bed combustion of coal (FBC), specifically as applied to base-load generation of electrical energy by utilities. The public health impacts of Fluidized-Bed Combustion (FBC) plants are expected to be quite similar to those for Low Sulfur Coal (LSC) and Flue Gas Desulfurization (FGD) plants because all appear to be able to meet Federal emission standards; however, there are emissions not covered by standards. Hydrocarbon emissions are higher and trace element emissions are lower for FBC than for conventional technologies. For FBC, based on an analytical model and a single emission data point, the polycyclic organic material decreases the anticipated lifespan of the highly exposed public very slightly. Added health protection due to lower trace element emissions is not known. Although there is a large quantity of solid wastes from the generating plant, the environmental impact of the FBC technology due to solid residue appears lower than for FGD, where sludge management requires larger land areas and presents problems due to the environmentally noxious calcium sulfite in the waste. Fixing the sludge may become a requirement that increases the cost of wet-limestone FGD but makes that system more acceptable. The potential for aquatic or terrestrial impacts from hydrocarbon emissions is low. If application of AFBC technology increases the use of local high-sulfur coals to the detriment of western low-sulfur coal, a sociological benefit could accrue to the FBC (or FGD) technology, because impacts caused by western boom towns would decrease. The infrastructure of areas that mine high-sulfur coal in the Midwest are better equipped to handle increased mining than the West.

  2. Privacy Impact Assessment (PIA) Repository

    Data.gov (United States)

    Department of Veterans Affairs — This repository contains Privacy Impact Assessments (PIA) that have been vetted/approved. Section 208 of the Electronic Government Act of 2002 (E-Gov Act) requires...

  3. Beyond risk assessment: principles for assessing community impacts.

    Science.gov (United States)

    Dunn, Amy J; Alexeeff, George V

    2010-01-01

    Risk assessment methods have evolved over time to become better at evaluating risks associated with single chemical exposures, yet are limited in evaluating risks faced by communities with exposures to a range of chemical hazards via multiple routes. Recognizing the need to identify better approaches to assess disparate impacts facing certain populations due to environmental pollution, the authors evaluated activities within the Office of Environmental Health Hazard Assessment (in California's Environmental Protection Agency) that had begun addressing these concerns by moving beyond standard risk assessment practices. On the basis of these examples, the authors identify 4 overarching principles to guide community assessments and explore how their application can improve these assessments. More work is needed in several areas, including developing information on exposure differences due to cultural practices, lifestyle patterns, and other factors; developing methods to recognize and take into account increased susceptibility; developing tools for assessing cumulative impacts; and improving communication with communities.

  4. A narrative review of research impact assessment models and methods.

    Science.gov (United States)

    Milat, Andrew J; Bauman, Adrian E; Redman, Sally

    2015-03-18

    Research funding agencies continue to grapple with assessing research impact. Theoretical frameworks are useful tools for describing and understanding research impact. The purpose of this narrative literature review was to synthesize evidence that describes processes and conceptual models for assessing policy and practice impacts of public health research. The review involved keyword searches of electronic databases, including MEDLINE, CINAHL, PsycINFO, EBM Reviews, and Google Scholar in July/August 2013. Review search terms included 'research impact', 'policy and practice', 'intervention research', 'translational research', 'health promotion', and 'public health'. The review included theoretical and opinion pieces, case studies, descriptive studies, frameworks and systematic reviews describing processes, and conceptual models for assessing research impact. The review was conducted in two phases: initially, abstracts were retrieved and assessed against the review criteria followed by the retrieval and assessment of full papers against review criteria. Thirty one primary studies and one systematic review met the review criteria, with 88% of studies published since 2006. Studies comprised assessments of the impacts of a wide range of health-related research, including basic and biomedical research, clinical trials, health service research, as well as public health research. Six studies had an explicit focus on assessing impacts of health promotion or public health research and one had a specific focus on intervention research impact assessment. A total of 16 different impact assessment models were identified, with the 'payback model' the most frequently used conceptual framework. Typically, impacts were assessed across multiple dimensions using mixed methodologies, including publication and citation analysis, interviews with principal investigators, peer assessment, case studies, and document analysis. The vast majority of studies relied on principal investigator

  5. Impact assessment of a maternal health project in a megacity, Nigeria: toward a future with more demand for maternal health services.

    Science.gov (United States)

    Matsuoka, Sadatoshi; Koga, Sumiko; Suzui, Emiko; Tsukada, Yoshiko; Ohashi, Kazutomo; Johnson, Taiwo

    2017-10-01

    To improve the quantity and quality of maternal health services in Lagos State, Nigeria having a maternal mortality ratio of 555 per 100 000 live births, a four-year project was implemented since February 2010. The major activity of the project was training for both the service supply and demand sides. This study aimed to examine the impact of the project on coverages and quality of the services in target areas, and guide statewide policies. The Cochran-Armitage test for trend was applied to understand trends in the service coverages during 2009-2013. The same test was performed to analyse trends in the proportions of perineal conditions (i.e. intact or tear) and to evaluate variations in midwives' snkill during 2011-2013. The paired t-test was used to analyse changes in midwives' knowledge. The project interventions contributed to a significant increase in the overall service coverages, including improvements in midwifery knowledge and possibly in their skills. However, the service coverage was still limited as of the termination of the project. To instal the interventions and maximise the effect of them state-wide, it is recommended to undertake five tasks: (i) establishment of public primary health centres offering 24-h maternal health services; (ii) redeployment and recruitment of public health personnel; (iii) expansion of midwifery trainings and continuous education by the local trainers; (iv) review of grass-roots level activities; and (v) scrutiny of barriers to maternal health services. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  6. Environmental impact assessment screening tool

    International Nuclear Information System (INIS)

    1995-05-01

    An environmental assessment and impact planning software, SCREENER, was tested at a pilot project at the Cameco site (Port Hope). SCREENER was used to screen the impacts of a new construction project in accordance with the process and reporting requirements laid out in the Canadian Environmental Assessment Act. The software test concentrated on the activities that are directly involved with the structure construction and site preparation activities. In addition, a two and one half day training course was given to three AECB staff using the test case as a hands on example. The conclusion of this project is that an automated tool such as SCREENER (or Calyx, the new generation of environmental assessment tools from ESSA Software Ltd.), will help the AECB to standardize the approach to environmental assessment, assist in project planning, and save resources in the screening process. The new approach could allow to allocate AECB limited resources to the detailed assessments required for maximum impact activities

  7. Assessing the Impact of Homophobic Name Calling on Early Adolescent Mental Health: A Longitudinal Social Network Analysis of Competing Peer Influence Effects.

    Science.gov (United States)

    DeLay, Dawn; Hanish, Laura D; Zhang, Linlin; Martin, Carol Lynn

    2017-05-01

    The goal of the current study was to improve our understanding of why adolescence is a critical period for the consideration of declining mental health. We did this by focusing on the impact of homophobic name calling on early adolescent mental health after the transition to middle school. Because we know that homophobic name calling emerges within a dynamic peer group structure, we used longitudinal social network analysis to assess the relation between homophobic name calling, depressive symptoms, and self-esteem while simultaneously limiting bias from alternative peer socialization mechanisms. A sample of adolescents who recently transitioned to a large public middle school (N = 299; 53 % girls; M age  = 11.13 years, SD = 0.48) were assessed. Longitudinal assessments of peer relationship networks, depressive symptoms, and self-esteem were collected during the fall and spring of the academic year. The results suggest that, after accounting for the simultaneous effect of alternative peer socialization processes, adolescent experiences of homophobic name calling in the fall predict higher levels of depressive symptoms and lower levels of self-esteem over the course of the academic year. These findings provide evidence of a significant influence of homophobic name calling on adolescent mental health.

  8. Climate Change Effects on Heat- and Cold-Related Mortality in the Netherlands: A Scenario-Based Integrated Environmental Health Impact Assessment.

    Science.gov (United States)

    Huynen, Maud M T E; Martens, Pim

    2015-10-23

    Although people will most likely adjust to warmer temperatures, it is still difficult to assess what this adaptation will look like. This scenario-based integrated health impacts assessment explores baseline (1981-2010) and future (2050) population attributable fractions (PAF) of mortality due to heat (PAFheat) and cold (PAFcold), by combining observed temperature-mortality relationships with the Dutch KNMI'14 climate scenarios and three adaptation scenarios. The 2050 model results without adaptation reveal a decrease in PAFcold (8.90% at baseline; 6.56%-7.85% in 2050) that outweighs the increase in PAFheat (1.15% at baseline; 1.66%-2.52% in 2050). When the 2050 model runs applying the different adaptation scenarios are considered as well, however, the PAFheat ranges between 0.94% and 2.52% and the PAFcold between 6.56% and 9.85%. Hence, PAFheat and PAFcold can decrease as well as increase in view of climate change (depending on the adaptation scenario). The associated annual mortality burdens in 2050-accounting for both the increasing temperatures and mortality trend-show that heat-related deaths will range between 1879 and 5061 (1511 at baseline) and cold-related deaths between 13,149 and 19,753 (11,727 at baseline). Our results clearly illustrate that model outcomes are not only highly dependent on climate scenarios, but also on adaptation assumptions. Hence, a better understanding of (the impact of various) plausible adaptation scenarios is required to advance future integrated health impact assessments.

  9. Climate Change Effects on Heat- and Cold-Related Mortality in the Netherlands: A Scenario-Based Integrated Environmental Health Impact Assessment

    Directory of Open Access Journals (Sweden)

    Maud M. T. E. Huynen

    2015-10-01

    Full Text Available Although people will most likely adjust to warmer temperatures, it is still difficult to assess what this adaptation will look like. This scenario-based integrated health impacts assessment explores baseline (1981–2010 and future (2050 population attributable fractions (PAF of mortality due to heat (PAFheat and cold (PAFcold, by combining observed temperature–mortality relationships with the Dutch KNMI’14 climate scenarios and three adaptation scenarios. The 2050 model results without adaptation reveal a decrease in PAFcold (8.90% at baseline; 6.56%–7.85% in 2050 that outweighs the increase in PAFheat (1.15% at baseline; 1.66%–2.52% in 2050. When the 2050 model runs applying the different adaptation scenarios are considered as well, however, the PAFheat ranges between 0.94% and 2.52% and the PAFcold between 6.56% and 9.85%. Hence, PAFheat and PAFcold can decrease as well as increase in view of climate change (depending on the adaptation scenario. The associated annual mortality burdens in 2050—accounting for both the increasing temperatures and mortality trend—show that heat-related deaths will range between 1879 and 5061 (1511 at baseline and cold-related deaths between 13,149 and 19,753 (11,727 at baseline. Our results clearly illustrate that model outcomes are not only highly dependent on climate scenarios, but also on adaptation assumptions. Hence, a better understanding of (the impact of various plausible adaptation scenarios is required to advance future integrated health impact assessments.

  10. Comparative assessment and management of the health and environmental impacts of energy systems. General framework and preliminary results for the nuclear fuel cycle

    International Nuclear Information System (INIS)

    Rostron, W.; Schneider, T.; Thieme, M.; Dreicer, M.

    1992-06-01

    The comparison of the effects of electricity producing systems is of growing importance in decision-making processes for energy planning. This report documents the preliminary results of a project for the CEC-DG XII Radiation Protection Programme on the comparative assessment and management of the health and environmental impacts of energy systems. The work reported in this document has also been supported by EDF - Mission Environnement. In order to profit from the comparative studies already existing, some of the most important ones were surveyed. The aim of these past energy comparison studies was mainly to obtain a global measure of the risks associated with an energy cycle, with a view to ranking the various electricity production systems; but this is now recognised as merely an academic exercise, with a limited impact in decision-making. For energy planning the development of a multi-dimensional approach seems more suitable, as this allows the different types of indicators and measures needed to assess the risks of different energy cycles to be compared. From the past studies it has been seen that health indicators are generally well established, but a weakness is noted with respect to indicators of environmental impacts. This remains a difficult subject, and until such indicators are established, surrogates like concentrations in the environment will have to be used, or qualitative comparisons must suffice. This report presents a general framework allowing for consistent comparisons between different energy systems. The key issues discussed are: assessment by fuel cycle, consideration of the dimensions of time and space, the impact pathway approach for assessing risk, and coherent indicators that can be used to measure the impacts. First results are presented for four activities of the nuclear fuel cycle according to the approach developed: (1) the construction and dismantling of a 900 MWe pressurized water reactor, (2) the transportation of materials between

  11. Managing Air Quality - Human Health, Environmental and Economic Assessments

    Science.gov (United States)

    Human health and environmental assessments characterize health and environmental risks associated with exposure to pollution. Economic assessments evaluate the cost and economic impact of a policy or regulation & can estimate economic benefits.

  12. Assessment of metal and bacterial contamination in cultivated fish and impact on human health for residents living in the Mekong Delta.

    Science.gov (United States)

    Chanpiwat, Penradee; Sthiannopkao, Suthipong; Widmer, Kenneth; Himeno, Seiichiro; Miyataka, Hideki; Vu, Ngoc-Ut; Tran, Van-Viet; Pham, Thi-Tuyet-Ngan

    2016-11-01

    Fish is the main source of animal protein and micronutrients for inhabitants in the lower Mekong River basin. Consumption of fish in the basin ranges from 41 to 51 kg capita(-1) year(-1). Thus, concerns of human health impacts caused by daily intake of metals contained in fish, and the incidence of bacterial contamination from Listeria and Escherichia coli have been raised. This study was conducted to 1) determine concentrations of metals, fecal indicator organisms, and Listeria spp. in cultivated common diet fish, and 2) assess human health risks as results of fish consumption on a daily basis. The results showed significant impacts of metal accumulation in fish especially from the intensive aquaculture. Chemical use to promote the rapid allometric growth of fish was expected to be the explanation for this finding. Concentrations of metals contained in different fish species were not statistically different with the exceptions of Na, Mn, and Zn. This might be due to the mobility of elements in aquaculture farms. Listeria and E. coli log CFU/g were 1.36 ± 0.11 (standard error) and 1.57 ± 0.1 s.e., respectively with higher counts observed in samples collected in market sites. Lastly, for human health risk assessment via fish consumption, it was found that hazard quotients of consuming As, Cu, and Zn contained in all fish species could contribute adverse health effects to the local residents (hazard quotients higher than 1). Therefore, risk management measures must be promoted and implemented in all study areas to reduce potential risks to local Vietnamese residents. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. National Impact Assessment of CMS Quality Measures Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Impact Assessment of the Centers for Medicare and Medicaid Services (CMS) Quality Measures Reports (Impact Reports) are mandated by section 3014(b), as...

  14. The regional impacts of climate change: an assessment of vulnerability

    National Research Council Canada - National Science Library

    Zinyowera, Marufu C; Moss, Richard H; Watson, R. T

    1998-01-01

    .... The Regional Impacts of Climate Change: An Assessment of Vulnerability reviews state-of-the-art information on potential impacts of climate change for ecological systems, water supply, food production, coastal infrastructure, human health...

  15. Health technology assessment of new drugs for rare disorders in Canada: impact of disease prevalence and cost.

    Science.gov (United States)

    Rawson, Nigel S B

    2017-03-23

    Authors from the Canadian Agency for Drugs and Technologies in Health (CADTH) presented an analysis of submissions to the Common Drug Review (CDR) between 2004 and February 3, 2016 for drugs for rare disorders (disorders with a prevalence of cost in the CDR reports varied with the prevalence of the disorder treated by the drug grouped into three decreasing categories: 10, ≤10 to >1, and ≤1 per 100,000. As the prevalence of the treated disorder decreased, the median daily cost of the drug, the negative recommendation rate and the proportion of submissions with statements in the CDR reports highlighting the cost of the drug increased, while the proportion of submissions with acceptable evidence of clinical efficacy decreased. Moreover, although the CADTH authors reported that only two submissions received a negative recommendation due to a "lack of cost-effectiveness/high cost," high cost was mentioned in the CDR reports of 15 drugs with negative recommendations, all for disorders with a prevalence of ≤10 per 100,000. The aggregated analysis of CDR submissions for drugs for disorders with wide ranging prevalence rates concealed information of concern to patients. The negative reimbursement recommendation rate and the significance of cost in the CDR assessments increased as the prevalence of the treated disorder decreased. Since 2012, the manner in which high cost drugs for rare disorders have been dealt with by the CDR has changed. Cost has ceased to be a factor in negative recommendations but is included in criteria accompanying positive recommendations. This trend is associated with the integration of the CDR process with the system for price negotiation between public drug plans and pharmaceutical companies.

  16. Potential health impact of wind turbines

    International Nuclear Information System (INIS)

    2010-05-01

    In response to public health concerns about wind turbines, a study was conducted to review the scientific evidence on the potential health effects of wind turbines. Several research questions were examined, including scientific evidence on the potential health impacts of wind turbines; the relationship between wind turbine noise and health; the relationship between low frequency sound, infrasound and health; assessment of exposure to wind turbines; wind turbine health and safety hazards and Ontario wind turbine setbacks; community consultation prior to wind farm construction and data gaps and research needs. The study showed that although some people living near wind turbines reported symptoms such as dizziness, headaches, and sleep disturbance, the scientific evidence available to date does not demonstrate a direct causal link between wind turbine noise and adverse health effects. The sound level from wind turbines at common residential setbacks is not sufficient to cause hearing impairment or other direct health effects, although some people may find it annoying. 41 refs., 1 appendix.

  17. Potential health impact of wind turbines

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-05-15

    In response to public health concerns about wind turbines, a study was conducted to review the scientific evidence on the potential health effects of wind turbines. Several research questions were examined, including scientific evidence on the potential health impacts of wind turbines; the relationship between wind turbine noise and health; the relationship between low frequency sound, infrasound and health; assessment of exposure to wind turbines; wind turbine health and safety hazards and Ontario wind turbine setbacks; community consultation prior to wind farm construction and data gaps and research needs. The study showed that although some people living near wind turbines reported symptoms such as dizziness, headaches, and sleep disturbance, the scientific evidence available to date does not demonstrate a direct causal link between wind turbine noise and adverse health effects. The sound level from wind turbines at common residential setbacks is not sufficient to cause hearing impairment or other direct health effects, although some people may find it annoying. 41 refs., 1 appendix.

  18. Methods and baseline results of a repeated cross-sectional survey to assess the public health impact of antiretroviral therapy in Lusaka, Zambia.

    Science.gov (United States)

    Giganti, Mark J; Levy, Jens W; Banda, Yolan; Kusanthan, Thankian; Sinkala, Moses; Stringer, Jeffrey S A; Chi, Benjamin H

    2010-05-01

    Although the individual-level impact of antiretroviral therapy (ART) is well documented, there are few available data describing the public health impact of services for persons infected with human immunodeficiency virus in resource-constrained settings. We describe the methods and baseline results of a household survey that assessed the population-level impact of the national program for HIV care in Zambia and treatment in the city of Lusaka. The survey was timed with the staggered expansion of services and repeated cross-sectional surveys planned for pre-implementation and post-implementation comparisons made by community. In the initial survey round, which was performed during the early phases of the program (November-December 2004), 18,110 persons were enumerated from 3,600 households surveyed. Respondents were asked questions designed to evaluate community-level mortality and respondent knowledge and attitudes towards HIV. These findings will serve as a reliable reference in the future analysis of the population-level impact of this HIV treatment and care program in Zambia.

  19. Assessing prevention research impact: a bibliometric analysis.

    Science.gov (United States)

    Franks, Adele L; Simoes, Eduardo J; Singh, Rajdeep; Sajor Gray, Barbara

    2006-03-01

    This study was undertaken to explore a bibliometric approach to assessing the impact of selected prevention research center (PRC) peer-reviewed publications. The 25 eligible PRCs were asked to submit 15 papers that they considered the most important to be published in the decade 1994-2004. Journal articles (n=227) were verified in 2004 and categorized: 73% were research reports, 10% discussion articles, 9% dissemination articles, and 7% review articles. Only 189 articles (83%) were searchable via the Institute of Scientific Information (ISI) Web of Science databases for citation tracking in 2004. These 189 articles were published in 76 distinct journals and subsequently cited 4628 times (range 0 to 1523) in 1013 journals. Articles published before 2001 were cited a median of 14 times each. Publishing journals had a median ISI impact factor of 2.6, and ISI half-life of 7.2. No suitable benchmarks were available for comparison. The PRC influence factor (number of PRCs that considered a journal highly influential) was only weakly correlated with the ISI impact factor and was not correlated with half-life. Conventional bibliometric analysis to assess the scientific impact of public health prevention research is feasible, but of limited utility because of omissions from ISI's databases, and because citation benchmarks for prevention research have not been established: these problems can and should be addressed. Assessment of impact on public health practice, policy, or on the health of populations, will require more than a bibliometric approach.

  20. Impact assessment of biomass-based district heating systems in densely populated communities. Part II: Would the replacement of fossil fuels improve ambient air quality and human health?

    Science.gov (United States)

    Petrov, Olga; Bi, Xiaotao; Lau, Anthony

    2017-07-01

    To determine if replacing fossil fuel combustion with biomass gasification would impact air quality, we evaluated the impact of a small-scale biomass gasification plant (BRDF) at a university campus over 5 scenarios. The overall incremental contribution of fine particles (PM2.5) is found to be at least one order of magnitude lower than the provincial air quality objectives. The maximum PM2.5 emission from the natural gas fueled power house (PH) could adversely add to the already high background concentration levels. Nitrogen dioxide (NO2) emissions from the BRDF with no engineered pollution controls for NOx in place exceeded the provincial objective in all seasons except during summer. The impact score, IS, was the highest for NO2 (677 Disability Adjusted Life Years, DALY) when biomass entirely replaced fossil fuels, and the highest for PM2.5 (64 DALY) and CO (3 DALY) if all energy was produced by natural gas at PH. Complete replacement of fossil fuels by one biomass plant can result in almost 28% higher health impacts (708 DALY) compared to 513 DALY when both the current BRDF and the PH are operational mostly due to uncontrolled NO2 emissions. Observations from this study inform academic community, city planners, policy makers and technology developers on the impacts of community district heating systems and possible mitigation strategies: a) community energy demand could be met either by splitting emissions into more than one source at different locations and different fuel types or by a single source with the least-impact-based location selection criteria with biomass as a fuel; b) advanced high-efficiency pollution control devices are essential to lower emissions for emission sources located in a densely populated community; c) a spatial and temporal impact assessment should be performed in developing bioenergy-based district heating systems, in which the capital and operational costs should be balanced with not only the benefit to greenhouse gas emission

  1. Assessment and comparison of clinical dental status and its impact on oral health-related quality of life among rural and urban adults of Udaipur, India: A cross-sectional study

    OpenAIRE

    Sanadhya, Sudhanshu; Aapaliya, Pankaj; Jain, Sorabh; Sharma, Nidhi; Choudhary, Garima; Dobaria, Nirali

    2015-01-01

    Background: Dental diseases negatively influence people's oral health-related quality of life (OHRQoL) and thus their perceived need for dental care. QoL is increasingly acknowledged as a valid, appropriate and significant indicator of service need and intervention outcomes in contemporary public health research and practice. Objectives: (1) To assess the psychometric properties of oral health impact profile-14 (OHIP-14) scale among rural and urban OHIP of Udaipur population. (2) To assess an...

  2. Impacts on human health

    CSIR Research Space (South Africa)

    Genthe, Bettina

    2016-11-01

    Full Text Available of Nelspoort’s water is obtained from two boreholes. Blue Drop and Green Drop scores (Figure 12.2 and text box) assessing the management of drinking water and waste water treatment facilities, respectively, demonstrated fairly good management and maintenance.... This information then allows for adequate monitoring and compliance with standards and regulations. Transparency and impartial monitoring are essential. For example, SGD companies in the US are able to publically disclose the chemical additives in their fracking...

  3. Assessment of the Public Health impact from the accidental release of UF6 at the Sequoyah Fuels Corporation Facility at Gore, Oklahoma (Docket No. 40-8027). Volume 2

    International Nuclear Information System (INIS)

    1986-03-01

    Following the accidental release of UF 6 from the Sequoyah Fuels Facility on January 4, 1986, an Ad Hoc Interagency Public Health Assessment Task Force was established. The Task Force consists of technical staff members from various agencies who have prepared this assessment of the public health impact associated with the accidental release. Volume 2 of the report contains Appendices which provide more detailed information used in the assessment and support the discussion in Volume 1

  4. Experience and lessons from health impact assessment guiding prevention and control of HIV/AIDS in a copper mine project, northwestern Zambia.

    Science.gov (United States)

    Knoblauch, Astrid M; Divall, Mark J; Owuor, Milka; Nduna, Kennedy; Ng'uni, Harrison; Musunka, Gertrude; Pascall, Anna; Utzinger, Jürg; Winkler, Mirko S

    2017-07-04

    To avoid or mitigate potential project-related adverse health effects, the Trident copper project in Kalumbila, northwestern Zambia, commissioned a health impact assessment. HIV was identified a priority health issue based on the local vulnerability to HIV transmission and experience from other mining projects in Africa. Hence, an HIV/AIDS management plan was developed, including community and workplace interventions, with HIV testing and counselling (HTC) being one of the key components. We present trends in HTC data over a 4-year period. In 13 communities affected by the Trident project, HTC was implemented from 2012 onwards, using rapid diagnostic tests, accompanied by pre- and post-test counselling through trained personnel. In addition, HTC was initiated in the project workforce in 2013, coinciding with the launch of the mine development. HTC uptake and HIV positivity rates were assessed in the study population and linked to demographic factors using regression analysis. In total, 11,638 community members and 5564 workers have taken up HTC with an increase over time. The HIV positivity rate in the community was 3.0% in 2012 and 3.4% in 2015, while positivity rate in the workforce was 5.2% in 2013 and 4.3% in 2015. Females showed a significantly higher odds of having a positive test result than males (odds ratio (OR) = 1.96, 95% confidence interval (CI): 1.55-2.50 among women in the community and OR = 2.90, 95% CI: 1.74-4.84 among women in the workforce). HTC users in the 35-49 years age group were most affected by HIV, with an average positivity rate of 6.6% in the community sample and 7.9% in the workforce sample. These study groups had 4.50 and 4.95 higher odds of being positive, respectively, compared to their younger counterparts (15-24 years). While HTC uptake increased five-fold in the community and almost three-fold in the workplace, the HIV positivity rates were insignificantly higher in 2015 compared to 2012. Our data can be used alongside other

  5. Evaluating the health benefits of natural sounds: an approach for assessing the environmental impacts of transportation noise

    Science.gov (United States)

    2012-08-19

    Excessive anthropogenic noise has been associated with annoyance, disruption of sleep and cognitive processes, hearing impairment, and adverse impacts on cardiovascular and endocrine systems. Although transportation is a major source of noise, nation...

  6. [Prevalence of hypertension and assessment of its impact on self-rated health in rural populations: a cross-sectional study in northern Senegal].

    Science.gov (United States)

    Seck, S M; Diop-Dia, A; Dia, D Gueye; Gueye, L

    2015-01-01

    High blood pressure (hypertension) is a growing public health problem, and its impact on the overall health of patients in Africa is not well known. The objective of this study was to determine its prevalence and its influence on self-rated health among people living in rural areas of Senegal. This cross-sectional study was conducted over a two-week period in the rural communities of Labgar and Lougré Thiolly, located in the central northern region of Senegal, in an agricultural area. Randomly recruited volunteers were questioned during direct individual interviews about socio-demographic (age, sex, marital status, education, occupation) and lifestyle data (smoking or alcohol, physical activity). Clinical data (medical history, weight, height, blood pressure, course of treatment) were also collected. Self-rated health (SRH) was assessed by asking if they felt their health was bad or good. We included 627 patients with a mean age of 40.93 ± 17.2 years (range: 15-100 years), 59.9% of them women. Illiteracy and overweight were more common among women than among men, and smoking and alcohol consumption more frequent in men. The overall prevalence of hypertension was 23.4% and did not differ significantly between men (24.9%) and women (22.4%)(P = 0.50). Self-rated health was similar in men and women (with respectively 66.9% and 72.9% reporting good health, P = 0.10). On univariate analysis, the factors associated with perceived health status were age (OR = 1.34, P = 0.04), smoking (OR = 2.16, P = 0.03), educational level (OR = 1.21, P = 0.04), and the presence of hypertension (OR = 0.63, P = 0.05). The multivariate regression analysis showed that among women, advanced age (≥50 years) and hypertension (≥140/90 mmHg) were associated with poorer perceived health, whereas for men, only smoking was significantly correlated with poor health status (OR = 0.41, P = 0.01). This study shows that hypertension is common in this rural area of Senegal and is significantly

  7. Quantification of years of life lost attributable to chronic air pollution exposure in a health impact assessment: the case of Nantes

    International Nuclear Information System (INIS)

    Guillois-Becel, Y.; Eilstein, D.; Glorennec, Ph.; Lefranc, A.

    2007-01-01

    Background: When French regional planning for air quality first began, exposure-response functions from time-series studies were used to assess the short-term health impact of urban air pollution. The World Health Organisation also suggests that exposure-response functions from cohort studies be taken into account to evaluate the effects of chronic exposure and to quantify the prematurity of deaths related to chronic exposure to air pollution. This work characterizes the long term effects of air pollution in Nantes by considering years of life lost as well as the number of attributable deaths. methods: the study population is classified in birth cohorts. for each cohort, 2 survival curves are built based on current mortality conditions: the first is built for current exposure to air pollution and the second for exposure to a lower reference level of air pollution. The area between the 2 curves represents years of life lost attributable to urban air pollution. results: the estimated number of premature deaths due to air pollution is approximately 56, or about 2% of the deaths of those older than 30 years. The health impact on the Nantes population is estimated at 27.2 years of life lost attributable to urban air pollution in 1999 and 2388.1 years of life lost for the 1999-2008 period. This amounts to a decrease of roughly 4 months in the life expectancy of those aged 30 years. Conclusion: This study, which also identifies and discusses relevant errors and uncertainty, confirmed that air pollution in Nantes has significant health effects and that chronic exposure plays an essential role in this impact. the number of years of life lost and the reduction in life expectancy provide new reasons to reject the assumption that health effects are limited to the premature deaths of terminally-ill people. the expected health gains in Nantes associated with reduced although still moderate air pollution levels are on the same scale as, and possibly better than, those found in 9

  8. Introducing Life Cycle Impact Assessment

    DEFF Research Database (Denmark)

    Hauschild, Michael Zwicky; Huijbregts, Mark AJ

    2015-01-01

    methodology projects and presents the international scientific discussions and methodological consensus attempts in consecutive working groups under the auspices of the Society of Environmental Toxicology and Chemistry (SETAC) as well as the UNEP/ SETAC Life Cycle Initiative, and the (almost) parallel......This chapter serves as an introduction to the presentation of the many aspects of life cycle impact assessment (LCIA) in this volume of the book series ‘LCA Compendium’. It starts with a brief historical overview of the development of life cycle impact assessment driven by numerous national LCIA...

  9. Health technology assessment in oral health.

    Science.gov (United States)

    Esfandiari, Shahrokh; Feine, Jocelyne

    2011-01-01

    Health-care costs are rising at an alarmingly fast rate worldwide, particularly in developed countries such as the United States. This is predominantly a result of the development of new, high-cost health technologies intended for improved diagnosis and treatment. The purpose of health technology assessment is to systematically determine the true benefits of new technologies, taking into account clinical efficacy/effectiveness and cost as well as societal preference and ethical issues. In this report, the purpose of health technology assessment is explained in light of new developments in oral health technology, particularly intraoral implants. This information is intended to educate and to challenge oral health opinion leaders to consider all of the issues involved in the development and diffusion of new oral health technologies.

  10. Measuring the impact of allied health research

    Directory of Open Access Journals (Sweden)

    Heath J

    2011-06-01

    Full Text Available Jan Heath, Karen Grimmer-Somers, Steve Milanese, Susan Hillier, Ellena King, Kylie Johnston, Kylie Wall, Olivia Thorpe, Alexandra Young, Saravana KumarSchool of Health Sciences, University of South Australia, Adelaide, SA, AustraliaBackground: Excellence in Research for Australia (ERA rankings are given to academic journals in which Australian academics publish. This provides a metric on which Australian institutions and disciplines are ranked for international competitiveness. This paper explores the issues surrounding the ERA rankings of allied health journals in Australia.Methods: We conducted a broad search to establish a representative list of general allied health and discipline-specific journals for common allied health disciplines. We identified the ERA rankings and impact factors for each journal and tested the congruence between these metrics within the disciplines.Results: Few allied health journals have high ERA rankings (A*/A, and there is variability in the impact factors assigned to journals within the same ERA rank. There is a small group of allied health researchers worldwide, and this group is even smaller when divided by discipline. Current publication metrics may not adequately assess the impact of research, which is largely aimed at clinicians to improve clinical practice. Moreover, many journals are produced by underfunded professional associations, and readership is often constrained by small numbers of clinicians in specific allied health disciplines who are association members.Conclusion: Allied health must have a stronger united voice in the next round of ERA rankings. The clinical impact of allied health journals also needs to be better understood and promoted as a research metric.Keywords: allied health, research impact, publication metrics

  11. Impacts of globalization in health.

    Science.gov (United States)

    Ioannou, Andriani; Mechili, Aggelos; Kolokathi, Aikaterini; Diomidous, Marianna

    2013-01-01

    Globalization is the process of international integration arising from the interchange of world views, products, ideas, and other aspects of culture. Globalization describes the interplay of macro-social forces across cultures. The purpose of this study is a systematic review of the bibliography on the impacts of globalization in health. The consequences of globalization on health present a twofold dimension, on the one hand affects the health of the population and on the other hand organization and functioning of health systems. As a result of globalization, there has been an undeniable economic development and technological progress to support the level of health around the world, improving the health status of certain populations with a beneficial increase in life expectancy. In many aspects globalization is good but there are many problems too.

  12. IMPACT OF JUTE RETTING ON NATIVE FISH DIVERSITY AND AQUATIC HEALTH OF ROADSIDE TRANSITORY WATER BODIES: AN ASSESSMENT IN EASTERN INDIA

    Directory of Open Access Journals (Sweden)

    Dipankar Ghosh

    2015-09-01

    Full Text Available Roadside transitory water bodies being manmade depressions have a great ecological and socio-economic importance from years. The effects of agricultural runoffs, jute retting, macro-phytes infestations and inadequate rainfall in changed climate often degrade transitory water bodies’ environment while the biodiversity have impacted severely because of population pressure, over exploitation and indiscriminate use of fine meshed fishing gears as a whole. Physico-chemical and biological analysis with fish species composition, relative abundance, diversity indices like species richness, evenness and Shannon-Wiener index were carried out for pre-, during and post-jute retting season and for year mean as a whole to assess impact of jute retting on the roadside transitory water body’s environmental health and indigenous fish diversity at Sahebnagar village in Nadia District, India. All the physico-chemical parameters barring biochemical oxygen demand and water transparency remained more or less same or marginally got little changed during those three seasons. As much as 19 native fish species with varied relative abundances and dominances were identified. Jute retting impacted lower native fish diversity indices like Shannon-Wiener index values (1.94 to 2.68 clearly indicated poor to moderate pollution status of the transitory water body in that area during monsoon in particular and throughout the year in general. So we opined there should be some control over the intense jute retting in the road side transitory water bodies for sustainable management of these manmade resources.

  13. A Work-Based Research Assessment of the Impact of "Lean Manufacturing" on Health and Safety Education within an SME

    Science.gov (United States)

    Nikolou-Walker, Elda; Lavery, Kathy

    2009-01-01

    Globalisation has had a major impact on the engineering industry as Pacific Rim countries undercut manufacturing costs and provide a more cost-effective location for many businesses. Engineering in Northern Ireland has mostly declined owing to increased competition from these countries. Engineering companies are now forced to streamline their…

  14. Atmospheric deposition of trace elements around point sources and human health risk assessment. I: Impact zones around a lead source

    DEFF Research Database (Denmark)

    Moseholm, L.; Larsen, Erik Huusfeldt; Andersen, B.

    1992-01-01

    The deposition of lead was monitored over 8 years in the area around a car battery factory north of Copenhagen, Denmark. The area also has heavy traffic. Deposition was measured by in-situ grown vegetables, transplant grass culture biomonitors, bulk deposition and soil samples. Three impact zones...

  15. Impact assessment in EU lawmaking

    NARCIS (Netherlands)

    Meuwese, Anne Claartje Margreet

    2008-01-01

    The European Commission introduced impact assessment (IA) in 2002 following recommendations from the Mandelkern group on Better Regulation. The basic rationale of IA is that proposals must be prepared on the basis of an analysis of whether regulatory intervention is needed and whether it is

  16. Environmental Impact Assessment in Antarctica

    NARCIS (Netherlands)

    Bastmeijer, C.J.; Roura, R.; Bastmeijer, K.; Koivurova, T.

    2008-01-01

    This publication focuses on the instrument of Environmental Impact Assessment (EIA) that has been developed within the Antarctic Treaty System (ATS) as one of the tools to promote environmental protection. The states involved in the ATS already recognized the importance of this instrument in 1975

  17. Impact assessment of commodity standards

    NARCIS (Netherlands)

    Ruben, Ruerd

    2017-01-01

    Voluntary commodity standards are widely used to enhance the performance of tropical agro-food chains and to support the welfare and sustainability of smallholder farmers. Different methods and approaches are used to assess the effectiveness and impact of these certification schemes at

  18. ENVIRONMENTAL IMPACT ASSESSMENT AND MONITORING ...

    African Journals Online (AJOL)

    Production activities in any industry may “harm the environment through their damaging effects on air, water, soil and biodiversity.”1. To protect the environment, it is imperative to conduct environmental impact assessment (“EIA”) of investment projects in order to identify their potential harms. Appropriate measures should be ...

  19. Los Angeles County Department of Public Health's Health Hazard Assessment: putting the "health" into hazard assessment.

    Science.gov (United States)

    Dean, Brandon; Bagwell, Dee Ann; Dora, Vinita; Khan, Sinan; Plough, Alonzo

    2013-01-01

    A ll communities, explicitly or implicitly, assess and prepare for the natural and manmade hazards that they know could impact their community. The commonality of hazard-based threats in most all communities does not usually result in standard or evidence-based preparedness practice and outcomes across those communities. Without specific efforts to build a shared perspective and prioritization, "all-hazards" preparedness can result in a random hodgepodge of priorities and preparedness strategies, resulting in diminished emergency response capabilities. Traditional risk assessments, with a focus on physical infrastructure, do not present the potential health and medical impacts of specific hazards and threats. With the implementation of Centers for Disease Control and Prevention's capability-based planning, there is broad recognition that a health-focused hazard assessment process--that engages the "Whole of Community"--is needed. Los Angeles County's Health Hazard Assessment and Prioritization tool provides a practical and innovative approach to enhance existing planning capacities. Successful utilization of this tool can provide a way for local and state health agencies and officials to more effectively identify the health consequences related to hazard-specific threats and risk, determine priorities, and develop improved and better coordinated agency planning, including community engagement in prioritization.

  20. Assessing the Mental Health Impact of the 2011 Great Japan Earthquake, Tsunami, and Radiation Disaster on Elementary and Middle School Children in the Fukushima Prefecture of Japan.

    Science.gov (United States)

    Lieber, Mark

    2017-01-01

    On March 11, 2011, a magnitude 9.0 earthquake occurred off of Japan's Pacific coast, which was followed by huge tsunamis that destroyed many coastal cities in the area. Due to the earthquake and subsequent tsunami, malfunctions occurred at the Fukushima Daiichi (Fukushima I) nuclear power plant, resulting in the release of radioactive material in the region. While recent studies have investigated the effects of these events on the mental health of adults in the region, no studies have yet been performed investigating similar effects among children. This study aims to fill that gap by: 1) assessing the mental health of elementary and middle school children living within the Fukushima prefecture of Japan, and 2) identifying risk and protective factors that are associated with the children's mental health scores. These factors were quantified using an original demographics survey, the Strengths and Difficulties Questionnaire (SDQ), and the Impact of Event Scale-Revised (IES-R), the latter two of which have been previously validated in a Japanese setting. The surveys were distributed to approximately 3,650 elementary and middle school students during the months of February and March, 2012. The data suggests that those children who had been relocated to the city of Koriyama had significantly higher SDQ scores than those children who were native to Koriyama (p natural disasters, younger children and those with parents suffering from trauma-related distress are particularly vulnerable to the onset of pediatric mental disturbances.

  1. Characterization of Sleep During Military Operations and the Impact of Deployment-Related Factors: The Behavioral Health Needs Assessment Survey

    Science.gov (United States)

    2014-09-11

    memory and attention, equivalent to those observed after 24 hours of sleep deprivation (Van Dongen, Maislin, Mullington, & Dinges, 2003) or with a...particularly in attention and memory (Van Dongen et al., 2003). While individuals across all groups experienced chronic partial sleep deprivation , the degree...Jackson, Pak, & Gehrman, 2012) and psychological (Pigeon, Pinquart, & Conner, 2012) health problems. Additionally, sleep deprivation directly

  2. Assessment of impact of air pollution on human health and environment in the South Durban Industrial Basin

    DEFF Research Database (Denmark)

    Madsen, P. V.; Hertel, O.; Bøgh, E.

    This study predicts the spatial variation of air quality and estimate the human health risk of air pollution in SDIB. The study is based on the operational air pollution (OML) model which is predicting the dispersion and quantifying the contribution of selected air pollutant as PM10, SO2 and NOX...

  3. Risk Assessment of Salmonellosis from Consumption of Alfalfa Sprouts and Evaluation of the Public Health Impact of Sprout Seed Treatment and Spent Irrigation Water Testing.

    Science.gov (United States)

    Chen, Yuhuan; Pouillot, Régis; Santillana Farakos, Sofia M; Duret, Steven; Spungen, Judith; Fu, Tong-Jen; Shakir, Fazila; Homola, Patricia A; Dennis, Sherri; Van Doren, Jane M

    2018-01-16

    We developed a risk assessment of human salmonellosis associated with consumption of alfalfa sprouts in the United States to evaluate the public health impact of applying treatments to seeds (0-5-log 10 reduction in Salmonella) and testing spent irrigation water (SIW) during production. The risk model considered variability and uncertainty in Salmonella contamination in seeds, Salmonella growth and spread during sprout production, sprout consumption, and Salmonella dose response. Based on an estimated prevalence of 2.35% for 6.8 kg seed batches and without interventions, the model predicted 76,600 (95% confidence interval (CI) 15,400-248,000) cases/year. Risk reduction (by 5- to 7-fold) predicted from a 1-log 10 seed treatment alone was comparable to SIW testing alone, and each additional 1-log 10 seed treatment was predicted to provide a greater risk reduction than SIW testing. A 3-log 10 or a 5-log 10 seed treatment reduced the predicted cases/year to 139 (95% CI 33-448) or 1.4 (95% CI testing, a 3-log 10 or 5-log 10 seed treatment reduced the cases/year to 45 (95% CI 10-146) or testing with 20% coverage resulted in an estimated 92 (95% CI 22-298) cases/year. Analysis of alternative scenarios using different assumptions for key model inputs showed that the predicted relative risk reductions are robust. This risk assessment provides a comprehensive approach for evaluating the public health impact of various interventions in a sprout production system. © 2018 Society for Risk Analysis.

  4. Buying health: assessing the impact of a consumer-side vegetable subsidy on purchasing, consumption and waste.

    Science.gov (United States)

    Smith-Drelich, Noah

    2016-02-01

    To measure the impact of a reimbursement-based consumer subsidy on vegetable expenditures, consumption and waste. Two-arm randomized controlled trial; two-week baseline observation period, three-week intervention period. Participants' vegetable expenditures, consumption and waste were monitored using receipts collection and through an FFQ. During the intervention period, the treatment group received reimbursement of up to 50 US dollars ($) for purchased vegetables. Participants were solicited from Palo Alto, CA, USA using materials advertising a 'consumer behavior study' and a small participation incentive. To prevent selection bias, solicitation materials did not describe the specific behaviour being evaluated. One hundred and fifty potential participants responded to the solicitations and 144 participants enrolled in the study; 138 participants completed all five weekly surveys. Accounting for the control group (n 69) and the two-week baseline period, the intervention significantly impacted the treatment group's (n 69) vegetable expenditures (+$8.16 (sd 2.67)/week, Prestaurant vegetable consumption to grocery vegetable consumption.

  5. Mapping from the Health Assessment Questionnaire to the EQ-5D: the impact of different algorithms on cost-effectiveness results.

    Science.gov (United States)

    Pennington, Becky; Davis, Sarah

    2014-12-01

    Many algorithms exist for converting the Health Assessment Questionnaire (HAQ) score to utility in rheumatoid arthritis (RA). Different algorithms convert the same HAQ score to different utility values, and could therefore lead to different cost-effectiveness results. To investigate the impact of different mapping algorithms within the same cost-effectiveness model. We rebuilt an existing economic model that had previously been used for estimating the cost-effectiveness of second-line biologics in RA. We reviewed the literature to identify algorithms that converted the HAQ score to utility and incorporated them into the model. We compared the cost-effectiveness results using different algorithms, exploring the reasons behind the different results and the potential effect on reimbursement decisions. We identified 24 different algorithms that estimated utility on the basis of the HAQ score, age, sex, and pain. The incremental cost-effectiveness ratio for rituximab versus disease-modifying antirheumatic drugs varied between £18,407/quality-adjusted life-year and £32,039/quality-adjusted life-year, which we speculate could have changed the recommendations made by the National Institute for Health and Care Excellence. Using different algorithms to convert the HAQ score to utility affects the cost-effectiveness of second-line biologics for the treatment of RA. Using different algorithms in economic modeling for RA could lead health technology assessment bodies to make different reimbursement decisions. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  6. Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana: A Randomized Cluster Trial

    NARCIS (Netherlands)

    Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F.

    2016-01-01

    Health worker density per 1000 population in Ghana is one of the lowest in the world estimated to be 2.3, below the global average of 9.3. Low health worker motivation induced by poor working conditions partly explain this challenge. Albeit the wage bill for public sector health workers is about 90%

  7. Knowledge in health technology assessment

    DEFF Research Database (Denmark)

    Tjørnhøj-Thomsen, Tine; Hansen, Helle Ploug

    2011-01-01

    Health systems are placing more and more emphasis on designing and delivering services that are focused on the patient, and there is a growing interest in patient aspects of health policy research and health technology assessment (HTA). Only a few HTA agencies use and invest in scientific methods...

  8. Nuclear-physical analysis methods in medical geology: Assessment of the impact of environmental factors on human health

    Science.gov (United States)

    Gorbunov, A. V.; Lyapunov, S. M.; Okina, O. I.; Frontas'eva, M. V.; Pavlov, S. S.; Il'chenko, I. N.

    2015-05-01

    The procedure for geomedical studies is outlined, and the niche occupied by the nuclear-physical analysis methods in these studies is pointed out. The necessity of construction of an efficient complex of the most modern analytical methods is demonstrated. The metrological parameters of methods applied in the analysis of natural environments and biological materials are evaluated. The current state of pollution of natural environments with heavy and toxic metals is characterized in two specific industrial hubs: the towns of Gus-Khrustalny and Podolsk. The levels of pollution of diagnostic biological materials (hair and blood) from children living in various urban districts are studied in the light of specific features of the manufacturing industry in these towns and the life environment of child population. The results of studies focused on evaluating the effect of environment on the health of child population are detailed. The actual damage to child health, their neuropsychic development and behavior, and the effect of socioeconomic factors are determined. Preventive problems among the child population exposed to lead and other toxic metals are evaluated, and ways to solve them are proposed. A system of early diagnosis and preventive measures for the mitigation of adverse effect of toxic metals (Pb, Cu, Mn, Zn, Cr, Ni, As, etc.) on the neuropsychic development of children is developed based on an actual ecogeochemical estimation of the state of the region under study.

  9. Lessons learned from evaluating Maryland's anti-drunk driving campaign: assessing the evidence for cognitive, behavioral, and public health impact.

    Science.gov (United States)

    Beck, Kenneth H

    2009-07-01

    The evidence concerning Maryland's anti-drunk driving program, Checkpoint Strikeforce, is reviewed. To date, there is no evidence to indicate that this campaign, which involves a number of sobriety checkpoints and media activities to promote these efforts, has had any impact on public perceptions, driver behaviors, or alcohol-related motor vehicle crashes and injuries. This conclusion is drawn after examining statistics for alcohol-related crashes, police citations for impaired driving, and public perceptions of alcohol-impaired driving risk. Comparisons are also made with other states in the mid-Atlantic region, where similar campaign activities have occurred. Reasons for this failure in Maryland include insufficient levels of enforcement (e.g., too few sobriety checkpoints and vehicle contacts occurred to raise public perceptions of risk pertaining to impaired driving) and inadequate publicity surrounding this campaign. Suggestions for overcoming these problems are offered.

  10. A framework for combining social impact assessment and risk assessment

    NARCIS (Netherlands)

    Mahmoudi, Hossein; Renn, Ortwin; Vanclay, Frank; Hoffmann, Volker; Karami, Ezatollah

    2013-01-01

    An increasing focus on integrative approaches is one of the current trends in impact assessment. There is potential to combine impact assessment with various other forms of assessment, such as risk assessment, to make impact assessment and the management of social risks more effective. We identify

  11. Failures in risk assessment and risk management for cosmetic preservatives in Europe and the impact on public health

    DEFF Research Database (Denmark)

    Schwensen, Jakob F; White, Ian R; Thyssen, Jacob P

    2015-01-01

    BACKGROUND: In view of the current and unprecedented increase in contact allergy to methylisothiazolinone (MI), we characterized and evaluated two recent epidemics of contact allergy to preservatives used in cosmetic products to address failures in risk assessment and risk management. OBJECTIVE......: To evaluate temporal trends of preservative contact allergy. METHODS: The study population included consecutive patch tested eczema patients seen at a university hospital between 1985 and 2013. A total of 23 138 patients were investigated for a contact allergy. RESULTS: The overall prevalence of contact...... the proportion of patients with current clinical disease attributable to methyldibromo glutaronitrile contact allergy decreased significantly following the ban on its use in cosmetic products (p

  12. Web-based self-assessment health tools: who are the users and what is the impact of missing input information?

    Science.gov (United States)

    Neufingerl, Nicole; Cobain, Mark R; Newson, Rachel S

    2014-09-26

    Web-based health applications, such as self-assessment tools, can aid in the early detection and prevention of diseases. However, there are concerns as to whether such tools actually reach users with elevated disease risk (where prevention efforts are still viable), and whether inaccurate or missing information on risk factors may lead to incorrect evaluations. This study aimed to evaluate (1) evaluate whether a Web-based cardiovascular disease (CVD) risk communication tool (Heart Age tool) was reaching users at risk of developing CVD, (2) the impact of awareness of total cholesterol (TC), HDL-cholesterol (HDL-C), and systolic blood pressure (SBP) values on the risk estimates, and (3) the key predictors of awareness and reporting of physiological risk factors. Heart Age is a tool available via a free open access website. Data from 2,744,091 first-time users aged 21-80 years with no prior heart disease were collected from 13 countries in 2009-2011. Users self-reported demographic and CVD risk factor information. Based on these data, an individual's 10-year CVD risk was calculated according to Framingham CVD risk models and translated into a Heart Age. This is the age for which the individual's reported CVD risk would be considered "normal". Depending on the availability of known TC, HDL-C, and SBP values, different algorithms were applied. The impact of awareness of TC, HDL-C, and SBP values on Heart Age was determined using a subsample that had complete risk factor information. Heart Age users (N=2,744,091) were mostly in their 20s (22.76%) and 40s (23.99%), female (56.03%), had multiple (mean 2.9, SD 1.4) risk factors, and a Heart Age exceeding their chronological age (mean 4.00, SD 6.43 years). The proportion of users unaware of their TC, HDL-C, or SBP values was high (77.47%, 93.03%, and 46.55% respectively). Lacking awareness of physiological risk factor values led to overestimation of Heart Age by an average 2.1-4.5 years depending on the (combination of

  13. Assessment of Traffic Noise Impacts

    DEFF Research Database (Denmark)

    Rich, Jeppe Husted; Nielsen, Otto Anker

    2004-01-01

    A steady growth in traffic intensities in most urban areas throughout the world has forced planners and politicians to seriously consider the resulting environmental impact, such as traffic noise, accidents and air pollution. The assessment of such negative factors is needed in order to reveal...... the true social benefit of infrastructure plans. The paper presents a noise assessment model for the Copenhagen region, which brings together GIS technology and non-linear hedonic regression models to reveal the implicit costs of traffic noise measured as the marginal percentage loss in property values...... with respect to the decibel traffic noise. The model distinguishes between houses and apartments and shows that the ability to include refined accessibility variables have significant impact on estimated prices....

  14. [Environment and energy in hospitals: assessment of usage and impact of Health Facilities in the Lombardy Region].

    Science.gov (United States)

    Brioschi, A; Capolongo, S; Buffoli, M

    2010-01-01

    The research moves from the current global and local context and from shared development strategies. From the observation and the analysis of contemporary environmental and energy issues and redefined directions of growth of human activity, it is addressing the question of environmental sustainability and energy conservation of building hospital systems. The work has developed a field survey relating the specific topic of energy saving and efficiency of the Park Hospital in the Italian Lombardy Region. This has been articulated in a diagnosis of technology and efficiency of regional hospitals, implemented through a census, and in a subsequent identification of interventional cases, in order to show its economic, environmental and health performance of the energy efficiency consumption and the environmentally sound.

  15. Failures in risk assessment and risk management for cosmetic preservatives in Europe and the impact on public health.

    Science.gov (United States)

    Schwensen, Jakob F; White, Ian R; Thyssen, Jacob P; Menné, Torkil; Johansen, Jeanne D

    2015-09-01

    In view of the current and unprecedented increase in contact allergy to methylisothiazolinone (MI), we characterized and evaluated two recent epidemics of contact allergy to preservatives used in cosmetic products to address failures in risk assessment and risk management. To evaluate temporal trends of preservative contact allergy. The study population included consecutive patch tested eczema patients seen at a university hospital between 1985 and 2013. A total of 23 138 patients were investigated for a contact allergy. The overall prevalence of contact allergy to at least one preservative increased significantly over the study period, from 6.7% in 1985 to 11.8% in 2013 (p preservatives methyldibromo glutaronitrile and MI rapidly resulted in high sensitization prevalence rates, which reached epidemic proportions. Although the proportion of patients with current clinical disease attributable to methyldibromo glutaronitrile contact allergy decreased significantly following the ban on its use in cosmetic products (p preservatives in Europe with inadequate pre-market risk assessment has rapidly increased the overall burden of cutaneous disease caused by preservatives. We suggest that the cosmetic industry has a responsibility to react faster and replace troublesome preservatives when a preservative contact allergy epidemic is recognized, but the European Commission has the ultimate responsibility for failures in risk management after new, major sensitizing preservatives are introduced onto the market. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.