WorldWideScience

Sample records for health impact assessment

  1. 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.

  2. 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.

  3. 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.

  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

    DEFF Research Database (Denmark)

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

    2011-01-01

    contribute to the systematic translation and assessment of genomic health applications by focussing at population level and on public health policy making. It is shown to what extent HTA, HNA and HIA contribute to translational research by using the continuum of translational research (T1-T4) in genomic...... into the impact on public health and health care practice of those technologies that are actually introduced. This paper aims to give an overview of the major assessment instruments in public health [ health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could...... medicine as an analytic framework. The selected assessment methodologies predominantly cover 2 to 4 phases within the T1-T4 system. HTA delivers the most complete set of methodologies when assessing health applications. HNA can be used to prioritize areas where genomic health applications are needed...

  5. The relation of risk assessment and health impact assessment

    DEFF Research Database (Denmark)

    Ádám, Balázs; Gulis, Gabriel

    2013-01-01

    than assessing a present situation. As part of this process, however, methods applied in risk assessment are used. Risk assessment typically characterises relation of a well-defined risk factor to a well-defined health outcome. Within HIA usually several individual risk assessments are needed...... of the causal chain from the proposal through related health determinants and risk factors to health outcomes. The stepwise analysis, systematic prioritization and consideration of horizontal interactions between the causal pathways make it feasible to use widely recognized risk assessment methods in the HIA......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...

  6. 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.

    Science.gov (United States)

    Rosenkötter, N; Vondeling, H; 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 impact on public health and health care practice of those technologies that are actually introduced. This paper aims to give an overview of the major assessment instruments in public health [health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could contribute to the systematic translation and assessment of genomic health applications by focussing at population level and on public health policy making. It is shown to what extent HTA, HNA and HIA contribute to translational research by using the continuum of translational research (T1-T4) in genomic medicine as an analytic framework. The selected assessment methodologies predominantly cover 2 to 4 phases within the T1-T4 system. HTA delivers the most complete set of methodologies when assessing health applications. HNA can be used to prioritize areas where genomic health applications are needed 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 applications. They are broad in scope and go beyond the continuum of T1-T4 translational research regarding policy translation. Copyright © 2010 S. Karger AG, Basel.

  7. Institutionalizing policy-level health impact assessment in Europe: is coupling health impact assessment with strategic environmental assessment the next step forward?

    OpenAIRE

    Wright, John; Parry, Jayne; Scully, Edward

    2005-01-01

    European Union (EU) Member States are interested in using health impact assessment (HIA) as a means of safeguarding their obligations to protect human health under the 1997 Treaty of Amsterdam. However, several have encountered difficulties institutionalizing HIA with the policy-making process. As a consequence, the World Health Organization (WHO) Regional Office for Europe has suggested coupling HIA with strategic environmental assessment (SEA). Traditionally, the incorporation of HIA into o...

  8. Institutionalizing policy-level health impact assessment in Europe: is coupling health impact assessment with strategic environmental assessment the next step forward?

    Science.gov (United States)

    Wright, John; Parry, Jayne; Scully, Edward

    2005-06-01

    European Union (EU) Member States are interested in using health impact assessment (HIA) as a means of safeguarding their obligations to protect human health under the 1997 Treaty of Amsterdam. However, several have encountered difficulties institutionalizing HIA with the policy-making process. As a consequence, the World Health Organization (WHO) Regional Office for Europe has suggested coupling HIA with strategic environmental assessment (SEA). Traditionally, the incorporation of HIA into other forms of impact assessment has been resisted, for fear of losing its focus on health issues to environmental concerns, and compromising its social model of health with the introduction of biophysical indicators. But can these fears be substantiated? In this paper, we investigate the grounds for such concerns by reviewing the relevant policy documents and departmental guidelines of four non-European countries that have considered the use of integrated assessment. We found that the case for associating HIA with SEA in Europe is strong, and offers potential solutions to problems of screening, theoretical framework, causal pathways and ready entry to the policy process. Coupling HIA with SEA may thus be the next step forward in a longer journey towards institutionalizing HIA as an independent policy-linked device.

  9. 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.

  10. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Dhondt, Stijn, E-mail: stijn.dhondt@vub.ac.be [Department of Medical Sociology and Health Sciences, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090, Brussels (Belgium); Beckx, Carolien, E-mail: Carolien.Beckx@vito.be [Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol (Belgium); Degraeuwe, Bart, E-mail: Bart.Degraeuwe@vito.be [Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol (Belgium); Lefebvre, Wouter, E-mail: Wouter.Lefebvre@vito.be [Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol (Belgium); Kochan, Bruno, E-mail: Bruno.Kochan@uhasselt.be [Transportation Research Institute, Hasselt University, Wetenschapspark 5 bus 6, 3590 Diepenbeek (Belgium); Bellemans, Tom, E-mail: Tom.Bellemans@uhasselt.be [Transportation Research Institute, Hasselt University, Wetenschapspark 5 bus 6, 3590 Diepenbeek (Belgium); Int Panis, Luc, E-mail: Luc.intpanis@vito.be [Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol (Belgium); Transportation Research Institute, Hasselt University, Wetenschapspark 5 bus 6, 3590 Diepenbeek (Belgium); Macharis, Cathy, E-mail: cjmachar@vub.ac.be [Department MOSI-Transport and Logistics, Vrije Universiteit Brussel, Pleinlaan 2, B-1050, Brussels (Belgium); Putman, Koen, E-mail: kputman@vub.ac.be [Department of Medical Sociology and Health Sciences, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090, Brussels (Belgium); Interuniversity Centre for Health Economics Research (I-CHER), Vrije Universiteit Brussel, Brussels (Belgium)

    2012-09-15

    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{sub 2} and O{sub 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{sub 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: Black-Right-Pointing-Pointer Exposure to ambient air pollution was assessed integrating population mobility. Black-Right-Pointing-Pointer This dynamic exposure was integrated into a health impact assessment. Black-Right-Pointing-Pointer Differences between the dynamic and residential exposure were quantified. Black-Right-Pointing-Pointer Modest differences in health impact were found at a regional level. Black

  12. Integrating Ecosystem Services Into Health Impact Assessment

    Science.gov (United States)

    Health Impact Assessment (HIA) provides a methodology for incorporating considerations of public health into planning and decision-making processes. HIA promotes interdisciplinary action, stakeholder participation, and timeliness and takes into account equity, sustainability, and...

  13. 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.

  14. ENVIRONMENTAL IMPACT ASSESSMENT OF A HEALTH TECHNOLOGY: A SCOPING REVIEW.

    Science.gov (United States)

    Polisena, Julie; De Angelis, Gino; Kaunelis, David; Gutierrez-Ibarluzea, Iñaki

    2018-06-13

    The Health Technology Expert Review Panel is an advisory body to Canadian Agency for Drugs and Technologies in Health (CADTH) that develops recommendations on health technology assessments (HTAs) for nondrug health technologies using a deliberative framework. The framework spans several domains, including the environmental impact of the health technology(ies). Our research objective was to identify articles on frameworks, methods or case studies on the environmental impact assessment of health technologies. A literature search in major databases and a focused gray literature search were conducted. The main search concepts were HTA and environmental impact/sustainability. Eligible articles were those that described a conceptual framework or methods used to conduct an environmental assessment of health technologies, and case studies on the application of an environmental assessment. From the 1,710 citations identified, thirteen publications were included. Two articles presented a framework to incorporate environmental assessment in HTAs. Other approaches described weight of evidence practices and comprehensive and integrated environmental impact assessments. Central themes derived include transparency and repeatability, integration of components in a framework or of evidence into a single outcome, data availability to ensure the accuracy of findings, and familiarity with the approach used. Each framework and methods presented have different foci related to the ecosystem, health economics, or engineering practices. Their descriptions suggested transparency, repeatability, and the integration of components or of evidence into a single outcome as their main strengths. Our review is an initial step of a larger initiative by CADTH to develop the methods and processes to address the environmental impact question in an HTA.

  15. 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

  16. 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

  17. 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.

  18. Health impact assessment in planning: Development of the design for health HIA tools

    International Nuclear Information System (INIS)

    Forsyth, Ann; Slotterback, Carissa Schively; Krizek, Kevin J.

    2010-01-01

    How can planners more systematically incorporate health concerns into practical planning processes? This paper describes a suite of health impact assessment tools (HIAs) developed specifically for planning practice. Taking an evidence-based approach the tools are designed to fit into existing planning activities. The tools include: a short audit tool, the Preliminary Checklist; a structured participatory workshop, the Rapid HIA; an intermediate health impact assessment, the Threshold Analysis; and a set of Plan Review Checklists. This description provides a basis for future work including assessing tool validity, refining specific tools, and creating alternatives.

  19. 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.

  20. 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.

  1. 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.

  2. Health impact assessment in environmental impact assessment in China: Status, practice and problems

    International Nuclear Information System (INIS)

    Chang, I-Shin; Yilihamu, Qimanguli; Wu, Jing; Wu, Huilei; Nan, Bo

    2017-01-01

    In China, the environmental impact assessment (EIA) system has gradually developed into an integrated evaluation system, owing to continuous improvement on institutional framework, system infrastructure, technical methods and professionals training, since EIA was first introduced in 1979. Though health impact assessment (HIA) is a part of the EIA system, the development of HIA is so slow as to remain at the early developing stage. This research aims to understand the extent and main issues concerning “health considerations” under the context of EIA, in China. Through case study on 42 environmental impact statements, the results demonstrate that HIA was not implemented in most of the cases, and health issues were not even mentioned in more than half of these cases. Where HIA was implemented, various problems were revealed through this study, including lacks of systematic approaching tools, insufficient supporting data on health effects, ineffective public participation, limited health considerations on biophysics, and so forth. Nevertheless, these problems can be attributed to lacks of legal supports, systematic evaluation methods, knowledge on evaluation technologies, and professional training institutions for HIA in China. In order to improve HIA methodologies, technologies, and management, to perfect HIA evaluation system, and to enhance public participation system within HIA, some recommendations from institutional, technical, administrative, and managerial aspects were then proposed in this study. - Highlights: •The status and deficiencies of HIA in EIA in China were identified and evaluated. •There were great industrial differences for the implementation of HIA in EIA. •Public participation was not well executed within HIA in EIA.

  3. 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

  4. 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

  5. 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.

  6. Identifying and assessing strategies for evaluating the impact of mobile eye health units on health outcomes.

    Science.gov (United States)

    Fu, Shiwan; Turner, Angus; Tan, Irene; Muir, Josephine

    2017-12-01

    To identify and assess strategies for evaluating the impact of mobile eye health units on health outcomes. Systematic literature review. Worldwide. Peer-reviewed journal articles that included the use of a mobile eye health unit. Journal articles were included if outcome measures reflected an assessment of the impact of a mobile eye health unit on health outcomes. Six studies were identified with mobile services offering diabetic retinopathy screening (three studies), optometric services (two studies) and orthoptic services (one study). This review identified and assessed strategies in existing literature used to evaluate the impact of mobile eye health units on health outcomes. Studies included in this review used patient outcomes (i.e. disease detection, vision impairment, treatment compliance) and/or service delivery outcomes (i.e. cost per attendance, hospital transport use, inappropriate referrals, time from diabetic retinopathy photography to treatment) to evaluate the impact of mobile eye health units. Limitations include difficulty proving causation of specific outcome measures and the overall shortage of impact evaluation studies. Variation in geographical location, service population and nature of eye care providers limits broad application. © 2017 National Rural Health Alliance Inc.

  7. The 6/94 gap in health impact assessment

    International Nuclear Information System (INIS)

    Erlanger, Tobias E.; Krieger, Gary R.; Singer, Burton H.; Utzinger, Juerg

    2008-01-01

    Health impact assessment (HIA), a methodology that aims to facilitate the mitigation of negative and enhancement of positive health effects due to projects, programmes and policies, has been developed over the past 20-30 years. There is an underlying assumption that HIA has become a full fledged critical piece of the impact assessment process with a stature equal to both environmental and social impact assessments. This assumption needs to be supported by evidence however. Within the context of projects in developing country settings, HIA is simply a slogan without a clearly articulated and relevant methodology, offered by academia and having little or no salience in the decision-making process regarding impacts. This harsh assertion is supported by posing a simple question: 'Where in the world have HIAs been carried out?' To answer this question, we systematically searched the peer-reviewed literature and online HIA-specific databases. We identified 237 HIA-related publications, but only 6% of these publications had a focus on the developing world. What emerges is, therefore, a huge disparity, which we coin the 6/94 gap in HIA, even worse than the widely known 10/90 gap in health research (10% of health research funding is utilized for diseases causing 90% of the global burden of disease). Implications of this 6/94 gap in HIA are discussed with pointed emphasis on extractive industries (oil/gas and mining) and water resources development. We conclude that there is a pressing need to institutionalize HIA in the developing world, as a consequence of current predictions of major extractive industry and water resources development, with China's investments in these sectors across Africa being particularly salient

  8. 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.

  9. 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.

  10. 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

  11. 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

  12. 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 or ecosy......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...

  13. Health impact and damage cost assessment of pesticides in Europe.

    Science.gov (United States)

    Fantke, Peter; Friedrich, Rainer; Jolliet, Olivier

    2012-11-15

    Health impacts from pesticide use are of continuous concern in the European population, requiring a constant evaluation of European pesticide policy. However, health impacts have never been quantified accounting for specific crops contributing differently to overall human exposure as well as accounting for individual substances showing distinct environmental behavior and toxicity. We quantify health impacts and related damage costs from exposure to 133 pesticides applied in 24 European countries in 2003 adding up to almost 50% of the total pesticide mass applied in that year. Only 13 substances applied to 3 crop classes (grapes/vines, fruit trees, vegetables) contribute to 90% of the overall health impacts of about 2000 disability-adjusted life years in Europe per year corresponding to annual damage costs of 78 million Euro. Considering uncertainties along the full impact pathway mainly attributable to non-cancer dose-response relationships and residues in treated crops, we obtain an average burden of lifetime lost per person of 2.6 hours (95% confidence interval between 22 seconds and 45.3 days) or costs per person over lifetime of 12 Euro (95% confidence interval between 0.03 Euro and 5142 Euro), respectively. 33 of the 133 assessed substances accounting for 20% of health impacts in 2003 are now banned from the European market according to current legislation. The main limitation in assessing human health impacts from pesticides is related to the lack of systematic application data for all used substances. Since health impacts can be substantially influenced by the choice of pesticides, the need for more information about substance application becomes evident. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Assessing the health impact of transnational corporations: its importance and a framework.

    Science.gov (United States)

    Baum, Frances E; Sanders, David M; Fisher, Matt; Anaf, Julia; Freudenberg, Nicholas; Friel, Sharon; Labonté, Ronald; London, Leslie; Monteiro, Carlos; Scott-Samuel, Alex; Sen, Amit

    2016-06-15

    The adverse health and equity impacts of transnational corporations' (TNCs) practices have become central public health concerns as TNCs increasingly dominate global trade and investment and shape national economies. Despite this, methodologies have been lacking with which to study the health equity impacts of individual corporations and thus to inform actions to mitigate or reverse negative and increase positive impacts. This paper reports on a framework designed to conduct corporate health impact assessment (CHIA), developed at a meeting held at the Rockefeller Foundation Bellagio Center in May 2015. On the basis of the deliberations at the meeting it was recommended that the CHIA should be based on ex post assessment and follow the standard HIA steps of screening, scoping, identification, assessment, decision-making and recommendations. A framework to conduct the CHIA was developed and designed to be applied to a TNC's practices internationally, and within countries to enable comparison of practices and health impacts in different settings. The meeting participants proposed that impacts should be assessed according to the TNC's global and national operating context; its organisational structure, political and business practices (including the type, distribution and marketing of its products); and workforce and working conditions, social factors, the environment, consumption patterns, and economic conditions within countries. We anticipate that the results of the CHIA will be used by civil society for capacity building and advocacy purposes, by governments to inform regulatory decision-making, and by TNCs to lessen their negative health impacts on health and fulfil commitments made to corporate social responsibility.

  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. 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.

  17. What is Health Impact Assessment?

    Directory of Open Access Journals (Sweden)

    Ahmet Soysal

    2010-12-01

    Full Text Available Health Impact Assessment (HIA was disseminated by World Health Organization (WHO European Region in Gothenburg consensus paper in 1999. In this consensus, HIA is defined as ‘a combination of procedures, methods and tools by which a policy, program or project may be judged as to its potential effects on the health of population and the distribution of those effects within the population’. HIA was accepted as a goal for 4th phase of healthy city projects between 2003- 2008. HIA is a new process for our country and especially municipal boroughs, local authorities interest with it. There is no legal base for HIA in our country. EIA practices conducted since 1993 showed us that, environmental and public health was postponed. Functional and decisive implementation of HAI depends on legal basis and national acceptance. If legal basis is supplied, society must take care about it, work for strict application and have to put a crimp in going back. [TAF Prev Med Bull 2010; 9(6.000: 689-694

  18. Assessment of the health impact of an environmental pollution and quantitative assessment of health risks; Estimation de l'impact sanitaire d'une pollution environnementale et evaluation quantitative des risques sanitaires

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-09-15

    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 "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.

  20. CAPACITY BUILDING PROCESS IN ENVIRONMENTAL AND HEALTH IMPACT ASSESSMENT FOR A THAI COMMUNITY.

    Science.gov (United States)

    Chaithui, Suthat; Sithisarankul, Pornchai; Hengpraprom, Sarunya

    2017-03-01

    This research aimed at exploring the development of the capacitybuilding process in environmental and health impact assessment, including the consideration of subsequent, capacity-building achievements. Data were gathered through questionnaires, participatory observations, in-depth interviews, focus group discussions, and capacity building checklist forms. These data were analyzed using content analysis, descriptive statistics, and inferential statistics. Our study used the components of the final draft for capacity-building processes consisting of ten steps that were formulated by synthesis from each respective process. Additionally, the evaluation of capacity building levels was performed using 10-item evaluation criteria for nine communities. The results indicated that the communities performed well under these criteria. Finally, exploration of the factors influencing capacity building in environmental and health impact assessment indicated that the learning of community members by knowledge exchange via activities and study visits were the most influential factors of the capacity building processes in environmental and health impact assessment. The final revised version of capacitybuilding process in environmental and health impact assessment could serve as a basis for the consideration of interventions in similar areas, so that they increased capacity in environmental and health impact assessments.

  1. 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.

  2. 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

  3. The need for health impact assessment in China: Potential benefits for public health and steps forward

    Energy Technology Data Exchange (ETDEWEB)

    Wu Liming, E-mail: lmwu@scdc.sh.c [Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336 (China); Center for Environment and Population Health, Griffith University, Nathan 4111 (Australia); Rutherford, Shannon; Chu, Cordia [Center for Environment and Population Health, Griffith University, Nathan 4111 (Australia)

    2011-07-15

    Health impact assessment (HIA) is a useful tool to predict and estimate the potential health impact associated with programs, projects, and policies by comprehensively identifying relevant health determinants and their consequences. China is undergoing massive and rapid socio-economic changes leading to environment and population health challenges such as a large increase in non-communicable diseases, the emergence and re-emergence of infectious diseases, new health risks associated with environmental pollutants and escalating health inequality. These health issues are affected by multiple determinants which can be influenced by planned policies, programs, and projects. This paper discusses the needs for health impact assessment in China in order to minimize the negative health consequences from projects, programs and policies associated with rapid social and economic development. It first describes the scope of China's current impact assessment system and points out its inadequacy in meeting the requirements of population health protection and promotion. It then analyses the potential use of HIA and why China needs to develop and apply HIA as a tool to identify potential health impacts of proposed programs, projects and policies so as to influence decision-making early in the planning process. Thus, the paper recommends the development of HIA as a useful tool in China to enhance decision-making for the protection and promotion of population health. For this to happen, the paper outlines steps necessary for the establishment and successful implementation of HIA in China: beginning with the establishment of a HIA framework, followed by workforce capacity building, methodology design, and intersectoral collaboration and stakeholder engagement.

  4. The need for health impact assessment in China: Potential benefits for public health and steps forward

    International Nuclear Information System (INIS)

    Wu Liming; Rutherford, Shannon; Chu, Cordia

    2011-01-01

    Health impact assessment (HIA) is a useful tool to predict and estimate the potential health impact associated with programs, projects, and policies by comprehensively identifying relevant health determinants and their consequences. China is undergoing massive and rapid socio-economic changes leading to environment and population health challenges such as a large increase in non-communicable diseases, the emergence and re-emergence of infectious diseases, new health risks associated with environmental pollutants and escalating health inequality. These health issues are affected by multiple determinants which can be influenced by planned policies, programs, and projects. This paper discusses the needs for health impact assessment in China in order to minimize the negative health consequences from projects, programs and policies associated with rapid social and economic development. It first describes the scope of China's current impact assessment system and points out its inadequacy in meeting the requirements of population health protection and promotion. It then analyses the potential use of HIA and why China needs to develop and apply HIA as a tool to identify potential health impacts of proposed programs, projects and policies so as to influence decision-making early in the planning process. Thus, the paper recommends the development of HIA as a useful tool in China to enhance decision-making for the protection and promotion of population health. For this to happen, the paper outlines steps necessary for the establishment and successful implementation of HIA in China: beginning with the establishment of a HIA framework, followed by workforce capacity building, methodology design, and intersectoral collaboration and stakeholder engagement.

  5. Motivators and Barriers to Incorporating Climate Change-Related Health Risks in Environmental Health Impact Assessment

    Directory of Open Access Journals (Sweden)

    Shilu Tong

    2013-03-01

    Full Text Available 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.

  6. 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.

  7. 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

  8. 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.

  9. Motivators and Barriers to Incorporating Climate Change-Related Health Risks in Environmental Health Impact Assessment

    OpenAIRE

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

    2013-01-01

    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...

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

    Energy Technology Data Exchange (ETDEWEB)

    Winkler, Mirko S., E-mail: mirko.winkler@unibas.ch [Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel (Switzerland); University of Basel, P.O. Box, CH-4003 Basel (Switzerland); Divall, Mark J., E-mail: mdivall@shapeconsulting.org [SHAPE Consulting Ltd., Pretoria 0062 (South Africa); Krieger, Gary R., E-mail: gkrieger@newfields.com [NewFields, LLC, Denver, CO 80202 (United States); Schmidlin, Sandro, E-mail: sandro.schmidlin@gmail.com [Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel (Switzerland); University of Basel, P.O. Box, CH-4003 Basel (Switzerland); Magassouba, Mohamed L., E-mail: laminemagass@yahoo.fr [Clinique Ambroise Pare, P.O. Box, 1042 Conakry (Guinea); Knoblauch, Astrid M., E-mail: astrid.knoblauch@me.com [SHAPE Consulting Ltd., Pretoria 0062 (South Africa); Singer, Burton H., E-mail: bhsinger@epi.ufl.edu [Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610 (United States); Utzinger, Juerg, E-mail: juerg.utzinger@unibas.ch [Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel (Switzerland); University of Basel, P.O. Box, CH-4003 Basel (Switzerland)

    2012-02-15

    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.

  11. 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.

  12. 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.

  13. Validating health impact assessment: Prediction is difficult (especially about the future)

    International Nuclear Information System (INIS)

    Petticrew, Mark; Cummins, Steven; Sparks, Leigh; Findlay, Anne

    2007-01-01

    Health impact assessment (HIA) has been recommended as a means of estimating how policies, programmes and projects may impact on public health and on health inequalities. This paper considers the difference between predicting health impacts and measuring those impacts. It draws upon a case study of the building of a new hypermarket in a deprived area of Glasgow, which offered an opportunity to reflect on the issue of the predictive validity of HIA, and to consider the difference between potential and actual impacts. We found that the actual impacts of the new hypermarket on diet differed from that which would have been predicted based on previous studies. Furthermore, they challenge current received wisdom about the impact of food retail outlets in poorer areas. These results are relevant to the validity of HIA as a process and emphasise the importance of further research on the predictive validity of HIA, which should help improve its value to decision-makers

  14. 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

  15. 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

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

    OpenAIRE

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

    2017-01-01

    Background 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. Methods We adapted existing Health Impact Assessment methods to assess M...

  17. 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

  18. 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.

  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. 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.

  1. [Tools to assess the impact on health of public health programmes and community interventions from an equity perspective].

    Science.gov (United States)

    Suárez Álvarez, Óscar; Fernández-Feito, Ana; Vallina Crespo, Henar; Aldasoro Unamuno, Elena; Cofiño, Rafael

    2018-05-11

    It is essential to develop a comprehensive approach to institutionally promoted interventions to assess their impact on health from the perspective of the social determinants of health and equity. Simple, adapted tools must be developed to carry out these assessments. The aim of this paper is to present two tools to assess the impact of programmes and community-based interventions on the social determinants of health. The first tool is intended to assess health programmes through interviews and analysis of information provided by the assessment team. The second tool, by means of online assessments of community-based interventions, also enables a report on inequality issues that includes recommendations for improvement. In addition to reducing health-related social inequities, the implementation of these tools can also help to improve the efficiency of public health interventions. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. A holistic model for the selection of environmental assessment indicators to assess the impact of industrialization on indigenous health.

    Science.gov (United States)

    Kryzanowski, Julie A; McIntyre, Lynn

    2011-01-01

    Mainstream environmental assessment (EA) methodologies often inadequately address health, social and cultural impacts of concern for Canadian indigenous communities affected by industrialization. Our objective is to present a holistic, culturally-appropriate framework for the selection of indigenous health indicators for baseline health assessment, impact prediction, or monitoring of impacts over time. We used a critical population health approach to explore the determinants of health and health inequities in indigenous communities and conceptualize the pathways by which industrialization affects these determinants. We integrated and extended key elements from three indigenous health frameworks into a new holistic model for the selection of indigenous EA indicators. The holistic model conceptualizes individual and community determinants of health within external social, economic and political contexts and thus provides a comprehensive framework for selecting indicators of indigenous health. Indigenous health is the product of interactions among multiple determinants of health and contexts. Potential applications are discussed using case study examples involving indigenous communities affected by industrialization. Industrialization can worsen indigenous health inequities by perpetuating the health, social and cultural impacts of historic environmental dispossession. To mitigate impacts, EA should explicitly recognize linkages between environmental dispossession and the determinants of health and health inequities and meaningfully involve indigenous communities in the process.

  3. 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.

  4. 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...

  5. Health impact assessment as an agent of policy change: improving the health impacts of the mayor of London's draft transport strategy.

    Science.gov (United States)

    Mindell, J; Sheridan, L; Joffe, M; Samson-Barry, H; Atkinson, S

    2004-03-01

    To increase the positive and mitigate the negative health impacts of the mayor's draft transport strategy for London. A rapid prospective health impact assessment (HIA) of the penultimate draft of the strategy, using a review commissioned by the regional director of public health; an appraisal of congestion charging; and a participatory workshop. Two audits of changes were performed to assess the impact on policy of the HIA process. Regional government policy development. Recommendations from the rapid HIA were fed back into the drafting process. Changes (a) between the penultimate draft and the draft for public consultation and (b) between that and the final mayoral strategy. The draft transport strategy published for consultation differed in a number of respects from the previous version. Almost all the recommendations from the HIA were incorporated into the final strategy. Significant changes included promoting sustainable travel plans for workplaces and schools; giving priority to infrastructure and services that benefit London's deprived communities; increased emphasis on promoting walking and cycling and reducing reliance on private cars; and a commitment to track the health impacts of the final strategy and its implementation. Specific additions included re-allocating road space. HIA was successful in influencing the transport strategy for London, resulting in several improvements from a health viewpoint. HIA is an effective method both for bringing about significant change in policy proposals and in increasing policy makers' understanding of determinants of health and hence in changing attitudes of policy makers.

  6. Preliminary assessment of the environmental and health impacts of nuclear and coal fuel cycles

    International Nuclear Information System (INIS)

    Yang Yin; Chen Zhuzhou; Pan Ziqiang

    1992-01-01

    The paper reports on the environmental impacts and health effects of coal and nuclear fuel cycles in China. Data of interest for China are presented in a comparative manner; epidemiological investigations in Shanxi province indicate that the incidences of chronic pulmonary diseases and infant cogenital malformation were apparently increased over the fall-out areas of coal-fired power stations and coal mines. The authors outline the framework of a research project on environmental assessment of nuclear energy and other energy systems. The main features of the project are: environmental and health impacts of coal and nuclear fuel cycles, environmental impact assessment of coal transportation, cost accounting of nuclear and other energy sources, health risk assessment. (author). 24 refs, 4 tabs

  7. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Schuchter, Joseph, E-mail: jws@berkeley.edu [University of California, Berkeley, School of Public Health, Department of Environmental Health Sciences, 50 University Hall, Berkeley, CA 94720-7360 (United States); Bhatia, Rajiv [University of California, Berkeley, Institute of Urban and Regional Development (United States); Corburn, Jason [University of California, Berkeley, College of Environmental Design, Department of City and Regional Planning (United States); Seto, Edmund [University of Washington, School of Public Health, Department of Environmental and Occupational Health (United States)

    2014-07-01

    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

  9. 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

  10. Integrating human health into environmental impact assessment: an unrealized opportunity for environmental health and justice.

    Science.gov (United States)

    Bhatia, Rajiv; Wernham, Aaron

    2008-08-01

    The National Environmental Policy Act and related state laws require many public agencies to analyze and disclose potentially significant environmental effects of agency actions, including effects on human health. In this paper we review the purpose and procedures of environmental impact assessment (EIA), existing regulatory requirements for health effects analysis, and potential barriers to and opportunities for improving integration of human health concerns within the EIA process. We use statutes, regulations, guidelines, court opinions, and empirical research on EIA along with recent case examples of integrated health impact assessment (HIA)/EIA at both the state and federal level. We extract lessons and recommendations for integrated HIA/EIA practice from both existing practices as well as case studies. The case studies demonstrate the adequacy, scope, and power of existing statutory requirements for health analysis within EIA. The following support the success of integrated HIA/EIA: a proponent recognizing EIA as an available regulatory strategy for public health; the openness of the agency conducting the EIA; involvement of public health institutions; and complementary objectives among community stakeholders and health practitioners. We recommend greater collaboration among institutions responsible for EIA, public health institutions, and affected stakeholders along with guidance, resources, and training for integrated HIA/EIA practice.

  11. 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.

  12. 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

  13. 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

    2018-04-01

    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.

  14. 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

  15. 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

  16. 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

    . Conclusions: Systematic and sustainable capacity building is needed to achieve high level implementation of HIA in Danish municipalities. Development of validated tools, most importantly screening tools with focus on priorities of national public health policy would enhance implementation on municipal level.......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...... policy. Methods: Qualitative interviews were conducted in 6 municipalities (3 with HIA inducted in their health policy and 3 without it) gathering information on knowledge and attitudes to HIA, barriers to its implementation, social system and communication channels used or expected to be used...

  17. Mental health consumer participation in undergraduate occupational therapy student assessment: No negative impact.

    Science.gov (United States)

    Logan, Alexandra; Yule, Elisa; Taylor, Michael; Imms, Christine

    2018-05-28

    Australian accreditation standards for occupational therapy courses require consumer participation in the design, delivery and evaluation of programs. This study investigated whether a mental health consumer - as one of two assessors for an oral assessment in a mental health unit - impacted engagement, anxiety states and academic performance of undergraduate occupational therapy students. Students (n = 131 eligible) self-selected into two groups but were blinded to the group differences (assessor panel composition) until shortly prior to the oral assessment. Control group assessors were two occupational therapy educators, while consumer group assessors included an occupational therapy educator and a mental health consumer. Pre- and post-assessment data were successfully matched for 79 students (overall response rate = 73.1%). No evidence was found of significant differences between the two groups for engagement, anxiety or academic performance (all P values >0.05). Including mental health consumers as assessors did not negatively impact student engagement and academic performance, nor increase student anxiety beyond that typically observed in oral assessment tasks. The findings provide support for expanding the role of mental health consumers in the education and assessment of occupational therapy students. Development of methods to determine the efficacy of consumer involvement remains an area for future research. © 2018 Occupational Therapy Australia.

  18. 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.

  19. [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.

  20. 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.

  1. Participation in health impact assessment: objectives, methods and core values.

    Science.gov (United States)

    Wright, John; Parry, Jayne; Mathers, Jonathan

    2005-01-01

    Health impact assessment (HIA) is a multidisciplinary aid to decision-making that assesses the impact of policy on public health and on health inequalities. Its purpose is to assist decision-makers to maximize health gains and to reduce inequalities. The 1999 Gothenburg Consensus Paper (GCP) provides researchers with a rationale for establishing community participation as a core value of HIA. According to the GCP, participation in HIA empowers people within the decision-making process and redresses the democratic deficit between government and society. Participation in HIA generates a sense that health and decision-making is community-owned, and the personal experiences of citizens become integral to the formulation of policy. However, the participatory and empowering dimensions of HIA may prove difficult to operationalize. In this review of the participation strategies adopted in key applications of HIA in the United Kingdom, we found that HIA's aim of influencing decision-making creates tension between its participatory and knowledge-gathering dimensions. Accordingly, researchers have decreased the participatory dimension of HIA by reducing the importance attached to the community's experience of empowerment, ownership and democracy, while enlarging its knowledge-gathering dimension by giving pre-eminence to "expert" and "research-generated" evidence. Recent applications of HIA offer a serviceable rationale for participation as a means of information gathering and it is no longer tenable to uphold HIA as a means of empowering communities and advancing the aims of participatory democracy. PMID:15682250

  2. How do we make health impact assessment fit for purpose?

    Science.gov (United States)

    Joffe, M

    2003-09-01

    Progress has been made in recent years in the process of health impact assessment (HIA), including community involvement. The technical side is less well developed. A minimum requirement is that there should be some consistency or robustness, so that the outcome of an HIA does not depend just on who happens to carry it out, that it is not easily swayed by the vested interests that typically surround any project, and that it can withstand legal challenge. Validity is an important criterion, as well as repeatability, as the latter can be achieved merely by propagating errors. All types of evidence should be considered legitimate, including qualitative and quantitative methods. The quality of evidence, and its generalisability, need to be carefully assessed; we should leave behind the divisive discourse around "positivism". Typically there is less information on the links from interventions (policies or projects) to changes in determinants of health than there is on the immediate precursors of health and ill-health. A practical question is, how the best existing knowledge can be made available to HIA practitioners. Other issues are more tractable than is often thought, e.g. that an HIA has to be able to trade off positive and negative impacts to different groups of people, and that the complexity of social causation prevents clear analysis of cause and effect.

  3. Tool for assessing health and equity impacts of interventions modifying air quality in urban environments.

    Science.gov (United States)

    Cartier, Yuri; Benmarhnia, Tarik; Brousselle, Astrid

    2015-12-01

    Urban outdoor air pollution (AP) is a major public health concern but the mechanisms by which interventions impact health and social inequities are rarely assessed. Health and equity impacts of policies and interventions are questioned, but managers and policy agents in various institutional contexts have very few practical tools to help them better orient interventions in sectors other than the health sector. Our objective was to create such a tool to facilitate the assessment of health impacts of urban outdoor AP interventions by non-public health experts. An iterative process of reviewing the academic literature, brainstorming, and consultation with experts was used to identify the chain of effects of urban outdoor AP and the major modifying factors. To test its applicability, the tool was applied to two interventions, the London Low Emission Zone and the Montréal BIXI public bicycle-sharing program. We identify the chain of effects, six categories of modifying factors: those controlling the source of emissions, the quantity of emissions, concentrations of emitted pollutants, their spatial distribution, personal exposure, and individual vulnerability. Modifiable and non-modifiable factors are also identified. Results are presented in the text but also graphically, as we wanted it to be a practical tool, from pollution sources to emission, exposure, and finally, health effects. The tool represents a practical first step to assessing AP-related interventions for health and equity impacts. Understanding how different factors affect health and equity through air pollution can provide insight to city policymakers pursuing Health in All Policies. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. 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.

  5. 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.

  6. 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

  7. 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...... to decrease the prevalence of active and passive smoking and result in a considerably positive effect on several diseases, among which lung cancer, chronic pulmonary diseases, coronary heart diseases and stroke have the greatest importance. The health gain calculated for the quantifiable health outcomes...

  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. 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.

  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

    Nutritional effects from the 'use stage' of the life cycle of food products can have a substantial effect on human health; yet, they are often not considered in life cycle assessment (LCA). In this study we explore the trade-offs between environmental and nutritional health effects associated wit...... be extended to other human health impacts (e.g. water use) and used in making sustainable diets decisions.[GRAPHICS]...... diet could result in an avoided health impact of 19.0 mu DALY (respective avoided impact for vegetables: 5.25 mu DALY). Overall, adding one fruits serving to the average US diet may lead to substantial health benefits: nutrition-related avoided impact (benefit) is 50 times higher than environmental...... health impacts (Figure 2). The benefit is slightly enhanced when increased fruit intake is substituted by food associated with adverse health outcomes, such as trans-fat and red meat, with the benefit mainly linked to avoided nutritional health impact. Benefits exceed impacts even when considering...

  11. 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

    Health impact assessments (HIA) dominantly apply only qualitative evaluation, although a comprehensive HIA ideally integrates both qualitative and quantitative evidence and methods, since quantification has several advantages when using assessment results in the decision making process......-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...

  12. Transport policy and health inequalities: a health impact assessment of Edinburgh's transport policy.

    Science.gov (United States)

    Gorman, D; Douglas, M J; Conway, L; Noble, P; Hanlon, P

    2003-01-01

    Health impact assessment (HIA) can be used to examine the relationships between inequalities and health. This HIA of Edinburgh's transport policy demonstrates how HIA can examine how different transport policies can affect different population groupings to varying degrees. In this case, Edinburgh's economy is based on tourism, financial services and Government bodies. These need a good transport infrastructure, which maintains a vibrant city centre. A transport policy that promotes walking, cycling and public transport supports this and is also good for health. The HIA suggested that greater spend on public transport and supporting sustainable modes of transport was beneficial to health, and offered scope to reduce inequalities. This message was understood by the City Council and influenced the development of the city's transport and land-use strategies. The paper discusses how HIA can influence public policy.

  13. Messing with Mother Nature Can Be Hazardous to Your Health. Assessment of Environmental Health Impacts.

    Science.gov (United States)

    Americans for Indian Opportunity, Inc., Albuquerque, NM.

    Environmental health impacts of development on Indian communities, and the roles of government agencies responsible for environmental protection and individual safety are being assessed by Americans for Indian Opportunity (AIO) during a two-year project. Although the more than 250 Indian tribes within the U.S. have federal guarantees for…

  14. Does health intervention research have real world policy and practice impacts: testing a new impact assessment tool.

    Science.gov (United States)

    Cohen, Gillian; Schroeder, Jacqueline; Newson, Robyn; King, Lesley; Rychetnik, Lucie; Milat, Andrew J; Bauman, Adrian E; Redman, Sally; Chapman, Simon

    2015-01-01

    There is a growing emphasis on the importance of research having demonstrable public benefit. Measurements of the impacts of research are therefore needed. We applied a modified impact assessment process that builds on best practice to 5 years (2003-2007) of intervention research funded by Australia's National Health and Medical Research Council to determine if these studies had post-research real-world policy and practice impacts. We used a mixed method sequential methodology whereby chief investigators of eligible intervention studies who completed two surveys and an interview were included in our final sample (n = 50), on which we conducted post-research impact assessments. Data from the surveys and interviews were triangulated with additional information obtained from documentary analysis to develop comprehensive case studies. These case studies were then summarized and the reported impacts were scored by an expert panel using criteria for four impact dimensions: corroboration; attribution, reach, and importance. Nineteen (38%) of the cases in our final sample were found to have had policy and practice impacts, with an even distribution of high, medium, and low impact scores. While the tool facilitated a rigorous and explicit criterion-based assessment of post-research impacts, it was not always possible to obtain evidence using documentary analysis to corroborate the impacts reported in chief investigator interviews. While policy and practice is ideally informed by reviews of evidence, some intervention research can and does have real world impacts that can be attributed to single studies. We recommend impact assessments apply explicit criteria to consider the corroboration, attribution, reach, and importance of reported impacts on policy and practice. Impact assessments should also allow sufficient time between impact data collection and completion of the original research and include mechanisms to obtain end-user input to corroborate claims and reduce biases

  15. 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.

  16. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Negev, Maya, E-mail: mayane@tau.ac.il [Hartog School of Government and Policy, Faculty of Social Sciences, Tel Aviv University, P.O.B. 39040, Tel Aviv 69978 (Israel); Davidovitch, Nadav, E-mail: nadavd@bgu.ac.il [Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University, P.O.B. 653, Be' er Sheva 84105 (Israel); Garb, Yaakov, E-mail: ygarb@bgu.ac.il [Swiss Institute for Dryland Environmental Research, The Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Sede Boqer 84990 (Israel); Tal, Alon, E-mail: alontal@bgu.ac.il [Mitrani Department of Dryland Ecology, Swiss Institute for Dryland Environmental Research, The Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Sede Boqer 84990 (Israel)

    2013-11-15

    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.

  18. 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

  19. Assessment of health risks of policies

    Energy Technology Data Exchange (ETDEWEB)

    Ádám, Balázs, E-mail: badam@cmss.sdu.dk [Unit for Health Promotion Research, Faculty of Health Sciences, University of Southern Denmark, Niels Bohrs Vej 9, DK-6700 Esbjerg (Denmark); Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Molnár, Ágnes, E-mail: MolnarAg@smh.ca [Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Centre for Research on Inner City Health, Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael' s Hospital, Victoria 209, Rm. 3-26.22, M5B 1C6 Toronto, Ontario (Canada); Ádány, Róza, E-mail: adany.roza@sph.unideb.hu [Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Bianchi, Fabrizio, E-mail: Fabriepi@ifc.cnr.it [Unit of Environmental Epidemiology, Institute of Clinical Physiology, National Council of Research, Moruzzi 1, 56124 Pisa (Italy); Bitenc, Katarina, E-mail: katarina.bitenc@ivz-rs.si [National Institute of Public Health, Trubarjeva 2, SI-1000 Ljubljana (Slovenia); Chereches, Razvan, E-mail: razvan.m.chereches@gmail.com [Faculty of Political, Administrative and Communication Sciences, Babes-Bolyai University, Strada Mihail Kogalniceanu 1, 3400 Cluj (Romania); Cori, Liliana, E-mail: liliana.cori@ifc.cnr.it [Unit of Environmental Epidemiology, Institute of Clinical Physiology, National Council of Research, Moruzzi 1, 56124 Pisa (Italy); Fehr, Rainer, E-mail: rainer.fehr@uni-bielefeld.de [NRW Centre for Health, Westerfeldstr. 35-37, 33611 Bielefeld (Germany); Kobza, Joanna, E-mail: koga1@poczta.onet.pl [Public Health Department, Silesian Medical University, 18 Medykow Street, 40-752 Katowice (Poland); Kollarova, Jana, E-mail: janakollarova@yahoo.com [Department of Health Promotion, Regional Public Health Authority, Ipelska 1, 04011 Kosice (Slovakia); and others

    2014-09-15

    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.

  20. The need to include Health Impact Assessment at the International Monetary Fund.

    Science.gov (United States)

    Cave, Ben; Birley, Martin

    2010-01-01

    The lending and technical support provided by the International Monetary Fund affect the determinants of health and healthy equity. Most health determinants lie outside the control of the health sector, and thus non-health-sector policies have profound positive and negative effects on population health. Health Impact Assessment (HIA) is an instrument for identifying the effect of policies, plans, programs, and projects on population health and health equity. It is a feasible, cost-effective, and transparent process that has been adopted by several financial institutions, including members of the World Bank Group. Adopting HIA would assist the IMF in ensuring that the potential health consequences of its policies are identified and addressed.

  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. 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

  3. 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

  4. 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.

  5. 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

  6. An equity tool for health impact assessments: Reflections from Mongolia

    International Nuclear Information System (INIS)

    Snyder, Jeremy; Wagler, Meghan; Lkhagvasuren, Oyun; Laing, Lory; Davison, Colleen; Janes, Craig

    2012-01-01

    A health impact assessment (HIA) is a tool for assessing the potential effects of a project or policy on a population's health. In this paper, we discuss a tool for successfully integrating equity concerns into HIAs. This discussion is the product of collaboration by Mongolian and Canadian experts, and it incorporates comments and suggestions of participants of a workshop on equity focused HIAs that took place in Mongolia in October, 2010. Our motivation for discussing this tool is based on the observation that existing HIAs tend either to fail to define equity or use problematic accounts of this concept. In this paper we give an overview of socio-demographic and health indicators in Mongolia and briefly discuss its mining industry. We then review three accounts of equity and argue for the importance of developing a consensus understanding of this concept when integrating considerations of equity into an HIA. Finally, we present findings from the workshop in Mongolia and outline a tool, derived from lessons from this workshop, for critically considering and integrating the concept of equity into an HIA.

  7. 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.

  8. 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.

  9. 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

  10. 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

  11. Health impact assessment in multinationals: A case study of the Royal Dutch/Shell Group

    International Nuclear Information System (INIS)

    Birley, Martin

    2005-01-01

    Health impact assessment is part of the risk management process of multinational corporations/companies. Sexually transmitted infections, including HIV/AIDS, and the 'paradox of plenty' are used as examples of the challenges they face. The 'business case' for impact assessment is explained. The policies, procedures, standards, and activities used by Shell to manage such risks are described. An approach to capacity building and competency development is presented that applies to both company staff and external contractors

  12. Impact of response shift on the assessment of treatment effects using the Oral Health Impact Profile.

    Science.gov (United States)

    Reissmann, Daniel R; Remmler, Antje; John, Mike T; Schierz, Oliver; Hirsch, Christian

    2012-12-01

    The assessment of changes in oral health-related quality of life (OHRQoL) is challenging because individuals' concepts and internal standards of OHRQoL may change over time. The aim of this study was to detect response shifts in OHRQoL assessments made using the Oral Health Impact Profile (OHIP). Oral health-related quality of life was assessed in a consecutive sample of 126 patients seeking prosthodontic care. Patients were asked to rate their OHRQoL before treatment started and 1 month after treatment was finished, using the German 49-item version of the OHIP. When rating their OHRQoL after treatment, patients were also asked to rate their pre-treatment OHRQoL without having access to their baseline data. The response shift was calculated as the difference in OHIP summary scores between the initial assessment and the retrospective baseline assessment. The OHIP mean scores decreased from 31.8 at the initial baseline assessment to 24.4 after treatment. The retrospective baseline assessment resulted in an OHIP mean score of 38.1, corresponding to a response shift of 6.3 OHIP points. The effect size (Cohen's d = 0.21) of the response shift was considered small. The response shift phenomenon and its magnitude have important implications for dental practice, where patients and dentists often assess perceived treatment effects retrospectively. © 2012 Eur J Oral Sci.

  13. 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

  14. 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.

  15. [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

  16. 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.

  17. Impact assessment of the contents of agricultural health discipline

    Directory of Open Access Journals (Sweden)

    Élida Fredesvinda Cordero Peña

    2013-06-01

    Full Text Available This article refers to the theoretical considerations in the process of assessing the impact of a program from the initial training requirements of a teacher's career Agricultural at the present time, so that once graduates are able to project themselves into matching their needs and possibilities. Our research has its practical exponent in the Agricultural Health discipline as science for the develop ment of knowledge, professional skills training and values, consistent with the protection of cultivated plants and domestic animals, in student’s career of Agricultural, at the University of Educational Sciences, in Pinar del Rio, Cuba.

  18. 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.

  19. 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.

  20. Future health impact assessment of air pollution at the global, European and Ile-de-France scales: the Air Pollution Climate Health Impact Assessment (A-C HIA) project

    International Nuclear Information System (INIS)

    Likhvar, Victoria; Hauglustaine, Didier; Kinney, Patrick; Colette, Augustin; Valari, Myrto; Markakis, Konstandinos; Pascal, Mathilde; Medina, Sylvia

    2016-01-01

    Ozone and fine particles are current risk factors for premature death all over the globe. In coming decades, substantial improvements in public health may be achieved by reducing air pollution. The overall objective of the A-C HIA project (2011-2014) was to apply state of the art climate, air quality, and health modelling tools to assess future health impacts of O 3 and PM2.5 under different scenarios of emissions for the period 2030-2050. A-C HIA created an interdisciplinary team to study the impacts of climate change on health through air quality changes, and to establish longer-term collaborations between communities. This question has been explored at three spatial scales: global, regional (Europe), and urban (ile-de-France). We f ind that 1.5 millions of cardio-vascular deaths could be delayed each year in 2030 compared to 2010. In Europe, air-pollution-related mortality should decrease in 2030 compared to 2010. At the finer scale (ile-de-France) we found that the respiratory mortality should increase over the highly populated area of Paris. In the coming years, substantial benefits to public health could be achieved through coordinated strategies to reduce emissions of greenhouse gases and improving air quality. (authors)

  1. 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

    of less healthy foods (sugar-sweetened beverages). Further studies are needed to test whether this conclusion holds within a more comprehensive assessment of environmental and nutritional health impacts. Conclusions This case study provides the first quantitative epidemiology-based estimate......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......-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...

  2. System impact research - increasing public health and health care system performance.

    Science.gov (United States)

    Malmivaara, Antti

    2016-01-01

    Interventions directed to system features of public health and health care should increase health and welfare of patients and population. To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. System Impact Research - creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population. Key messages The new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features. SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency, and equality of services. SIR creates the

  3. 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.

  4. Prioritising action on occupational carcinogens in Europe: a socioeconomic and health impact assessment.

    Science.gov (United States)

    Cherrie, J W; Hutchings, S; Gorman Ng, M; Mistry, R; Corden, C; Lamb, J; Sánchez Jiménez, A; Shafrir, A; Sobey, M; van Tongeren, M; Rushton, L

    2017-07-11

    Work-related cancer is an important public health issue with a large financial impact on society. The key European legislative instrument is the Carcinogens and Mutagens Directive (2004/37/EC). In preparation for updating the Directive, the European Commission commissioned a study to provide a socioeconomic, health and environmental impact assessment. The evaluation was undertaken for 25 preselected hazardous substances or mixtures. Estimates were made of the number of cases of cancer attributable to workplace exposure, both currently and in the future, with and without any regulatory interventions, and these data were used to estimate the financial health costs and benefits. It was estimated that if no action is taken there will be >700 000 attributable cancer deaths over the next 60 years for the substances assessed. However, there are only seven substances where the data suggest a clear benefit in terms of avoided cancer cases from introducing a binding limit at the levels considered. Overall, the costs of the proposed interventions were very high (up to [euro ]34 000 million) and the associated monetised health benefits were mostly less than the compliance costs. The strongest cases for the introduction of a limit value are for: respirable crystalline silica, hexavalent chromium, and hardwood dust.

  5. Implementation of health impact assessment in Danish municipal context.

    Science.gov (United States)

    Kraemer, Stella Rebecca Johnsdatter; Nikolajsen, Louise Theilgaard; Gulis, Gabriel

    2014-12-01

    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 policy. Qualitative interviews were conducted in 6 municipalities (3 with HIA inducted in their health policy and 3 without it) gathering information on knowledge and attitudes to HIA, barriers to its implementation, social system and communication channels used or expected to be used for implementation of HIA. No significant differences were found among analyzed municipalities by status of HIA inclusion into health policy. Among barriers; a lack of tools with general validity, a lack of intersectoral working culture, balance between centralized versus participatory way of working and organizational structure of a municipality, and a lack of capacities were enlisted as most relevant. The last one is a crucial factor of an internal social system of a municipality. With regards to communication channels, reporting and presentation skills of implementers and doers are of key importance. Systematic and sustainable capacity building is needed to achieve high level implementation of HIA in Danish municipalities. Development of validated tools, most importantly screening tools with focus on priorities of national public health policy would enhance implementation on municipal level.

  6. The health cost of energy. The health impacts of the different energy sources

    International Nuclear Information System (INIS)

    Masse, Roland

    2017-01-01

    This publication proposes an assessment of impacts of the different energy sources on public health. After a discussion of general aspects regarding this issue, the author addresses the identification and assessment of risks. While referring to different statistical data, he discusses the impacts of accidents in terms of dead, injured or evacuated people. He also addresses health impacts during a normal operation of power plants, i.e. in the case of nuclear plants (issue of exposure to various levels of radiation at the different steps of fuel cycle), of carbon-based plants (health risks and impacts during coal extraction, due to CO 2 emissions and to other toxic emissions, due to atmospheric pollution, identified risks, modelling attempts, assessment of a loss in life expectancy), and of other energies. While acknowledging that there are still many unknowns to assess these health impacts, the author compares these assessments. A summarized version of this article is proposed, in which the author briefly comments data regarding severe accidents related to energy production, discusses health consequences of electric power production and use, and makes a distinction between the most and less hazardous energies as far as public health is concerned

  7. 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

  8. Assessing elders using the functional health pattern assessment model.

    Science.gov (United States)

    Beyea, S; Matzo, M

    1989-01-01

    The impact of older Americans on the health care system requires we increase our students' awareness of their unique needs. The authors discuss strategies to develop skills using Gordon's Functional Health Patterns Assessment for assessing older clients.

  9. Reconstruction of railroads at Klaipéda da National Seaport: Local Health Impact Assessment Case in Lithuania

    Directory of Open Access Journals (Sweden)

    Ingrida Zurlytè

    2007-09-01

    Full Text Available Background: Introduction of health impact assessment (HIA as a national legal requirement for planned economic activity projects in 2002 and the further development of related procedures and methodological requirements has boosted the number of HIAs carried out both as an integrated part of environmental impact assessment (EIA procedures as well as an independent activity. Most of HIAs have been conduct for local projects. The HIA for the reconstruction of the southern section of the railroads in Klaip da National Seaport is one of the local HIAs in Lithuania carried out as an independent procedure. Methods: The HIA for the reconstruction of the southern section of the railroads in Klaipda National Seaport was carried out following the national legal procedure for the cases not foreseen in the Law on Environmental Impact Assessment of Planned Economic Activity and the national HIA methodological regulations. The HIA included a literature review, analysis of related technical documentation, data on existing and estimated air pollution and environmental noise levels and possible health consequences, analysis of local demographic and health statistics; interviews with the residents living in proximity of the planned activity, analysis of public complaints on existing activities at Klaip da National Seaport, site visit and round table discussions with the proponent of the planned activity, planning company and representatives of the public health authority. The standard or intermediate type of perspective HIA was applied. Results: The HIA report has pointed out noise, vibration, ambient air pollution, psychological factors as related to possible negative impact on health of residents living in the mostly exposed locations. Interviews with inhabitants living in proximity of the planned activity have shown that majority of them knew nothing about the reconstruction plans. Recommendations were provided in the report how to minimise

  10. The impact of inclusion criteria in health economic assessments.

    Science.gov (United States)

    Richter, Anke; Thieda, Patricia; Thaler, Kylie; Gartlehner, Gerald

    2011-05-01

    The debate surrounding whether the findings of efficacy studies are applicable to real-world treatment situations is ongoing. The issue of lack of applicability due to a lack of clinical heterogeneity could be addressed by employing less restrictive inclusion criteria. Given that health economic assessments based on cost-effectiveness measures are required by many governments and insurance providers, the impact of this choice may be far reaching. The objective of this article was to explore the use of a pilot study to examine the impact of inclusion criteria on cost-effectiveness results and clinical heterogeneity. A health economic assessment was conducted using QRISK®2 and simulation modelling of different population groups within the pilot study in Lower Austria. Patients were referred by their family physicians to 'Active Prevention' (Vorsorge Aktiv), a community-based lifestyle intervention focused on exercise and nutritional programmes. Cardiovascular risk factors were recorded before and after the intervention and translated to cardiovascular events. As expected, enforcing restrictive inclusion criteria produced stronger and more irrefutable computations - in the expected number of events, the number of deaths, the incremental cost per life-year saved and in the 95% confidence interval. These findings provide insight into the issues surrounding clinical heterogeneity and the need for restrictive inclusion criteria. This is not a full health economic assessment of the intervention. While inclusion criteria provide stronger results by limiting populations to those who would benefit the most, they must be enforced, both within and outside the clinical trial setting. Enforcement has costs, both monetary and arising from unintended negative consequences of enforcement mechanisms. All these considerations will affect the results realized by the payer organization. A pilot study can reveal whether an intervention may be cost effective 'enough' without restrictive

  11. 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.

  12. 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)

  13. 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.

  14. [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.

  15. 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

  16. 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.

  17. The Coffs Harbour 'Our Living City Settlement Strategy' Health Impact Assessment

    International Nuclear Information System (INIS)

    Tugwell, Andrew; Johnson, Pamela

    2011-01-01

    Aim: The short report reviews an experience of conducting a Health Impact Assessment (HIA) in the local government context. The aim of this review was to identify if carrying out an HIA would result in recommendations that could influence council planning and help establish ongoing working relationships between North Coast Area Health Service (NCAHS) staff and the Coffs Harbour City Council. Methods: A process and impact evaluation was conducted on the Coffs Harbour 'Our Living City Settlement Strategy' HIA, which focused on the Coffs Harbour City Council's strategic planning document. Information gained through the evaluation was themed and the findings were reviewed against published information on HIA experience. Main findings: HIA has reported benefits for both the Coffs Harbour City Council and NCAHS as it provides a tool to address many of the issues facing these organisations. Local council has increasing responsibilities including the environment, housing and urban planning, which all have health implications. HIA has been demonstrated as an effective tool for NCAHS staff and the Coffs Harbour City Council to engage and build relationships, increase the understanding of all planning aspects related to health, and most importantly utilise evidence to inform decision making. Conclusion: HIA should be adopted as a key tool to facilitate effective working partnerships between organisations. Improved engagement, partnerships and use of evidence to produce shared outcomes can result from utilising this tool.

  18. Health impact assessment in Latin American countries: Current practice and prospects

    International Nuclear Information System (INIS)

    Pereira, Carlos A.R.; Périssé, André R.S.; Knoblauch, Astrid M.; Utzinger, Jürg; Hacon, Sandra de Souza

    2017-01-01

    Background: With the objective to avoid and mitigate potential adverse health impacts of projects, programmes and policies, health impact assessment (HIA) offers an opportunity for disease prevention and health promotion. Although HIA has gained importance over the past two decades, it is unclear whether and to what extent HIA practice has been established and institutionalised in Latin America. To address this issue, the current practice and prospects of HIA in Latin America was assessed in the peer-reviewed literature and existing guidelines. Methodology: The peer-reviewed literature was systematically searched using five electronic databases until February 2016. Studies were included on a set of pre-defined criteria. The search was carried out in English, French, Portuguese and Spanish. Additionally, a search for HIA guidelines used in Latin American countries and territories was performed by means of a Google search and on websites of government departments and institutions that may promote HIA. Results: The search yielded 167 hits in the peer-reviewed literature of which 17 articles met inclusion criteria. Only four peer-reviewed articles described prospective HIAs and four featured a discussion of the HIA approach. The remaining nine articles presented health impact evaluations. Most studies were published only recently, after 2012 (88%). Seven HIA guideline documents were identified, two of which were country-specific (i.e. Brazil and Mexico) and the remaining five addressed HIA at the regional level. Conclusions: This study confirmed the paucity of literature pertaining to HIA implementation, as well as HIA guidelines in Latin America. Mexico, Brazil and Cuba have the longest track record in scientific literature and guidelines on HIA. In order to better understand current barriers and limitations to practice and institutionalisation of HIA in Latin American countries, a broad discussion among policy makers, academic institutions and HIA practitioners is

  19. Assessing the human health impacts of exposure to disinfection by-products--a critical review of concepts and methods.

    Science.gov (United States)

    Grellier, James; Rushton, Lesley; Briggs, David J; Nieuwenhuijsen, Mark J

    2015-05-01

    Understanding the public health implications of chemical contamination of drinking water is important for societies and their decision-makers. The possible population health impacts associated with exposure to disinfection by-products (DBPs) are of particular interest due to their potential carcinogenicity and their widespread occurrence as a result of treatments employed to control waterborne infectious disease. We searched the literature for studies that have attempted quantitatively to assess population health impacts and health risks associated with exposure to DBPs in drinking water. We summarised and evaluated these assessments in terms of their objectives, methods, treatment of uncertainties, and interpretation and communication of results. In total we identified 40 studies matching our search criteria. The vast majority of studies presented estimates of generic cancer and non-cancer risks based on toxicological data and methods that were designed with regulatory, health-protective purposes in mind, and therefore presented imprecise and biased estimates of health impacts. Many studies insufficiently addressed the numerous challenges to DBP risk assessment, failing to evaluate the evidence for a causal relationship, not appropriately addressing the complex nature of DBP occurrence as a mixture of chemicals, not adequately characterising exposure in space and time, not defining specific health outcomes, not accounting for characteristics of target populations, and not balancing potential risks of DBPs against the health benefits related with drinking water disinfection. Uncertainties were often poorly explained or insufficiently accounted for, and important limitations of data and methods frequently not discussed. Grave conceptual and methodological limitations in study design, as well as erroneous use of available dose-response data, seriously impede the extent to which many of these assessments contribute to understanding the public health implications of

  20. 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.

  1. Methodologies of health impact assessment as part of an integrated approach to reduce effects of air pollution

    OpenAIRE

    Aunan, Kristin; Seip, Hans Martin

    1995-01-01

    Quantification of average frequencies of health effects on a population level is an essential part of an integrated assessment of pollution effects. Epidemiological studies seem to provide the best basis for such estimates. This paper gives an introduction to a methodology for health impact assessment. It also gives results from some selected parts of a case-study in Hungary. This study is aimed at testing and improving the methodology for integrated assessment and focuses on energy productio...

  2. 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/

  3. Hazard Ranking Methodology for Assessing Health Impacts of Unconventional Natural Gas Development and Production: The Maryland Case Study.

    Directory of Open Access Journals (Sweden)

    Meleah D Boyle

    Full Text Available The recent growth of unconventional natural gas development and production (UNGDP has outpaced research on the potential health impacts associated with the process. The Maryland Marcellus Shale Public Health Study was conducted to inform the Maryland Marcellus Shale Safe Drilling Initiative Advisory Commission, State legislators and the Governor about potential public health impacts associated with UNGDP so they could make an informed decision that considers the health and well-being of Marylanders. In this paper, we describe an impact assessment and hazard ranking methodology we used to assess the potential public health impacts for eight hazards associated with the UNGDP process. The hazard ranking included seven metrics: 1 presence of vulnerable populations (e.g. children under the age of 5, individuals over the age of 65, surface owners, 2 duration of exposure, 3 frequency of exposure, 4 likelihood of health effects, 5 magnitude/severity of health effects, 6 geographic extent, and 7 effectiveness of setbacks. Overall public health concern was determined by a color-coded ranking system (low, moderately high, and high that was generated based on the overall sum of the scores for each hazard. We provide three illustrative examples of applying our methodology for air quality and health care infrastructure which were ranked as high concern and for water quality which was ranked moderately high concern. The hazard ranking was a valuable tool that allowed us to systematically evaluate each of the hazards and provide recommendations to minimize the hazards.

  4. System impact research – increasing public health and health care system performance

    Science.gov (United States)

    Malmivaara, Antti

    2016-01-01

    Abstract Background Interventions directed to system features of public health and health care should increase health and welfare of patients and population. Aims To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). Methods The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. Results The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. Conclusions System Impact Research – creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population.Key messagesThe new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features.SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency

  5. 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.

  6. Multi-model assessment of health impacts of air pollution in Europe and the U.S.

    Science.gov (United States)

    Im, Ulas; Brandt, Jørgen; Christensen, Jesper H.; Geels, Camilla; Hansen, Kaj M.; Andersen, Mikael S.; Solazzo, Efisio; Hogrefe, Christian; Galmarini, Stefano

    2017-04-01

    According to the World Health Organization (WHO), air pollution is now the world's largest single environmental health risk. Assessments of health impacts and the associated external costs related to air pollution are estimated based on observed and/or modelled air pollutant levels. Chemistry and transport models (CTMs) are useful tools to calculate the concentrations of health-related pollutants taking into account the non-linearities in the chemistry and the complex interactions between meteorology and chemistry. However, the CTMs include different chemical and aerosol schemes that introduce differences in the representation of the processes. Likewise, will differences in the emissions and boundary conditions used in the models add to the overall uncertainties. These uncertainties are introduced also into the health impact estimates using output from the CTMs. Multi-model (MM) ensembles can be useful to minimize these uncertainties introduced by the individual CTMs. In the present study, the simulated surface concentrations of health related air pollutants for the year 2010 from fifteen modelling groups participating in the AQMEII exercise, serve as input to the Economic Valuation of Air Pollution model (EVA), in order to calculate the impacts of these pollutants on human health and the associated external costs in Europe and U.S. In addition, the impacts of a 20% global emission reduction scenario on the human health and associated costs have been calculated. Preliminary results show that in Europe and U.S., the MM mean number of premature deaths due to air pollution is calculated to be 400 000 and 160 000, respectively. Estimated health impacts among different models can vary up to a factor of 3 and 1.2 in Europe and U.S., respectively. PM is calculated to be the major pollutant affecting the health impacts and the differences in models regarding the treatment of aerosol composition, physics and dynamics is a key factor. The total MM mean costs due to health

  7. 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

  8. Is it worth it? Patient and public views on the impact of their involvement in health research and its assessment: a UK-based qualitative interview study.

    Science.gov (United States)

    Crocker, Joanna C; Boylan, Anne-Marie; Bostock, Jennifer; Locock, Louise

    2017-06-01

    There are mounting calls for robust, critical evaluation of the impact of patient and public involvement (PPI) in health research. However, questions remain about how to assess its impact, and whether it should be assessed at all. The debate has thus far been dominated by professionals. To explore the views of PPI contributors involved in health research regarding the impact of PPI on research, whether and how it should be assessed. Qualitative interview study. Thirty-eight PPI contributors involved in health research across the UK. Participants felt that PPI has a beneficial impact on health research. They described various impactful roles, which we conceptualize as the 'expert in lived experience', the 'creative outsider', the 'free challenger', the 'bridger', the 'motivator' and the 'passive presence'. Participants generally supported assessing the impact of PPI, while acknowledging the challenges and concerns about the appropriateness and feasibility of measurement. They expressed a range of views about what impacts should be assessed, by whom and how. Individual feedback on impact was seen as an important driver of improved impact and motivation to stay involved. While there appears to be widespread support for PPI impact assessment among PPI contributors, their views on what to assess and how are diverse. PPI contributors should be involved as equal partners in debates and decisions about these issues. Individual feedback on impact may increase PPI contributors' potential impact and their motivation to stay involved. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  9. 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.

  10. Health impacts of large dams

    International Nuclear Information System (INIS)

    Lerer, L.B.

    1999-01-01

    Large dams have been criticized because of their negative environmental and social impacts. Public health interest largely has focused on vector-borne diseases, such as schistosomiasis, associated with reservoirs and irrigation projects. Large dams also influence health through changes in water and food security, increases in communicable diseases, and the social disruption caused by construction and involuntary resettlement. Communities living in close proximity to large dams often do not benefit from water transfer and electricity generation revenues. A comprehensive health component is required in environmental and social impact assessments for large dam projects

  11. A new approach to criteria for health risk assessment

    International Nuclear Information System (INIS)

    Spickett, Jeffery; Katscherian, Dianne; Goh, Yang Miang

    2012-01-01

    Health Impact Assessment (HIA) is a developing component of the overall impact assessment process and as such needs access to procedures that can enable more consistent approaches to the stepwise process that is now generally accepted in both EIA and HIA. The guidelines developed during this project provide a structured process, based on risk assessment procedures which use consequences and likelihood, as a way of ranking risks to adverse health outcomes from activities subjected to HIA or HIA as part of EIA. The aim is to assess the potential for both acute and chronic health outcomes. The consequences component also identifies a series of consequences for the health care system, depicted as expressions of financial expenditure and the capacity of the health system. These more specific health risk assessment characteristics should provide for a broader consideration of health consequences and a more consistent estimation of the adverse health risks of a proposed development at both the scoping and risk assessment stages of the HIA process. - Highlights: ► A more objective approach to health risk assessment is provided. ► An objective set of criteria for the consequences for chronic and acute impacts. ► An objective set of criteria for the consequences on the health care system. ► An objective set of criteria for event frequency that could impact on health. ► The approach presented is currently being trialled in Australia.

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

    Energy Technology Data Exchange (ETDEWEB)

    McCallum, Lindsay C., E-mail: lindsay.mccallum@mail.utoronto.ca [University of Toronto, Department of Physical and Environmental Sciences, 1265 Military Trail, Toronto, Ontario M1C 1A4 (Canada); Intrinsik Environmental Sciences Inc., 6605 Hurontario Street, Mississauga, Ontario L5T0A3 (Canada); Ollson, Christopher A., E-mail: collson@intrinsik.com [Intrinsik Environmental Sciences Inc., 6605 Hurontario Street, Mississauga, Ontario L5T0A3 (Canada); Stefanovic, Ingrid L., E-mail: fenvdean@sfu.ca [Simon Fraser University, Faculty of Environment, 8888 University Drive, Burnaby, British Columbia V5A 1S6 (Canada)

    2015-11-15

    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.

  13. Health impact assessment: A comparison of 45 local, national, and international guidelines

    International Nuclear Information System (INIS)

    Hebert, Katherine A.; Wendel, Arthur M.; Kennedy, Sarah K.; Dannenberg, Andrew L.

    2012-01-01

    This article provides a comparison of health impact assessment (HIA) guidelines from around the world and for multiple geographic scales. We identify commonalities and differences within HIA guides to discuss the plausibility of consensus guidelines and to inform guideline development. The practice of HIA has grown over the last two decades with a concurrent growth of HIA guides. This study expands on earlier review work and includes guides published since 2007 (Mindell, Boltong and Forde, 2008). From April 2010 to October 2011, 45 HIA guides were identified through an internet search and review of previous research. Common characteristics, key features, and the HIA process were analyzed. The 45 documents recommended similar but not identical processes for conducting HIAs. These analyses suggest that guidelines for HIAs are similar in many areas of the world and that new HIA practitioners can use these findings to inform their approach. Further discussion is needed to determine if the approaches established in these guidelines are followed and if one set of common guidelines could be written for use in numerous countries and regions. - Highlights: ► We analyze 45 health impact assessment (HIA) guidelines worldwide. ► We examine similarities and unique attributes of each guideline. ► We discuss the advantages and disadvantages of developing consensus guidelines. ► Identifying additional guidelines aides in future HIA work and evaluation.

  14. 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

  15. 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.

  16. The Impact of Health Insurance on Health Care Provision in ...

    African Journals Online (AJOL)

    This study assesses the impact of the NHIS scheme in promoting access to health care. It identifies a need for all stakeholders to engage in the active promotion of awareness on health insurance as option of health care provisioning. It argues that health insurance can make health care more accessible to a wider segment ...

  17. 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)

  18. 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

  19. Conceptualising the effectiveness of impact assessment processes

    Energy Technology Data Exchange (ETDEWEB)

    Chanchitpricha, Chaunjit, E-mail: chaunjit@g.sut.ac.th [School of Environmental Health, Suranaree University of Technology, 111 University Avenue, Maung District, Nakhon Ratchasima 30000 (Thailand); Bond, Alan, E-mail: alan.bond@uea.ac.uk [School of Environmental Sciences, University of East Anglia, Norwich NR4 7TJ (United Kingdom); Unit for Environmental Sciences and Management School of Geo and Spatial Sciences, Internal Box 375, North West University (Potchefstroom campus) (South Africa)

    2013-11-15

    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.

  20. Approaches to health assessment related to housing

    NARCIS (Netherlands)

    Guerra Santin, O.

    2006-01-01

    This research had the purpose of providing more information about possible approaches and indicators to measure indoor health in relation to housing. In researches related with health and some Life Cycle Assessment (LCA) databases, the model used for health assessment is the Impact Pathway Analysis

  1. Managing partnerships and impact on decision-making: the example of health technology assessment in genetics.

    Science.gov (United States)

    Blancquaert, Ingeborg

    2006-01-01

    For an emerging field such as Public Health Genetics, the partnerships that will be developed with stakeholders are of strategic importance, since they may affect long-term impact on policy-making. A concrete example in the field of health technology assessment in genetics was chosen to illustrate how the context in which scientific advisory bodies operate and the nature of partnerships developed over time influence the impact on decision-making at different levels, from the micro (professional) level through the meso (institutional) level to the macro (policy) level. As pointed out in the knowledge transfer literature, impact is not only reflected by instrumental use of knowledge, but also by problem-framing and strategic use of knowledge. Solid partnerships at the micro level, with researchers and health care professionals, are essential to build credibility and trust, and they lay the groundwork for contextualized and relevant advice and potential impact at the policy level. Even though maintaining the necessary critical distance with respect to all stakeholders is easier for institutions that are at arm's length from government, achieving the right balance between an institution's independence and service relationship is a real challenge. Copyright (c) 2006 S. Karger AG, Basel.

  2. 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.

  3. 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

  4. 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

  5. Methodologies of health impact assessment as part of an integrated approach to reduce effects of air pollution

    Energy Technology Data Exchange (ETDEWEB)

    Aunan, K; Seip, H M

    1995-12-01

    Quantification of average frequencies of health effects on a population level is an essential part of an integrated assessment of pollution effects. Epidemiological studies seem to provide the best basis for such estimates. This paper gives an introduction to a methodology for health impact assessment and also the results from selected parts of a case study in Hungary. This case study is aimed at testing and improving the methodology for integrated assessment and focuses on energy production and consumption and implications for air pollution. Using monitoring data from Budapest, the paper gives estimates of excess frequencies of respiratory illness, mortality and other health end-points. For a number of health end-points, particles probably may serve as a good indicator component. Stochastic simulation is used to illustrate the uncertainties imbedded in the exposure-response function applied. The paper uses the ``bottom up approach`` to find cost-effective abatement strategies against pollution damages, where specific abatement measures such as emission standards for vehicles are explored in detail. It is concluded that in spite of large uncertainties in every step of the analysis, an integrated assessment of costs and benefits of different abatement measures is valuable as it clarifies the main objectives of an abatement policy and explicitly describes the adverse impacts of different activities and their relative importance. 46 refs., 11 figs., 2 tabs.

  6. 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.

  7. Assessment on health and energy sources

    International Nuclear Information System (INIS)

    Acket, C.; Yvon, M.

    2013-01-01

    After having recalled some issues related to the prevention of environmental health risks and mentioned in the preparation of the debate on energy transition in France, this document gathers actual objective elements for an assessment of health impact of the different energy sources. It discusses the impacts on health (mortality, sicknesses and diseases) of fossil fuels (coal and its wastes, gas), of renewable energies, of nuclear energy. For this last one, the document outlines the lack of documentation for various topics, discusses some results published on the dose impact of nuclear operation, and comment the issue of waste storage. It also recalls the main accidents (Three Mile Island, Chernobyl, and Fukushima) and some of the known and assessed impacts. The third part proposes comparisons between the different energy sources in terms of deadly accidents, of pollution and greenhouse effect (current and late mortality), of released radioactivity (release sources and collective dose). In conclusion, the authors outline that the impact on health of environmental risks must be one of the essential issues for the definition of energy policy, and discuss the resulting implications. Various data are provided in appendix: energy in France and in the world, origins of radioactivity

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

    International Nuclear Information System (INIS)

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

    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 kilometers and a share of 50% electric-powered private vehicle kilometers) on particulate matter (PM 2.5 ), 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. Results: 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 PM 2.5 and EC by around 40% and 60% respectively, from 2010 to 2020. Discussion: 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. - Highlights: • We estimated co-benefits of greenhouse gas reduction policies from 2010 to 2020. • The city scale health impact assessment base on real transport policy scenarios. • Effects of particulate matter, elemental carbon and noise on health are assessed. • The effects are rather

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

    Energy Technology Data Exchange (ETDEWEB)

    Tobollik, Myriam, E-mail: mtobollik@uni-bielefeld.de [School of Public Health, Bielefeld University, Bielefeld (Germany); German Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Corrensplatz 1, 14195 Berlin (Germany); Keuken, Menno [Netherlands Applied Research Organization (TNO), Utrecht (Netherlands); Sabel, Clive [School of Geographical Sciences, University of Bristol, Bristol (United Kingdom); Cowie, Hilary [Institute of Occupational Medicine, Edinburgh (United Kingdom); Tuomisto, Jouni [National Institute for Health and Welfare Kuopio, Kuopio (Finland); Sarigiannis, Denis [Aristotle University of Thessaloniki, Thessaloniki (Greece); Künzli, Nino; Perez, Laura [Swiss Tropical and Public Health Institute, Basel (Switzerland); University of Basel, Basel (Switzerland); Mudu, Pierpaolo, E-mail: mudup@ecehbonn.euro.who.int [WHO European Centre for Environment and Health, World Health Organization Regional Office for Europe, Bonn (Germany)

    2016-04-15

    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 kilometers and a share of 50% electric-powered private vehicle kilometers) on particulate matter (PM{sub 2.5}), 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. Results: 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 PM{sub 2.5} and EC by around 40% and 60% respectively, from 2010 to 2020. Discussion: 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. - Highlights: • We estimated co-benefits of greenhouse gas reduction policies from 2010 to 2020. • The city scale health impact assessment base on real transport policy scenarios. • Effects of particulate matter, elemental carbon and noise on health are assessed. • The effects are

  10. A health equity impact assessment umbrella program (AAPRISS) to tackle social inequalities in health: program description.

    Science.gov (United States)

    Lang, Thierry; Bidault, Elsa; Villeval, Mélanie; Alias, François; Gandouet, Benjamin; Servat, Martine; Theis, Ivan; Breton, Eric; Haschar-Noé, Nadine; Grosclaude, Pascale

    2016-09-01

    The failure to simultaneously address two objectives (increasing the average health of the population and reducing health inequalities) may have led to what has been observed in France so far: an overall decrease in mortality and increase in inequality. The Apprendre et Agir pour Réduire les Inégalités Sociales de Santé (AAPRISS) methodology is to analyze and modify interventions that are already underway in terms of their potential impact on health inequalities. It relies on partnership between researchers and actors in the health field, as well as policy makers. In this paper, we describe the program and discuss its feasibility and acceptability. This program is not a single intervention, but a process aiming at assessing and reshaping existing health programs, therefore acting as a kind of meta-intervention. The program develops scientific and methodological support stemming from co-construction methods aimed at increasing equity within the programs. Stakeholders from prevention policy-making and the health care system, as well as researchers, collaborate in defining interventions, monitoring their progress, and choosing indicators, methods and evaluation procedures. The target population is mainly the population of the greater Toulouse area. The steps of the process are described: (1) establishment of AAPRISS governance and partnerships; (2) inclusion of projects; and (3) the projects' process. Many partners have rallied around this program, which has been shown to be feasible and acceptable by partners and health actors. A major challenge is understanding each partner's expectations in terms of temporality of interventions, expected outcomes, assessment methods and indicators. Analyzing the projects has been quite feasible, and some modifications have been implemented in them in order to take inequalities in health into account. © The Author(s) 2015.

  11. 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

  12. 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

  13. 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.

  14. A multi-scale health impact assessment of air pollution over the 21st century.

    Science.gov (United States)

    Likhvar, Victoria N; Pascal, Mathilde; Markakis, Konstantinos; Colette, Augustin; Hauglustaine, Didier; Valari, Myrto; Klimont, Zbigniew; Medina, Sylvia; Kinney, Patrick

    2015-05-01

    Ozone and PM₂.₅ are current risk factors for premature death all over the globe. In coming decades, substantial improvements in public health may be achieved by reducing air pollution. To better understand the potential of emissions policies, studies are needed that assess possible future health impacts under alternative assumptions about future emissions and climate across multiple spatial scales. We used consistent climate-air-quality-health modeling framework across three geographical scales (World, Europe and Ile-de-France) to assess future (2030-2050) health impacts of ozone and PM₂.₅ under two emissions scenarios (Current Legislation Emissions, CLE, and Maximum Feasible Reductions, MFR). Consistently across the scales, we found more reductions in deaths under MFR scenario compared to CLE. 1.5 [95% CI: 0.4, 2.4] million CV deaths could be delayed each year in 2030 compared to 2010 under MFR scenario, 84% of which would occur in Asia, especially in China. In Europe, the benefits under MFR scenario (219000 CV deaths) are noticeably larger than those under CLE (109,000 CV deaths). In Ile-de-France, under MFR more than 2830 annual CV deaths associated with PM₂.₅ changes could be delayed in 2050 compared to 2010. In Paris, ozone-related respiratory mortality should increase under both scenarios. Multi-scale HIAs can illustrate the difference in direct consequences of costly mitigation policies and provide results that may help decision-makers choose between different policy alternatives at different scales. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. The Impact of a Computerized Dietary Assessment on Nutrition Knowledge

    Science.gov (United States)

    Hensleigh, Katherine Elizabeth; Eddy, James M.; Wang, Min Qi; Dennison, Darwin; Chaney, J. Don

    2004-01-01

    In recent years, many health educators have integrated computer applications into their health education program interventions. The assessment of the impact of these interventions is limited. This study assessed the impact of the Pyramid Challenge nutrition software program on nutrition knowledge levels of students enrolled in traditional personal…

  16. 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

    2018-04-01

    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.

  17. Impacts of Climate Change on Human Health in the United ...

    Science.gov (United States)

    Climate change threatens human health and well-being in the United States. To address this growing threat, the Interagency Group on Climate Change and Human Health (CCHHG), a working group of the U.S. Global Change Research Program’s (USGCRP), has developed this assessment as part of the ongoing efforts of the USGCRP’s National Climate Assessment (NCA) and as called for under the President’s Climate Action Plan. The authors of this assessment have compiled and assessed current research on human health impacts of climate change and summarized the current “state of the science” for a number of key impact areas. This assessment provides a comprehensive update to the most recent detailed technical assessment for the health impacts of climate change, 2008 Synthesis and Assessment Product 4.6 (SAP 4.6) Analyses of the Effects of Global Change on Human Health and Welfare and Human Systems (CCSP 2008). It also updates and builds upon the health chapter of the third NCA (Melillo et al. 2014). The lead and coordinating Federal agencies for the USGCRP Climate and Health Assessment are the Centers for Disease Control and Prevention (CDC), Environmental Protection Agency (EPA), National Institute of Health (NIH), and National Oceanic and Atmospheric Administration (NOAA). Available at https://health2016.globalchange.gov/ The interagency U.S. Global Change Research Program (USGCRP) has developed this assessment as part of the ongoing efforts of their National C

  18. Health economic assessment: a methodological primer.

    Science.gov (United States)

    Simoens, Steven

    2009-12-01

    This review article aims to provide an introduction to the methodology of health economic assessment of a health technology. Attention is paid to defining the fundamental concepts and terms that are relevant to health economic assessments. The article describes the methodology underlying a cost study (identification, measurement and valuation of resource use, calculation of costs), an economic evaluation (type of economic evaluation, the cost-effectiveness plane, trial- and model-based economic evaluation, discounting, sensitivity analysis, incremental analysis), and a budget impact analysis. Key references are provided for those readers who wish a more advanced understanding of health economic assessments.

  19. Health Economic Assessment: A Methodological Primer

    Directory of Open Access Journals (Sweden)

    Steven Simoens

    2009-11-01

    Full Text Available This review article aims to provide an introduction to the methodology of health economic assessment of a health technology. Attention is paid to defining the fundamental concepts and terms that are relevant to health economic assessments. The article describes the methodology underlying a cost study (identification, measurement and valuation of resource use, calculation of costs, an economic evaluation (type of economic evaluation, the cost-effectiveness plane, trial- and model-based economic evaluation, discounting, sensitivity analysis, incremental analysis, and a budget impact analysis. Key references are provided for those readers who wish a more advanced understanding of health economic assessments.

  20. 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

  1. 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

  2. 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.

  3. Cumulative Risk Assessment (CRA): transforming the way we assess health risks.

    Science.gov (United States)

    Williams, Pamela R D; Dotson, G Scott; Maier, Andrew

    2012-10-16

    Human health risk assessments continue to evolve and now focus on the need for cumulative risk assessment (CRA). CRA involves assessing the combined risk from coexposure to multiple chemical and nonchemical stressors for varying health effects. CRAs are broader in scope than traditional chemical risk assessments because they allow for a more comprehensive evaluation of the interaction between different stressors and their combined impact on human health. Future directions of CRA include greater emphasis on local-level community-based assessments; integrating environmental, occupational, community, and individual risk factors; and identifying and implementing common frameworks and risk metrics for incorporating multiple stressors.

  4. Impact on Health-Related Quality of Life in Adults with Eosinophilic Gastritis and Gastroenteritis: A Qualitative Assessment.

    Science.gov (United States)

    Bedell, Alyse; Taft, Tiffany; Craven, Meredith R; Guadagnoli, Livia; Hirano, Ikuo; Gonsalves, Nirmala

    2018-05-01

    Eosinophilic gastritis (EG) and eosinophilic gastroenteritis (EGE) are chronic immune-mediated conditions of the digestive tract, which affect the stomach only, or the stomach and small intestines, respectively. Though these disorders are uncommon, they are being increasingly recognized and diagnosed. While health-related quality of life (HRQOL) has been evaluated in other eosinophilic gastrointestinal diseases, this study is the first to describe HRQOL impacts unique to EG/EGE. This study aims to qualitatively describe experiences of adults diagnosed with EG and EGE. We aim to identify impacts on HRQOL in this population in order to inform clinical care and assessment. Seven patients diagnosed with EG or EGE participated in semi-structured interviews assessing common domains of HRQOL. Four distinct themes emerged from qualitative analyses, which represent impacts to HRQOL: the psychological impact of the diagnosis, impact on social relationships, financial impact, and impact on the body. These generally improved over time and with effective treatment. This study demonstrated that patients with EG/EGE experience impacts to HRQOL, some of which differ from HRQOL of other eosinophilic gastrointestinal diseases. These results support the development of a disease-specific measure, or adaptation of an existing measure, to assess HRQOL in EG/EGE.

  5. 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. PMID:12894324

  6. 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.

  7. The impact of using visual images of the body within a personalized health risk assessment: an experimental study.

    Science.gov (United States)

    Hollands, Gareth J; Marteau, Theresa M

    2013-05-01

    To examine the motivational impact of the addition of a visual image to a personalized health risk assessment and the underlying cognitive and emotional mechanisms. An online experimental study in which participants (n = 901; mean age = 27.2 years; 61.5% female) received an assessment and information focusing on the health implications of internal body fat and highlighting the protective benefits of physical activity. Participants were randomized to receive this in either (a) solely text form (control arm) or (b) text plus a visual image of predicted internal body fat (image arm). Participants received information representing one of three levels of health threat, determined by how physically active they were: high, moderate or benign. Main outcome measures were physical activity intentions (assessed pre- and post-intervention), worry, coherence and believability of the information. Intentions to undertake recommended levels of physical activity were significantly higher in the image arm, but only amongst those participants who received a high-threat communication. Believability of the results received was greater in the image arm and mediated the intervention effect on intentions. The addition of a visual image to a risk assessment led to small but significant increases in intentions to undertake recommended levels of physical activity in those at increased health risk. Limitations of the study and implications for future research are discussed. What is already known on this subject? Health risk information that is personalized to the individual may more strongly motivate risk-reducing behaviour change. Little prior research attention has been paid specifically to the motivational impact of personalized visual images and underlying mechanisms. What does this study add? In an experimental design, it is shown that receipt of visual images increases intentions to engage in risk-reducing behaviour, although only when a significant level of threat is presented. The

  8. The impact of mHealth interventions on health systems: a systematic review protocol.

    Science.gov (United States)

    Fortuin, Jill; Salie, Faatiema; Abdullahi, Leila H; Douglas, Tania S

    2016-11-25

    Mobile health (mHealth) has been described as a health enabling tool that impacts positively on the health system in terms of improved access, quality and cost of health care. The proposed systematic review will examine the impact of mHealth on health systems by assessing access, quality and cost of health care as indicators. The systematic review will include literature from various sources including published and unpublished/grey literature. The databases to be searched include: PubMed, Cochrane Library, Google Scholar, NHS Health Technology Assessment Database and Web of Science. The reference lists of studies will be screened and conference proceedings searched for additional eligible reports. Literature to be included will have mHealth as the primary intervention. Two authors will independently screen the search output, select studies and extract data; discrepancies will be resolved by consensus and discussion with the assistance of the third author. The systematic review will inform policy makers, investors, health professionals, technologists and engineers about the impact of mHealth in strengthening the health system. In particular, it will focus on three metrics to determine whether mHealth strengthens the health system, namely quality of, access to and cost of health care services. Systematic review registration: PROSPERO CRD42015026070.

  9. Exploring available options in characterising the health impact of industrially contaminated sites.

    Science.gov (United States)

    Pasetto, Roberto; Martin-Olmedo, Piedad; Martuzzi, Marco; Iavarone, Ivano

    2016-01-01

    Industrially contaminated sites (ICS) are of high concern from an environmental public health perspective, since industrial plants may produce a widespread contamination that can result in several health impacts on the populations living in their neighbourhood. The objective of this contribution is to briefly explore available options in studying the health impact of ICS, mainly referring to information provided by documents and activities developed by the WHO and the WHO Collaborating Center for Environmental Health in Contaminated Sites. In current practice the health impact of ICS is evaluated using studies and assessments falling in two broad types of strategies: one based on epidemiology and the other on risk assessment methods. In recent years, traditional approaches to assess relationships between environmental risks and health has been evolved considering the intricate nature between them and other factors. New developments should be explored in the context of ICS to find common strategies and tools to assess their impacts and to guide public health interventions.

  10. Health Impact Assessment (HIA) of Proposed Code Changes Regarding Onsite Sewage Disposal Systems in Suffolk County, NY

    Science.gov (United States)

    The U.S. Environmental Protection Agency (EPA) conducted a Health Impact Assessment (HIA) of proposed code changes regarding residential onsite sewage disposal systems (OSDS) in Suffolk County, New York. Of the approximately 569,000 housing units in Suffolk County, 365,000 are no...

  11. Methodology for comparative assessment of various electricity generation systems using health and environmental impacts as the indicators

    International Nuclear Information System (INIS)

    Takahara, Shogo; Homma, Toshimitsu; Matsuki, Yoshio; Muramatsu, Ken

    2010-12-01

    This report describes the procedure of the comparative risk assessment, which is the standard approach to compare health and environmental impacts of different electricity generation systems, together with the results of the assessments and the international consensus. While there are several approaches to compare the impacts, the Impact Pathway (Damage Function) Approach is known as a popular method. This approach is characterized as the methodology that considers the emissions from power plants and the other sources, the dispersions of those pollutants, and then the impacts to the recipients of the pollutants; while, the scope of the assessments, such as types of the fuel chains as well as the time and the space of the impacts, needs to be defined upon the purpose, and the data and the model need to be justified through the process of the assessment. This approach was examined at the Coordinated Research Programme (hereinafter, 'CRP), which the International Atomic Energy Agency (hereinafter, 'IAEA) implemented with the research institutes of 12 countries on the comparative risk assessment. Upon the results of the assessments made by the CRP of the IAEA and the ExternE of the European Commission (hereinafter 'EC'), it is concluded that the impacts of the fossil fuel (coal, oil and natural gas) chains are relatively larger than of the other fuel chains, especially when the secondary chemical transformation of the pollutants and the effects of global warming are considered. On the contrary, the impacts of nuclear fuel cycle are smaller than of the fossil fuel chains'; although, there are still needs for further consensus building on the risks of the severe accidents and on the impacts of long-lived radio-nuclides spreading on the global level. (author)

  12. The inclusion of migrants in health impact assessments: A scoping review

    Energy Technology Data Exchange (ETDEWEB)

    Benkhalti Jandu, Maria, E-mail: mbenkhal@uottawa.ca [University of Ottawa, Institute of Population Health, 1 Stewart Street, Suite 201, Ottawa, ON K1N 6N5 (Canada); Canuto de Medeiros, Bruno, E-mail: aporo@hotmail.com [University of Ottawa, Institute of Population Health, 1 Stewart Street, Suite 201, Ottawa, ON K1N 6N5 (Canada); Bourgeault, Ivy, E-mail: Ivy.Bourgeault@uottawa.ca [University of Ottawa, Interdisciplinary School of Health Sciences, 1 Stewart Street, Suite 207, Ottawa, ON K1N 6N5 (Canada); Tugwell, Peter, E-mail: Tugwell.BB@uottawa.ca [University of Ottawa, Department of Medicine, Faculty of Medicine, K1H 8M5 Ottawa (Canada); Ottawa Hospital Research Institute, Clinical Epidemiology Program, K1Y 4E9 Ottawa (Canada); University of Ottawa, Department of Epidemiology and Community Medicine, Faculty of Medicine, K1H 8M5 Ottawa (Canada); Institute of Population Health, University of Ottawa, K1N 6N5 Ottawa (Canada)

    2015-01-15

    This article reports the findings of a scoping review assessing the extent and ways in which migrants have been included in health impact assessments (HIAs) and HIA evaluations worldwide. A total of 117 HIAs and two HIA evaluations were included. Only 14% of hand-searched HIAs mentioned migrants, 5% analysed migrants and only 2% included them in their recommendations. Nonetheless, migrants would be expected to be part of the analysis based on the reasons for which migrants were most commonly mentioned. Although the majority of HIAs included in the review mentioned migrants in baseline conditions and impact analysis steps, migrants were seldom included in recommendations. Furthermore, the use of frameworks or tools guiding the completion of an HIA was negatively associated with the inclusion of migrants in recommendations. This is a pivotal risk of frameworks not mentioning migrants. Although workshops and stakeholder engagement were a frequent way of including migrants in HIAs, this usually involved organizations representing migrants, and only seldom included members of the migrant community themselves. The main barriers to including migrants in the HIA impact analysis were the lack of available data on migrants and the significant additional resources required to gather and analyse additional data on migrants. Guidance is needed on ways to optimally include migrants in HIAs and ensure that recommendations for mitigation measures are optimal. - Highlights: • Scoping review found 14% of hand-searched HIAs mentioned migrants • Migrants are seldom mentioned in recommendations even when analysed • Guiding frameworks can hinder the inclusion of migrants if not explicitly mentioned • Often migrants organizations are the ones included in engagement • Main barriers to including migrants are available data and resources required.

  13. The inclusion of migrants in health impact assessments: A scoping review

    International Nuclear Information System (INIS)

    Benkhalti Jandu, Maria; Canuto de Medeiros, Bruno; Bourgeault, Ivy; Tugwell, Peter

    2015-01-01

    This article reports the findings of a scoping review assessing the extent and ways in which migrants have been included in health impact assessments (HIAs) and HIA evaluations worldwide. A total of 117 HIAs and two HIA evaluations were included. Only 14% of hand-searched HIAs mentioned migrants, 5% analysed migrants and only 2% included them in their recommendations. Nonetheless, migrants would be expected to be part of the analysis based on the reasons for which migrants were most commonly mentioned. Although the majority of HIAs included in the review mentioned migrants in baseline conditions and impact analysis steps, migrants were seldom included in recommendations. Furthermore, the use of frameworks or tools guiding the completion of an HIA was negatively associated with the inclusion of migrants in recommendations. This is a pivotal risk of frameworks not mentioning migrants. Although workshops and stakeholder engagement were a frequent way of including migrants in HIAs, this usually involved organizations representing migrants, and only seldom included members of the migrant community themselves. The main barriers to including migrants in the HIA impact analysis were the lack of available data on migrants and the significant additional resources required to gather and analyse additional data on migrants. Guidance is needed on ways to optimally include migrants in HIAs and ensure that recommendations for mitigation measures are optimal. - Highlights: • Scoping review found 14% of hand-searched HIAs mentioned migrants • Migrants are seldom mentioned in recommendations even when analysed • Guiding frameworks can hinder the inclusion of migrants if not explicitly mentioned • Often migrants organizations are the ones included in engagement • Main barriers to including migrants are available data and resources required

  14. 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...

  15. [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

  16. 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.

  17. 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.

  18. 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.

  19. Encouraging translation and assessing impact of the Centre for Research Excellence in Integrated Quality Improvement: rationale and protocol for a research impact assessment.

    Science.gov (United States)

    Ramanathan, Shanthi; Reeves, Penny; Deeming, Simon; Bailie, Ross Stewart; Bailie, Jodie; Bainbridge, Roxanne; Cunningham, Frances; Doran, Christopher; McPhail Bell, Karen; Searles, Andrew

    2017-12-04

    There is growing recognition among health researchers and funders that the wider benefits of research such as economic, social and health impacts ought to be assessed and valued alongside academic outputs such as peer-reviewed papers. Research translation needs to increase and the pathways to impact ought to be more transparent. These processes are particularly pertinent to the Indigenous health sector given continued concerns that Indigenous communities are over-researched with little corresponding improvement in health outcomes. This paper describes the research protocol of a mixed methods study to apply FAIT (Framework to Assess the Impact from Translational health research) to the Centre for Research Excellence in Integrated Quality Improvement (CRE-IQI). FAIT will be applied to five selected CRE-IQI Flagship projects to encourage research translation and assess the wider impact of that research. Phase I will develop a modified programme logic model for each Flagship project including identifying process, output and impact metrics so progress can be monitored. A scoping review will inform potential benefits. In phase II, programme logic models will be updated to account for changes in the research pathways over time. Audit and feedback will be used to encourage research translation and collect evidence of achievement of any process, output and interim impacts. In phase III, three proven methodologies for measuring research impact-Payback, economic assessment and narratives-will be applied. Data on the application of FAIT will be collected and analysed to inform and improve FAIT's performance. This study is funded by a nationally competitive grant (ID 1078927) from the Australian National Health and Medical Research Council. Ethics approval was obtained from the University of Newcastle's Human Research Ethics Committee (ID: H-2017-0026). The results from the study will be presented in several peer-reviewed publications, through conference presentations and via

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

    Energy Technology Data Exchange (ETDEWEB)

    Lai, Karen [Institute for Medical Research, Kuala Lumpur (Malaysia)

    1997-12-31

    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.

  1. 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

  2. Assessing the impact of aflatoxin consumption on animal health and ...

    African Journals Online (AJOL)

    They are toxic to humans, fish and many other animals, even in low concentrations. Susceptibility to aflatoxins varies by age, health status, species and other factors. Most research has focused on aflatoxins in maize or groundnuts and their impacts on human health. However, aflatoxins are found in other foods and can also ...

  3. 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.

  4. River modeling and multi-level fish health assessment to evaluate impacts from oil sands water releases (Part 2)

    International Nuclear Information System (INIS)

    Shaw, R.; Swanson, S.M.; Lagimodiere, M.; Gulley, J.

    1995-01-01

    A multi-level, multi-scale approach was used to assess potential impacts to fish health from oil sands water releases. The method used to arrive at predicted impacts involved assembling experimental data on the effects of chronic exposure to oil sands wastewaters on biochemical, physiological and whole-organism endpoint. This information was used to determine no effect levels (NOELs) and lowest effect levels (LOELs) for the suite of fish health parameters used in laboratory experiments (primarily biochemical and physiological measurement endpoints). LOELs and NOELs were compared to modeled concentrations of wastewater in the Athabasca River for five time snapshots. For each time period, concentrations were predicted based on mean annual flows and 7Q10 flows (low flows). This comparison was used to predict impacts on biochemical/physiological endpoints. Impacts on at the whole-organism and population-level were determined by comparing what the laboratory data would predict with what was observed in the field. This process was used to draw a conclusion regarding the health and sustainability of fish populations

  5. How have Global Health Initiatives impacted on health equity?

    Science.gov (United States)

    Hanefeld, Johanna

    2008-01-01

    This review examines the impact of Global Health Initiatives (GHIs) on health equity, focusing on low- and middle-income countries. It is a summary of a literature review commissioned by the WHO Commission on the Social Determinants of Health. GHIs have emerged during the past decade as a mechanism in development assistance for health. The review focuses on three GHIs, the US President's Emergency Plan For AIDS Relief (PEPFAR), the World Bank's Multi-country AIDS Programme (MAP) and the Global Fund to Fight AIDS, TB and Malaria. All three have leveraged significant amounts of funding for their focal diseases - together these three GHIs provide an estimated two-thirds of external resources going to HIV/AIDS. This paper examines their impact on gender equity. An analysis of these Initiatives finds that they have a significant impact on health equity, including gender equity, through their processes of programme formulation and implementation, and through the activities they fund and implement, including through their impact on health systems and human resources. However, GHIs have so far paid insufficient attention to health inequities. While increasingly acknowledging equity, including gender equity, as a concern, Initiatives have so far failed to adequately translate this into programmes that address drivers of health inequity, including gender inequities. The review highlights the comparative advantage of individual GHIs, which point to an increased need for, and continued difficulties in, harmonisation of activities at country level. On the basis of this comparative analysis, key recommendations are made. They include a call for equity-sensitive targets, the collection of gender-disaggregated data, the use of policy-making processes for empowerment, programmes that explicitly address causes of health inequity and impact assessments of interventions' effect on social inequities.

  6. Research and development of technologies for safe and environmentally optimal recovery and disposal of explosive wastes. Task 2, Preliminary impact assessment for environment, health and safety (EIA)

    Energy Technology Data Exchange (ETDEWEB)

    Duijm, N.J.; Markert, F. [Risoe (Denmark); Larsen, S.G. [DEMEX A/S (Denmark)

    1998-09-01

    As described in the project proposal `Research and Development of Technologies for Safe and Environmentally optimal recovery and Disposal of Explosive Wastes`, dated 31. May 1996, the objective of Task 2, Preliminary Impact Assessment for Environment, Health and Safety, is to: Analyse the environmental impact of noise and emissions to air, water and soil; Assess the risk of hazards to workers` health and safety and to the public. Task 2, Preliminary Impact Assessment for Environment, Health and Safety (EIA), has been performed from August 1997 to September 1998. First, a methodology has been established, based on Multi-Criteria Decision Analysis (MCDA), to select the `best` technology on the basis of clearly defined objectives, including minimal impacts on environment, health and safety. This included a review of different types of explosive waste with a focus on the environment implications, identifying the issues relevant to defining the criteria or objectives with respect to environment and safety in the framework of explosive waste, as well as the preliminary definition of objectives for the final impact assessment. Second, the previously identified recovery and disposal technologies (Task 1) have been qualitatively assessed on the basis of the relevant objectives. This qualitative assessment includes also economic considerations and an attempt to rank the technologies in an MCDA framework. (au)

  7. 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

  8. Practical consequences of the assessment of different energy health risks

    International Nuclear Information System (INIS)

    Hamilton, L.D.

    1984-01-01

    Public authorities must make decisions about energy, and the risks of alternative strategies need to be calculated including health and environmental costs. Information from various sources must be organized into a logical framework for comparing impacts. This must include the widest practicable range of health and environmental damage - public health impact of pollution, role of accidents, disease and hazardous materials in the workplace, and odds for catastrophes. It must put each part of the energy cycle into perspective - giving particular attention to uncertainties in knowledge - to convey what is known, what is uncertain, and the importance of each factor in the overall picture. This paper gives examples of the use of health-impact assessment by decision-makers: (1) comparative risk assessment of the health effects of coal and nuclear fuel cycles used in nuclear power plant siting and licensing hearings, and (2) health risks of acid deposition and other air-transported pollutants, carried out as part of an assessment for the U.S. Congress Office of Technology Assessment. (author)

  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. 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

  11. Health Impact Assessment of Air Pollution in São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Karina Camasmie Abe

    2016-07-01

    Full Text Available Epidemiological research suggests that air pollution may cause chronic diseases, as well as exacerbation of related pathologies such as cardiovascular and respiratory morbidity and mortality. This study evaluates air pollution scenarios considering a Health Impact Assessment approach in São Paulo, Brazil. We have analyzed abatement scenarios of Particulate Matter (PM with an aerodynamic diameter <10 μm (PM10, <2.5 μm (PM2.5 and ozone concentrations and the health effects on respiratory and cardiovascular morbidity and mortality in the period from 2009 to 2011 through the APHEKOM tool, as well as the associated health costs. Considering World Health Organization (WHO standards of PM2.5 (10 μg/m3, São Paulo would avoid more than 5012 premature deaths (equivalent to 266,486 life years’ gain and save US$15.1 billion annually. If São Paulo could even diminish the mean of PM2.5 by 5 μg/m3, nearly 1724 deaths would be avoided, resulting in a gain of US$ 4.96 billion annually. Reduced levels of PM10, PM2.5 and ozone could save lives and an impressive amount of money in a country where economic resources are scarce. Moreover, the reduced levels of air pollution would also lower the demand for hospital care, since hospitalizations would diminish. In this sense, Brazil should urgently adopt WHO air pollution standards in order to improve the quality of life of its population.

  12. Privacy impact assessment in the design of transnational public health information systems: the BIRO project.

    Science.gov (United States)

    Di Iorio, C T; Carinci, F; Azzopardi, J; Baglioni, V; Beck, P; Cunningham, S; Evripidou, A; Leese, G; Loevaas, K F; Olympios, G; Federici, M Orsini; Pruna, S; Palladino, P; Skeie, S; Taverner, P; Traynor, V; Benedetti, M Massi

    2009-12-01

    To foster the development of a privacy-protective, sustainable cross-border information system in the framework of a European public health project. A targeted privacy impact assessment was implemented to identify the best architecture for a European information system for diabetes directly tapping into clinical registries. Four steps were used to provide input to software designers and developers: a structured literature search, analysis of data flow scenarios or options, creation of an ad hoc questionnaire and conduction of a Delphi procedure. The literature search identified a core set of relevant papers on privacy (n = 11). Technicians envisaged three candidate system architectures, with associated data flows, to source an information flow questionnaire that was submitted to the Delphi panel for the selection of the best architecture. A detailed scheme envisaging an "aggregation by group of patients" was finally chosen, based upon the exchange of finely tuned summary tables. Public health information systems should be carefully engineered only after a clear strategy for privacy protection has been planned, to avoid breaching current regulations and future concerns and to optimise the development of statistical routines. The BIRO (Best Information Through Regional Outcomes) project delivers a specific method of privacy impact assessment that can be conveniently used in similar situations across Europe.

  13. Encouraging translation and assessing impact of the Centre for Research Excellence in Integrated Quality Improvement: rationale and protocol for a research impact assessment

    Science.gov (United States)

    Ramanathan, Shanthi; Reeves, Penny; Deeming, Simon; Bailie, Ross Stewart; Bailie, Jodie; Bainbridge, Roxanne; Cunningham, Frances; Doran, Christopher; McPhail Bell, Karen; Searles, Andrew

    2017-01-01

    Introduction There is growing recognition among health researchers and funders that the wider benefits of research such as economic, social and health impacts ought to be assessed and valued alongside academic outputs such as peer-reviewed papers. Research translation needs to increase and the pathways to impact ought to be more transparent. These processes are particularly pertinent to the Indigenous health sector given continued concerns that Indigenous communities are over-researched with little corresponding improvement in health outcomes. This paper describes the research protocol of a mixed methods study to apply FAIT (Framework to Assess the Impact from Translational health research) to the Centre for Research Excellence in Integrated Quality Improvement (CRE-IQI). FAIT will be applied to five selected CRE-IQI Flagship projects to encourage research translation and assess the wider impact of that research. Methods and analysis Phase I will develop a modified programme logic model for each Flagship project including identifying process, output and impact metrics so progress can be monitored. A scoping review will inform potential benefits. In phase II, programme logic models will be updated to account for changes in the research pathways over time. Audit and feedback will be used to encourage research translation and collect evidence of achievement of any process, output and interim impacts. In phase III, three proven methodologies for measuring research impact—Payback, economic assessment and narratives—will be applied. Data on the application of FAIT will be collected and analysed to inform and improve FAIT’s performance. Ethics and dissemination This study is funded by a nationally competitive grant (ID 1078927) from the Australian National Health and Medical Research Council. Ethics approval was obtained from the University of Newcastle’s Human Research Ethics Committee (ID: H-2017–0026). The results from the study will be presented in several

  14. Risk assessment for improved treatment of health considerations in EIA

    International Nuclear Information System (INIS)

    Demidova, Olga; Cherp, Aleg

    2005-01-01

    Environmental Impact Assessment (EIA) and Risk Assessment (RA) processes are rarely used to complement each other despite potential benefits of such integration. This paper proposes a model for procedural and methodological integration of EIA and RA based on reported best practice approaches. The proposed model stipulates 'embedding' RA into EIA and is organized in accordance with the generic stages of the EIA process. The model forms the basis for the proposed Evaluation Package which can be used as a benchmarking tool for evaluating the effectiveness of integration of RA within particular EIAs. The current paper uses the package for evaluating seven Environmental Impact Statements (EISs) of waste incineration facilities in the UK produced between 1990 and 2000. Though RA was found to be an element of these EIAs, its prominence varied considerably from case to case. Systematic application of RA in accordance with the best practice was not observed. Particular omissions were demonstrated in assessing health impacts not directly associated with air emissions, identifying the receptors of health impacts (affected population), interpreting health impacts as health risks, dealing with uncertainties, and risk communications

  15. 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.

  16. Impacts of “metals” on human health

    DEFF Research Database (Denmark)

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

    2011-01-01

    This paper looks into the differences and uncertainties in determining the impact of “metals” emissions on human health, in Life Cycle Impact Assessment (LCIA). Metals are diverse substances, with different properties and characteristics, considered important in LCIA because of their toxicity...... to humans and ecosystems. First, we defined a list of the most significant metals in terms of impacts on human health. This was done according to precise criteria accounting for both physical and toxic properties of the metals. Second, we performed a LCIA on different key processes using various existing...... to the total impact on human health changes greatly according to the LCIA method used. These differences are due mainly to the number of metals included in each method and to the technique used to calculate the characterization factors. Results obtained with USEtox show no apparent correlation with results...

  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. Expanding Health Technology Assessments to Include Effects on the Environment.

    Science.gov (United States)

    Marsh, Kevin; Ganz, Michael L; Hsu, John; Strandberg-Larsen, Martin; Gonzalez, Raquel Palomino; Lund, Niels

    2016-01-01

    There is growing awareness of the impact of human activity on the climate and the need to stem this impact. Public health care decision makers from Sweden and the United Kingdom have started examining environmental impacts when assessing new technologies. This article considers the case 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 and objectives extending beyond health care. Two types of challenges hinder this process. First, the nascent evidence base is insufficient to support the accurate comparison of technologies' environmental impacts. Second, cost-utility analysis, which is favored by many HTA agencies, could capture some of the value of environmental impacts, especially those generating health impacts, but might not be suitable for addressing broader concerns. Both cost-benefit and multicriteria decision analyses are potential methods for evaluating health and environmental outcomes, but are less familiar to health care decision makers. Health care is an important and sizable sector of the economy that could warrant closer policy attention to its impact on the environment. Considerable work is needed to track decision makers' demands, augment the environmental evidence base, and develop robust methods for capturing and incorporating environmental data as part of HTA. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  19. Overview of Environmental Impact Assessment of Oil and Gas ...

    African Journals Online (AJOL)

    The environmental impact assessment (EIA) of oil and gas projects in Nigeria ... natural, social and health components of the environment; Determination of issues ... of impact quantification through which the Environmental Management Plan ...

  20. 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)

  1. 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...

  2. 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.

  3. Comparing the health impacts of different energy sources

    International Nuclear Information System (INIS)

    Hamilton, L.D.

    1982-01-01

    Assessing health impacts of different energy sources requires synthesis of research results from many different disciplines into a rational framework. Information is often scanty; qualitatively different risks, or energy systems with substantially different end uses, must be put on a common footing. Historically institutional constraints have inhibited agencies from making incisive intercomparisons necessary for formulating energy policy; this has exacerbated public controversy over appropriate energy sources. Risk assessment methods reviewed include examples drawn from work of the Biomedical and Environmental Assessment Division at Brookhaven National Laboratory and elsewhere. Uncertainty over the mechanism and size of air pollution health damage is addressed through a probabilistic health-damage function, using sulphate-particle exposure as an indicator. This facilitates intercomparison through analysis of each step in the whole fuel cycle between a typical coal and nuclear power plant. Occupational health impacts, a significant fraction of overall damage, are illustrated by accident trends in coal-mining. In broadening comparisons to include new technologies, one must include the impact of manufacturing the energy-producing device as part of an expanded fuel cycle, via input/output methods. Throughout the analysis, uncertainties must be made explicit in the results, including uncertainty of data and uncertainty in choice of appropriate models and methods. No single method of comparative risk assessment is fully satisfactory; each has its limitations. Several methods must be compared if decision-making is to be realistic. (author)

  4. Development Impact Assessment (DIA) Case Study. South Africa

    Energy Technology Data Exchange (ETDEWEB)

    Cox, Sadie [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Nawaz, Kathleen [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Sandor, Debra [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2015-05-19

    This case study reviews South Africa’s experience in considering the impacts of climate change action on development goals, focusing on the South African energy sector and development impact assessments (DIAs) that have and could be used to influence energy policy or inform the selection of energy activities. It includes a review of assessments—conducted by government ministries, technical partners, and academic institutes and non-governmental organizations (NGOs)—that consider employment, health, and water implications of possible energy sector actions, as well as multi-criteria impact assessments.

  5. 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...... the highest and lowest socio-economic groups may decrease by 75% or increase by 21% depending on the size of the relative risk. Assuming the same smoking prevalence for the lowest socio-economic group as for the highest (impact fraction), then the inequality may decrease by 7-26%. Consequently, the size...

  6. Spatiotemporal Assessment of PM2.5-Related Economic Losses from Health Impacts during 2014–2016 in China

    Directory of Open Access Journals (Sweden)

    Yang Yang

    2018-06-01

    Full Text Available Background: Particulate air pollution, especially PM2.5, is highly correlated with various adverse health impacts and, ultimately, economic losses for society, however, few studies have undertaken a spatiotemporal assessment of PM2.5-related economic losses from health impacts covering all of the main cities in China. Methods: PM2.5 concentration data were retrieved for 190 Chinese cities for the period 2014–2016. We used a log-linear exposure–response model and monetary valuation methods, such as value of a statistical life (VSL, amended human capital (AHC, and cost of illness to evaluate PM2.5-related economic losses from health impacts at the city level. In addition, Monte Carlo simulation was used to analyze uncertainty. Results: The average economic loss was 0.3% (AHC to 1% (VSL of the total gross domestic product (GDP of 190 Chinese cities from 2014 to 2016. Overall, China experienced a downward trend in total economic losses over the three-year period, but the Beijing–Tianjin–Hebei, Shandong Peninsula, Yangtze River Delta, and Chengdu-Chongqing regions experienced greater annual economic losses. Conclusions: Exploration of spatiotemporal variations in PM2.5-related economic losses from long-term health impacts could provide new information for policymakers regarding priority areas for PM2.5 pollution prevention and control in China.

  7. New approaches in human health risk assessment.

    Science.gov (United States)

    Abass, Khaled; Carlsen, Anders; Rautio, Arja

    2016-01-01

    Studies on the precise impact of environmental pollutants on human health are difficult to undertake and interpret, because many genetic and environmental factors influence health at the same time and to varying degrees. Our chapter in the AMAP report was based on new approaches to describe risks and future needs. In this paper, we will introduce the issues associated with risk assessment of single chemicals, and present suggestions for future studies as well as a summary of lessons learned during the health-related parts of the European Union-funded FP7 project ArcRisk (Arctic Health Risks: Impacts on health in the Arctic and Europe owing to climate-induced changes in contaminant cycling, 2009-2014; www.arcrisk.eu).

  8. Data resources for assessing regional impacts of energy facilities on health and the environment

    International Nuclear Information System (INIS)

    Olson, R.J.

    1982-01-01

    Atmospheric emissions from fossil-fuel power plants and other sources continue to cause concern about impacts of these pollutants on human health and the environment. Assessing these impacts requires a regional-scale approach that integrates spatial and temporal patterns of emissions, environmental factors and human populations. Two examples of regional studies are presented, including a comparison of patterns of coal-fired power plants and selected diseases and identification of areas sensitive to acid rain which may transfer acid and toxic metals to aquatic systems and man. Energy, socio-economic, health and environmental data are often collected and summarized for counties in the USA. Counties are well-defined geopolitical units which can be used to integrate data, to aggregate data into larger regional units, and to display data as thematic maps. However, researchers are too frequently faced with the tedious task of assembling and reformatting files from several data-collection agencies prior to conducting regional studies. Systems such as UPGRADE, DIDS, SEEDIS and Geoecology have standardized many files into integrated data bases which utilize counties as the primary spatial unit. These systems are compared and data resources discussed. (author)

  9. Human scenarios for the screening assessment. Columbia River Comprehensive Impact Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Napier, B.A.; Harper, B.L.; Lane, N.K.; Strenge, D.L.; Spivey, R.B.

    1996-03-01

    Because of past nuclear production operations along the Columbia River, there is intense public and tribal interest in assessing any residual Hanford Site related contamination along the river from the Hanford Reach to the Pacific Ocean. The Columbia River Impact Assessment (CRCIA) was proposed to address these concerns. The assessment of the Columbia River is being conducted in phases. The initial phase is a screening assessment of risk, which addresses current environmental conditions for a range of potential uses. One component of the screening assessment estimates the risk from contaminants in the Columbia River to humans. Because humans affected by the Columbia river are involved in a wide range of activities, various scenarios have been developed on which to base the risk assessments. The scenarios illustrate the range of activities possible by members of the public coming in contact with the Columbia River so that the impact of contaminants in the river on human health can be assessed. Each scenario illustrates particular activity patterns by a specific group. Risk will be assessed at the screening level for each scenario. This report defines the scenarios and the exposure factors that will be the basis for estimating the potential range of risk to human health from Hanford-derived radioactive as well as non-radioactive contaminants associated with the Columbia River.

  10. Human scenarios for the screening assessment. Columbia River Comprehensive Impact Assessment

    International Nuclear Information System (INIS)

    Napier, B.A.; Harper, B.L.; Lane, N.K.; Strenge, D.L.; Spivey, R.B.

    1996-03-01

    Because of past nuclear production operations along the Columbia River, there is intense public and tribal interest in assessing any residual Hanford Site related contamination along the river from the Hanford Reach to the Pacific Ocean. The Columbia River Impact Assessment (CRCIA) was proposed to address these concerns. The assessment of the Columbia River is being conducted in phases. The initial phase is a screening assessment of risk, which addresses current environmental conditions for a range of potential uses. One component of the screening assessment estimates the risk from contaminants in the Columbia River to humans. Because humans affected by the Columbia river are involved in a wide range of activities, various scenarios have been developed on which to base the risk assessments. The scenarios illustrate the range of activities possible by members of the public coming in contact with the Columbia River so that the impact of contaminants in the river on human health can be assessed. Each scenario illustrates particular activity patterns by a specific group. Risk will be assessed at the screening level for each scenario. This report defines the scenarios and the exposure factors that will be the basis for estimating the potential range of risk to human health from Hanford-derived radioactive as well as non-radioactive contaminants associated with the Columbia River

  11. 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.

  12. Assessing the Differences in Public Health Impact of Salmonella Subtypes Using a Bayesian Microbial Subtyping Approach for Source Attribution

    DEFF Research Database (Denmark)

    Pires, Sara Monteiro; Hald, Tine

    2010-01-01

    Salmonella is a major cause of human gastroenteritis worldwide. To prioritize interventions and assess the effectiveness of efforts to reduce illness, it is important to attribute salmonellosis to the responsible sources. Studies have suggested that some Salmonella subtypes have a higher health...... impact than others. Likewise, some food sources appear to have a higher impact than others. Knowledge of variability in the impact of subtypes and sources may provide valuable added information for research, risk management, and public health strategies. We developed a Bayesian model that attributes...... illness to specific sources and allows for a better estimation of the differences in the ability of Salmonella subtypes and food types to result in reported salmonellosis. The model accommodates data for multiple years and is based on the Danish Salmonella surveillance. The number of sporadic cases caused...

  13. Assessing corporate project impacts in changeable contexts: A human rights perspective

    Energy Technology Data Exchange (ETDEWEB)

    Salcito, Kendyl, E-mail: kendyl.salcito@unibas.ch [Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel (Switzerland); University of Basel, P.O. Box, CH-4003 Basel (Switzerland); NomoGaia, 1900 Wazee Street, Suite 303, Denver, CO 80202 (United States); NewFields, LLC, Denver, CO 80202 (United States); Singer, Burton H., E-mail: bhsinger@epi.ufl.edu [Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610 (United States); Krieger, Gary R., E-mail: gkrieger@newfields.com [NewFields, LLC, Denver, CO 80202 (United States); Weiss, Mitchell G., E-mail: mitchell-g.weiss@unibas.ch [Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel (Switzerland); University of Basel, P.O. Box, CH-4003 Basel (Switzerland); Wielga, Mark, E-mail: wielga@nomogaia.org [NomoGaia, 1900 Wazee Street, Suite 303, Denver, CO 80202 (United States); NewFields, LLC, Denver, CO 80202 (United States); Utzinger, Jürg, E-mail: juerg.utzinger@unibas.ch [Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel (Switzerland); University of Basel, P.O. Box, CH-4003 Basel (Switzerland)

    2014-07-01

    Project-level impact assessment was originally conceived as a snapshot taken in advance of project implementation, contrasting current conditions with a likely future scenario involving a variety of predicted impacts. Current best practice guidance has encouraged a shift towards longitudinal assessments from the pre-project stage through the implementation and operating phases. Experience and study show, however, that assessment of infrastructure-intensive projects rarely endures past the project's construction phase. Negative consequences for environmental, social and health outcomes have been documented. Such consequences clarify the pressing need for longitudinal assessment in each of these domains, with human rights impact assessment (HRIA) as an umbrella over, and critical augmentation of, environmental, social and health assessments. Project impacts on human rights are more closely linked to political, economic and other factors beyond immediate effects of a company's policy and action throughout the project lifecycle. Delineating these processes requires an adequate framework, with strategies for collecting longitudinal data, protocols that provide core information for impact assessment and guidance for adaptive mitigation strategies as project-related effects change over time. This article presents general principles for the design and implementation of sustained, longitudinal HRIA, based on experience assessing and responding to human rights impact in a uranium mining project in Malawi. The case study demonstrates the value of longitudinal assessment both for limiting corporate risk and improving human welfare. - Graphical abstract: Assessing changes in human rights condition as affected by both project and context, over time. - Highlights: • Corporate capital projects affect human rights in myriad ways. • Ongoing, longitudinal impact assessment techniques are needed. • We present an approach for conducting longitudinal human rights impact

  14. Assessing corporate project impacts in changeable contexts: A human rights perspective

    International Nuclear Information System (INIS)

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

    2014-01-01

    Project-level impact assessment was originally conceived as a snapshot taken in advance of project implementation, contrasting current conditions with a likely future scenario involving a variety of predicted impacts. Current best practice guidance has encouraged a shift towards longitudinal assessments from the pre-project stage through the implementation and operating phases. Experience and study show, however, that assessment of infrastructure-intensive projects rarely endures past the project's construction phase. Negative consequences for environmental, social and health outcomes have been documented. Such consequences clarify the pressing need for longitudinal assessment in each of these domains, with human rights impact assessment (HRIA) as an umbrella over, and critical augmentation of, environmental, social and health assessments. Project impacts on human rights are more closely linked to political, economic and other factors beyond immediate effects of a company's policy and action throughout the project lifecycle. Delineating these processes requires an adequate framework, with strategies for collecting longitudinal data, protocols that provide core information for impact assessment and guidance for adaptive mitigation strategies as project-related effects change over time. This article presents general principles for the design and implementation of sustained, longitudinal HRIA, based on experience assessing and responding to human rights impact in a uranium mining project in Malawi. The case study demonstrates the value of longitudinal assessment both for limiting corporate risk and improving human welfare. - Graphical abstract: Assessing changes in human rights condition as affected by both project and context, over time. - Highlights: • Corporate capital projects affect human rights in myriad ways. • Ongoing, longitudinal impact assessment techniques are needed. • We present an approach for conducting longitudinal human rights impact assessment

  15. Assessing the social impacts of the biofuel lifecycle

    DEFF Research Database (Denmark)

    Jørgensen, Andreas; Hauschild, Michael Zwicky

    In order to assess the social impacts of the biofuel lifecycle, Social Life Cycle Assessment (SLCA) may be a promising tool. However, as this review study points out, several problems are still to be solved. SLCA can be defined as a tool for assessing a product’s or service’s total impact on human...... health and well-being throughout its life cycle. During the recent years several different approaches towards SLCA have been developing. This review reveals a broad variety in how the SLCAs address all methodological steps. One of the main differences is in the choice and formulation of social indicators....... The indicators address a wide variety of issues; some approaches focus on impacts created in the very close proximity of the processes included in the product system, whereas others focus on the more remote societal consequences. The perception of social impacts is thus very varying. An assessment focussing...

  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. 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.

  18. New approaches in human health risk assessment

    Directory of Open Access Journals (Sweden)

    Khaled Abass

    2016-12-01

    Full Text Available Studies on the precise impact of environmental pollutants on human health are difficult to undertake and interpret, because many genetic and environmental factors influence health at the same time and to varying degrees. Our chapter in the AMAP report was based on new approaches to describe risks and future needs. In this paper, we will introduce the issues associated with risk assessment of single chemicals, and present suggestions for future studies as well as a summary of lessons learned during the health-related parts of the European Union-funded FP7 project ArcRisk (Arctic Health Risks: Impacts on health in the Arctic and Europe owing to climate-induced changes in contaminant cycling, 2009–2014; www.arcrisk.eu.

  19. Physiotherapy students’ mental health assessment

    OpenAIRE

    Gesouli-Voltyraki –E.; Charisi E.; Papastergiou D.; Κostopoulou S.; Borou A.; Alverti V.; Avlakiotis K.; Spanos S.

    2012-01-01

    Introduction: Educational environment has a serious impact on students’ mental health. Few data are available on mental health of Physiotherapy students. Aim: The purpose of this study was to assess the mental heath of students in a tertiary Physiotherapy Department during the 3rd years of studies. Material and methods: 80 males and females physiotherapy students of the 5th and 6th semester of a tertiary Physiotherapy Department filled in the GHQ-28 questionnaire. Comparisons between groups w...

  20. Menu labeling as a potential strategy for combating the obesity epidemic: a health impact assessment.

    Science.gov (United States)

    Kuo, Tony; Jarosz, Christopher J; Simon, Paul; Fielding, Jonathan E

    2009-09-01

    We conducted a health impact assessment to quantify the potential impact of a state menu-labeling law on population weight gain in Los Angeles County, California. We utilized published and unpublished data to model consumer response to point-of-purchase calorie postings at large chain restaurants in Los Angeles County. We conducted sensitivity analyses to account for uncertainty in consumer response and in the total annual revenue, market share, and average meal price of large chain restaurants in the county. Assuming that 10% of the restaurant patrons would order reduced-calorie meals in response to calorie postings, resulting in an average reduction of 100 calories per meal, we estimated that menu labeling would avert 40.6% of the 6.75 million pound average annual weight gain in the county population aged 5 years and older. Substantially larger impacts would be realized if higher percentages of patrons ordered reduced-calorie meals or if average per-meal calorie reductions increased. Our findings suggest that mandated menu labeling could have a sizable salutary impact on the obesity epidemic, even with only modest changes in consumer behavior.

  1. 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...

  2. 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.

  3. 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

  4. 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

  5. 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.

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

    Science.gov (United States)

    Lötters, F J B; Lenoir-Wijnkoop, I; Fardellone, P; Rizzoli, R; Rocher, E; Poley, M J

    2013-01-01

    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, taking a health economics perspective. This study seeks, first, to estimate the impact of an increased dairy consumption on reducing the burden of osteoporosis in terms of health outcomes and costs, and, second, to contribute to a generic methodology for assessing the health-economic outcomes of food products. We constructed a model that generated the number of hip fractures that potentially can be prevented with dairy foods intakes, and then calculated costs avoided, considering the healthcare costs of hip fractures and the costs of additional dairy foods, as well as the number of disability-adjusted life years (DALYs) lost due to hip fractures associated with low nutritional calcium intake. Separate analyses were done for The Netherlands, France, and Sweden, three countries with different levels of dairy products consumption. The number of hip fractures that may potentially be prevented each year with additional dairy products was highest in France (2,023), followed by Sweden (455) and The Netherlands (132). The yearly number of DALYs lost was 6,263 for France, 1,246 for Sweden, and 374 for The Netherlands. The corresponding total costs that might potentially be avoided are about 129 million, 34 million, and 6 million Euros, in these countries, respectively. This study quantified the potential nutrition economic impact of increased dairy consumption on osteoporotic fractures, building connections between the fields of nutrition and health economics. Future research should further collect longitudinal population data for documenting the net benefits of increasing dairy consumption on bone health and on the related utilization of healthcare resources.

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

    International Nuclear Information System (INIS)

    Broeder, Lea den; Uiters, Ellen; Have, Wim ten; 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 selection consisted of 43 papers, including case studies, evaluation studies, reviews, and opinion papers. After analysis, consultation of four experts was performed to check preliminary study outcomes. A grey literature web search was performed to check and complement the results. Results show that community participation is generally considered a core element in HIA. Views as expressed in the papers concern, firstly, the need for and value of local knowledge, secondly, the adherence to or application of democratic values and, thirdly, empowerment of communities. Three categories of methods are used in relation to community participation, often in combination: methods to facilitate knowledge elicitation, to ensure the inclusion of communities in the HIA process, and to build community capacity to participate in policy development. However, the theoretical or practical underpinning of the choice for specific methods is mostly not presented. The experiences described in the papers mainly focus on the access to local knowledge and its usability as a source of evidence in the HIA process. Described effects of community participation are (improved) relations between communities and local agencies, policy makers and professionals and the empowerment of community members. Although these effects are ascribed to community participation, many papers do not provide support for this conclusion beyond the retrospective perception of participants. Expert consultation and additional analysis of the grey literature supported the results derived from the scientific literature and provided more in-depth knowledge. In the grey literature theoretical frameworks, methods and tools for

  8. 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

  9. 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

  10. A health impact assessment of a proposed bill to decrease speed limits on local roads in Massachusetts (U.S.A.).

    Science.gov (United States)

    James, Peter; Ito, Kate; Banay, Rachel F; Buonocore, Jonathan J; Wood, Benjamin; Arcaya, Mariana C

    2014-10-02

    Decreasing traffic speeds increases the amount of time drivers have to react to road hazards, potentially averting collisions, and makes crashes that do happen less severe. Boston's regional planning agency, the Metropolitan Area Planning Council (MAPC), in partnership with the Massachusetts Department of Public Health (MDPH), conducted a Health Impact Assessment (HIA) that examined the potential health impacts of a proposed bill in the state legislature to lower the default speed limits on local roads from 30 miles per hour (mph) to 25 mph. The aim was to reduce vehicle speeds on local roads to a limit that is safer for pedestrians, cyclists, and children. The passage of this proposed legislation could have had far-reaching and potentially important public health impacts. Lower default speed limits may prevent around 18 fatalities and 1200 serious injuries to motorists, cyclists and pedestrians each year, as well as promote active transportation by making local roads feel more hospitable to cyclists and pedestrians. While a lower speed limit would increase congestion and slightly worsen air quality, the benefits outweigh the costs from both a health and economic perspective and would save the state approximately $62 million annually from prevented fatalities and injuries.

  11. Impact of Chronic Diseases and Multimorbidity on Health and Health Care Costs: The Additional Role of Musculoskeletal Disorders

    NARCIS (Netherlands)

    Zee-Neuen, A. van der; Putrik, P.; Ramiro, S.; Keszei, A.; Bie, R. de; Chorus, A.; Boonen, A.

    2016-01-01

    Objective: Chronic diseases are increasingly prevalent and often occur as multimorbidity. This study compares the impact of musculoskeletal disorders (MSKDs) on health and health care costs with other chronic diseases, and assesses the additional impact of MSKDs on these outcomes when occurring as

  12. Health Care Facilities Resilient to Climate Change Impacts

    Directory of Open Access Journals (Sweden)

    Jaclyn Paterson

    2014-12-01

    Full Text Available Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator’s guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change.

  13. Integrated approach to assess ecosystem health in harbor areas.

    Science.gov (United States)

    Bebianno, M J; Pereira, C G; Rey, F; Cravo, A; Duarte, D; D'Errico, G; Regoli, F

    2015-05-01

    Harbors are critical environments with strategic economic importance but with potential environmental impact: health assessment criteria are a key issue. An ecosystem health status approach was carried out in Portimão harbor as a case-study. Priority and specific chemical levels in sediments along with their bioavailability in mussels, bioassays and a wide array of biomarkers were integrated in a biomarker index (IBR index) and the overall data in a weight of evidence (WOE) model. Metals, PAHs, PCBs and HCB were not particularly high compared with sediment guidelines and standards for dredging. Bioavailability was evident for Cd, Cu and Zn. Biomarkers proved more sensitive namely changes of antioxidant responses, metallothioneins and vittellogenin-like proteins. IBR index indicated that site 4 was the most impacted area. Assessment of the health status by WOE approach highlighted the importance of integrating sediment chemistry, bioaccumulation, biomarkers and bioassays and revealed that despite some disturbance in the harbor area, there was also an impact of urban effluents from upstream. Environmental quality assessment in harbors. Copyright © 2015 Elsevier B.V. All rights reserved.

  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. 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.

  16. A preliminary assessment of the health status of feral populations of ...

    African Journals Online (AJOL)

    A 'snapshot' evaluation of the health status of feral populations of the brackish water catfish, Chrysichthys nigrodigitatus, was carried out in 2006 at four locations in the Lagos lagoon complex, with varying levels of anthropogenic impacts, using a modified Health Assessment Index (HAI) protocol. Fish health was assessed ...

  17. 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.

  18. Comprehensive assessment of fruits and vegetables human health effects in a LCA context

    DEFF Research Database (Denmark)

    Stylianou, Katerina S.; Jolliet, O.; Fantke, Peter

    2016-01-01

    the environmental and nutritional effects of foods expressed in Disability Adjusted Life Years (DALYs). For the environmental health assessment we consider impact categories such as global warming and particulate matter (PM) as well as chemical exposure due to pesticide residues. Global warming and PM are assessed...... following a traditional LCA approach. For the pesticide residue exposure, we use publically available health impact scores derived from toxicological studies of numerous pesticide active ingredients. For the nutritional assessment we focus on the various health outcomes considered in the global burden...... in which the substituted food items are associated with negative health effects, such as red meat and trans-fat. Overall environmental health impacts associated with this addition are substantially smaller compared to nutritional benefits in each scenario, even when considering an uncertainty factor of 400...

  19. Introducing Health Impact Assessment

    DEFF Research Database (Denmark)

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

    2007-01-01

    health status of the population. There was a lack of multi-intersectoral knowledge, co-operation and function between sectors and actors. Enablers on the other hand were the membership of international organizations which called for new solutions, and the strong political commitment and belief...... 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...

  20. Health impact assessment as an accountability mechanism for the International Monetary Fund: the case of sub-Saharan Africa.

    Science.gov (United States)

    O'Keefe, Eileen; Scott-Samuel, Alex

    2010-01-01

    Health impact assessment (HIA) is both an effective tool for promoting healthy public policies and one that has the potential to help hold accountable for their actions those who create unhealthy public policies. This article identifies some of the issues that arise in considering the application of HIA to the operation of the International Monetary Fund (IMF), especially in the context of sub-Saharan Africa. The authors do this in the belief that the IMF's lending conditionalities and macroeconomic policies constitute an important social determinant of health. The recent report of the Commission on Social Determinants of Health has created helpful and timely policy space for the development of a health equity- and human rights-oriented accountability framework for the IMF.

  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. Royal Society of Canada expert panel report : environmental and health impacts of Canada's oil sands industry

    International Nuclear Information System (INIS)

    Gosselin, P.; Hrudey, S.E.; Naeth, M.A.; Plourde, A.; Therrien, R.; Laval Univ., Quebec City, PQ; Van Der Kraak, G.; Guelph Univ., ON; Xu, Z.

    2010-12-01

    This expert panel report was commissioned by the Royal Society of Canada to provide a comprehensive evidence-based assessment of the environmental and health impacts of Canada's oil sands industry. The report evaluated the feasibility of land reclamation and the impacts of oil sands contaminants on downstream residents. Health impacts on residents living in the Regional Municipality of Wood Buffalo were assessed, and the impacts on regional water supplies were evaluated. Regional water and ground water quantities were examined, and issues related to tailing pond operations and reclamation were examined. Ambient air quality impacts were assessed, as well as potential impacts of the oil sands industry on greenhouse gas (GHG) emissions. The environmental regulatory performance of operators in the industry was also evaluated. A summary of economic and policy issues related to the industry was also provided. The study identified major gaps in the process of assessment, prevention, and mitigation of the health impacts of oil sands exploitation, as as major indirect health impacts linked to past exploitation activities. 672 refs., 11 tabs., 11 figs. 10 appendices.

  3. 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

  4. 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'.

  5. Nutrition economics - characterising the economic and health impact of nutrition.

    Science.gov (United States)

    Lenoir-Wijnkoop, I; Dapoigny, M; Dubois, D; van Ganse, E; Gutiérrez-Ibarluzea, I; Hutton, J; Jones, P; Mittendorf, T; Poley, M J; Salminen, S; Nuijten, M J C

    2011-01-01

    There is a new merging of health economics and nutrition disciplines to assess the impact of diet on health and disease prevention and to characterise the health and economic aspects of specific changes in nutritional behaviour and nutrition recommendations. A rationale exists for developing the field of nutrition economics which could offer a better understanding of both nutrition, in the context of having a significant influence on health outcomes, and economics, in order to estimate the absolute and relative monetary impact of health measures. For this purpose, an expert meeting assessed questions aimed at clarifying the scope and identifying the key issues that should be taken into consideration in developing nutrition economics as a discipline that could potentially address important questions. We propose a first multidisciplinary outline for understanding the principles and particular characteristics of this emerging field. We summarise here the concepts and the observations of workshop participants and propose a basic setting for nutrition economics and health outcomes research as a novel discipline to support nutrition, health economics and health policy development in an evidence and health-benefit-based manner.

  6. Evaluation of the Personal Impact Health Assessment Questionnaire (PI HAQ) to capture the impact of disability in osteoarthritis.

    Science.gov (United States)

    Wylde, Vikki; Livesey, Christine; Learmonth, Ian D; Blom, Ashley W; Hewlett, Sarah

    2010-06-01

    Measuring facts about disability may not reflect their personal impact. An individualized values instrument has been used to weight difficulty in performing activities of daily living in rheumatoid arthritis, and calculate personal impact (Personal Impact Health Assessment Questionnaire; PI HAQ). This study aimed to evaluate the PI HAQ in osteoarthritis (OA). Study 1: 51 people with OA completed short and long versions of the value instrument at 0 and 1 week. Study 2: 116 people with OA completed the short value instrument, disability and psychological measures at 0 and 4 weeks. Study 1: The eight-category and 20-item value instruments correlated well (r = 0.85) and scores differed by just 2.7%. The eight-category instrument showed good internal consistency reliability (Cronbach's alpha = 0.85) and moderate one-week test-retest reliability (r = 0.68, Wilcoxon signed-rank test p = 0.16, intra-class correlation coefficient [ICC] 0.62). Study 2: Values for disability were not associated with disability severity or clinical status. After weighting disability by value, the resulting PI HAQ scores were significantly associated with dissatisfaction with disability, perceived increase in disability, poor clinical status and life dissatisfaction, and differed significantly between people with high and low clinical status (convergent and discriminant construct validity). There was moderate association with the disease repercussion profile disability subscale (r = 0.511; p personal impact of disability in people with OA, setting disability within a personal context. Further studies, including sensitivity to change, are required.

  7. GIS-based models for ambient PM exposure and health impact assessment for the UK

    International Nuclear Information System (INIS)

    Stedman, John R; Grice, Susannah; Kent, Andrew; Cooke, Sally

    2009-01-01

    GIS-based models have been developed to map ambient PM 10 and PM 25 mass concentrations across the UK. The resulting maps are used for the assessments of air quality required by the EU ambient air quality directives, health impact assessment and the development of UK air quality policy. Maps are presented for 2006 along with projections to 2020. The largest single contribution to the UK population-weighted mean annual mean background concentrations of PM 10 in 2006 is estimated to be from secondary PM (43%), followed by the contribution from primary PM (24%). Concentrations are predicted to decline by 15% for PM 10 and 13% for PM 25 over the period from 2006 to 2020. The extent of exceedence of the 24-hour limit value is predicted to decline from 1.9% to 0.1% of urban major roads over the same period. The potential health benefits of reductions in ambient PM are large. A reduction in concentration of 0.93 μg m -3 as a result of a possible package of measures has been estimated within the UK Air Quality Strategy to result in a reduction in life years lost of approximately 2 - 4 million over a period of 100 years.

  8. Quantitative health impact assessment of transport policies: two simulations related to speed limit reduction and traffic re-allocation in the Netherlands.

    Science.gov (United States)

    Schram-Bijkerk, D; van Kempen, E; Knol, A B; Kruize, H; Staatsen, B; van Kamp, I

    2009-10-01

    Few quantitative health impact assessments (HIAs) of transport policies have been published so far and there is a lack of a common methodology for such assessments. To evaluate the usability of existing HIA methodology to quantify health effects of transport policies at the local level. Health impact of two simulated but realistic transport interventions - speed limit reduction and traffic re-allocation - was quantified by selecting traffic-related exposures and health endpoints, modelling of population exposure, selecting exposure-effect relations and estimating the number of local traffic-related cases and disease burden, expressed in disability-adjusted life-years (DALYs), before and after the intervention. Exposure information was difficult to retrieve because of the local scale of the interventions, and exposure-effect relations for subgroups and combined effects were missing. Given uncertainty in the outcomes originating from this kind of missing information, simulated changes in population health by two local traffic interventions were estimated to be small (<5%), except for the estimated reduction in DALYs by less traffic accidents (60%) due to speed limit reduction. Quantitative HIA of transport policies at a local scale is possible, provided that data on exposures, the exposed population and their baseline health status are available. The interpretation of the HIA information should be carried out in the context of the quality of input data and assumptions and uncertainties of the analysis.

  9. 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.

  10. Health Impacts of Increased Physical Activity from Changes in Transportation Infrastructure: Quantitative Estimates for Three Communities

    Science.gov (United States)

    2015-01-01

    Recently, two quantitative tools have emerged for predicting the health impacts of projects that change population physical activity: the Health Economic Assessment Tool (HEAT) and Dynamic Modeling for Health Impact Assessment (DYNAMO-HIA). HEAT has been used to support health impact assessments of transportation infrastructure projects, but DYNAMO-HIA has not been previously employed for this purpose nor have the two tools been compared. To demonstrate the use of DYNAMO-HIA for supporting health impact assessments of transportation infrastructure projects, we employed the model in three communities (urban, suburban, and rural) in North Carolina. We also compared DYNAMO-HIA and HEAT predictions in the urban community. Using DYNAMO-HIA, we estimated benefit-cost ratios of 20.2 (95% C.I.: 8.7–30.6), 0.6 (0.3–0.9), and 4.7 (2.1–7.1) for the urban, suburban, and rural projects, respectively. For a 40-year time period, the HEAT predictions of deaths avoided by the urban infrastructure project were three times as high as DYNAMO-HIA's predictions due to HEAT's inability to account for changing population health characteristics over time. Quantitative health impact assessment coupled with economic valuation is a powerful tool for integrating health considerations into transportation decision-making. However, to avoid overestimating benefits, such quantitative HIAs should use dynamic, rather than static, approaches. PMID:26504832

  11. Climate change and Public health: vulnerability, impacts, and adaptation

    Science.gov (United States)

    Guzzone, F.; Setegn, S.

    2013-12-01

    Climate Change plays a significant role in public health. Changes in climate affect weather conditions that we are accustomed to. Increases in the frequency or severity of extreme weather events such as storms could increase the risk of dangerous flooding, high winds, and other direct threats to people and property. Changes in temperature, precipitation patterns, and extreme events could enhance the spread of some diseases. According to studies by EPA, the impacts of climate change on health will depend on many factors. These factors include the effectiveness of a community's public health and safety systems to address or prepare for the risk and the behavior, age, gender, and economic status of individuals affected. Impacts will likely vary by region, the sensitivity of populations, the extent and length of exposure to climate change impacts, and society's ability to adapt to change. Transmissions of infectious disease have been associated with social, economic, ecological, health care access, and climatic factors. Some vector-borne diseases typically exhibit seasonal patterns in which the role of temperature and rainfall is well documented. Some of the infectious diseases that have been documented by previous studies, include the correlation between rainfall and drought in the occurrence of malaria, the influence of the dry season on epidemic meningococcal disease in the sub-Saharan African, and the importance of warm ocean waters in driving cholera occurrence in the Ganges River delta in Asia The rise of climate change has been a major concern in the public health sector. Climate change mainly affects vulnerable populations especially in developing countries; therefore, it's important that public health advocates are involve in the decision-making process in order to provide resources and preventative measures for the challenges that are associated with climate change. The main objective of this study is to assess the vulnerability and impact of climate change

  12. Integrated impact assessment in the UK--use, efficacy and future development

    International Nuclear Information System (INIS)

    Milner, Susan J.; Bailey, Cathy; Deans, Julia; Pettigrew, Dulcie

    2005-01-01

    This paper reports on the findings of an English Department of Health funded study that mapped out examples of integrated impact assessment (IIA) activity, mainly in the UK. Approximately 350 regional and local organisations that have policy and policy implementation roles were contacted via e-mail and from these, 77 telephone interviews were carried out. The interviews revealed 21 examples of IIA being used or developed within the UK. The 77 interviews also generated a rich discussion about the use, efficacy and future development of IIA. Although the findings indicate little IIA activity in the UK, discussions with interviewees suggest that there is growing receptiveness to integrating different forms of assessment into a single assessment process. In part this appears to be driven by sustainable development objectives, both at a strategic and at a local level. In part receptivity to IIA may also be driven by a growing interest in health impact assessment (HIA). There are advocates of the need to integrate health criteria more fully into other forms of impact assessment. The study also highlights the challenges involved in trying to develop IIA methods that are adaptable, flexible and tailored to the different needs of policy-makers and planners

  13. 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

  14. Assessing catastrophic and impoverishing effects of health care payments in Uganda

    OpenAIRE

    Kwesiga, Brendan; Zikusooka, Charlotte M; Ataguba, John E

    2015-01-01

    Background Direct out-of-pocket payments for health care are recognised as limiting access to health care services and also endangering the welfare of households. In Uganda, such payments comprise a large portion of total health financing. This study assesses the catastrophic and impoverishing impact of paying for health care out-of-pocket in Uganda. Methods Using data from the Uganda National Household Surveys 2009/10, the catastrophic impact of out-of-pocket health care payments is defined ...

  15. Assessing the environmental impacts of freshwater consumption in LCA.

    Science.gov (United States)

    Pfister, Stephan; Koehler, Annette; Hellweg, Stefanie

    2009-06-01

    A method for assessing the environmental impacts of freshwater consumption was developed. This method considers damages to three areas of protection: human health, ecosystem quality, and resources. The method can be used within most existing life-cycle impact assessment (LCIA) methods. The relative importance of water consumption was analyzed by integrating the method into the Eco-indicator-99 LCIA method. The relative impact of water consumption in LCIA was analyzed with a case study on worldwide cotton production. The importance of regionalized characterization factors for water use was also examined in the case study. In arid regions, water consumption may dominate the aggregated life-cycle impacts of cotton-textile production. Therefore, the consideration of water consumption is crucial in life-cycle assessment (LCA) studies that include water-intensive products, such as agricultural goods. A regionalized assessment is necessary, since the impacts of water use vary greatly as a function of location. The presented method is useful for environmental decision-support in the production of water-intensive products as well as for environmentally responsible value-chain management.

  16. 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.

  17. Measuring the impact and distress of health problems from the individual's perspective: development of the Perceived Impact of Problem Profile (PIPP)

    Science.gov (United States)

    Pallant, Julie F; Misajon, RoseAnne; Bennett, Elizabeth; Manderson, Lenore

    2006-01-01

    Background The aim of this study was to develop and conduct preliminary validation of the Perceived Impact of Problem Profile (PIPP). Based on the biopsychosocial model of health and functioning, the PIPP was intended as a generic research and clinical measurement tool to assess the impact and distress of health conditions from the individuals' perspective. The ICF classification system was used to guide the structure of the PIPP with subscales included to assess impact on self-care, mobility, participation, relationships and psychological well-being. While the ICF focuses on the classification of objective health and health related status, the PIPP broadens this focus to address the individuals' subjective experience of their health condition. Methods An item pool of 23 items assessing both impact and distress on five key domains was generated. These were administered to 169 adults with mobility impairment. Rasch analysis using RUMM2020 was conducted to assess the psychometric properties of each set of items. Preliminary construct validation of the PIPP was performed using the EQ5D. Results For both the Impact and Distress scales of the PIPP, the five subscales (Self-care, Mobility, Participation, Relationships, and Psychological Well-being) showed adequate psychometric properties, demonstrating fit to the Rasch model. All subscales showed adequate person separation reliability and no evidence of differential item functioning for sex, age, educational level or rural vs urban residence. Preliminary validity testing using the EQ5D items provided support for the subscales. Conclusion This preliminary study, using a sample of adults with mobility impairment, provides support for the psychometric properties of the PIPP as a potential clinical and research measurement tool. The PIPP provides a brief, but comprehensive means to assess the key ICF components, focusing on the individuals' perspective of the impact and distress caused by their health condition. Further

  18. Measuring the impact and distress of health problems from the individual's perspective: development of the Perceived Impact of Problem Profile (PIPP

    Directory of Open Access Journals (Sweden)

    Bennett Elizabeth

    2006-06-01

    Full Text Available Abstract Background The aim of this study was to develop and conduct preliminary validation of the Perceived Impact of Problem Profile (PIPP. Based on the biopsychosocial model of health and functioning, the PIPP was intended as a generic research and clinical measurement tool to assess the impact and distress of health conditions from the individuals' perspective. The ICF classification system was used to guide the structure of the PIPP with subscales included to assess impact on self-care, mobility, participation, relationships and psychological well-being. While the ICF focuses on the classification of objective health and health related status, the PIPP broadens this focus to address the individuals' subjective experience of their health condition. Methods An item pool of 23 items assessing both impact and distress on five key domains was generated. These were administered to 169 adults with mobility impairment. Rasch analysis using RUMM2020 was conducted to assess the psychometric properties of each set of items. Preliminary construct validation of the PIPP was performed using the EQ5D. Results For both the Impact and Distress scales of the PIPP, the five subscales (Self-care, Mobility, Participation, Relationships, and Psychological Well-being showed adequate psychometric properties, demonstrating fit to the Rasch model. All subscales showed adequate person separation reliability and no evidence of differential item functioning for sex, age, educational level or rural vs urban residence. Preliminary validity testing using the EQ5D items provided support for the subscales. Conclusion This preliminary study, using a sample of adults with mobility impairment, provides support for the psychometric properties of the PIPP as a potential clinical and research measurement tool. The PIPP provides a brief, but comprehensive means to assess the key ICF components, focusing on the individuals' perspective of the impact and distress caused by their

  19. Common and Critical Components Among Community Health Assessment and Community Health Improvement Planning Models.

    Science.gov (United States)

    Pennel, Cara L; Burdine, James N; Prochaska, John D; McLeroy, Kenneth R

    Community health assessment and community health improvement planning are continuous, systematic processes for assessing and addressing health needs in a community. Since there are different models to guide assessment and planning, as well as a variety of organizations and agencies that carry out these activities, there may be confusion in choosing among approaches. By examining the various components of the different assessment and planning models, we are able to identify areas for coordination, ways to maximize collaboration, and strategies to further improve community health. We identified 11 common assessment and planning components across 18 models and requirements, with a particular focus on health department, health system, and hospital models and requirements. These common components included preplanning; developing partnerships; developing vision and scope; collecting, analyzing, and interpreting data; identifying community assets; identifying priorities; developing and implementing an intervention plan; developing and implementing an evaluation plan; communicating and receiving feedback on the assessment findings and/or the plan; planning for sustainability; and celebrating success. Within several of these components, we discuss characteristics that are critical to improving community health. Practice implications include better understanding of different models and requirements by health departments, hospitals, and others involved in assessment and planning to improve cross-sector collaboration, collective impact, and community health. In addition, federal and state policy and accreditation requirements may be revised or implemented to better facilitate assessment and planning collaboration between health departments, hospitals, and others for the purpose of improving community health.

  20. Community based interventional study to assess the impact of health education on alcohol use among adult males in Bareilly, Uttar Pradesh

    Directory of Open Access Journals (Sweden)

    Himalaya Singh

    2017-12-01

    Full Text Available Background: Alcoholic beverages have been a part of social life for millennia, yet societies have always found it difficult to understand or restrain their use. Apart from the health concerns, chronic alcoholism is one of the greatest causes for poverty in the country. Objective: To assess the impact of health education on alcohol use among adult males in Bareilly District, Uttar Pradesh. Material & Methods: A community based interventional study conducted in the Bareilly district among males aged >15 years during November 2015 to April 2017 taking a sample of 699 by 30 cluster sampling with PPS. Data was collected by home visit using WHO-AUDIT (Alcohol Use Disorder Identification Test questionnaire. After data collection, health education was given to study population in form of speech, posters, short films and focus group discussion. One year after providing health education, AUDIT questionnaire was re-filled by current alcohol drinkers to know the impact of health education. Results: Prevalence of drinking alcohol is 30.47% i.e. 213 current drinkers. AUDIT Scores before and after Health education were positively correlated (r=.768, p=0.0001. There was a significant average difference between AUDIT Scores before and after Health education (t178=2.973, p=0.003. Conclusion: Health education has a positive impact on alcohol use therefore research focus should be on primary prevention by health education/behaviour change communication in primary and secondary care settings.

  1. Community based interventional study to assess the impact of health education on alcohol use among adult males in Bareilly, Uttar Pradesh

    Directory of Open Access Journals (Sweden)

    Himalaya Singh

    2017-12-01

    Full Text Available Background: Alcoholic beverages have been a part of social life for millennia, yet societies have always found it difficult to understand or restrain their use. Apart from the health concerns, chronic alcoholism is one of the greatest causes for poverty in the country. Objective: To assess the impact of health education on alcohol use among adult males in Bareilly District, Uttar Pradesh. Material & Methods: A community based interventional study conducted in the Bareilly district among males aged >15 years during November 2015 to April 2017 taking a sample of 699 by 30 cluster sampling with PPS. Data was collected by home visit using WHO-AUDIT (Alcohol Use Disorder Identification Test questionnaire. After data collection, health education was given to study population in form of speech, posters, short films and focus group discussion. One year after providing health education, AUDIT questionnaire was re-filled by current alcohol drinkers to know the impact of health education. Results: Prevalence of drinking alcohol is 30.47% i.e. 213 current drinkers. AUDIT Scores before and after Health education were positively correlated (r=.768, p=0.0001. There was a significant average difference between AUDIT Scores before and after Health education (t178=2.973, p=0.003. Conclusion: Health education has a positive impact on alcohol use therefore research focus should be on primary prevention by health education/behaviour change communication in primary and secondary care settings.

  2. We are all experts! Does stakeholder engagement in health impact scoping lead to consensus? A Dutch case study

    NARCIS (Netherlands)

    Broeder, den Lea; Yin Chung, Kai; Geelen, Loes; Schuit, Albertina Jantine; Wagemakers, A.

    2016-01-01

    Stakeholder engagement in Environmental Impact Assessment (EIA) and Health Impact Assessment (HIA) provides opportunities for inclusive environmental decision-making contributing to the attainment of agreement about the potential environmental and health impacts of a plan. A case evaluation of

  3. Health Literacy Assessment in an Otolaryngology Clinic Population.

    Science.gov (United States)

    Megwalu, Uchechukwu C; Lee, Jennifer Y

    2016-12-01

    To assess health literacy in an adult tertiary care otolaryngology clinic population and to explore potential determinants of inadequate health literacy. Cross-sectional study. Tertiary care otolaryngology clinic. The study population included all adult patients treated at 3 of Stanford University's adult otolaryngology clinic sites between March 1 and 11, 2016. Data were collected via an anonymous questionnaire. Health literacy was assessed with the Brief Health Literacy Screen. Ten percent of patients had inadequate health literacy. White race (odds ratio [OR], 0.23) and having English as the primary language (OR, 0.12) were associated with adequate health literacy, while high school or lower level of education (OR, 3.2) was associated with inadequate health literacy. Age, sex, and Hispanic ethnicity were not associated with health literacy. Our study highlights the need for health literacy screening in the otolaryngology clinic setting and identifies sociodemographic risk factors for inadequate health literacy. Further studies are needed to assess the impact of health literacy on patient outcomes and to test specific interventions to address health literacy and health outcomes. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  4. 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

  5. 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.)

  6. Impact of air pollution on health in Europe

    Energy Technology Data Exchange (ETDEWEB)

    Kruzyzanowski, M. [WHO European Centre for Environment and Health, Bilthoven (Netherlands)

    1995-12-31

    Assessment of health risks due to air pollution should be an important indicator for setting the priorities for the environmental policies and for the abatement of the pollution. The scale of such assessment depends on the level, and scope, of the policy decisions relying on the evaluation. The analysis may range from an estimate of the health impact of a single pollution source, through the risk assessment in a community or a region of a country, to an international, or pan-continental approach. Such assessment, addressing population of all Europe, was one of the aims of the project `Concern for Europe`s Tomorrow` (CET). The WHO European Centre for Environment and Health completed this project, and the corresponding report, as a contribution to the Second European Conference on Environment and Health which gathered ministries of health and of environment from all European countries in Helsinki in June 1994. Using the report as the background information, the ministries have endorsed the `Environmental Health Action Plan for Europe`, the document formulating common environmental health policy of the Region. In this article, the summary of the evaluation will be presented and the main constraints of the pan-European approach will be addressed. (author)

  7. Impact of air pollution on health in Europe

    Energy Technology Data Exchange (ETDEWEB)

    Kruzyzanowski, M [WHO European Centre for Environment and Health, Bilthoven (Netherlands)

    1996-12-31

    Assessment of health risks due to air pollution should be an important indicator for setting the priorities for the environmental policies and for the abatement of the pollution. The scale of such assessment depends on the level, and scope, of the policy decisions relying on the evaluation. The analysis may range from an estimate of the health impact of a single pollution source, through the risk assessment in a community or a region of a country, to an international, or pan-continental approach. Such assessment, addressing population of all Europe, was one of the aims of the project `Concern for Europe`s Tomorrow` (CET). The WHO European Centre for Environment and Health completed this project, and the corresponding report, as a contribution to the Second European Conference on Environment and Health which gathered ministries of health and of environment from all European countries in Helsinki in June 1994. Using the report as the background information, the ministries have endorsed the `Environmental Health Action Plan for Europe`, the document formulating common environmental health policy of the Region. In this article, the summary of the evaluation will be presented and the main constraints of the pan-European approach will be addressed. (author)

  8. Applicability of a Serbian version of the “Oral Impacts on Daily Performance (OIDP” index - assessment of oral health-related quality of life

    Directory of Open Access Journals (Sweden)

    Stančić Ivica

    2012-01-01

    Full Text Available Background/Aim. The Oral Impacts on Daily Performance (OIDP is a well-known psychometric test used internationally to assess the oral health-related quality of life. The interview and self-administrated questionnaire both assess the degree to which oral health problems have affected the life of the participants over the previous 6 months. The aim of this study was to translate the OIDP index into Serbian and to assess its reliability in practice as its initial verification in the Serbian speaking area. Methods. Following an internationally established methods, the OIDP scale was translated using standardized methodology that consisted of forward translation, pilot study and backward translation. Results. A pilot study was carried out with 44 respondents (24 males i 20 females using a preliminar Serbian version of the OIDP index. All patients were aged over 65 years. A total of 68.2% of the participants replied that they had at least one OIDP impact on daily life in the past 6 months. These troubles were most prominent during eating (47.7% and speaking (36.4%, but there is a little impact of troubles in the domain of psychosocial sphere. The corrected item-total correlation coefficients for all items were above the minimum recommended level of 0.20 for including an item in a scale. The standardized Cronbach’s alpha coefficient was 0.75. Conclusion. Based on these results, we can conclude that this index is suitable for use in everyday practice in Serbian speaking area providing useful information required to assess oral health-related quality of life.

  9. Comparing the health impacts of different sources of energy. Keynote address

    International Nuclear Information System (INIS)

    Hamilton, L.D.

    1981-01-01

    Assessing health impacts of different energy sources requires synthesis of research results from any different disciplines into a rational framework. Information is often scanty; qualitatively different risks, or energy systems with substantially different end uses, must be put on a common footing. Historically institutional constraints have inhibited agencies from making incisive comparisons necessary for formulating energy policy; this has exacerbated public controversy over appropriate energy sources. Risk assessment methods reviewed include examples drawn from work of the Biomedical and Environmental Assessment Division at Brookhaven National Laboratory and elsewhere. Uncertainty over the mechanism and size of air pollution health damage is addressed through a probabilistic health-damage function, using sulfate-particle exposure as an indicator. This facilitates intercomparison through analysis of each step in the whole fuel cycle between a typical coal and nuclear powerplant. Occupational health impacts, a significant fraction of overall damage, are illustrated by accident trends in coal mining. In broadening comparisons to include new technologies, one must include the impact of manufacturing the energy-producing device as part of an expanded fuel cycle, via input/output methods. Throughout the analysis, uncertainties must be made explicit in the results, including uncertainty of data and uncertainty in choice of appropriate models and methods. No single method of comparative risk assessment is fully satisfactory; each has its limitations. One needs to compare several methods if decision-making is to be realistic

  10. Cumulative Impact Assessment: Approaching Environmental Capacity in Development Area Using Environmental Impact Assessment Information

    Science.gov (United States)

    Cho, N.; Lee, M. J.; Maeng, J. H.

    2017-12-01

    Environmental impact assessment estimates the impact of development as a business unit and establishes mitigation plan. If the development is done, its economic effects can spread to the nearby areas. So that various developments can be distributed at different time intervals. The impact of the new developments can be combined with existing environmental impacts and can have a larger impact. That is, Cumulative impact assessment is needed to consider the environmental capacity of the Nearby area. Cumulative impact assessments require policy tools such as environmental impact assessment information and cumulative impact estimation models. In Korea, environmental information (water quality, air quality, etc.) of the development site is measured for environmental impact assessment and monitored for a certain period (generally 5 years) after the project. In addition, by constructing the environmental information as a spatial database, it is possible to express the environmental impact on a regional basis spatially and to intuitively use it for development site selection. Utilizing a composite model of environmental impact assessment information and Remote Sensing data for cumulative impact estimation, That can be used as a policy decision support tool that provides quantitative information for development area management, such as time series effect and sprawl phenomenon.

  11. 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.

  12. 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

  13. 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.

  14. 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.

  15. Assessment of the Effects of Economic Sanctions on Iranians’ Right to Health by Using Human Rights Impact Assessment Tool: A Systematic Review

    Science.gov (United States)

    Kokabisaghi, Fatemeh

    2018-01-01

    Background: Over the years, economic sanctions have contributed to violation of right to health in target countries. Iran has been under comprehensive unilateral economic sanctions by groups of countries (not United Nations [UN]) in recent years. They have been intensified from 2012 because of international community’s uncertainty about peaceful purpose of Iran’s nuclear program and inadequacy of trust-building actions of this country. This review aimed to identify the humanitarian effects of the sanctions on the right of Iranians to health and the obligations of Iran and international community about it. Methods: To assess economic sanction policies and identify violated rights and the obligations of states according to international human rights laws, in this study, Human Rights Impact Assessments (HRIA) tool is used. Applying this tool requires collection of evidences regarding the situation of rights. To provide such evidence, a systematic review of literature which involved 55 papers retrieved from the web-based databases and official webpages of Iran’s government and UN’ health and human rights committees and organizations was done. All articles about the consequences of economic sanctions related to nuclear activities of Iran on welfare and health of Iranians published from January 2012 till February 2017 in English and Persian languages were included. Search terms were economic sanctions, embargoes, Iran, welfare, health and medicine. Additional studies were identified by cross checking the reference lists of accessed articles. All selected papers were abstracted and entered into a matrix describing study design and findings, and categorized into a framework of themes reflecting the areas covered (health and its determinants). According to HRIA framework, related obligations of Iran and other states about adverse effects of the sanctions on Iranians’ right to health were extracted. Results: The sanctions on Iran caused a fall of country

  16. Assessing STD Partner Services in State and Local Health Departments.

    Science.gov (United States)

    Cuffe, Kendra M; Leichliter, Jami S; Gift, Thomas L

    2018-02-07

    State and local health department STD programs provide several partner services to reduce disease transmission. Budget cuts and temporary staff reassignments for public health emergencies may affect the provision of partner services. Determining the impact of staffing reductions on STD rates and public health response should be further assessed.

  17. Expanding Health Technology Assessments to Include Effects on the Environment

    DEFF Research Database (Denmark)

    Marsh, Kevin; Ganz, Michael Lee; Hsu, John

    2016-01-01

    decision makers. Health care is an important and sizable sector of the economy that could warrant closer policy attention to its impact on the environment. Considerable work is needed to track decision makers' demands, augment the environmental evidence base, and develop robust methods for capturing......There is growing awareness of the impact of human activity on the climate and the need to stem this impact. Public health care decision makers from Sweden and the United Kingdom have started examining environmental impacts when assessing new technologies. This article considers the case...... and objectives extending beyond health care. Two types of challenges hinder this process. First, the nascent evidence base is insufficient to support the accurate comparison of technologies' environmental impacts. Second, cost-utility analysis, which is favored by many HTA agencies, could capture some...

  18. Global health and economic impacts of future ozone pollution

    International Nuclear Information System (INIS)

    Selin, N E; Nam, K M; Reilly, J M; Paltsev, S; Prinn, R G; Webster, M D; Wu, S

    2009-01-01

    We assess the human health and economic impacts of projected 2000-2050 changes in ozone pollution using the MIT Emissions Prediction and Policy Analysis - Health Effects (EPPA-HE) model, in combination with results from the GEOS-Chem global tropospheric chemistry model of climate and chemistry effects of projected future emissions. We use EPPA-HE to assess the human health damages (including mortality and morbidity) caused by ozone pollution, and quantify their economic impacts in sixteen world regions. We compare the costs of ozone pollution under scenarios with 2000 and 2050 ozone precursor and greenhouse gas emissions (using the Intergovernmental Panel on Climate Change (IPCC) Special Report on Emissions Scenarios (SRES) A1B scenario). We estimate that health costs due to global ozone pollution above pre-industrial levels by 2050 will be $580 billion (year 2000$) and that mortalities from acute exposure will exceed 2 million. We find that previous methodologies underestimate costs of air pollution by more than a third because they do not take into account the long-term, compounding effects of health costs. The economic effects of emissions changes far exceed the influence of climate alone.

  19. Adapting to Health Impacts of Climate Change in the Department of Defense.

    Science.gov (United States)

    Chrétien, Jean-Paul

    2016-01-01

    The Department of Defense (DoD) recognizes climate change as a threat to its mission and recently issued policy to implement climate change adaptation measures. However, the DoD has not conducted a comprehensive assessment of health-related climate change effects. To catalyze the needed assessment--a first step toward a comprehensive DoD climate change adaptation plan for health--this article discusses the DoD relevance of 3 selected climate change impacts: heat injuries, vector-borne diseases, and extreme weather that could lead to natural disasters. The author uses these examples to propose a comprehensive approach to planning for health-related climate change impacts in the DoD.

  20. 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)

  1. The impact of health insurance on maternal health care utilization: evidence from Ghana, Indonesia and Rwanda.

    Science.gov (United States)

    Wang, Wenjuan; Temsah, Gheda; Mallick, Lindsay

    2017-04-01

    While research has assessed the impact of health insurance on health care utilization, few studies have focused on the effects of health insurance on use of maternal health care. Analyzing nationally representative data from the Demographic and Health Surveys (DHS), this study estimates the impact of health insurance status on the use of maternal health services in three countries with relatively high levels of health insurance coverage-Ghana, Indonesia and Rwanda. The analysis uses propensity score matching to adjust for selection bias in health insurance uptake and to assess the effect of health insurance on four measurements of maternal health care utilization: making at least one antenatal care visit; making four or more antenatal care visits; initiating antenatal care within the first trimester and giving birth in a health facility. Although health insurance schemes in these three countries are mostly designed to focus on the poor, coverage has been highly skewed toward the rich, especially in Ghana and Rwanda. Indonesia shows less variation in coverage by wealth status. The analysis found significant positive effects of health insurance coverage on at least two of the four measures of maternal health care utilization in each of the three countries. Indonesia stands out for the most systematic effect of health insurance across all four measures. The positive impact of health insurance appears more consistent on use of facility-based delivery than use of antenatal care. The analysis suggests that broadening health insurance to include income-sensitive premiums or exemptions for the poor and low or no copayments can increase use of maternal health care. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  2. 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.

  3. Assessment of the potential public health impact of Herpes Zoster vaccination in Germany.

    Science.gov (United States)

    Curran, Desmond; Van Oorschot, Desirée; Varghese, Lijoy; Oostvogels, Lidia; Mrkvan, Tomas; Colindres, Romulo; von Krempelhuber, Alfred; Anastassopoulou, Anastassia

    2017-10-03

    The aim of this study was to compare the public health impact of introducing 2 Herpes Zoster (HZ) vaccines, Zoster Vaccine Live (ZVL) versus a non-live adjuvanted subunit candidate vaccine (HZ/su), in the German population aged 50+ years split into 3 age cohorts, i.e. 50-59, 60-69 and 70+ years, respectively. A multi-cohort static Markov model was developed following age cohorts over their lifetime. Demographic data were obtained from the German federal statistical office. HZ incidence and the proportion of HZ individuals developing post-herpetic neuralgia (PHN) were derived from German specific sources. Age-specific vaccine efficacy and waning rates were based on published clinical trial data. Vaccine coverage for both vaccines was assumed to be 40%, with compliance of the second dose of the HZ/su vaccine of 70%. Sensitivity analyses were performed to assess the robustness of the results. It was estimated that, over the remaining lifetime since vaccination, the HZ/su vaccine would reduce the number of HZ cases by 725,233, 533,162 and 486,794 in the 3 age cohorts, respectively, compared with 198,477, 196,000 and 104,640, using ZVL. The number needed to vaccinate (NNV) to prevent one HZ case ranged from 8 to 11 using the HZ/su vaccine compared with 20 to 50 using ZVL. Corresponding NNV to prevent one PHN case ranged from 39 to 53 using the HZ/su vaccine compared with 94 to 198 using ZVL. Due to the higher, sustained vaccine efficacy, the candidate HZ/su vaccine demonstrated superior public health impact compared with ZVL.

  4. The impact of HTA reports on health policy: a systematic review.

    Science.gov (United States)

    Gerhardus, Ansgar; Dintsios, Charalabos-Markos

    2005-11-02

    The objective of health technology assessment (HTA) is to support decision-making in the health sector by assessing health technologies systematically under medical, economic, social, and ethical aspects. The present study aims at identifying ways of enabling the impact of HTA on decision-making processes in the German health sector. The authors formulate three research questions: (1) Can methods be identified that allow a valid assessment of the impact of HTA reports on the decision-making processes? (2) Has been shown an impact of HTA reports on decision-making processes in the health sector? (3) Which are the factors responsible for a high or a low impact of HTA? The authors include studies that present a methodology to assess the impact of HTA, that investigate the impact of HTA on decision-making processes, or study the factors that might enhance or hinder the impact of HTA. Medical and social science electronic databases, lists of publications and projects of the European, North American, Canadian, and Australian HTA agencies, as well as the bibliography of the identified articles and documents are looked through. The writers do a handsearch of the International Journal of Technology Assessment in Health Care and contact 64 HTA agencies by a letter, requesting information on investigations that might not have been published. Abstracts from about 5,000 articles are read. 57 articles are ordered as full-text, 43 are finally included and 14 excluded. (1) In eight studies interviews with decision-makers are used to elicit the information, in three studies document analysis is employed, and in six surveys the results rely only on the observations and interpretations of the authors. One study analyses service data and in nine examinations more than one of the methods listed above are employed. Only in two studies pre-defined indicators were used and only in one clinical trial a prospective design is chosen. (2) In nine studies the impact of a population of HTA

  5. The impact of HTA reports on health policy: a systematic review

    Directory of Open Access Journals (Sweden)

    Gerhardus, Ansgar

    2005-11-01

    Full Text Available Research Question: The objective of health technology assessment (HTA is to support decision-making in the health sector by assessing health technologies systematically under medical, economic, social, and ethical aspects. The present study aims at identifying ways of enabling the impact of HTA on decision-making processes in the German health sector. The authors formulate three research questions: (1 Can methods be identified that allow a valid assessment of the impact of HTA reports on the decision-making processes? (2 Has been shown an impact of HTA reports on decision-making processes in the health sector? (3 Which are the factors responsible for a high or a low impact of HTA? Methods: The authors include studies that present a methodology to assess the impact of HTA, that investigate the impact of HTA on decision-making processes, or study the factors that might enhance or hinder the impact of HTA. Medical and social science electronic databases, lists of publications and projects of the European, North American, Canadian, and Australian HTA agencies, as well as the bibliography of the identified articles and documents are looked through. The writers do a handsearch of the International Journal of Technology Assessment in Health Care and contact 64 HTA agencies by a letter, requesting information on investigations that might not have been published. Results: Abstracts from about 5,000 articles are read. 57 articles are ordered as full-text, 43 are finally included and 14 excluded. (1 In eight studies interviews with decision-makers are used to elicit the information, in three studies document analysis is employed, and in six surveys the results rely only on the observations and interpretations of the authors. One study analyses service data and in nine examinations more than one of the methods listed above are employed. Only in two studies pre-defined indicators were used and only in one clinical trial a prospective design is chosen. (2 In

  6. Global guidance on environmental life cycle impact assessment indicators: impacts of climate change, fine particulate matter formation, water consumption and land use

    DEFF Research Database (Denmark)

    Jolliet, Olivier; Antón, Assumpció; Boulay, Anne-Marie

    2018-01-01

    of water consumption on human health assesses the DALYs from malnutrition caused by lack of water for irrigated food production. Land use impacts: CFs representing global potential species loss from land use are proposed as interim recommendation suitable to assess biodiversity loss due to land use......Purpose: Guidance is needed on best-suited indicators to quantify and monitor the man-made impacts on human health, biodiversity and resources. Therefore, the UNEP-SETAC Life Cycle Initiative initiated a global consensus process to agree on an updated overall life cycle impact assessment (LCIA...... are recommended: (a) The global warming potential 100 years (GWP 100) represents shorter term impacts associated with rate of change and adaptation capacity, and (b) the global temperature change potential 100 years (GTP 100) characterizes the century-scale long term impacts, both including climate-carbon cycle...

  7. Human health impacts in the life cycle of future European electricity generation

    International Nuclear Information System (INIS)

    Treyer, Karin; Bauer, Christian; Simons, Andrew

    2014-01-01

    This paper presents Life Cycle Assessment (LCA) based quantification of the potential human health impacts (HHI) of base-load power generation technologies for the year 2030. Cumulative Greenhouse Gas (GHG) emissions per kWh electricity produced are shown in order to provide the basis for comparison with existing literature. Minimising negative impacts on human health is one of the key elements of policy making towards sustainable development: besides their direct impacts on quality of life, HHI also trigger other impacts, e.g. external costs in the health care system. These HHI are measured using the Life Cycle Impact Assessment (LCIA) methods “ReCiPe” with its three different perspectives and “IMPACT2002+”. Total HHI as well as the shares of the contributing damage categories vary largely between these perspectives and methods. Impacts due to climate change, human toxicity, and particulate matter formation are the main contributors to total HHI. Independently of the perspective chosen, the overall impacts on human health from nuclear power and renewables are substantially lower than those caused by coal power, while natural gas can have lower HHI than nuclear and some renewables. Fossil fuel combustion as well as coal, uranium and metal mining are the life cycle stages generating the highest HHI. - Highlights: • Life cycle human health impacts (HHI) due to electricity production are analysed. • Results are shown for the three ReCiPe perspectives and IMPACT2002+LCIA method. • Total HHI of nuclear and renewables are much below those of fossil technologies. • Climate change and human toxicity contribute most to total HHI. • Fossil fuel combustion and coal mining are the most polluting life cycle stages

  8. Does Indigenous health research have impact? A systematic review of reviews.

    Science.gov (United States)

    Kinchin, Irina; Mccalman, Janya; Bainbridge, Roxanne; Tsey, Komla; Lui, Felecia Watkin

    2017-03-21

    Aboriginal and Torres Strait Islander Australians (hereafter respectfully Indigenous Australians) claim that they have been over-researched without corresponding research benefit. This claim raises two questions. The first, which has been covered to some extent in the literature, is about what type(s) of research are likely to achieve benefits for Indigenous people. The second is how researchers report the impact of their research for Indigenous people. This systematic review of Indigenous health reviews addresses the second enquiry. Fourteen electronic databases were systematically searched for Indigenous health reviews which met eligibility criteria. Two reviewers assessed their characteristics and methodological rigour using an a priori protocol. Three research hypotheses were stated and tested: (1) reviews address Indigenous health priority needs; (2) reviews adopt best practice guidelines on research conduct and reporting in respect to methodological transparency and rigour, as well as acceptability and appropriateness of research implementation to Indigenous people; and (3) reviews explicitly report the incremental impacts of the included studies and translation of research. We argue that if review authors explicitly address each of these three hypotheses, then the impact of research for Indigenous peoples' health would be explicated. Seventy-six reviews were included; comprising 55 journal articles and 21 Australian Government commissioned evidence review reports. While reviews are gaining prominence and recognition in Indigenous health research and increasing in number, breadth and complexity, there is little reporting of the impact of health research for Indigenous people. This finding raises questions about the relevance of these reviews for Indigenous people, their impact on policy and practice and how reviews have been commissioned, reported and evaluated. The findings of our study serve two main purposes. First, we have identified knowledge and

  9. 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

  10. 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.

  11. Assessing health literacy in the eastern and middle-eastern cultures

    Directory of Open Access Journals (Sweden)

    Satish Chandrasekhar Nair

    2016-08-01

    Full Text Available Abstract Background Health literacy is a term employed to assess the ability of people to meet the increasing demands related to health in a rapidly evolving society. Low health literacy can affect the social determinants of health, health outcomes and the use of healthcare services. The purpose of the study was to develop a survey construct to assess health literacy within the context of regional culture. Different socioeconomic status among the Eastern and Middle Eastern countries may restrict, health information access and utilization for those with low literacy. Methods By employing expert panel, Delphi technique, focus group methodologies, and pre-testing using participants (N = 900 from the UAE and India, a survey construct to the Eastern-Middle Eastern cultures was developed. Reliability was assessed using Cronbach’s α and validity using Factor analysis. Kiaser-Meyer-Olkin (KMO sampling adequacy and Bartlett’s tests were used to assess the strength of the relationship among the variables. Results Inclusion of non-health related items were found to be critical in the authentic assessment of health literacy in the Eastern and Middle Eastern population given the influence of social desirability. Thirty-two percentage of the original 19-item construct was eliminated by the focus group for reasons of relevance and impact for the local culture. Field pretesting participants from two countries, indicated overall construct reliability (Cronbach’s α =0.85, validity and consistency (KMO value of 0.92 and Bartlett’s test of sphericity was significant. Conclusion The Eastern-Middle Eastern Adult Health Literacy (EMAHL13, screening instrument is brief, simple, a useful indicator of whether or not a patient can read. It assessespatients’ ability to comprehend by distinguishing between health and non-health related items. The EMAHL13 will be a useful too for the reliable assessment of health literacy in countries, where culture plays a

  12. Assessing health literacy in the eastern and middle-eastern cultures.

    Science.gov (United States)

    Nair, Satish Chandrasekhar; Satish, Karthyayani Priya; Sreedharan, Jayadevan; Ibrahim, Halah

    2016-08-19

    Health literacy is a term employed to assess the ability of people to meet the increasing demands related to health in a rapidly evolving society. Low health literacy can affect the social determinants of health, health outcomes and the use of healthcare services. The purpose of the study was to develop a survey construct to assess health literacy within the context of regional culture. Different socioeconomic status among the Eastern and Middle Eastern countries may restrict, health information access and utilization for those with low literacy. By employing expert panel, Delphi technique, focus group methodologies, and pre-testing using participants (N = 900) from the UAE and India, a survey construct to the Eastern-Middle Eastern cultures was developed. Reliability was assessed using Cronbach's α and validity using Factor analysis. Kiaser-Meyer-Olkin (KMO) sampling adequacy and Bartlett's tests were used to assess the strength of the relationship among the variables. Inclusion of non-health related items were found to be critical in the authentic assessment of health literacy in the Eastern and Middle Eastern population given the influence of social desirability. Thirty-two percentage of the original 19-item construct was eliminated by the focus group for reasons of relevance and impact for the local culture. Field pretesting participants from two countries, indicated overall construct reliability (Cronbach's α =0.85), validity and consistency (KMO value of 0.92 and Bartlett's test of sphericity was significant). The Eastern-Middle Eastern Adult Health Literacy (EMAHL13), screening instrument is brief, simple, a useful indicator of whether or not a patient can read. It assessespatients' ability to comprehend by distinguishing between health and non-health related items. The EMAHL13 will be a useful too for the reliable assessment of health literacy in countries, where culture plays a significant impact. This will be the first steptowards providing

  13. Total environmental impacts of biofuels from corn stover using a hybrid life cycle assessment model combining process life cycle assessment and economic input-output life cycle assessment.

    Science.gov (United States)

    Liu, Changqi; Huang, Yaji; Wang, Xinye; Tai, Yang; Liu, Lingqin; Liu, Hao

    2018-01-01

    Studies on the environmental analysis of biofuels by fast pyrolysis and hydroprocessing (BFPH) have so far focused only on the environmental impacts from direct emissions and have included few indirect emissions. The influence of ignoring some indirect emissions on the environmental performance of BFPH has not been well investigated and hence is not really understood. In addition, in order to avoid shifting environmental problems from one medium to another, a comprehensive assessment of environmental impacts caused by the processes must quantify the environmental emissions to all media (air, water, and land) in relation to each life cycle stage. A well-to-wheels assessment of the total environmental impacts resulting from direct emissions and indirect emissions of a BFPH system with corn stover is conducted using a hybrid life cycle assessment (LCA) model combining the economic input-output LCA and the process LCA. The Tool for the Reduction and Assessment of Chemical and other environmental Impacts (TRACI) has been used to estimate the environmental impacts in terms of acidification, eutrophication, global climate change, ozone depletion, human health criteria, photochemical smog formation, ecotoxicity, human health cancer, and human health noncancer caused by 1 MJ biofuel production. Taking account of all the indirect greenhouse gas (GHG) emissions, the net GHG emissions (81.8 g CO 2 eq/MJ) of the biofuels are still less than those of petroleum-based fuels (94 g CO 2 eq/MJ). Maize production and pyrolysis and hydroprocessing make major contributions to all impact categories except the human health criteria. All impact categories resulting from indirect emissions except eutrophication and smog air make more than 24% contribution to the total environmental impacts. Therefore, the indirect emissions are important and cannot be ignored. Sensitivity analysis has shown that corn stover yield and bio-oil yield affect the total environmental impacts of the biofuels

  14. Animal welfare impact assessments

    DEFF Research Database (Denmark)

    Sandøe, Peter; Gamborg, Christian

    2017-01-01

    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...... is a welfare issue. Furthermore, we argue that AWIA is unlikely to prevent serious moral disagreements over how to weigh concerns about wild animals against priorities in human health, the health of domestic and farm animals, and biodiversity, but that it may nonetheless serve to limit harms imposed......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...

  15. Assessing systemwide occupational health and safety risks of energy technologies

    International Nuclear Information System (INIS)

    Rowe, M.D.

    1982-01-01

    Input-output modelling is now being used to assess systemwide occupational and public health and safety risks of energy technologies. Some of the advantages and disadvantages of this method are presented and some of its important limitations are discussed. Its primary advantage is that it provides a standard method with which to compare technologies on a consistent basis without extensive economic analysis. Among the disadvantages are limited range of applicability, limited spectrum of health impacts, and inability to identify unusual health impacts unique to a new technology. (author)

  16. A Review of NICE Methods and Processes Across Health Technology Assessment Programmes: Why the Differences and What is the Impact?

    Science.gov (United States)

    Cowles, Emma; Marsden, Grace; Cole, Amanda; Devlin, Nancy

    2017-08-01

    Decisions made by the National Institute for Health and Care Excellence (NICE) exert an influence on the allocation of resources within 'fixed' National Health Service budgets. Yet guidance for different types of health interventions is handled via different 'programmes' within NICE, which follow different methods and processes. The objective of this research was to identify differences in the processes and methods of NICE health technology assessment programmes and to explore how these could impact on allocative efficiency within the National Health Service. Data were extracted from the NICE technology appraisal programme, medical technologies guidance, diagnostic assessment programme, highly specialised technologies programme, and clinical guidelines process and methods manuals to undertake a systematic comparison. Five qualitative interviews were carried out with NICE members of staff and committee members to explore the reasons for the differences found. The main differences identified were in the required evidence review period, or lack thereof, mandatory funding status, the provision of a reference case for economic evaluation, the requirement for and the type of economic analysis undertaken, and the decision making criteria used for appraisal. Many of the differences found can be justified on grounds of practicality and relevance to the health technologies under assessment. Nevertheless, from a strict utilitarian view, there are several potential areas of inefficiency that could lead to the misallocation of resources within the National Health Service, although some of these might be eliminated or reduced if an egalitarian view is taken. The challenge is determining where society is willing to trade health gains between different people.

  17. Including Health in Environmental Assessments of Major Transport Infrastructure Projects: A Documentary Analysis.

    Science.gov (United States)

    Riley, Emily; Harris, Patrick; Kent, Jennifer; Sainsbury, Peter; Lane, Anna; Baum, Fran

    2018-05-10

    Transport policy and practice impacts health. Environmental Impact Assessments (EIAs) are regulated public policy mechanisms that can be used to consider the health impacts of major transport projects before they are approved. The way health is considered in these environmental assessments (EAs) is not well known. This research asked: How and to what extent was human health considered in EAs of four major transport projects in Australia. We developed a comprehensive coding framework to analyse the Environmental Impact Statements (EISs) of four transport infrastructure projects: three road and one light rail. The coding framework was designed to capture how health was directly and indirectly included. We found that health was partially considered in all four EISs. In the three New South Wales (NSW) projects, but not the one South Australian project, this was influenced by the requirements issued to proponents by the government which directed the content of the EIS. Health was assessed using human health risk assessment (HHRA). We found this to be narrow in focus and revealed a need for a broader social determinants of health approach, using multiple methods. The road assessments emphasised air quality and noise risks, concluding these were minimal or predicted to improve. The South Australian project was the only road project not to include health data explicitly. The light rail EIS considered the health benefits of the project whereas the others focused on risk. Only one project considered mental health, although in less detail than air quality or noise. Our findings suggest EIAs lag behind the known evidence linking transport infrastructure to health. If health is to be comprehensively included, a more complete model of health is required, as well as a shift away from health risk assessment as the main method used. This needs to be mandatory for all significant developments. We also found that considering health only at the EIA stage may be a significant

  18. Policy Directions Addressing the Public Health Impact of Climate Change in South Korea: The Climate-change Health Adaptation and Mitigation Program.

    Science.gov (United States)

    Shin, Yong Seung; Ha, Jongsik

    2012-01-01

    Climate change, caused by global warming, is increasingly recognized as a major threat to mankind's survival. Climate change concurrently has both direct and modifying influences on environmental, social, and public health systems undermining human health as a whole. Environmental health policy-makers need to make use of political and technological alternatives to address these ramifying effects. The objective of this paper is to review public health policy in Korea, as well as internationally, particularly as it relates to climate change health adaptation and mitigation programs (such as C-CHAMP of Korea), in order to assess and elicit directions for a robust environmental health policy that is adaptive to the health impacts of climate change. In Korea, comprehensive measures to prevent or mitigate overall health effects are limited, and the diffusion of responsibility among various government departments makes consistency in policy execution very difficult. This paper proposes integration, synergy, and utilization as the three core principles of policy direction for the assessment and adaptation to the health impacts of climate change. For specific action plans, we suggest policy making based on scientifically integrated health impact assessments and the prioritization of environmental factors in climate change; the development of practical and technological tools that support policy decisions by making their political implementation more efficient; and customized policy development that deals with the vulnerability of local communities.

  19. Policy Directions Addressing the Public Health Impact of Climate Change in South Korea: The Climate-change Health Adaptation and Mitigation Program

    Science.gov (United States)

    Shin, Yong Seung

    2012-01-01

    Climate change, caused by global warming, is increasingly recognized as a major threat to mankind's survival. Climate change concurrently has both direct and modifying influences on environmental, social, and public health systems undermining human health as a whole. Environmental health policy-makers need to make use of political and technological alternatives to address these ramifying effects. The objective of this paper is to review public health policy in Korea, as well as internationally, particularly as it relates to climate change health adaptation and mitigation programs (such as C-CHAMP of Korea), in order to assess and elicit directions for a robust environmental health policy that is adaptive to the health impacts of climate change. In Korea, comprehensive measures to prevent or mitigate overall health effects are limited, and the diffusion of responsibility among various government departments makes consistency in policy execution very difficult. This paper proposes integration, synergy, and utilization as the three core principles of policy direction for the assessment and adaptation to the health impacts of climate change. For specific action plans, we suggest policy making based on scientifically integrated health impact assessments and the prioritization of environmental factors in climate change; the development of practical and technological tools that support policy decisions by making their political implementation more efficient; and customized policy development that deals with the vulnerability of local communities. PMID:23256088

  20. Health Monitoring System Technology Assessments: Cost Benefits Analysis

    Science.gov (United States)

    Kent, Renee M.; Murphy, Dennis A.

    2000-01-01

    The subject of sensor-based structural health monitoring is very diverse and encompasses a wide range of activities including initiatives and innovations involving the development of advanced sensor, signal processing, data analysis, and actuation and control technologies. In addition, it embraces the consideration of the availability of low-cost, high-quality contributing technologies, computational utilities, and hardware and software resources that enable the operational realization of robust health monitoring technologies. This report presents a detailed analysis of the cost benefit and other logistics and operational considerations associated with the implementation and utilization of sensor-based technologies for use in aerospace structure health monitoring. The scope of this volume is to assess the economic impact, from an end-user perspective, implementation health monitoring technologies on three structures. It specifically focuses on evaluating the impact on maintaining and supporting these structures with and without health monitoring capability.

  1. Nutrition economics – characterising the economic and health impact of nutrition

    Science.gov (United States)

    Lenoir-Wijnkoop, I.; Dapoigny, M.; Dubois, D.; van Ganse, E.; Gutiérrez-Ibarluzea, I.; Hutton, J.; Jones, P.; Mittendorf, T.; Poley, M. J.; Salminen, S.; Nuijten, M. J. C.

    2011-01-01

    There is a new merging of health economics and nutrition disciplines to assess the impact of diet on health and disease prevention and to characterise the health and economic aspects of specific changes in nutritional behaviour and nutrition recommendations. A rationale exists for developing the field of nutrition economics which could offer a better understanding of both nutrition, in the context of having a significant influence on health outcomes, and economics, in order to estimate the absolute and relative monetary impact of health measures. For this purpose, an expert meeting assessed questions aimed at clarifying the scope and identifying the key issues that should be taken into consideration in developing nutrition economics as a discipline that could potentially address important questions. We propose a first multidisciplinary outline for understanding the principles and particular characteristics of this emerging field. We summarise here the concepts and the observations of workshop participants and propose a basic setting for nutrition economics and health outcomes research as a novel discipline to support nutrition, health economics and health policy development in an evidence and health-benefit-based manner. PMID:20797310

  2. A Measure of the Potential Impact of Hospital Community Health Activities on Population Health and Equity.

    Science.gov (United States)

    Begun, James W; Kahn, Linda M; Cunningham, Brooke A; Malcolm, Jan K; Potthoff, Sandra

    2017-12-13

    Many hospitals in the United States are exploring greater investment in community health activities that address upstream causes of poor health. Develop and apply a measure to categorize and estimate the potential impact of hospitals' community health activities on population health and equity. We propose a scale of potential impact on population health and equity, based on the cliff analogy developed by Jones and colleagues. The scale is applied to the 317 activities reported in the community health needs assessment implementation plan reports of 23 health care organizations in the Minneapolis-St Paul, Minnesota metropolitan area in 2015. Using a 5-point ordinal scale, we assigned a score of potential impact on population health and equity to each community health activity. A majority (50.2%) of health care organizations' community health activities are classified as addressing social determinants of health (level 4 on the 5-point scale), though very few (5.4%) address structural causes of health equity (level 5 on the 5-point scale). Activities that score highest on potential impact fall into the topic categories of "community health and connectedness" and "healthy lifestyles and wellness." Lower-scoring activities focus on sick or at-risk individuals, such as the topic category of "chronic disease prevention, management, and screening." Health care organizations in the Minneapolis-St Paul metropolitan area vary substantially in the potential impact of their aggregated community health activities. Hospitals can be significant contributors to investment in upstream community health programs. This article provides a scale that can be used not only by hospitals but by other health care and public health organizations to better align their community health strategies, investments, and partnerships with programming and policies that address the foundational causes of population health and equity within the communities they serve.

  3. Institutionalizing Health Impact Assessment: A consultation with experts on the barriers and facilitators to implementing HIA in Italy.

    Science.gov (United States)

    Linzalone, Nunzia; Ballarini, Adele; Piccinelli, Cristiano; Viliani, Francesca; Bianchi, Fabrizio

    2018-07-15

    A Health Impact Assessment (HIA) is an evidence-based methodology that includes health promotion and protection goals in decision-making. HIA has been introduced and/or institutionalized to various extents in different countries. In order to promote HIA and preventive health assessments in Italy, a research methodology was followed to identify specific obstacles or facilitators. The experiences of various countries reported in the literature were analyzed in terms of facilitating or hindering the introduction and institutionalization of HIA. A consultation with the proponents of projects and plans in Italy was carried out with a multi-approach methodology in order to characterize the national context. A general implementation plan was drawn up from the international experiences. In Italy this is not yet in place. Specific areas of intervention need to be addressed, including: 1) data availability; 2) tools and methods; 3) engagement of stakeholders; 4) capacity building. The research suggests that the institutionalization of HIA in Italy rests on the government's commitment to providing specific legislation regarding HIA so that skills, intersectoral coordination and dedicated budgets can be built and maintained. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Assessment of the Effects of Economic Sanctions on Iranians' Right to Health by Using Human Rights Impact Assessment Tool: A Systematic Review.

    Science.gov (United States)

    Kokabisaghi, Fatemeh

    2018-01-20

    Over the years, economic sanctions have contributed to violation of right to health in target countries. Iran has been under comprehensive unilateral economic sanctions by groups of countries (not United Nations [UN]) in recent years. They have been intensified from 2012 because of international community's uncertainty about peaceful purpose of Iran's nuclear program and inadequacy of trust-building actions of this country. This review aimed to identify the humanitarian effects of the sanctions on the right of Iranians to health and the obligations of Iran and international community about it. To assess economic sanction policies and identify violated rights and the obligations of states according to international human rights laws, in this study, Human Rights Impact Assessments (HRIA) tool is used. Applying this tool requires collection of evidences regarding the situation of rights. To provide such evidence, a systematic review of literature which involved 55 papers retrieved from the web-based databases and official webpages of Iran's government and UN' health and human rights committees and organizations was done. All articles about the consequences of economic sanctions related to nuclear activities of Iran on welfare and health of Iranians published from January 2012 till February 2017 in English and Persian languages were included. Search terms were economic sanctions, embargoes, Iran, welfare, health and medicine. Additional studies were identified by cross checking the reference lists of accessed articles. All selected papers were abstracted and entered into a matrix describing study design and findings, and categorized into a framework of themes reflecting the areas covered (health and its determinants). According to HRIA framework, related obligations of Iran and other states about adverse effects of the sanctions on Iranians' right to health were extracted. The sanctions on Iran caused a fall of country's revenues, devaluation of national currency, and

  5. Climate change adaptation impact cost assessment in France

    International Nuclear Information System (INIS)

    2009-01-01

    This document reports the works of an inter-departmental group and of sector-based and transverse groups which aimed at assessing the impacts of climate change. After a first contribution about the assessment methodology, the works of sector-based groups and transverse groups are reported. These groups are dealing with agriculture, forest, infrastructures and built environment, tourism, energy, health, water, natural risks (and insurance and adaptation to climatic change in metropolitan France), biodiversity and land. For each of them, challenges, assessment approaches, first results and perspectives are discussed

  6. Impact assessment revisited

    DEFF Research Database (Denmark)

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

    2010-01-01

    ; 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......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 we discuss the quantification of the invaded range. These improvements are crucial for impact assessment with the overall aim of prioritizing management of invasive species....

  7. 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.

  8. Environmental impact assessment report

    Energy Technology Data Exchange (ETDEWEB)

    Jung, K. J.; Paik, S. T.; Chung, U. S.; Jung, K. H.; Park, S. K.; Lee, D. G.; Kim, H. R.; Kim, J. K.; Yang, S. H.; Lee, B. J.; Kim, E. H.; Choi, K. S

    2000-10-01

    This report is the revised Environmental Impact Assessment Report which was made and submitted as one of the license documents for TRIGA Research Reactor D and D Project. The Environmental Impact Assessment Report includes introduction of decommissioning plan, status of reactors and environmental impact of surroundings. Also it was assessed and analyzed on radioactivity for environment, and the plan was established to minimize radioactive material release. Finally environmental monitoring plan was established to confirm whether contaminated or not from radioactivity during decommissioning period. According to the assessment results, the risk of excess exposure will be not on environment and public. The first Environmental Impact Assessment Report was submitted to the government for the license and reviewed by Korea Institute of Nuclear Safety. The first Report was revised including answers for the questions arising from review process.

  9. 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...... 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...... 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...

  10. A framework for combining social impact assessment and risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    Mahmoudi, Hossein, E-mail: mahmoudi@uni-hohenheim.de [Department of Social Sciences in Agriculture, University of Hohenheim (Germany); Environmental Sciences Research Institute, Shahid Beheshti University, G.C. (Iran, Islamic Republic of); Renn, Ortwin [Department of Technology and Environmental Sociology (and DIALOGIK), University of Stuttgart (Germany); Vanclay, Frank [Department of Cultural Geography, Faculty of Spatial Sciences, University of Groningen, Groningen (Netherlands); Hoffmann, Volker [Department of Social Sciences in Agriculture, University of Hohenheim (Germany); Karami, Ezatollah [College of Agriculture, Shiraz University, Shiraz (Iran, Islamic Republic of)

    2013-11-15

    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 the common features of social impact assessment (SIA) and social risk assessment (SRA), and discuss the merits of a combined approach. A hybrid model combining SIA and SRA to form a new approach called, ‘risk and social impact assessment’ (RSIA) is introduced. RSIA expands the capacity of SIA to evaluate and manage the social impacts of risky projects such as nuclear energy as well as natural hazards and disasters such as droughts and floods. We outline the three stages of RSIA, namely: impact identification, impact assessment, and impact management. -- Highlights: • A hybrid model to combine SIA and SRA namely RSIA is proposed. • RSIA can provide the proper mechanism to assess social impacts of natural hazards. • RSIA can play the role of ex-post as well as ex-ante assessment. • For some complicated and sensitive cases like nuclear energy, conducting a RSIA is necessary.

  11. A framework for combining social impact assessment and risk assessment

    International Nuclear Information System (INIS)

    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 the common features of social impact assessment (SIA) and social risk assessment (SRA), and discuss the merits of a combined approach. A hybrid model combining SIA and SRA to form a new approach called, ‘risk and social impact assessment’ (RSIA) is introduced. RSIA expands the capacity of SIA to evaluate and manage the social impacts of risky projects such as nuclear energy as well as natural hazards and disasters such as droughts and floods. We outline the three stages of RSIA, namely: impact identification, impact assessment, and impact management. -- Highlights: • A hybrid model to combine SIA and SRA namely RSIA is proposed. • RSIA can provide the proper mechanism to assess social impacts of natural hazards. • RSIA can play the role of ex-post as well as ex-ante assessment. • For some complicated and sensitive cases like nuclear energy, conducting a RSIA is necessary

  12. 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

  13. Impact assessment of waste management options in Singapore.

    Science.gov (United States)

    Tan, Reginald B H; Khoo, Hsien H

    2006-03-01

    This paper describes the application of life cycle assessment for evaluating various waste management options in Singapore, a small-island city state. The impact assessment method by SimaPro is carried out for comparing the potential environmental impacts of waste treatment options including landfilling, incineration, recycling, and composting. The inventory data include gases and leachate from landfills, air emissions and energy recovery from incinerators, energy (and emission) savings from recycling, composting gases, and transport pollution. The impact assessment results for climate change, acidification, and ecotoxicity show that the incineration of materials imposes considerable harm to both human health and the environment, especially for the burning of plastics, paper/cardboard, and ferrous metals. The results also show that, although some amount of energy can be derived from the incineration of wastes, these benefits are outweighed by the air pollution (heavy metals and dioxins/furans) that incinerators produce. For Singapore, landfill gases and leachate generate minimal environmental damage because of the nation's policy to landfill only 10% of the total disposed wastes. Land transportation and separation of waste materials also pose minimal environmental damage. However, sea transportation to the landfill could contribute significantly to acidification because of the emissions of sulfur oxides and nitrogen oxides from barges. The composting of horticultural wastes hardly imposes any environmental damage. Out of all the waste strategies, the recycling of wastes offers the best solution for environmental protection and improved human health for the nation. Significant emission savings can be realized through recycling.

  14. 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.

  15. Health and equity impacts of climate change in Aotearoa-New Zealand, and health gains from climate action.

    Science.gov (United States)

    Bennett, Hayley; Jones, Rhys; Keating, Gay; Woodward, Alistair; Hales, Simon; Metcalfe, Scott

    2014-11-28

    Human-caused climate change poses an increasingly serious and urgent threat to health and health equity. Under all the climate projections reported in the recent Intergovernmental Panel on Climate Change assessment, New Zealand will experience direct impacts, biologically mediated impacts, and socially mediated impacts on health. These will disproportionately affect populations that already experience disadvantage and poorer health. Without rapid global action to reduce greenhouse gas emissions (particularly from fossil fuels), the world will breach its carbon budget and may experience high levels of warming (land temperatures on average 4-7 degrees Celsius higher by 2100). This level of climate change would threaten the habitability of some parts of the world because of extreme weather, limits on working outdoors, and severely reduced food production. However, well-planned action to reduce greenhouse gas emissions could bring about substantial benefits to health, and help New Zealand tackle its costly burden of health inequity and chronic disease.

  16. A scoping review of the public health impact of vitamin D-fortified dairy products for fracture prevention.

    Science.gov (United States)

    Hiligsmann, Mickael; Neuprez, Audrey; Buckinx, Fanny; Locquet, Médéa; Reginster, Jean-Yves

    2017-12-01

    Dairy products are rich in nutrients that positively influence bone health and hence fracture risk, and have therefore been recommended and used for fracture prevention. To help decision makers to efficiently allocate scare resources, it is further important to assess the public health and economic impact of any health intervention. In recent years, several studies have been conducted to estimate the public health and/or economic impact of dairy products but no overview is currently available. This article aims therefore to summarize evidence and review articles that estimated the public health and/or economic impact of vitamin D-fortified dairy products for fracture prevention. A literature review was conducted using PubMed to identify original studies that assessed the public health and/or economic impact of dairy products (or of calcium/vitamin D supplementation) for fracture prevention up to January 15, 2017. Seven articles were identified. Different strategies were used by the authors to model the economic/public health impact of dairy products. The four studies assessing the public health impact of dairy products revealed a substantial benefit in terms of fracture prevented, life years, disability-adjusted life years and/or quality-adjusted life years gained. Studies assessing the cost-effectiveness revealed that the use of dairy products is generally cost-effective in the general population aged above 70 years, and from the age of 60 years in populations at high risk of fractures. This systematic review suggests that the use of dairy products could substantially reduce the burden of osteoporotic fractures and seem to be an economically beneficial strategy.

  17. 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.

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

    International Nuclear Information System (INIS)

    Schuchter, Joseph; Rutt, Candace; Satariano, William A.; Seto, Edmund

    2015-01-01

    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. 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. Applying social impact assessment to nursing research.

    Science.gov (United States)

    Bradbury-Jones, Caroline; Taylor, Julie

    2014-08-05

    Many nurses need to construct a research proposal at some stage of their career and there are multiple texts that provide guidance on doing so. However, most texts do not provide explicit guidance on the issue of social impact--the effect of research on the social health and wellbeing of individuals, families and communities and on the improved performance of relevant services. This article proposes that social impact should be considered from the beginning of a research project. It outlines a framework for assessing social impact to help strengthen the quality of research proposals and assist nurses constructing the proposal and also those evaluating it, including academic assessors or funding body reviewers. Nursing research should be useful and should have a positive effect on practice. Focusing on social impact can increase the chances of this desirable outcome.

  1. Health risk and impact evaluation for recycling of radioactive scrap metal

    International Nuclear Information System (INIS)

    Nieves, L.A.; Chen, S.Y.; Murphie, W.E.; Lilly, M.J. III

    1994-01-01

    The DoE, Office of Environmental Restoration and Waste Management, is participating with the Organization for Economic Cooperation and Development in providing analytical support for developing international standards for recycling of radioactive scrap metals. For this purpose, Argonne National Laboratory is assessing health, environmental and societal implications of recycling and/or disposal process alternatives. This effort includes development of international inventory estimates for contaminated metals; investigation of international scrap metal markets; assessment of radiological and non-radiological human health risks; impacts on environmental quality and resources; and investigation of social and political factors. The RSM disposal option is being assessed with regard to the environmental and health impacts of replacing the metals if they are withdrawn from use. Impact estimates are developed for steel as an illustrative example because steel comprises a major portion of the scrap metal inventory. Current and potential sources of RSM include nuclear power plants, fuel cycle and weapons production facilities, industrial and medical facilities and equipment, and petroleum and phosphate rock extraction equipment. Millions of metric tons (t) of scrap iron and steel, stainless steel, and copper, as well as lesser quantities of aluminum, nickel, lead, and zirconium, are likely to become available in the future as these facilities are withdrawn from service

  2. Assessment of health impacts and policy options in relation to transport noise

    NARCIS (Netherlands)

    Staatsen BAM; Nijland HA; van Kempem EMM; de Hollander AEM; Franssen AEM; van Kamp I; MGO

    2004-01-01

    This paper has been drafted within the framework of a joint international project (Austria, France, Malta, Sweden, Switzerland and the Netherlands). The aim of this project is to describe the state of the art on transport related health impacts, highlight (if possible) costs and benefits, identify

  3. A health impact assessment of proposed public transportation service cuts and fare increases in Boston, Massachusetts (U.S.A.).

    Science.gov (United States)

    James, Peter; Ito, Kate; Buonocore, Jonathan J; Levy, Jonathan I; Arcaya, Mariana C

    2014-08-07

    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.

  4. 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.

  5. 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

  6. Health impact of external funding for HIV, tuberculosis and malaria: systematic review

    NARCIS (Netherlands)

    Jongh, T.E. de; Harnmeijer, J.H.; Atun, R.; Korenromp, E.L.; Zhao, J.; Puvimanasinghe, J.; Baltussen, R.M.P.M.

    2014-01-01

    BACKGROUND: Since 2002, development assistance for health has substantially increased, especially investments for HIV, tuberculosis (TB) and malaria control. We undertook a systematic review to assess and synthesize the existing evidence in the scientific literature on the health impacts of these

  7. Health impact of external funding for HIV, tuberculosis and malaria: Systematic review

    NARCIS (Netherlands)

    T.E. De Jongh (Thyra E.); J.H. Harnmeijer (Joanne H.); R. Atun (Rifat); E.L. Korenromp (Eline); J. Zhao (Jinkou); J.P.A. Puvimanasinghe (John); R.M.P.M. Baltussen (Rob)

    2014-01-01

    textabstractBackground Since 2002, development assistance for health has substantially increased, especially investments for HIV, tuberculosis (TB) and malaria control. We undertook a systematic review to assess and synthesize the existing evidence in the scientific literature on the health impacts

  8. Knowledge and perceptions about the health impact of climate change among health sciences students in Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Nigatu, Andualem S; Asamoah, Benedict O; Kloos, Helmut

    2014-06-11

    Climate change affects human health in various ways. Health planners and policy makers are increasingly addressing potential health impacts of climate change. Ethiopia is vulnerable to these impacts. Assessing students' knowledge, understanding and perception about the health impact of climate change may promote educational endeavors to increase awareness of health impacts linked to climate change and to facilitate interventions. A cross-sectional study using a questionnaire was carried out among the health science students at Haramaya University. Quantitative methods were used to analyze the results. Over three quarters of the students were aware of health consequences of climate change, with slightly higher rates in females than males and a range from 60.7% (pharmacy students) to 100% (environmental health and post-graduate public health students). Electronic mass media was reportedly the major source of information but almost all (87.7%) students stated that their knowledge was insufficient to fully understand the public health impacts of climate change. Students who knew about climate change were more likely to perceive it as a serious health threat than those who were unaware of these impacts [OR: 17.8, 95% CI: 8.8-32.1] and also considered their departments to be concerned about climate change (OR: 7.3, 95% CI: 2.8-18.8), a perception that was also significantly more common among students who obtained their information from the electronic mass media and schools (p health impacts of climate change. Health sciences students at Haramaya University may benefit from a more comprehensive curriculum on climate change and its impacts on health.

  9. USEtox: The UNEP-SETAC consensus model for life-cycle impacts on human health and ecosystems

    DEFF Research Database (Denmark)

    Hauschild, Michael Zwicky; McKone, Tom; Huijbregts, Mark A.J.

    2007-01-01

    Life cycle impact assessment (LCIA) characterizes emissions for the life-cycle assessment (LCA) of a product by translating these emissions into their potential impacts on human health, ecosystems, global climate and other resources. This process requires substance-specific characterization factors...... (CFs) that represent the relative potential of specific chemical emissions to impact human disease burden and ecosystem health. Within the Life Cycle Initiative, a joint initiative of the United Nations Environment Program (UNEP) and of the Society of Environmental Toxicology and Chemistry (SETAC...... and transparent tool for making human health and ecosystem CF estimates. The consensus model has now been used to calculate CFs for several thousand substances and is intended to form the basis of the recommendations from UNEP-SETAC‘s Life Cycle Initiative regarding characterization of toxic impacts in Life Cycle...

  10. A framework for combining social impact assessment and risk assessment

    NARCIS (Netherlands)

    Mahmoudi, Hossein; Renn, Ortwin; Vanclay, Frank; Hoffmann, Volker; Karami, Ezatollah

    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. 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

  12. Environmental impact assessment of pharmaceutical prescriptions: Does location matter?

    Science.gov (United States)

    Oldenkamp, Rik; Huijbregts, Mark A J; Hollander, Anne; Ragas, Ad M J

    2014-11-01

    A methodology was developed for the assessment and comparison of the environmental impact of two alternative pharmaceutical prescriptions. This methodology provides physicians with the opportunity to include environmental considerations in their choice of prescription. A case study with the two antibiotics ciprofloxacin and levofloxacin at three locations throughout Europe showed that the preference for a pharmaceutical might show spatial variation, i.e. comparison of two pharmaceuticals might yield different results when prescribed at different locations. This holds when the comparison is based on both the impact on the aquatic environment and the impact on human health. The relative impacts of ciprofloxacin and levofloxacin on human health were largely determined by the local handling of secondary sludge, agricultural disposal practices, the extent of secondary sewage treatment, and local food consumption patterns. The relative impacts of ciprofloxacin and levofloxacin on the aquatic environment were mostly explained by the presence of specific sewage treatment techniques, as effluents from sewage treatment plants (STPs) are the most relevant emission pathway for the aquatic environment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Integrating Urban Infrastructure and Health System Impact Modeling for Disasters and Mass-Casualty Events

    Science.gov (United States)

    Balbus, J. M.; Kirsch, T.; Mitrani-Reiser, J.

    2017-12-01

    Over recent decades, natural disasters and mass-casualty events in United States have repeatedly revealed the serious consequences of health care facility vulnerability and the subsequent ability to deliver care for the affected people. Advances in predictive modeling and vulnerability assessment for health care facility failure, integrated infrastructure, and extreme weather events have now enabled a more rigorous scientific approach to evaluating health care system vulnerability and assessing impacts of natural and human disasters as well as the value of specific interventions. Concurrent advances in computing capacity also allow, for the first time, full integration of these multiple individual models, along with the modeling of population behaviors and mass casualty responses during a disaster. A team of federal and academic investigators led by the National Center for Disaster Medicine and Public Health (NCDMPH) is develoing a platform for integrating extreme event forecasts, health risk/impact assessment and population simulations, critical infrastructure (electrical, water, transportation, communication) impact and response models, health care facility-specific vulnerability and failure assessments, and health system/patient flow responses. The integration of these models is intended to develop much greater understanding of critical tipping points in the vulnerability of health systems during natural and human disasters and build an evidence base for specific interventions. Development of such a modeling platform will greatly facilitate the assessment of potential concurrent or sequential catastrophic events, such as a terrorism act following a severe heat wave or hurricane. This presentation will highlight the development of this modeling platform as well as applications not just for the US health system, but also for international science-based disaster risk reduction efforts, such as the Sendai Framework and the WHO SMART hospital project.

  14. 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

  15. 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.

  16. [Use of health technology assessment in decision-making processes by the Brazilian Ministry of Health on the incorporation of technologies in the Brazilian Unified National Health System].

    Science.gov (United States)

    Novaes, Hillegonda Maria Dutilh; Elias, Flávia Tavares Silva

    2013-11-01

    Policies for scientific development and knowledge production in health have increased in recent decades. In Brazil, incentives for research, development, and innovation have been part of the National Health Act since 1990, and science and technology policies for health, including health technology assessment (HTA), have been implemented since 1994, as in many other countries. The emphasis is now on impact evaluation of HTA policies in the incorporation of technologies by health services and systems. The article presents a case study of HTA utilization in decision-making processes in the Brazilian Ministry of Health, analyzing participation by the Department of Science and Technology (DECIT), responsible for the production of assessments used in the Commission on Technology Incorporation (CITEC) of the Ministry of Health from 2008 to 2010. CITEC used 103 assessments in its decisions during this period, of which DECIT produced 80%. Nearly all were literature reviews on therapeutic technologies. An increase in knowledge production was observed. A methodological and political learning process appears to have occurred in the use of HTA, but its impact on Brazilian Unified National Health System remains unclear.

  17. 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.

  18. Including pathogen risk in life cycle assessment of wastewater management. 2. Quantitative comparison of pathogen risk to other impacts on human health.

    Science.gov (United States)

    Heimersson, Sara; Harder, Robin; Peters, Gregory M; Svanström, Magdalena

    2014-08-19

    Resource recovery from sewage sludge has the potential to save natural resources, but the potential risks connected to human exposure to heavy metals, organic micropollutants, and pathogenic microorganisms attract stakeholder concern. The purpose of the presented study was to include pathogen risks to human health in life cycle assessment (LCA) of wastewater and sludge management systems, as this is commonly omitted from LCAs due to methodological limitations. Part 1 of this article series estimated the overall pathogen risk for such a system with agricultural use of the sludge, in a way that enables the results to be integrated in LCA. This article (part 2) presents a full LCA for two model systems (with agricultural utilization or incineration of sludge) to reveal the relative importance of pathogen risk in relation to other potential impacts on human health. The study showed that, for both model systems, pathogen risk can constitute an important part (in this study up to 20%) of the total life cycle impacts on human health (expressed in disability adjusted life years) which include other important impacts such as human toxicity potential, global warming potential, and photochemical oxidant formation potential.

  19. Creative potential: mental well-being impact assessment of the Liverpool 2008 European capital of culture programme.

    Science.gov (United States)

    West, H M; Scott-Samuel, A

    2010-04-01

    Culture has a number of potential impacts upon health and well-being. This project was undertaken to assess the potential impacts of the Liverpool 2008 European Capital of Culture programme upon mental well-being, so that positive effects can be maximized and negative impacts reduced, in order that health and well-being are promoted and inequalities are reduced. A mental well-being impact assessment (MWIA) toolkit has been developed, and was piloted in this study. MWIA uses a sequence of procedures designed to systematically assess the effect of projects, programmes and policies upon people's mental well-being and health. The MWIA toolkit was used to explore the potential positive and negative impacts on mental well-being of a sample of projects and policies from the European Capital of Culture programme. This was achieved by asking stakeholders to answer a series of questions, holding participative workshops, constructing a community profile and reviewing the research literature. Recommendations were developed which aim to enhance the impact of the programme on people's mental well-being. As expected, both positive and negative impacts of the European Capital of Culture programme on mental well-being were identified. Fourteen themes were identified as emerging from the workshops, screening and reviewing the research evidence. Based on these data, 33 recommendations were developed by the project steering group and have been presented to the Liverpool Culture Company. The process of conducting the assessment, particularly its participatory nature and its awareness-raising role, had impacts upon mental well-being. The findings demonstrate the potential for the Culture Company programme to have a profound impact upon mental well-being, and highlight areas which could be addressed to optimize the impact of the programme. 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  20. Integrating nutritional benefits and impacts in a life cycle assessment framework: A US dairy consumption case study

    DEFF Research Database (Denmark)

    Ernstoff, Alexi; Fulgoni III, Victor; Heller, Martin

    2014-01-01

    Although essential to understand the overall health impact of a food or diet, nutrition is not usually considered in food-related life cycle assessments (LCAs). As a case study to demonstrate comparing environmental and nutritional health impacts we investigate United States dairy consumption....... Nutritional impacts, interpreted from disease burden epidemiology, are compared to health impacts from more tradi-tional impacts (e.g. due to exposure to particulate matter emissions across the life cycle) considered in LCAs. After accounting for the present consumption, data relating dairy intake to public...... to environmental impacts suggesting the need for investigat-ing the balance between dietary public health advantages and disadvantages in comparison to environmental impacts....

  1. mHealth Assessment: Conceptualization of a Global Framework.

    Science.gov (United States)

    Bradway, Meghan; Carrion, Carme; Vallespin, Bárbara; Saadatfard, Omid; Puigdomènech, Elisa; Espallargues, Mireia; Kotzeva, Anna

    2017-05-02

    The mass availability and use of mobile health (mHealth) technologies offers the potential for these technologies to support or substitute medical advice. However, it is worrisome that most assessment initiatives are still not able to successfully evaluate all aspects of mHealth solutions. As a result, multiple strategies to assess mHealth solutions are being proposed by medical regulatory bodies and similar organizations. We aim to offer a collective description of a universally applicable description of mHealth assessment initiatives, given their current and, as we see it, potential impact. In doing so, we recommend a common foundation for the development or update of assessment initiatives by addressing the multistakeholder issues that mHealth technology adds to the traditional medical environment. Organized by the Mobile World Capital Barcelona Foundation, we represent a workgroup consisting of patient associations, developers, and health authority representatives, including medical practitioners, within Europe. Contributions from each group's diverse competencies has allowed us to create an overview of the complex yet similar approaches to mHealth evaluation that are being developed today, including common gaps in concepts and perspectives. In response, we summarize commonalities of existing initiatives and exemplify additional characteristics that we believe will strengthen and unify these efforts. As opposed to a universal standard or protocol in evaluating mHealth solutions, assessment frameworks should respect the needs and capacity of each medical system or country. Therefore, we expect that the medical system will specify the content, resources, and workflow of assessment protocols in order to ensure a sustainable plan for mHealth solutions within their respective countries. A common framework for all mHealth initiatives around the world will be useful in order to assess whatever mHealth solution is desirable in different areas, adapting it to the

  2. A Method for Quantifying the Acute Health Impacts of Residential Non-Biological Exposure Via Inhalation

    Energy Technology Data Exchange (ETDEWEB)

    Logue, Jennifer M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Sherman, Max H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Singer, Bret C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-08-01

    The inability to monetize the health costs of acute exposures in homes and the benefits of various control options is a barrier to justifying policies and approaches that can reduce exposure and improve health.We synthesized relationships between short-term outdoor concentration changes and health outcomes to estimate the health impacts of short-term in-home exposures. Damage and cost impacts of specific health outcomes were taken from the literature. We assessed the impact of vented and non-vented residential natural gas cooking burners on Southern California occupants for two pollutants (NO2 and CO).

  3. 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

  4. 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

  5. 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

  6. Hygienic environmental assessment and health of children in Penza

    Directory of Open Access Journals (Sweden)

    Yu.V. Korochkina

    2015-09-01

    Full Text Available Assessment of the carcinogenic risk from air pollution, the chemical composition of the drinking water and the content of contaminants in food showed that the total cancer risk for both inhalation and oral routes of administering priority pollutants and contaminants into the body of Penza children and adolescents complies with the maximum permissible level. The greatest risk of non-carcinogenic impact associated with air pollution is generated in respect of the respiratory system, eyes and immune system. The maximum hazard indices associated with the consumption of drinking water, are set for blood, hormone system and kidneys. The risk of negative impacts associated with the receipt of food contaminants is observed in respect of the hematopoietic and cardiovascular systems. Application of risk assessment methodology to study the effects of chemicals polluting the environment on health has allowed to justify preventive measures aimed at reducing the risk to the health of children and adolescents, as well as increased monitoring researches of environmental objects to isolate areas of high risk to children's health.

  7. Sense-making and Impact Assessment

    DEFF Research Database (Denmark)

    Lyhne, Ivar

    The poster integrates knowledge about how we make sense of situations into SEA methodology to strengthen the staging of impact assessments and the process of scoping impacts.......The poster integrates knowledge about how we make sense of situations into SEA methodology to strengthen the staging of impact assessments and the process of scoping impacts....

  8. 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

  9. Health impacts and research ethics in female trafficking.

    Science.gov (United States)

    Dhital, S R; Aro, R A; Sapkota, K

    2011-04-01

    Female trafficking is a social and public health problem, associated with physical and sexual abuse, psychological trauma, injuries from violence, sexually transmitted infections, adverse reproductive outcomes and substance misuse. It faces several challenges ranging from the hidden nature of the problem to ethical and human rights issues. The objectives of this paper are to analyze health impact of trafficking; ethical and research issues and anti-trafficking strategies in the Nepalese context. We collected published and unpublished data assessing the public health, ethical burden and research needs from different sources. Trafficked female involved in sex-industry that face grave situation as depicted and it might a reservoir of sexually transmitted diseases. Ethical issues related to survey of assessing the burden are difficult to carry out. The best ways to prevent and control these problems are to enhance anti- trafficking laws and raise awareness, empower and mobilize females and establish organizational capacity.

  10. [Health technology assessment and its impact on pharmaceutical pricing and reimbursement policies].

    Science.gov (United States)

    Castillo-Laborde, Carla; Silva-Illanes, Nicolás

    2014-01-01

    The article conceptualizes the pharmaceutical pricing and reimbursement policies related to financial coverage in the context of health systems. It introduces the pharmaceutical market as an imperfect one, in which appropriate regulation is required. Moreover, the basis that guide the pricing and reimbursement processes are defined and described in order to generate a categorization based on whether they are intended to assess the 'added value' and if the evaluation is based on cost-effectiveness criteria. This framework is used to review different types of these policies applied in the international context, discussing the role of the Health Technology Assessment in these processes. Finally, it briefly discusses the potential role of these types of policies in the Chilean context.

  11. Microbiological risk assessment and public health

    International Nuclear Information System (INIS)

    Roger Skinner

    1992-01-01

    Despite the advances made in risk assessment i the past twenty years, in areas as diverse as toxicology and offshore engineering, the risk assessment approach has made little impact on those addressing the microbiological aspects of public health. In this paper the advances which have been made are discussed and the difficulties preventing the wider application of microbiological risk assessment (MRA) to public health are considered. The term microbiological risk is used here to mean the probability of contracting a disease caused by a microorganism. I intend to demonstrate that the dynamic nature of microorganisms and the unique nature of the relationship between a pathogen (a microorganism which causes disease) and its host create special challenges for those involved in MRA. Although these problems are difficult they are not intractable. Indeed in some cases partial solutions have already been found and applied. It is hoped that this paper will help stimulate further thought and consideration in a variety of disciplines so that these challenges can be met, thereby allowing MRA to fulfil its potential

  12. Microbiological risk assessment and public health

    Energy Technology Data Exchange (ETDEWEB)

    Skinner, Roger

    1992-07-01

    Despite the advances made in risk assessment i the past twenty years, in areas as diverse as toxicology and offshore engineering, the risk assessment approach has made little impact on those addressing the microbiological aspects of public health. In this paper the advances which have been made are discussed and the difficulties preventing the wider application of microbiological risk assessment (MRA) to public health are considered. The term microbiological risk is used here to mean the probability of contracting a disease caused by a microorganism. I intend to demonstrate that the dynamic nature of microorganisms and the unique nature of the relationship between a pathogen (a microorganism which causes disease) and its host create special challenges for those involved in MRA. Although these problems are difficult they are not intractable. Indeed in some cases partial solutions have already been found and applied. It is hoped that this paper will help stimulate further thought and consideration in a variety of disciplines so that these challenges can be met, thereby allowing MRA to fulfil its potential.

  13. Methodology for assessing the radiological impact on environment

    International Nuclear Information System (INIS)

    Zhang Yongxing

    1988-01-01

    During the 1940s, the early stages of nuclear programmes, the assessment of the radionuclides released to the environment was first initiated for the large nuclear facilities, with emphasis placed on environmental monitoring. The radiological assessment is a quantitative process of estimating the impact on human, resulting from the releases of the radionuclides to the environment. It is a multidisciplinary subject including identification of source terms, environmental transport and dispersion, health effect evaluation and so on. This paper briefly, but comprehensively, describes the methodology for the assessment of the environmental radiological consequence, and discusses the trend of various research fields related to the subject

  14. 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.

  15. 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

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

    OpenAIRE

    Lötters, Freek; Lenoir-Wijnkoop, Irene; Fardellone, P.; Rizzoli, R.; Rocher, E.; 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, taking a health economics perspective. Introduction: This study seeks, first, to estimate the impact of an increased dairy consumption on reducing the burden of osteoporosis in terms of health outcomes and...

  17. Particulate Matter and Health Risk under a Changing Climate: Assessment for Portugal

    Directory of Open Access Journals (Sweden)

    Daniela Dias

    2012-01-01

    Full Text Available The potential impacts of climate-induced changes in air pollution levels and its impacts on population health were investigated. The IPCC scenario (SRES A2 was used to analyse the effects of climate on future PM10 concentrations over Portugal and their impact on short-term population exposure and mortality. The air quality modelling system has been applied with high spatial resolution looking on climate changes at regional scale. To quantify health impacts related to air pollution changes, the WHO methodology for health impact assessment was implemented. The results point to 8% increase of premature mortality attributed to future PM10 levels in Portugal. The pollution episodes with daily average PM10 concentration above the current legislated value (50 μg·m−3 would be responsible for 81% of attributable cases. The absolute number of deaths attributable to PM10 under future climate emphasizes the importance of indirect effects of climate change on human health.

  18. Institutionalising health technology assessment: establishing the Medical Technology Assessment Board in India.

    Science.gov (United States)

    Downey, Laura E; Mehndiratta, Abha; Grover, Ashoo; Gauba, Vijay; Sheikh, Kabir; Prinja, Shankar; Singh, Ravinder; Cluzeau, Francoise A; Dabak, Saudamini; Teerawattananon, Yot; Kumar, Sanjiv; Swaminathan, Soumya

    2017-01-01

    India is at crossroads with a commitment by the government to universal health coverage (UHC), driving efficiency and tackling waste across the public healthcare sector. Health technology assessment (HTA) is an important policy reform that can assist policy-makers to tackle inequities and inefficiencies by improving the way in which health resources are allocated towards cost-effective, appropriate and feasible interventions. The equitable and efficient distribution of health budget resources, as well as timely uptake of good value technologies, are critical to strengthen the Indian healthcare system. The government of India is set to establish a Medical Technology Assessment Board to evaluate existing and new health technologies in India, assist choices between comparable technologies for adoption by the healthcare system and improve the way in which priorities for health are set. This initiative aims to introduce a more transparent, inclusive, fair and evidence-based process by which decisions regarding the allocation of health resources are made in India towards the ultimate goal of UHC. In this analysis article, we report on plans and progress of the government of India for the institutionalisation of HTA in the country. Where India is home to one-sixth of the global population, improving the health services that the population receives will have a resounding impact not only for India but also for global health.

  19. Evaluating external costs of human health and environmental impacts using IAEA model SIMPACTS

    International Nuclear Information System (INIS)

    Bobric, Elena; Jelev, Adrian

    2005-01-01

    SIMPACTS (Simplified Approach for Estimating Impacts and External Costs of Electricity Generation) model developed at the International Atomic Energy Agency is a powerful and convenient tool for evaluating external costs induced by different energy sources. The model was developed for industrial countries and for developing countries as well where studies of alternatives of sustainable energy policies are conducted. The SIMPACTS allow the decision making factors involved in energy policy to have reasonable estimates of environment impacts and relating costs appealing to a rather low number of input parameters. The paper aims at analyzing by means of SIMPACTS the environmental impact produced by Cernavoda NPP operation in two cases: a) the impact of the Cernavoda NPP itself; b) the impact of an hypothetical coal based power plant of the same power level and located on the Cernavoda NPP site. The SIMPACTS modules AIRPACTS and NUCPACTS were applied to assess the impacts on human health, agricultural crops and building materials from exposure to routine atmospheric emissions and as well to quantify and value the adverse effects on human health due to routine atmospheric release of radionuclides from the NPP, via radioactive waste ground disposal or resulting from accidents in nuclear facility, respectively. The conclusion of this study based on SIMPACTS model application to assess the health effects and damage cost per year is that the Cernavoda NPP presents the lower health effects and damage cost comparing with power plants of other types

  20. Health workforce in India: assessment of availability, production and distribution.

    Science.gov (United States)

    Hazarika, Indrajit

    2013-01-01

    India faces an acute shortage of health personnel. Together with inequalities in distribution of health workers, this shortfall impedes progress towards achievement of the Millennium Development Goals. The aim of this study was to assess health-workforce distribution, identify inequalities in health-worker provision and estimate the impact of this maldistribution on key health outcomes in India. Health-workforce availability and production were assessed by use of year-end data for 2009 obtained from the Indian Ministry of Statistics and Programme Implementation. Inequalities in the distribution of doctors, dentists, nurses and midwives were estimated by use of the Gini coefficient and the relation between health-worker density and selected health outcomes was assessed by linear regression. Inequalities in the availability of health workers exist in India. Certain states are experiencing an acute shortage of health personnel. Inequalities in the distribution of health workers are highest for doctors and dentists and have a significant effect on health outcomes. Although the production of health workers has expanded greatly in recent years, the problems of imbalances in their distribution persist. As India seeks to achieve universal health coverage by 2020, the realization of this goal remains challenged by the current lack of availability and inequitable distribution of appropriately trained, motivated and supported health workers.

  1. Regionalized life cycle impact assessment of air pollution on the global scale: Damage to human health and vegetation

    Science.gov (United States)

    van Zelm, Rosalie; Preiss, Philipp; van Goethem, Thomas; Van Dingenen, Rita; Huijbregts, Mark

    2016-06-01

    We developed regionalized characterization factors (CFs) for human health damage from particulate matter (PM2.5) and ozone, and for damage to vegetation from ozone, at the global scale. These factors can be used in the impact assessment phase of an environmental life cycle assessment. CFs express the overall damage of a certain pollutant per unit of emission of a precursor, i.e. primary PM2.5, nitrogen oxides (NOx), ammonia (NH3), sulfur dioxide (SO2) and non-methane volatile organic compounds (NMVOCs). The global chemical transport model TM5 was used to calculate intake fractions of PM2.5 and ozone for 56 world regions covering the whole globe. Furthermore, region-specific effect and damage factors were derived, using mortality rates, background concentrations and years of life lost. The emission-weighted world average CF for primary PM2.5 emissions is 629 yr kton-1, varying up to 3 orders of magnitude over the regions. Larger CFs were obtained for emissions in central Asia and Europe, and smaller factors in Australia and South America. The world average CFs for PM2.5 from secondary aerosols, i.e. NOx, NH3, and SO2, is 67.2 to 183.4 yr kton-1. We found that the CFs for ozone human health damage are 2-4 orders of magnitude lower compared to the CFs for damage due to primary PM2.5 and PM2.5 precursor emissions. Human health damage due to the priority air pollutants considered in this study was 1.7·10-2 yr capita-1 worldwide in year 2010, with primary PM2.5 emissions as the main contributor (62%). The emission-weighted world average CF for ecosystem damage due to ozone was 2.5 km2 yr kton-1 for NMVOCs and 8.7 m2 yr kg-1 for NOx emissions, varying 2-3 orders of magnitude over the regions. Ecosystem damage due to the priority air pollutants considered in this study was 1.6·10-4 km2 capita-1 worldwide in 2010, with NOx as the main contributor (72%). The spatial range in CFs stresses the importance of including spatial variation in life cycle impact assessment of

  2. Waste management programmatic environmental impact statement methodology for estimating human health risks

    International Nuclear Information System (INIS)

    Bergenback, B.; Blaylock, B.P.; Legg, J.L.

    1995-05-01

    The US Department of Energy (DOE) has produced large quantities of radioactive and hazardous waste during years of nuclear weapons production. As a result, a large number of sites across the DOE Complex have become chemically and/or radiologically contaminated. In 1990, the Secretary of Energy charged the DOE Office of Environmental Restoration and Waste management (EM) with the task of preparing a Programmatic Environmental Impact Statement (PEIS). The PEIS should identify and assess the potential environmental impacts of implementing several integrated Environmental Restoration (ER) and Waste Management (WM) alternatives. The determination and integration of appropriate remediation activities and sound waste management practices is vital for ensuring the diminution of adverse human health impacts during site cleanup and waste management programs. This report documents the PEIS risk assessment methodology used to evaluate human health risks posed by WM activities. The methodology presents a programmatic cradle to grave risk assessment for EM program activities. A unit dose approach is used to estimate risks posed by WM activities and is the subject of this document

  3. Problem structuring in Health Technology Assessment. An argumentative approach to increase its usefulness.

    NARCIS (Netherlands)

    Moret-Hartman, M.

    2008-01-01

    This thesis addresses the problem of the limited impact of Health Technology Assessment (HTA) research on health policy and clinical practice. HTA is a type of policy research that aims to provide information concerning medical technologies in order to support health care decision making. Although,

  4. Practitioner survey of the state of health integration in environmental assessment: The case of northern Canada

    International Nuclear Information System (INIS)

    Noble, Bram; Bronson, Jackie

    2006-01-01

    Based on a case study of health integration in Canadian northern EA, this paper further demonstrates the lack of consistent integration of health in EA practice. A survey was administered to northern EA and health practitioners, administrators and special interest groups to assess current northern health assessment practices, the scope of health in EA, EA performance with regard to health assessment and the perceived barriers to health integration. Results suggest that health is currently recognized as an important component of northern EA and is addressed in the majority of cases; however, health is addressed primarily during the pre-decision stages of EA and less often during post-decision follow-up and monitoring. Moreover, when health is addressed, attention is limited to the physical components of health and health impacts due to physical environmental change, with considerably less attention given to the social aspects of health. Results also suggest dissent between EA practitioners, health practitioners and other interests concerning the overall state of health in EA; however, there is consensus on the key challenges to improved integration, namely differences in understanding of the scope of health and expectations of EA to assess health impacts; limited coordination between EA and health practitioners; limited scope and requirements of current EA legislation for health assessment; and the lack of supporting EA methods and frameworks

  5. Defining and Assessing Quality Improvement Outcomes: A Framework for Public Health

    Science.gov (United States)

    Nawaz, Saira; Thomas, Craig; Young, Andrea

    2015-01-01

    We describe an evidence-based framework to define and assess the impact of quality improvement (QI) in public health. Developed to address programmatic and research-identified needs for articulating the value of public health QI in aggregate, this framework proposes a standardized set of measures to monitor and improve the efficiency and effectiveness of public health programs and operations. We reviewed the scientific literature and analyzed QI initiatives implemented through the Centers for Disease Control and Prevention’s National Public Health Improvement Initiative to inform the selection of 5 efficiency and 8 effectiveness measures. This framework provides a model for identifying the types of improvement outcomes targeted by public health QI efforts and a means to understand QI’s impact on the practice of public health. PMID:25689185

  6. Environmental impact assessments and geological repositories for radioactive waste

    International Nuclear Information System (INIS)

    O'Sullivan, P.; McKirdy, B.; Askarieh, M.; Bond, A.; Russell, S.

    1999-01-01

    Since 1985 it has been obligatory that facilities in the European Union designed for the permanent storage or disposal of radioactive waste be assessed to determine their effects on the environment. This assessment must be undertaken in advance of any decision by national authorities to give consent for development work to proceed. Member States are given wide discretion on how the above requirements are implemented in practice, e.g. the relevant European Council Directives call for the results of the environmental assessment to be made available to the public before development consent is granted but the detailed arrangements for dissemination of such information and procedures for public consultation are determined by individual Member States. Although the Directives require an assessment of the direct and indirect effects of a project on human beings and on various elements of the natural environment, they are non-specific as to what particular impacts should be addressed, particularly as regards the effects of a project on human beings. Therefore, for example, each Member State may decide whether or not social, health and economic impacts should be included in the assessment. This paper discusses the above issues. It proposes a model approach to environmental impact assessment in the context of geological repositories, including the role of the assessment on the overall decision processes for repository development, the scope and content of the assessment report, and approaches to public involvement

  7. The impact of global health initiatives on the health system in Angola.

    Science.gov (United States)

    Craveiro, Isabel; Dussault, Gilles

    2016-01-01

    We assessed the impact of global health initiatives (GHIs) on the health care system of Angola, as a contribution to documenting how GHIs, such as the Global Fund, GAVI and PEPFAR, influence the planning and delivery of health services in low-income countries and how national systems respond. We collected the views of national and sub-national key informants through 42 semi-structured interviews between April 2009 and May 2011 (12 at the national level and 30 at the sub-national level). We used a snowball technique to identify respondents from government, donors and non-governmental organisations. GHIs stimulated the formulation of a health policy and of plans and strategies, but the country has yet to decide on its priorities for health. At the regional level, managers lack knowledge of how GHIs' function, but they assess the effects of external funds as positive as they increased training opportunities, and augment the number of workers engaged in HIV or other specific disease programmes. However, GHIs did not address the challenge of attraction and retention of qualified personnel in provinces. Since Angola is not entirely dependent on external funding, national strategic programmes and the interventions of GHIs co-habit well, in contrast to countries such as Mozambique, which heavily depend on external aid.

  8. Measuring the impact of health problems among adults with limited mobility in Thailand: further validation of the Perceived Impact of Problem Profile

    Directory of Open Access Journals (Sweden)

    Manderson Lenore

    2008-01-01

    Full Text Available Abstract Background The Perceived Impact of Problem Profile (PIPP was developed to provide a tool for measuring the impact of a health condition from the individual's perspective, using the ICF model as a framework. One of the aims of the ICF is to enable the comparison of data across countries, however, relatively little is known about the subjective experience of disability in middle and low-income countries. The aim of this study was to assess the validity of the Perceived Impact of Problem Profile (PIPP for use among adults with a disability in Thailand using Rasch analysis. Methods A total of 210 adults with mobility impairment from the urban, rural and remote areas of northeast Thailand completed the PIPP, which contains 23 items assessing both impact and distress across five key domains (Self-care, Mobility, Participation, Relationships, and Psychological Well-being. Rasch analysis, using RUMM2020, was conducted to assess the internal validity and psychometric properties of the PIPP Impact subscales. Validation of the PIPP Impact scales was conducted by comparing scores across the different response levels of the EQ5D items. Results Rasch analysis indicated that participants did not clearly differentiate between 'impact' and 'distress,' the two aspects assessed by the PIPP. Further analyses were therefore limited to the PIPP Impact subscales. These showed adequate psychometric properties, demonstrating fit to the Rasch model and good person separation reliability. Preliminary validity testing using the EQ5D items provided support for the PIPP Impact subscales. Conclusion The results provide further support for the psychometric properties of the PIPP Impact scales and indicate that it is a suitable tool for use among adults with a locomotor disability in Thailand. Further research is needed to validate the PIPP across different cultural contexts and health conditions and to assess the usefulness of separate Impact and Distress subscales.

  9. Measuring the impact of health problems among adults with limited mobility in Thailand: further validation of the Perceived Impact of Problem Profile

    Science.gov (United States)

    Misajon, RoseAnne; Pallant, Julie F; Manderson, Lenore; Chirawatkul, Siriporn

    2008-01-01

    Background The Perceived Impact of Problem Profile (PIPP) was developed to provide a tool for measuring the impact of a health condition from the individual's perspective, using the ICF model as a framework. One of the aims of the ICF is to enable the comparison of data across countries, however, relatively little is known about the subjective experience of disability in middle and low-income countries. The aim of this study was to assess the validity of the Perceived Impact of Problem Profile (PIPP) for use among adults with a disability in Thailand using Rasch analysis. Methods A total of 210 adults with mobility impairment from the urban, rural and remote areas of northeast Thailand completed the PIPP, which contains 23 items assessing both impact and distress across five key domains (Self-care, Mobility, Participation, Relationships, and Psychological Well-being). Rasch analysis, using RUMM2020, was conducted to assess the internal validity and psychometric properties of the PIPP Impact subscales. Validation of the PIPP Impact scales was conducted by comparing scores across the different response levels of the EQ5D items. Results Rasch analysis indicated that participants did not clearly differentiate between 'impact' and 'distress,' the two aspects assessed by the PIPP. Further analyses were therefore limited to the PIPP Impact subscales. These showed adequate psychometric properties, demonstrating fit to the Rasch model and good person separation reliability. Preliminary validity testing using the EQ5D items provided support for the PIPP Impact subscales. Conclusion The results provide further support for the psychometric properties of the PIPP Impact scales and indicate that it is a suitable tool for use among adults with a locomotor disability in Thailand. Further research is needed to validate the PIPP across different cultural contexts and health conditions and to assess the usefulness of separate Impact and Distress subscales. PMID:18208616

  10. ENVIRONMENTAL IMPACT ASSESSMENT AND MONITORING ...

    African Journals Online (AJOL)

    protect the environment, it is imperative to conduct environmental impact assessment ... Ethiopia enacted the Environmental Impact Assessment Proclamation in 2002 ... flora, fauna, soil, air, water, climate, natural or cultural heritage, other.

  11. The Impact of Work and Volunteer Hours on the Health of Undergraduate Students.

    Science.gov (United States)

    Lederer, Alyssa M; Autry, Dana M; Day, Carol R T; Oswalt, Sara B

    2015-01-01

    To examine the impact of work and volunteer hours on 4 health issues among undergraduate college students. Full-time undergraduate students (N = 70,068) enrolled at 129 institutions who participated in the Spring 2011 American College Health Association-National College Health Assessment II survey. Multiple linear regression and binary logistic regression were used to examine work and volunteer hour impact on depression, feelings of being overwhelmed, sleep, and physical activity. The impact of work and volunteer hours was inconsistent among the health outcomes. Increased work hours tended to negatively affect sleep and increase feelings of being overwhelmed. Students who volunteered were more likely to meet physical activity guidelines, and those who volunteered 1 to 9 hours per week reported less depression. College health professionals should consider integrating discussion of students' employment and volunteering and their intersection with health outcomes into clinical visits, programming, and other services.

  12. Challenges in Creating Evidence in Environmental Health Risk Assessments: The Example of Second-Hand Smoke

    Directory of Open Access Journals (Sweden)

    Florian Fischer

    2016-01-01

    Full Text Available Public health interventions are directed to influence the (state of a risk factor, either by behavioral or environmental changes. Therefore, environmental health risk assessments are highly relevant for public health decision making and policy development. The credibility of an environmental health risk assessment depends, to a large extent, on the strength of the scientific evidence on which it is based. In this article, the main challenges for assessing the impact of a potential adverse health effect from an environmental pollutant are described. Second-hand smoke (SHS was chosen to illustrate the current state of evidence. The assessment of the impact of potential adverse health effects from environmental risk factors is dependent on several issues, such as the hypothesized health outcome, the nature of the exposure, the dose-response-relationship and the variability and susceptibility of the exposed population. The example of SHS exposure highlights the need for evidence-based public health. Several challenges in terms of study design, assessment methods, as well as data analysis and synthesis with respect to the stratification of results, and consideration of bias and confounding exist. Future research needs to take into account which methods and techniques will be used to generate evidence for population-level decisions.

  13. 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

  14. Childhood circumstances, psychosocial factors and the social impact of adult oral health.

    Science.gov (United States)

    Sanders, Anne E; Spencer, A John

    2005-10-01

    The aim of this study was to determine whether childhood familial conditions are associated with the social impact of adult oral health and to investigate the role of psychosocial attributes as potential mechanisms by which risk might be conveyed from childhood to adulthood. Using a cross-sectional design, self-report data were obtained from a representative sample of adults in Australia with a telephonic interview and a self-completed questionnaire. The dependent variable was the sum of impacts on the short-form Oral Health Impact Profile (OHIP-14). Childhood familial conditions included socioeconomic position assessed by paternal occupation group, family structure and quality of rearing. Current adult sense of control, perceived stress and satisfaction with life were assessed with standard scales and social support was evaluated with four items. Data were obtained for 3678 dentate adults aged 18-91 years. In bivariate analysis controlling for sex, age and household income in adulthood, parenting style was significantly associated with OHIP-14 scores (anova, P parental rearing style was significantly associated with social impact after adjusting for sex, age and household income in adulthood, but was no longer significant in the presence of the psychosocial factors. The importance of parental rearing to adult oral health may be mediated through the quality and nature of psychosocial attributes.

  15. Evaluation of health and safety impacts of defense high-level waste in geologic repositories

    International Nuclear Information System (INIS)

    Smith, E.D.; Kocher, D.C.; Witherspoon, J.P.

    1985-02-01

    Pursuant to the requirement of the Nuclear Waste Policy Act of 1982 that the President evaluate the use of commercial high-level waste repositories for the disposal of defense high-level wastes, a comparative assessment has been performed of the potential health and safety impacts of disposal of defense wastes in commercial or defense-only repositories. Simplified models were used to make quantitative estimates of both long- and short-term health and safety impacts of several options for defense high-level waste disposal. The results indicate that potential health and safety impacts are not likely to vary significantly among the different disposal options for defense wastes. Estimated long-term health and safety impacts from all defense-waste disposal options are somewhat less than those from commercial waste disposal, while short-term health and safety impacts appear to be insensitive to the differences between defense and commercial wastes. In all cases, potential health and safety impacts are small because of the need to meet stringent standards promulgated by the US Environmental Protection Agency and the US Nuclear Regulatory Commission. We conclude that health and safety impacts should not be a significant factor in the choice of a disposal option for defense high-level wastes. 20 references, 14 tables

  16. Integrative Application of Life Cycle Assessment and Risk Assessment to Environmental Impacts of Anthropogenic Pollutants at a Watershed Scale.

    Science.gov (United States)

    Lin, Xiaodan; Yu, Shen; Ma, Hwongwen

    2018-01-01

    Intense human activities have led to increasing deterioration of the watershed environment via pollutant discharge, which threatens human health and ecosystem function. To meet a need of comprehensive environmental impact/risk assessment for sustainable watershed development, a biogeochemical process-based life cycle assessment and risk assessment (RA) integration for pollutants aided by geographic information system is proposed in this study. The integration is to frame a conceptual protocol of "watershed life cycle assessment (WLCA) for pollutants". The proposed WLCA protocol consists of (1) geographic and environmental characterization mapping; (2) life cycle inventory analysis; (3) integration of life-cycle impact assessment (LCIA) with RA via characterization factor of pollutant of interest; and (4) result analysis and interpretation. The WLCA protocol can visualize results of LCIA and RA spatially for the pollutants of interest, which might be useful for decision or policy makers for mitigating impacts of watershed development.

  17. 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.

  18. The practical impact of differential item functioning analyses in a health-related quality of life instrument

    DEFF Research Database (Denmark)

    Scott, Neil W; Fayers, Peter M; Aaronson, Neil K

    2009-01-01

    Differential item functioning (DIF) analyses are commonly used to evaluate health-related quality of life (HRQoL) instruments. There is, however, a lack of consensus as to how to assess the practical impact of statistically significant DIF results.......Differential item functioning (DIF) analyses are commonly used to evaluate health-related quality of life (HRQoL) instruments. There is, however, a lack of consensus as to how to assess the practical impact of statistically significant DIF results....

  19. Impact of Diabetes Mellitus on Occupational Health Outcomes in Canada

    Directory of Open Access Journals (Sweden)

    Anson KC Li

    2017-04-01

    Full Text Available Background: Research suggests that diabetes mellitus (DM has a negative impact on employment and workplace injury, but there is little data within the Canadian context. Objective: To determine if DM has an impact on various occupational health outcomes using the Canadian Community Health Survey (CCHS. Methods: CCHS data between 2001 and 2014 were used to assess the relationships between DM and various occupational health outcomes. The final sample size for the 14-year study period was 505 606, which represented 159 432 239 employed Canadians aged 15–75 years during this period. Results: We found significant associations between people with diabetes and their type of occupation (business, finance, administration: 2009, p=0.002; 2010, p=0.002; trades, transportation, equipment: 2008, p=0.025; 2011, p=0.002; primary industry, processing, manufacturing, utility: 2013, p=0.018, reasons for missing work (looking for work: 2001, p=0.024; school or education: 2003, p=0.04; family responsibilities: 2014, p=0.015; other reasons: 2001, p<0.001; 2003, p<0.001; 2010, p=0.015, the number of work days missed (2010, 3 days, p=0.033; 4 days, p=0.038; 11 days, p<0.001; 24 days, p<0.001, and work-related injuries (traveling to and from work: 2014, p=0.003; working at a job or business: 2009, p=0.021; 2014, p=0.001. Conclusion: DM is associated with various occupational health outcomes, including work-related injury, work loss productivity, and occupation type. This allows stakeholders to assess the impact of DM on health outcomes in workplace.

  20. 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....

  1. Health impacts of power-exporting plants in northern Mexico

    International Nuclear Information System (INIS)

    Blackman, Allen; Chandru, Santosh; Mendoza-Domínguez, Alberto; Russell, A.G.

    2012-01-01

    In the past two decades, rapid population and economic growth on the U.S.–Mexico border has spurred a dramatic increase in electricity demand. In response, American energy multinationals have built power plants just south of the border that export most of their electricity to the U.S. This development has stirred considerable controversy because these plants effectively skirt U.S. air pollution regulations in a severely degraded international airshed. Yet to our knowledge, this concern has not been subjected to rigorous scrutiny. This paper uses a suite of air dispersion, health impacts, and valuation models to assess the human health damages in the U.S. and Mexico caused by air emissions from two power-exporting plants in Mexicali, Baja California. We find that these emissions have limited but nontrivial health impacts, mostly by exacerbating particulate pollution in the U.S., and we value these damages at more than half a million dollars per year. These findings demonstrate that power-exporting plants can have cross-border health effects and bolster the case for systematically evaluating their environmental impacts. - Highlights: ► We estimate the health effects of emissions from Mexican electric power plants exporting to the U.S. ► The plants have limited but nontrivial effects, mostly from particulate pollution in the U.S. ► We value these damages at more than half a million dollars per year. ► Hence, power-exporting plants can have significant cross-border health effects.

  2. 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

  3. Reproducibility and Transparency of Omics Research - Impacts on Human Health Risk Assessment

    Science.gov (United States)

    Omics technologies are becoming more widely used in toxicology, necessitating their consideration in human health hazard and risk assessment programs. Today, risk assessors in the United States Environmental Protection Agency’s Integrated Risk Information System (IRIS) Toxicologi...

  4. A proposed impact assessment method for genetically modified plants (AS-GMP Method)

    International Nuclear Information System (INIS)

    Jesus-Hitzschky, Katia Regina Evaristo de; Silveira, Jose Maria F.J. da

    2009-01-01

    An essential step in the development of products based on biotechnology is an assessment of their potential economic impacts and safety, including an evaluation of the potential impact of transgenic crops and practices related to their cultivation on the environment and human or animal health. The purpose of this paper is to provide an assessment method to evaluate the impact of biotechnologies that uses quantifiable parameters and allows a comparative analysis between conventional technology and technologies using GMOs. This paper introduces a method to perform an impact analysis associated with the commercial release and use of genetically modified plants, the Assessment System GMP Method. The assessment is performed through indicators that are arranged according to their dimension criterion likewise: environmental, economic, social, capability and institutional approach. To perform an accurate evaluation of the GMP specific indicators related to genetic modification are grouped in common fields: genetic insert features, GM plant features, gene flow, food/feed field, introduction of the GMP, unexpected occurrences and specific indicators. The novelty is the possibility to include specific parameters to the biotechnology under assessment. In this case by case analysis the factors of moderation and the indexes are parameterized to perform an available assessment.

  5. Comparative assessment and management of the health and environmental impacts of energy systems. General framework and preliminary results for the nuclear fuel cycle

    Energy Technology Data Exchange (ETDEWEB)

    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

  6. Cost-effectiveness analysis: adding value to assessment of animal health welfare and production.

    Science.gov (United States)

    Babo Martins, S; Rushton, J

    2014-12-01

    Cost-effectiveness analysis (CEA) has been extensively used in economic assessments in fields related to animal health, namely in human health where it provides a decision-making framework for choices about the allocation of healthcare resources. Conversely, in animal health, cost-benefit analysis has been the preferred tool for economic analysis. In this paper, the use of CEA in related areas and the role of this technique in assessments of animal health, welfare and production are reviewed. Cost-effectiveness analysis can add further value to these assessments, particularly in programmes targeting animal welfare or animal diseases with an impact on human health, where outcomes are best valued in natural effects rather than in monetary units. Importantly, CEA can be performed during programme implementation stages to assess alternative courses of action in real time.

  7. Handbook for value-impact assessment

    International Nuclear Information System (INIS)

    Heaberlin, S.W.; Burnham, J.B.; Gallucci, R.H.V.

    1983-12-01

    The basic purpose of this handbook is to document a set of systematic procedures for providing information that can be used in performing value-impact assessments of Nuclear Regulatory Commission (NRC) regulatory actions. The handbook describes a structured but flexible process for performing the assessment. Chapter 1 is an introduction to the value-impact assessment process. Chapter 2 describes the attributes most frequently affected by proposed NRC actions, provides guidance concerningthe appropriate level of effort to be devoted to the assessment, suggests a standard format for documenting the assessment, and discusses the treatment of uncertainty. Chapter 3 contains detailed methods for evaluating each of the attributes affected by a regulatory action. The handbook has five appendixes containing background information, technical data, and example applications of the value-impact assessment procedures. This edition of the handbook focuses primarily on assessing nuclear power reactor safety issues

  8. Improved patient-reported health impact of multiple sclerosis

    DEFF Research Database (Denmark)

    Macdonell, Richard; Nagels, Guy; Laplaud, David-Axel

    2016-01-01

    BACKGROUND: Multiple sclerosis (MS) is a debilitating disease that negatively impacts patients' lives. OBJECTIVE: ENABLE assessed the effect of long-term prolonged-release (PR) fampridine (dalfampridine extended release in the United States) treatment on patient-perceived health impact in patients...... with MS with walking impairment. METHODS: ENABLE was a 48-week, open-label, Phase 4 study of PR-fampridine 10 mg twice daily. Patients who showed any improvement in Timed 25-Foot Walk walking speed at weeks 2 and 4 and any improvement in 12-item MS Walking Scale score at week 4 remained on treatment....... The primary endpoint was change from baseline in 36-Item Short-Form Health Survey (SF-36) physical component summary (PCS) score. RESULTS: At week 4, 707/901 (78.5%) patients met the criteria to remain on treatment. Patients on treatment demonstrated significant and clinically meaningful improvements in SF-36...

  9. Community Health Workers Promote Civic Engagement and Organizational Capacity to Impact Policy.

    Science.gov (United States)

    Sabo, Samantha; Flores, Melissa; Wennerstrom, Ashley; Bell, Melanie L; Verdugo, Lorena; Carvajal, Scott; Ingram, Maia

    2017-12-01

    Community health workers (CHW) have historically served to link structurally vulnerable populations to broad support systems. Emerging evidence suggests that CHWs engage in various forms of advocacy to promote policy and systems change. We assessed the impact of CHW community advocacy on community change, defined as civic engagement, organizational capacity and policy and systems change. Data are drawn from the 2014 National Community Health Worker Advocacy Survey (N = 1776) aimed to identify the state of the CHW profession, and their impact on health disparities through community advocacy and policy engagement. Our primary analysis used multiple linear regression to assess the association between CHW advocacy and community change. As predicted, there was a significant, positive association between CHW advocacy and change in community conditions. Additionally, both adjusted and sensitivity models had similar standardized beta estimates for advocacy, and adjusted R 2 statistics. CHW advocacy predicts positive change in community conditions and further advances the CHW Community Advocacy Framework designed to support and monitor CHW community advocacy to reduce health disparities through advocacy and policy change.

  10. The impact of oral health on the quality of life of nursing home residents.

    Science.gov (United States)

    Porter, Jessie; Ntouva, Antiopi; Read, Andrew; Murdoch, Mandy; Ola, Dennis; Tsakos, Georgios

    2015-07-15

    Good oral health in older residents of nursing homes is important for general health and quality of life. Very few studies have assessed how oral symptoms affect residents' quality of life. To assess the clinical and subjective oral health, including oral health related quality of life (OHRQoL), and the association of oral symptoms with OHRQoL in older people residing in nursing homes in Islington, London. Overall, 325 residents from nine nursing homes were clinically examined and 180 residents were interviewed to assess their oral symptoms and their OHRQoL using the OIDP measure. Managers and carers working in the homes were also interviewed. Almost two thirds of the sample were dentate (64.5%). 61.3% of dentate and 50.9% of edentate residents reported problems such as dry mouth, sore cracked lips, broken teeth and toothache and ill-fitting dentures. Oral health impacted considerably upon resident's OHRQoL; 20.2% of dentate and 30.9% of edentate reported at least one oral impact in the past 6 months. Sensitive teeth, toothache, bleeding gums, dry mouth and loose natural teeth among the dentate and loose or ill-fitting dentures among the edentate were strongly associated with higher prevalence of oral impacts even after adjusting for demographic and socio-economic factors, and for the number of teeth (dentate only). The burden of oral conditions was considerable. Oral symptoms were very common and were strongly associated with residents' worse OHRQoL. Health promotion programmes are important to help residents maintain an acceptable level of oral health and function.

  11. Environmental impact assessment of european non-ferro mining industries through life-cycle assessment

    Science.gov (United States)

    Hisan Farjana, Shahjadi; Huda, Nazmul; Parvez Mahmud, M. A.

    2018-05-01

    European mining industries are the vast industrial sector which contributes largely on their economy which constitutes of ferro and non-ferro metals and minerals industries. The non-ferro metals extraction and processing industries require focus of attention due to sustainability concerns as their manufacturing processes are highly energy intensive and impacts globally on environment. This paper analyses major environmental effects caused by European metal industries based on the life-cycle impact analysis technologies. This research work is the first work in considering the comparative environmental impact analysis of European non-ferro metal industries which will reveal their technological similarities and dissimilarities to assess their environmental loads. The life-cycle inventory datasets are collected from the EcoInvent database while the analysis is done using the CML baseline and ReCipe endpoint method using SimaPro software version 8.4. The CML and ReCipe method are chosen because they are specialized impact assessment methods for European continent. The impact categories outlined for discussion here are human health, global warming and ecotoxicity. The analysis results reveal that the gold industry is vulnerable for the environment due to waste emission and similar result retained by silver mines a little bit. But copper, lead, manganese and zinc mining processes and industries are environment friendly in terms of metal extraction technologies and waste emissions.

  12. Occupational health policies on risk assessment in Japan.

    Science.gov (United States)

    Horie, Seichi

    2010-09-01

    Industrial Safety and Health Law (ISH Law) of Japan requires abnormalities identified in evaluations of worker health and working environments are reported to occupational physicians, and employers are advised of measures to ensure appropriate accommodations in working environments and work procedures. Since the 1980s, notions of a risk assessment and occupational safety and health management system were expected to further prevent industrial accidents. In 2005, ISH Law stipulated workplace risk assessment using the wording "employers shall endeavor." Following the amendment, multiple documents and guidelines for risk assessment for different work procedures were developed. They require ISH Laws to be implemented fully and workplaces to plan and execute measures to reduce risks, ranking them from those addressing potential hazards to those requiring workers to wear protective articles. A governmental survey in 2005 found the performance of risk assessment was 20.4% and common reasons for not implementing risk assessments were lack of adequate personnel or knowledge. ISH Law specifies criminal penalties for both individuals and organizations. Moreover, under the Labor Contract Law promulgated in 2007, employers are obliged to make reasonable efforts to ensure employee health for foreseeable and avoidable risks. Therefore, enterprises neglecting even the non-binding provisions of guidelines are likely to suffer significant business impact if judged to be responsible for industrial accidents or occupational disease. To promote risk assessment, we must strengthen technical, financial, and physical support from public-service organizations, encourage the dissemination of good practices to reduce risks, and consider additional employer incentives, including relaxed mandatory regulations.

  13. Occupational Health Policies on Risk Assessment in Japan

    Directory of Open Access Journals (Sweden)

    Seichi Horie

    2010-09-01

    Full Text Available Industrial Safety and Health Law (ISH Law of Japan requires abnormalities identifi ed in evaluations of worker health and working environments are reported to occupational physicians, and employers are advised of measures to ensure appropriate accommodations in working environments and work procedures. Since the 1980s, notions of a risk assessment and occupational safety and health management system were expected to further prevent industrial accidents. In 2005, ISH Law stipulated workplace risk assessment using the wording “employers shall endeavor.” Following the amendment, multiple documents and guidelines for risk assessment for different work procedures were developed. They require ISH Laws to be implemented fully and workplaces to plan and execute measures to reduce risks, ranking them from those addressing potential hazards to those requiring workers to wear protective articles. A governmental survey in 2005 found the performance of risk assessment was 20.4% and common reasons for not implementing risk assessments were lack of adequate personnel or knowledge. ISH Law specifi es criminal penalties for both individuals and organizations. Moreover, under the Labor Contract Law promulgated in 2007, employers are obliged to make reasonable efforts to ensure employee health for foreseeable and avoidable risks. Therefore, enterprises neglecting even the non-binding provisions of guidelines are likely to suffer signifi cant business impact if judged to be responsible for industrial accidents or occupational disease. To promote risk assessment, we must strengthen technical, fi nancial, and physical support from public-service organizations, encourage the dissemination of good practices to reduce risks, and consider additional employer incentives, including relaxed mandatory regulations.

  14. Impact of School Staff Health on Work Productivity in Secondary Schools in Massachusetts

    Science.gov (United States)

    Alker, Heather J.; Wang, Monica L.; Pbert, Lori; Thorsen, Nancy; Lemon, Stephenie C.

    2015-01-01

    Background: Healthy, productive employees are an integral part of school health programs. There have been few assessments of work productivity among secondary school staff. This study describes the frequency of 3 common health risk factors--obesity, depressive symptoms, and smoking--and their impact on work productivity in secondary school…

  15. Health related quality of life impact from rotavirus diarrhea on children and their family caregivers in Thailand

    NARCIS (Netherlands)

    Rochanathimoke, Onwipa; Riewpaiboon, Arthorn; Postma, Maarten J; Thinyounyong, Wirawan; Thavorncharoensap, Montarat

    2018-01-01

    BACKGROUND: Rotavirus diarrhea is a major health problem among young children worldwide with potential negative impacts on health-related quality of life (HRQoL). This study assessed the impact of rotavirus diarrhea on HRQoL of children and their caregivers. METHODS: We performed a cross-sectional

  16. Impact of pay for performance on inequalities in health care: systematic review.

    Science.gov (United States)

    Alshamsan, Riyadh; Majeed, Azeem; Ashworth, Mark; Car, Josip; Millett, Christopher

    2010-07-01

    To assess the impact of pay for performance programmes on inequalities in the quality of health care in relation to age, sex, ethnicity and socioeconomic status. Systematic search and appraisal of experimental or observational studies that assessed quantitatively the impact of a monetary incentive on health care inequalities. We searched published articles in English identified in the MEDLINE, EMBASE, PsycINFO and Cochrane databases. Twenty-two studies were identified, 20 of which were conducted in the United Kingdom and examined the impact of the Quality and Outcomes Framework. Sixteen studies used practice level data rather than patient level data. Socioeconomic status was the most frequently examined inequality; age, sex and ethnic inequalities were less frequently assessed. There was some weak evidence that the use of financial incentives reduced inequalities in chronic disease management between socioeconomic groups. Inequalities in chronic disease management between age, sex and ethnic groups persisted after the use of such incentives. Inequalities in chronic disease management have largely persisted after the introduction of the Quality and Outcome Framework. Pay for performance programmes should be designed to reduce inequalities as well as improve the overall quality of care.

  17. The consideration of health in strategic environmental assessment (SEA)

    International Nuclear Information System (INIS)

    Fischer, Thomas B; Matuzzi, Marco; Nowacki, Julia

    2010-01-01

    Following the requirements of the European Directive 2001/42/EC on strategic environmental assessment (SEA) and the Protocol on Strategic Environmental Assessment (Kiev, 2003) to the Convention on Environmental Impact Assessment in a Transboundary Context (Espoo, 1991), health is one of the aspects to be considered in SEA. In this paper, results of an evaluation of eight SEAs from Austria, the Czech Republic, Germany, the Netherlands and the United Kingdom (England and Wales) regarding the consideration of health are presented. This includes SEAs for five spatial plans, as well as one SEA for each, a transport, a waste management and an economic development plan. It is found that while all SEAs cover important physical and natural aspects that are related to health, social and behavioural aspects are considered to a much smaller extent. Based on the results, facilitating factors and barriers for health inclusive SEA are identified. Overall, good baseline data can be seen as an important starting point for effective health inclusive SEA, while an effective monitoring system is crucial for effective implementation of the measures and recommendations brought forward in health inclusive SEA. Crucially, health authorities/health experts need to engage more with SEA, as this provides a key platform for cross sectoral dialogue on a range of issues. SEA presents the health sector with an opportunity to influence the policy and decision-making process to improve people's health and well-being.

  18. 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.

  19. Environmental Impacts of the U.S. Health Care System and Effects on Public Health.

    Science.gov (United States)

    Eckelman, Matthew J; Sherman, Jodi

    2016-01-01

    The U.S. health care sector is highly interconnected with industrial activities that emit much of the nation's pollution to air, water, and soils. We estimate emissions directly and indirectly attributable to the health care sector, and potential harmful effects on public health. Negative environmental and public health outcomes were estimated through economic input-output life cycle assessment (EIOLCA) modeling using National Health Expenditures (NHE) for the decade 2003-2013 and compared to national totals. In 2013, the health care sector was also responsible for significant fractions of national air pollution emissions and impacts, including acid rain (12%), greenhouse gas emissions (10%), smog formation (10%) criteria air pollutants (9%), stratospheric ozone depletion (1%), and carcinogenic and non-carcinogenic air toxics (1-2%). The largest contributors to impacts are discussed from both the supply side (EIOLCA economic sectors) and demand side (NHE categories), as are trends over the study period. Health damages from these pollutants are estimated at 470,000 DALYs lost from pollution-related disease, or 405,000 DALYs when adjusted for recent shifts in power generation sector emissions. These indirect health burdens are commensurate with the 44,000-98,000 people who die in hospitals each year in the U.S. as a result of preventable medical errors, but are currently not attributed to our health system. Concerted efforts to improve environmental performance of health care could reduce expenditures directly through waste reduction and energy savings, and indirectly through reducing pollution burden on public health, and ought to be included in efforts to improve health care quality and safety.

  20. Environmental Impacts of the U.S. Health Care System and Effects on Public Health.

    Directory of Open Access Journals (Sweden)

    Matthew J Eckelman

    Full Text Available The U.S. health care sector is highly interconnected with industrial activities that emit much of the nation's pollution to air, water, and soils. We estimate emissions directly and indirectly attributable to the health care sector, and potential harmful effects on public health. Negative environmental and public health outcomes were estimated through economic input-output life cycle assessment (EIOLCA modeling using National Health Expenditures (NHE for the decade 2003-2013 and compared to national totals. In 2013, the health care sector was also responsible for significant fractions of national air pollution emissions and impacts, including acid rain (12%, greenhouse gas emissions (10%, smog formation (10% criteria air pollutants (9%, stratospheric ozone depletion (1%, and carcinogenic and non-carcinogenic air toxics (1-2%. The largest contributors to impacts are discussed from both the supply side (EIOLCA economic sectors and demand side (NHE categories, as are trends over the study period. Health damages from these pollutants are estimated at 470,000 DALYs lost from pollution-related disease, or 405,000 DALYs when adjusted for recent shifts in power generation sector emissions. These indirect health burdens are commensurate with the 44,000-98,000 people who die in hospitals each year in the U.S. as a result of preventable medical errors, but are currently not attributed to our health system. Concerted efforts to improve environmental performance of health care could reduce expenditures directly through waste reduction and energy savings, and indirectly through reducing pollution burden on public health, and ought to be included in efforts to improve health care quality and safety.

  1. Using multilevel modeling to assess case-mix adjusters in consumer experience surveys in health care.

    Science.gov (United States)

    Damman, Olga C; Stubbe, Janine H; Hendriks, Michelle; Arah, Onyebuchi A; Spreeuwenberg, Peter; Delnoij, Diana M J; Groenewegen, Peter P

    2009-04-01

    Ratings on the quality of healthcare from the consumer's perspective need to be adjusted for consumer characteristics to ensure fair and accurate comparisons between healthcare providers or health plans. Although multilevel analysis is already considered an appropriate method for analyzing healthcare performance data, it has rarely been used to assess case-mix adjustment of such data. The purpose of this article is to investigate whether multilevel regression analysis is a useful tool to detect case-mix adjusters in consumer assessment of healthcare. We used data on 11,539 consumers from 27 Dutch health plans, which were collected using the Dutch Consumer Quality Index health plan instrument. We conducted multilevel regression analyses of consumers' responses nested within health plans to assess the effects of consumer characteristics on consumer experience. We compared our findings to the results of another methodology: the impact factor approach, which combines the predictive effect of each case-mix variable with its heterogeneity across health plans. Both multilevel regression and impact factor analyses showed that age and education were the most important case-mix adjusters for consumer experience and ratings of health plans. With the exception of age, case-mix adjustment had little impact on the ranking of health plans. On both theoretical and practical grounds, multilevel modeling is useful for adequate case-mix adjustment and analysis of performance ratings.

  2. Environmental impact assessment of fish farm hatcheries ...

    African Journals Online (AJOL)

    Environmental impact assessment of fish farm hatcheries management in lower ... Environmental impact assessments were taken to determine the causes of ... Of significance of impact assessment were activities like air, traffic, noise, had ...

  3. 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)

  4. Systematic review of community health impacts of mountaintop removal mining.

    Science.gov (United States)

    Boyles, Abee L; Blain, Robyn B; Rochester, Johanna R; Avanasi, Raghavendhran; Goldhaber, Susan B; McComb, Sofie; Holmgren, Stephanie D; Masten, Scott A; Thayer, Kristina A

    2017-10-01

    The objective of this evaluation is to understand the human health impacts of mountaintop removal (MTR) mining, the major method of coal mining in and around Central Appalachia. MTR mining impacts the air, water, and soil and raises concerns about potential adverse health effects in neighboring communities; exposures associated with MTR mining include particulate matter (PM), polycyclic aromatic hydrocarbons (PAHs), metals, hydrogen sulfide, and other recognized harmful substances. A systematic review was conducted of published studies of MTR mining and community health, occupational studies of MTR mining, and any available animal and in vitro experimental studies investigating the effects of exposures to MTR-mining-related chemical mixtures. Six databases (Embase, PsycINFO, PubMed, Scopus, Toxline, and Web of Science) were searched with customized terms, and no restrictions on publication year or language, through October 27, 2016. The eligibility criteria included all human population studies and animal models of human health, direct and indirect measures of MTR-mining exposure, any health-related effect or change in physiological response, and any study design type. Risk of bias was assessed for observational and experimental studies using an approach developed by the National Toxicology Program (NTP) Office of Health Assessment and Translation (OHAT). To provide context for these health effects, a summary of the exposure literature is included that focuses on describing findings for outdoor air, indoor air, and drinking water. From a literature search capturing 3088 studies, 33 human studies (29 community, four occupational), four experimental studies (two in rat, one in vitro and in mice, one in C. elegans), and 58 MTR mining exposure studies were identified. A number of health findings were reported in observational human studies, including cardiopulmonary effects, mortality, and birth defects. However, concerns for risk of bias were identified, especially

  5. WHO's health risk assessment of extremely low frequency electric fields

    International Nuclear Information System (INIS)

    Repacholi, M.H.

    2003-01-01

    The World Health Organization (WHO), the International Commission on Non-Ionizing Radiation Protection (ICNIRP), WHOs scientific collaborating centres (including the UKs National Radiological Protection Board (NRPB) and over 50 participating Member States are participants of WHOs International EMF Project. As part of WHOs health risk assessment process for extremely low frequency fields (ELFs), this workshop was convened by NRPB to assist WHO in evaluating potential health impacts of electrical currents and fields induced by ELF in molecules, cells, tissues and organs of the body. This paper describes the process by which WHO will conduct its health risk assessment. WHO is also trying to provide information on why exposure to ELF magnetic fields seems to be associated with an increased incidence of childhood leukaemia. Are there mechanisms that could lead to this health outcome or does the epidemiological evidence incorporate biases or other factors that need to be further explored? (author)

  6. Preliminary assessment of the environmental impacts of the Satellite Power System (SPS)

    International Nuclear Information System (INIS)

    Halverson, S.L.; Rote, D.M.; Rush, C.M.; Davis, K.; White, M.; Cahill, D.F.

    1978-01-01

    The impact of the Satellite Power System (SPS) Microwave Power Transmission System (MPTS) as well as impacts related to other elements of the total SPS on the environment are being determined. The goal of these programs is to advance the state of knowledge by the year 1980 to the point where an assessment can be made of the probability and severity of the impacts of the SPS. Assessments will be made of the effects on the health and safety of the public, and occupationally involved personnel, and the ecology; the upper and lower atmosphere including climatological impacts; and on communications systems including electromagnetic compatibility, the effects of microwave heating of the ionosphere and magnetosphere, and the effects of F-layer depletion by launch vehicle and transport vehicle effluents. If the assessment indicates that the impacts are acceptable or that feasible mitigating strategies can be implemented and if other related assessments (the impact on society and a competitive comparison of the SPS with other energy alternatives) are favorable, a decision may be made to implement the development of the SPS related technologies. This paper identifies postulated effects and summarizes the research efforts to determine whether or not these effects will occur

  7. Environmental impact assessment: Process and implementation

    International Nuclear Information System (INIS)

    Chen, S.Y.; Tsai, S.Y.

    1989-01-01

    In this paper, the procedures and issues regarding the preparation of an environmental impact assessment in accordance with the National Environmental Policy Act (NEPA) as promulgated by the US Congress in 1969 are discussed. NEPA procedures and requirements are covered in general, while particular attention is given to the preparation of the environmental impact assessment. Also included is a discussion of the social impact assessment. The aim of the social impact assessment is to address the social issues involved in enhancing public understanding of the hazardous risks, thereby mitigating any conflicts that may arise in the NEPA process. 3 refs., 1 fig., 1 tab

  8. Assessment of co-composting of sludge and woodchips in the perspective of environmental impacts (EASETECH)

    DEFF Research Database (Denmark)

    Zhao, Yan; Lu, Wenjing; Damgaard, Anders

    2015-01-01

    To reveal potential impacts to environment and human health quantitatively, co-composting and utilization of sludge and woodchips were investigated using a life-cycle-based model, EASETECH. Three scenarios were assessed through experiments using different material ratios. Emission amounts during ...... rather than farming. Trace gaseous compounds showed marginal impacts to global warming and toxicity categories. The results provide a new perspective and offer evidence for appropriate sludge treatment selection.......To reveal potential impacts to environment and human health quantitatively, co-composting and utilization of sludge and woodchips were investigated using a life-cycle-based model, EASETECH. Three scenarios were assessed through experiments using different material ratios. Emission amounts during co...... of phosphorus substitution. With the application of fewer woodchips, impacts to acidification and terrestrial eutrophication decreased because more ammonium was reserved rather than released. All impacts to human toxicity were not significant (8.2. ±. 0.6 PE) because the compost was used for urban landscaping...

  9. 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

  10. 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.

  11. Outcome and Impact Evaluation of a Transgender Health Course for Health Profession Students.

    Science.gov (United States)

    Braun, Hannan M; Garcia-Grossman, Ilana R; Quiñones-Rivera, Andrea; Deutsch, Madeline B

    2017-02-01

    Being transgender is associated with numerous health disparities, and transgender individuals face mistreatment and discrimination in healthcare settings. At the same time, healthcare professionals report inadequate preparation to care for transgender people, and patients often have to teach their own medical providers about transgender care. Our study aimed to evaluate the impact of an elective course for health profession students in transgender health that was implemented to address these gaps in provider knowledge. Students participated in a 10-session, lunch-hour elective course during the spring of 2015. To evaluate impact, course participants completed pre-, immediately post-, and 3-month postcourse questionnaires, including a previously validated nine-item transphobia scale, to determine the course's effect on knowledge, attitudes, and beliefs about transgender health. Forty-six students completed the pre- and immediately postelective questionnaire (74% response rate). Compared with pre-elective surveys, immediately postelective scores demonstrated increased knowledge in most domains and reduced transphobia. Specific knowledge domains with improvements included terminology, best practices for collecting gender identity, awareness of the DSM-V gender dysphoria diagnosis, medications used for gender affirmation, and relevant federal policies. A previously validated transphobia scale was found to have good reliability in the current sample. This elective course led to positive short-term changes in measures of multiple knowledge domains and reduced measures of transphobia among health profession students. Further study is needed to assess the long-term impact. Our methods and findings, including the demonstration of reliability of a previously validated nine-item transphobia scale, serve as formative data for the future development of theory-based transgender medicine curricula and measures.

  12. 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.

  13. Environmental impact assessment - a selected bibliography

    International Nuclear Information System (INIS)

    Lawson, W.J.

    1989-01-01

    This bibliography of literature relevant to the environmental impact assessment process is essentially a list of material dealing with the environmental impact assessment process held by Griffith University Library. The list is however well supplemented with citations of material not held in the Griffith University Library. Some economic and social impact assessment citations have been included in the bibliography, as the the environmental impact assessment concept has been interpreted very broadly. The citations are arranged according to broad subject areas, such as methodology, critical reviews, social impacts etc. Citations in each of these subject areas, which are listed in the table of contents, are identified by prefixes which are given in parentheses before the subjects headings. Within each subject area the citations are arragend in alphabetic author sequence

  14. 40 CFR 227.22 - Assessment of impact.

    Science.gov (United States)

    2010-07-01

    ... FOR THE EVALUATION OF PERMIT APPLICATIONS FOR OCEAN DUMPING OF MATERIALS Impact of the Proposed Dumping on Other Uses of the Ocean § 227.22 Assessment of impact. The assessment of impact on other uses... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Assessment of impact. 227.22 Section...

  15. Health Impacts of Active Transportation in Europe.

    Science.gov (United States)

    Rojas-Rueda, David; de Nazelle, Audrey; Andersen, Zorana J; Braun-Fahrländer, Charlotte; Bruha, Jan; Bruhova-Foltynova, Hana; Desqueyroux, Hélène; Praznoczy, Corinne; Ragettli, Martina S; Tainio, Marko; Nieuwenhuijsen, Mark J

    2016-01-01

    Policies that stimulate active transportation (walking and bicycling) have been related to heath benefits. This study aims to assess the potential health risks and benefits of promoting active transportation for commuting populations (age groups 16-64) in six European cities. We conducted a health impact assessment using two scenarios: increased cycling and increased walking. The primary outcome measure was all-cause mortality related to changes in physical activity level, exposure to fine particulate matter air pollution with a diameter Paris, Prague, and Warsaw. All scenarios produced health benefits in the six cities. An increase in bicycle trips to 35% of all trips (as in Copenhagen) produced the highest benefits among the different scenarios analysed in Warsaw 113 (76-163) annual deaths avoided, Prague 61 (29-104), Barcelona 37 (24-56), Paris 37 (18-64) and Basel 5 (3-9). An increase in walking trips to 50% of all trips (as in Paris) resulted in 19 (3-42) deaths avoided annually in Warsaw, 11(3-21) in Prague, 6 (4-9) in Basel, 3 (2-6) in Copenhagen and 3 (2-4) in Barcelona. The scenarios would also reduce carbon dioxide emissions in the six cities by 1,139 to 26,423 (metric tonnes per year). Policies to promote active transportation may produce health benefits, but these depend of the existing characteristics of the cities. Increased collaboration between health practitioners, transport specialists and urban planners will help to introduce the health perspective in transport policies and promote active transportation.

  16. Assessing catastrophic and impoverishing effects of health care payments in Uganda.

    Science.gov (United States)

    Kwesiga, Brendan; Zikusooka, Charlotte M; Ataguba, John E

    2015-01-22

    Direct out-of-pocket payments for health care are recognised as limiting access to health care services and also endangering the welfare of households. In Uganda, such payments comprise a large portion of total health financing. This study assesses the catastrophic and impoverishing impact of paying for health care out-of-pocket in Uganda. Using data from the Uganda National Household Surveys 2009/10, the catastrophic impact of out-of-pocket health care payments is defined using thresholds that vary with household income. The impoverishing effect of out-of-pocket health care payments is assessed using the Ugandan national poverty line and the World Bank poverty line ($1.25/day). A high level and intensity of both financial catastrophe and impoverishment due to out-of-pocket payments are recorded. Using an initial threshold of 10% of household income, about 23% of Ugandan households face financial ruin. Based on both the $1.25/day and the Ugandan poverty lines, about 4% of the population are further impoverished by such payments. This represents a relative increase in poverty head count of 17.1% and 18.1% respectively. The absence of financial protection in Uganda's health system calls for concerted action. Currently, out-of-pocket payments account for a large share of total health financing and there is no pooled prepayment system available. There is therefore a need to move towards mandatory prepayment. In this way, people could access the needed health services without any associated financial consequence.

  17. High-resolution modelling of health impacts from air pollution using the integrated model system EVA

    Science.gov (United States)

    Brandt, Jørgen; Andersen, Mikael S.; Bønløkke, Jakob; Christensen, Jesper H.; Geels, Camilla; Hansen, Kaj M.; Jensen, Steen S.; Ketzel, Matthias; Plejdrup, Marlene S.; Sigsgaard, Torben; Silver, Jeremy D.

    2014-05-01

    A high-resolution assessment of health impacts from air pollution and related external cost has been conducted for Denmark using the integrated EVA model system. The EVA system has been further developed by implementing an air quality model with a 1 km x 1 km resolution covering the whole of Denmark. New developments of the integrated model system will be presented as well as results for health impacts and related external costs over several decades. Furthermore, the sensitivity of health impacts to model resolution will be studied. We have developed an integrated model system EVA (Economic Valuation of Air pollution), based on the impact-pathway chain, to assess the health impacts and health-related economic externalities of air pollution resulting from specific emission sources or sectors. The system is used to support policymaking with respect to emission control. In Brandt et al. (2013a; 2013b), the EVA system was used to assess the impacts in Europe and Denmark from the past, present and future total air pollution levels as well as the contribution from the major anthropogenic emission sectors. The EVA system was applied using the hemispheric chemistry-transport model, the Danish Eulerian Hemispheric Model (DEHM), with nesting capability for higher resolution over Europe (50 km x 50 km) and Northern Europe (16.7 km x 16.7 km). In this study an Urban Background Model (UBM) has been further developed to cover the whole of Denmark with a 1 km x 1 km resolution and the model has been implemented as a part of the integrated model system, EVA. The EVA system is based on the impact-pathway methodology. The site-specific emissions will result (via atmospheric transport and chemistry) in a concentration distribution, which together with detailed population data, are used to estimate the population-level exposure. Using exposure-response functions and economic valuations, the exposure is transformed into impacts on human health and related external costs. In this study

  18. Health visiting assessment--unpacking critical attributes in health visitor needs assessment practice: a case study.

    Science.gov (United States)

    Appleton, Jane V; Cowley, Sarah

    2008-02-01

    Assessment of family health need is a central feature of health visiting practice in which a range of skills, knowledge and judgements are used. These assessments are pivotal in uncovering need, safeguarding children and in determining levels of health intervention to be offered to children and their families by the health visiting service in the UK. The central focus of this paper is to outline the critical attributes of the basic principles that underpin health visiting assessment practice that emerged as part of a case study enquiry. A case study design informed by a constructivist methodology was used to examine health visitors' professional judgements and use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support. The main study was conducted in three community Trust case sites in England, UK, with pilot work being undertaken in a fourth site. Fifteen health visitors participated in the main study and data were collected during 56 observed home visits to families receiving extra health visiting support. Separate in-depth interviews were conducted with the health visitors, pre- and post-home contacts, while 53 client interviews also took place. The analysis suggests that there are certain fundamental elements associated with the majority of health visitor assessments and these have been termed assessment principles. These characteristics are integral to, and provide the basis upon which health visitors' assessments are conducted and professional judgement is formed. They reflect the basic principles of health visiting assessment practice, which exist despite the constraints and realities of the practice context and can be differentiated from the activity centred methods of assessment processes.

  19. 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…

  20. Health technology assessment in Finland

    DEFF Research Database (Denmark)

    Mäkelä, Marjukka; Roine, Risto P

    2010-01-01

    Since the 1990s, health policy makers in Finland have been supportive of evidence-based medicine and approaches to implement its results. The Finnish Office for Health Technology Assessment (Finohta) has grown from a small start in 1995 to a medium-sized health technology assessment (HTA) agency,...... findings. The Managed Uptake of Medical Methods program links the hospital districts to agree on introduction of technologies. The Ohtanen database provides Finnish-language summaries of major assessments made in other countries.......Since the 1990s, health policy makers in Finland have been supportive of evidence-based medicine and approaches to implement its results. The Finnish Office for Health Technology Assessment (Finohta) has grown from a small start in 1995 to a medium-sized health technology assessment (HTA) agency......, with special responsibility in providing assessments to underpin national policies in screening. External evaluations enhanced the rapid growth. In the Finnish environment, decision making on health technologies is extremely decentralized, so Finohta has developed some practical tools for implementing HTA...

  1. 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

  2. 76 FR 12963 - Request for Information (NOT-ES-11-007): Needs and Approaches for Assessing the Human Health...

    Science.gov (United States)

    2011-03-09

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Request for Information (NOT-ES-11-007): Needs and Approaches for Assessing the Human Health Impacts of Exposure to Mixtures AGENCY: National Institutes of... analyzes its findings to assess potential hazards to human health from exposure to environmental substances...

  3. Integrating Social impacts on Health and Health-Care Systems in Systemic Seismic Vulnerability Analysis

    Science.gov (United States)

    Kunz-Plapp, T.; Khazai, B.; Daniell, J. E.

    2012-04-01

    This paper presents a new method for modeling health impacts caused by earthquake damage which allows for integrating key social impacts on individual health and health-care systems and for implementing these impacts in quantitative systemic seismic vulnerability analysis. In current earthquake casualty estimation models, demand on health-care systems is estimated by quantifying the number of fatalities and severity of injuries based on empirical data correlating building damage with casualties. The expected number of injured people (sorted by priorities of emergency treatment) is combined together with post-earthquake reduction of functionality of health-care facilities such as hospitals to estimate the impact on healthcare systems. The aim here is to extend these models by developing a combined engineering and social science approach. Although social vulnerability is recognized as a key component for the consequences of disasters, social vulnerability as such, is seldom linked to common formal and quantitative seismic loss estimates of injured people which provide direct impact on emergency health care services. Yet, there is a consensus that factors which affect vulnerability and post-earthquake health of at-risk populations include demographic characteristics such as age, education, occupation and employment and that these factors can aggravate health impacts further. Similarly, there are different social influences on the performance of health care systems after an earthquake both on an individual as well as on an institutional level. To link social impacts of health and health-care services to a systemic seismic vulnerability analysis, a conceptual model of social impacts of earthquakes on health and the health care systems has been developed. We identified and tested appropriate social indicators for individual health impacts and for health care impacts based on literature research, using available European statistical data. The results will be used to

  4. Perceived Impact of Health Sector Reform on Motivation of Health ...

    African Journals Online (AJOL)

    Perceived Impact of Health Sector Reform on Motivation of Health Workers and Quality of Health Care in Tanzania: the Perspectives of Healthcare Workers and District Council Health Managers in Four Districts.

  5. Developmental enamel defects and their impact on child oral health-related quality of life

    Directory of Open Access Journals (Sweden)

    Fabiana Vargas-Ferreira

    2011-12-01

    Full Text Available This cross-sectional study assessed the impact of Developmental Enamel Defects (DED on Child Oral Health-Related Quality of Life (COHRQoL. A sample of 944 11- to 14-year-old Brazilian schoolchildren was examined for the prevalence and severity of DED. The children completed the Child Perceptions Questionnaire (CPQ11-14, and socioeconomic status was also collected using a questionnaire. Poisson regression models were used to assess the association between DED and overall and domain-specific CPQ11-14 scores. The prevalence of DED was 19.7%. In general, children with DED did not indicate any decrease in self-perception. However, this condition was associated with an impact on the functional limitation domain. The presence of DED may cause negative impacts on a child's perception of oral health and on their daily performance.

  6. Incorporating Health Impacts from Exposure to Chemicals in Food Packaging in LCA

    DEFF Research Database (Denmark)

    Ernstoff, Alexi; Trier, Xenia; Jolliet, Oliver

    2014-01-01

    Life cycle assessments (LCA) on the environmental and public health impacts of food and beverage packaging materials have found some advantages to plastic over glass. Entirely missing from these evaluations are the health impacts of possible chemical, e.g. endocrine dis-ruptor, exposure through...... migration of chemicals from the packaging into the food product. We build a framework based on a life cycle perspective to predict which chemicals may be in a package that are not intentionally added ingredients, and we apply this approach to the US EPA’s CPCAT database. In total we find 1,154 chemicals...... within the CPCAT database related to food-contact materials; out of these 107 are potential endocrine disruptors according to the TEDX list of endocrine disruptors. We also build a framework in an effort to begin harmonizing LCA to include health impacts of chemical exposure related to food packaging...

  7. Does consideration and assessment of effects on health equity affect the conclusions of systematic reviews? A methodology study.

    Science.gov (United States)

    Welch, Vivian; Petticrew, Mark; Ueffing, Erin; Benkhalti Jandu, Maria; Brand, Kevin; Dhaliwal, Bharbhoor; Kristjansson, Elizabeth; Smylie, Janet; Wells, George Anthony; Tugwell, Peter

    2012-01-01

    Tackling health inequities both within and between countries remains high on the agenda of international organizations including the World Health Organization and local, regional and national governments. Systematic reviews can be a useful tool to assess effects on equity in health status because they include studies conducted in a variety of settings and populations. This study aims to describe the extent to which the impacts of health interventions on equity in health status are considered in systematic reviews, describe methods used, and assess the implications of their equity related findings for policy, practice and research. We conducted a methodology study of equity assessment in systematic reviews. Two independent reviewers extracted information on the reporting and analysis of impacts of health interventions on equity in health status in a group of 300 systematic reviews collected from all systematic reviews indexed in one month of MEDLINE, using a pre-tested data collection form. Any differences in data extraction were resolved by discussion. Of the 300 systematic reviews, 224 assessed the effectiveness of interventions on health outcomes. Of these 224 reviews, 29 systematic reviews assessed effects on equity in health status using subgroup analysis or targeted analyses of vulnerable populations. Of these, seven conducted subgroup analyses related to health equity which were reported in insufficient detail to judge their credibility. Of these 29 reviews, 18 described implications for policy and practice based on assessment of effects on health equity. The quality and completeness of reporting should be enhanced as a priority, because without this policymakers and practitioners will continue lack the evidence base they need to inform decision-making about health inequity. Furthermore, there is a need to develop methods to systematically consider impacts on equity in health status that is currently lacking in systematic reviews.

  8. Air pollution in moderately polluted urban areas: How does the definition of “neighborhood” impact exposure assessment?

    International Nuclear Information System (INIS)

    Tenailleau, Quentin M.; Mauny, Frédéric; Joly, Daniel; François, Stéphane; Bernard, Nadine

    2015-01-01

    Environmental health studies commonly quantify subjects' pollution exposure in their neighborhood. How this neighborhood is defined can vary, however, leading to different approaches to quantification whose impacts on exposure levels remain unclear. We explore the relationship between neighborhood definition and exposure assessment. NO 2 , benzene, PM 10 and PM 2.5 exposure estimates were computed in the vicinity of 10,825 buildings using twelve exposure assessment techniques reflecting different definitions of “neighborhood”. At the city scale, its definition does not significantly influence exposure estimates. It does impact levels at the building scale, however: at least a quarter of the buildings' exposure estimates for a 400 m buffer differ from the estimated 50 m buffer value (±1.0 μg/m 3 for NO 2 , PM 10 and PM 2.5 ; and ±0.05 μg/m 3 for benzene). This variation is significantly related to the definition of neighborhood. It is vitally important for investigators to understand the impact of chosen assessment techniques on exposure estimates. - Highlights: • Residential building air pollution was calculated using 12 assessment techniques. • These techniques refer to common epidemiological definitions of neighborhood. • At the city scale, neighborhood definition does not impact exposure estimates. • At the building scale, neighborhood definition does impact exposure estimates. • The impact of neighborhood definition varies with physical/deprivation variables. - Ignoring the impact of the neighborhood's definition on exposure estimates could lead to exposure quantification errors that impact resulting health studies, health risk evaluation, and consequently all the decision-making process.

  9. Healthy vinton: a health impact assessment focused on water and sanitation in a small rural town on the US-Mexico border.

    Science.gov (United States)

    Hargrove, William L; Juárez-Carillo, Patricia M; Korc, Marcelo

    2015-04-07

    We conducted a Health Impact Assessment (HIA) focused on water and sanitation in Vinton, TX, a small rural town on the U.S./Mexico Border. We present the Vinton HIA as a case study to inform the practice of HIA in rural limited resource communities with higher than average levels of unemployment and poverty, and limited infrastructure. Household surveys, focus groups, and interviews provided quantitative and qualitative data on water sources and quality, sanitation practices, and community health. We found that some of the current water sources in Vinton did not meet drinking water standards for total dissolved solids and arsenic; the majority of septic tanks were not managed properly; and there was a short-term risk of water scarcity due to prolonged drought in the region. Prevalent ailments reported by participants included stomach problems, diarrhea, and skin problems. These ailments can be related to arsenic and/or biological organisms in water. The positive direct and indirect health impacts of improved water and sanitation in Vinton included: reduced gastrointestinal illnesses and skin disorders; improved water quality, quantity, and pressure; reduced risks from failing septic systems; increased property value; potential economic growth; and enhanced quality of life. The negative direct and indirect impacts included: residents' initial and monthly costs; increased property taxes; increased debt by local government; and the need for ongoing support from changing elected decision makers. The unique challenges in completing this HIA included: (a) limited available data; (b) a culture of fear and distrust among residents; (c) residents' lack of education, awareness, and civic discourse regarding water and sanitation issues and their impact on public health; and (d) lack of civic discourse and participation in the democratic process. An important outcome of the HIA was the characterization of local water supplies, which motivated and empowered the community

  10. 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

  11. 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

  12. 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...

  13. International trade of health services: global trends and local impact.

    Science.gov (United States)

    Lautier, Marc

    2014-10-01

    Globalization is a key challenge facing health policy-makers. A significant dimension of this is trade in health services. Traditionally, the flow of health services exports went from North to South, with patients travelling in the opposite direction. This situation is changing and a number of papers have discussed the growth of health services exports from Southern countries in its different dimensions. Less attention has been paid to assess the real scope of this trade at the global level and its potential impact at the local level. Given the rapid development of this area, there are little empirical data. This paper therefore first built an estimate of the global size and of the growth trend of international trade in health services since 1997, which is compared with several country-based studies. The second purpose of the paper is to demonstrate the significant economic impact of this trade at the local level for the exporting country. We consider the case of health providers in the South-Mediterranean region for which the demand potential, the economic effects and the consequence for the health system are presented. These issues lead to the overall conclusion that different policy options would be appropriate, in relation to the nature of the demand. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Health technology assessment (HTA): definition, role and use in the changing healthcare environment.

    Science.gov (United States)

    Gallio, D; Berto, P

    2007-01-01

    The increasing availability of health care technology--boosted by considerable advances in areas like biotechnology, biomaterials, surgical techniques and computer technology--has accompanied burgeoning health care costs, and for this reason an increasing number of subjects (clinicians, health product makers, regulators, patients, hospitals, managers, payers, government leaders) demand for well-founded information to support decisions about development, adoption, acquisition and use of new and existing technologies. Technology assessment is a form of policy research that identifies policy issues, assesses the impact of alternative courses of action, and presents findings. This article is aimed at describing the historical development, reviewing the various definition and classifications, illustrating the purposes Fnd actors of Health Technology Assessment and its possible applications in the current healthcare scenario.

  15. The impact of urban regeneration programmes on health and health-related behaviour: Evaluation of the Dutch District Approach 6.5 years from the start.

    Directory of Open Access Journals (Sweden)

    Annemarie Ruijsbroek

    Full Text Available Large-scale regeneration programmes to improve the personal conditions and living circumstances in deprived areas may affect health and the lifestyle of the residents. Previous evaluations concluded that a large-scale urban regeneration programme in the Netherlands had some positive effects within 3.5 years. The aim of the current study was to evaluate the effects at the longer run.With a quasi-experimental research design we assessed changes in the prevalence of general health, mental health, physical activity, overweight, obesity, and smoking between the pre-intervention (2003-04 -mid 2008 and intervention period (mid 2008-2013-14 in 40 deprived target districts and comparably deprived control districts. We used the Difference-in-Difference (DiD to assess programme impact. Additionally, we stratified analyses by sex and by the intensity of the regeneration programme.Changes in health and health related behaviours from pre-intervention to the intervention period were about equally large in the target districts as in control districts. DiD impact estimates were inconsistent and not statistically significant. Sex differences in DiD estimates were not consistent or significant. Furthermore, DiD impact estimates were not consistently larger in target districts with more intensive intervention programmes.We found no evidence that this Dutch urban regeneration programme had an impact in the longer run on self-reported health and related behaviour at the area level.

  16. Assessment and longitudinal analysis of health impacts and stressors perceived to result from unconventional shale gas development in the Marcellus Shale region.

    Science.gov (United States)

    Ferrar, Kyle J; Kriesky, Jill; Christen, Charles L; Marshall, Lynne P; Malone, Samantha L; Sharma, Ravi K; Michanowicz, Drew R; Goldstein, Bernard D

    2013-01-01

    Concerns for health and social impacts have arisen as a result of Marcellus Shale unconventional natural gas development. Our goal was to document the self-reported health impacts and mental and physical health stressors perceived to result from Marcellus Shale development. Two sets of interviews were conducted with a convenience sample of community members living proximal to Marcellus Shale development, session 1 March-September 2010 (n = 33) and session 2 January-April 2012 (n = 20). Symptoms of health impacts and sources of psychological stress were coded. Symptom and stressor counts were quantified for each interview. The counts for each participant were compared longitudinally. Participants attributed 59 unique health impacts and 13 stressors to Marcellus Shale development. Stress was the most frequently-reported symptom. Over time, perceived health impacts increased (P = 0·042), while stressors remained constant (P = 0·855). Exposure-based epidemiological studies are needed to address identified health impacts and those that may develop as unconventional natural gas extraction continues. Many of the stressors can be addressed immediately.

  17. Environmental impact assessment screening tool

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    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. 2 figs. 7 refs.

  18. 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

  19. Health and Climate Impacts of Ocean-Going Vessels in East Asia

    Science.gov (United States)

    Liu, Huan; Fu, Mingliang; Jin, Xinxin; Shang, Yi; Shindell, Drew; Faluvegi, Greg; Shindell, Cary; He, Kebin

    2016-01-01

    East Asia has the most rapidly growing shipping emissions of both CO2 and traditional air pollutants, but the least in-depth analysis. Full evaluation of all pollutants is needed to assess the impacts of shipping emissions. Here, using an advanced method based on detailed dynamic ship activity data, we show that shipping emissions in East Asia accounted for 16% of global shipping CO2 in 2013, compared to only 4-7% in 2002-2005. Increased emissions lead to large adverse health impacts, with 14,500-37,500 premature deaths per year. Global mean radiative forcing from East Asian shipping is initially negative, but would become positive after approximately eight years for constant current emissions. As a large fraction of vessels are registered elsewhere, joint efforts are necessary to reduce emissions and mitigate the climate and health impacts of shipping in the region.

  20. Impact assessment of ionising radiation on wildlife

    International Nuclear Information System (INIS)

    Copplestone, D.; Bielby, S.; Jones, S.

    2001-01-01

    This R and D project was commissioned by the Environment Agency and English Nature in January 2001 to provide up-to-date information on the impacts of ionising radiation on wildlife, upon which a robust assessment approach may be developed. This approach will also feed into the European Commission funded project 'Framework for Assessment of Environmental Impact' (FASSET), due to complete in October 2003. This report describes the behaviour and transport of radionuclides in the environment, considers the impact of ionising radiation on wildlife, and makes recommendations on an approach for the impact assessment of ionising radiation on wildlife for England and Wales. The assessment approach focuses on three ecosystems representative of those considered potentially most at risk from the impact of authorised radioactive discharges, namely a coastal grassland (terrestrial ecosystem); estuarine and freshwater ecosystems. The likely scale of the impact on wildlife is also assessed in light of a preliminary analysis based on this assessment approach. The aims of the report are: to summarise the latest research on the behaviour, transfer and impact of ionising radiation effects on wildlife; an outline and review of the relevant European and national legislation which has impacts on the requirements for assessments of the impact of ionising radiation on wildlife in the UK; to consider the role of regulatory bodies in assessing the impact of ionising radiation on wildlife with respect to England and Wales; to make recommendations on the relative biological effectiveness of different types of radiation with respect to wildlife; and to recommend an approach to assess the impacts to wildlife from ionising radiation from authorised discharges in England and Wales, with spreadsheets to support the methodology. The report demonstrates the behaviour and transfer of radionuclides in a number of different ecosystem types. Particular emphasis is placed on exposure pathways in those

  1. Occupational Health Impacts Due to Exposure to Organic Chemicals over an Entire Product Life Cycle.

    Science.gov (United States)

    Kijko, Gaël; Jolliet, Olivier; Margni, Manuele

    2016-12-06

    This article presents an innovative approach to include occupational exposures to organic chemicals in life cycle impact assessment (LCIA) by building on the characterization factors set out in Kijko et al. (2015) to calculate the potential impact of occupational exposure over the entire supply chain of product or service. Based on an economic input-output model and labor and economic data, the total impacts per dollar of production are provided for 430 commodity categories and range from 0.025 to 6.6 disability-adjusted life years (DALY) per million dollar of final economic demand. The approach is applied on a case study assessing human health impacts over the life cycle of a piece of office furniture. It illustrates how to combine monitoring data collected at the manufacturing facility and averaged sector specific data to model the entire supply chain. This paper makes the inclusion of occupational exposure to chemicals fully compatible with the LCA framework by including the supply chain of a given production process and will help industries focus on the leading causes of human health impacts and prevent impact shifting.

  2. Impact assessment: Eroding benefits through streamlining?

    Energy Technology Data Exchange (ETDEWEB)

    Bond, Alan, E-mail: alan.bond@uea.ac.uk [School of Environmental Sciences, University of East Anglia (United Kingdom); School of Geo and Spatial Sciences, North-West University (South Africa); Pope, Jenny, E-mail: jenny@integral-sustainability.net [Integral Sustainability (Australia); Curtin University Sustainability Policy Institute (Australia); Morrison-Saunders, Angus, E-mail: A.Morrison-Saunders@murdoch.edu.au [School of Geo and Spatial Sciences, North-West University (South Africa); Environmental Science, Murdoch University (Australia); Retief, Francois, E-mail: francois.retief@nwu.ac.za [School of Geo and Spatial Sciences, North-West University (South Africa); Gunn, Jill A.E., E-mail: jill.gunn@usask.ca [Department of Geography and Planning and School of Environment and Sustainability, University of Saskatchewan (Canada)

    2014-02-15

    This paper argues that Governments have sought to streamline impact assessment in recent years (defined as the last five years) to counter concerns over the costs and potential for delays to economic development. We hypothesise that this has had some adverse consequences on the benefits that subsequently accrue from the assessments. This hypothesis is tested using a framework developed from arguments for the benefits brought by Environmental Impact Assessment made in 1982 in the face of the UK Government opposition to its implementation in a time of economic recession. The particular benefits investigated are ‘consistency and fairness’, ‘early warning’, ‘environment and development’, and ‘public involvement’. Canada, South Africa, the United Kingdom and Western Australia are the jurisdictions tested using this framework. The conclusions indicate that significant streamlining has been undertaken which has had direct adverse effects on some of the benefits that impact assessment should deliver, particularly in Canada and the UK. The research has not examined whether streamlining has had implications for the effectiveness of impact assessment, but the causal link between streamlining and benefits does sound warning bells that merit further investigation. -- Highlights: • Investigation of the extent to which government has streamlined IA. • Evaluation framework was developed based on benefits of impact assessment. • Canada, South Africa, the United Kingdom, and Western Australia were examined. • Trajectory in last five years is attrition of benefits of impact assessment.

  3. Impact assessment: Eroding benefits through streamlining?

    International Nuclear Information System (INIS)

    Bond, Alan; Pope, Jenny; Morrison-Saunders, Angus; Retief, Francois; Gunn, Jill A.E.

    2014-01-01

    This paper argues that Governments have sought to streamline impact assessment in recent years (defined as the last five years) to counter concerns over the costs and potential for delays to economic development. We hypothesise that this has had some adverse consequences on the benefits that subsequently accrue from the assessments. This hypothesis is tested using a framework developed from arguments for the benefits brought by Environmental Impact Assessment made in 1982 in the face of the UK Government opposition to its implementation in a time of economic recession. The particular benefits investigated are ‘consistency and fairness’, ‘early warning’, ‘environment and development’, and ‘public involvement’. Canada, South Africa, the United Kingdom and Western Australia are the jurisdictions tested using this framework. The conclusions indicate that significant streamlining has been undertaken which has had direct adverse effects on some of the benefits that impact assessment should deliver, particularly in Canada and the UK. The research has not examined whether streamlining has had implications for the effectiveness of impact assessment, but the causal link between streamlining and benefits does sound warning bells that merit further investigation. -- Highlights: • Investigation of the extent to which government has streamlined IA. • Evaluation framework was developed based on benefits of impact assessment. • Canada, South Africa, the United Kingdom, and Western Australia were examined. • Trajectory in last five years is attrition of benefits of impact assessment

  4. Is Environmental Impact Assessment fulfilling its potential?

    DEFF Research Database (Denmark)

    Larsen, Sanne Vammen

    2014-01-01

    fuel with CO2-neutral energy sources. A variety of these projects are subject to environmental impact assessment (EIA), which raises the following questions: What role does an impact assessment play? When is the project environmentally friendly? How are climate change-related impacts assessed......One of the topics receiving much attention in recent years is climate change and the potential of its integration in impact assessment, both in terms of achieving mitigation and adaptation. Renewable energy projects are part of the efforts to mitigate climate change, replacing the use of fossil...... adaptation is absent. Also, the results show an emphasis on positive impacts in the reports, and in a few cases discussions of enhancements. Identification and assessment of negative climate change impacts are less apparent. This leads to a discussion of the results in the light of the purpose of EIA....

  5. Impact of exercise capacity on dyspnea and health-related quality of life in patients with chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Jacobsen, Ramune; Frølich, Anne; Godtfredsen, Nina S

    2012-01-01

    To assess the impact of the amount of exercise training during pulmonary rehabilitation (PR) program for improvements in dyspnea and health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD).......To assess the impact of the amount of exercise training during pulmonary rehabilitation (PR) program for improvements in dyspnea and health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD)....

  6. 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

  7. Adapting to the Changing Climate: An Assessment of Local Health Department Preparations for Climate Change-Related Health Threats, 2008-2012.

    Science.gov (United States)

    Roser-Renouf, Connie; Maibach, Edward W; Li, Jennifer

    2016-01-01

    Climate change poses a major public health threat. A survey of U.S. local health department directors in 2008 found widespread recognition of the threat, but limited adaptive capacity, due to perceived lack of expertise and other resources. We assessed changes between 2008 and 2012 in local public health departments' preparedness for the public health threats of climate change, in light of increasing national polarization on the issue, and widespread funding cutbacks for public health. A geographically representative online survey of directors of local public health departments was conducted in 2011-2012 (N = 174; response rate = 50%), and compared to the 2008 telephone survey results (N = 133; response rate = 61%). Significant polarization had occurred: more respondents in 2012 were certain that the threat of local climate change impacts does/does not exist, and fewer were unsure. Roughly 10% said it is not a threat, compared to 1% in 2008. Adaptation capacity decreased in several areas: perceived departmental expertise in climate change risk assessment; departmental prioritization of adaptation; and the number of adaptation-related programs and services departments provided. In 2008, directors' perceptions of local impacts predicted the number of adaptation-related programs and services their departments offered, but in 2012, funding predicted programming and directors' impact perceptions did not. This suggests that budgets were constraining directors' ability to respond to local climate change-related health threats. Results also suggest that departmental expertise may mitigate funding constraints. Strategies for overcoming these obstacles to local public health departments' preparations for climate change are discussed.

  8. Managing environmental and health impacts of uranium mining

    Energy Technology Data Exchange (ETDEWEB)

    Vance, R.E.; Cameron, R., E-mail: robert.vance@oecd.org, E-mail: ron.cameron@oecd.org [OECD Nuclear Energy Agency (France)

    2014-07-01

    As the raw material that fuels nuclear power plants that generate significant amounts of electricity with full life cycle carbon emissions as low as renewable energy sources, uranium is a valuable commodity. Yet uranium mining remains controversial, principally because of environmental and health impacts created when mining was undertaken by governments to meet Cold War strategic requirements. Uranium mining is conducted under significantly different circumstances today. Since the era of military production, societal expectations of environmental protection and the safety of workers and the public have evolved as the outcomes of the early era of mining became apparent, driving changes in regulatory oversight and mining practices. Key aspects of leading practice uranium mining are presented (conventional worker health and safety, worker radiation protection, public health and safety, water quality, tailings and waste rock management) and compared with historic practices to demonstrate the scale of differences. The application of additional aspects of uranium mine life cycle management (public consultation, environmental impact assessment, analysis of socio-economic impacts/benefits, environmental monitoring, financial assurance, product transport, security and safeguards, emergency planning and knowledge transfer), introduced as the industry matured, enhance overall management practices for the long term. Results from several case studies show that improved management of key aspects of uranium mining, combined with the incorporation of new life cycle parameters, have transformed the industry into the most regulated and arguably one of the safest and environmentally responsible types of mining in the world. (author)

  9. Environmental and health impact by dairy cattle livestock and manure management in the Czech Republic

    NARCIS (Netherlands)

    Havlikova, M.; Kroeze, C.; Huijbregts, M.A.J.

    2008-01-01

    In this study we evaluate the potential environmental and health impact of dairy cattle livestock and manure management in the Czech Republic. We present a new approach for national assessments of the environmental impact of an agricultural sector. Emission estimates are combined with a

  10. Health Impacts of Active Transportation in Europe.

    Directory of Open Access Journals (Sweden)

    David Rojas-Rueda

    Full Text Available Policies that stimulate active transportation (walking and bicycling have been related to heath benefits. This study aims to assess the potential health risks and benefits of promoting active transportation for commuting populations (age groups 16-64 in six European cities. We conducted a health impact assessment using two scenarios: increased cycling and increased walking. The primary outcome measure was all-cause mortality related to changes in physical activity level, exposure to fine particulate matter air pollution with a diameter <2.5 μm, as well as traffic fatalities in the cities of Barcelona, Basel, Copenhagen, Paris, Prague, and Warsaw. All scenarios produced health benefits in the six cities. An increase in bicycle trips to 35% of all trips (as in Copenhagen produced the highest benefits among the different scenarios analysed in Warsaw 113 (76-163 annual deaths avoided, Prague 61 (29-104, Barcelona 37 (24-56, Paris 37 (18-64 and Basel 5 (3-9. An increase in walking trips to 50% of all trips (as in Paris resulted in 19 (3-42 deaths avoided annually in Warsaw, 11(3-21 in Prague, 6 (4-9 in Basel, 3 (2-6 in Copenhagen and 3 (2-4 in Barcelona. The scenarios would also reduce carbon dioxide emissions in the six cities by 1,139 to 26,423 (metric tonnes per year. Policies to promote active transportation may produce health benefits, but these depend of the existing characteristics of the cities. Increased collaboration between health practitioners, transport specialists and urban planners will help to introduce the health perspective in transport policies and promote active transportation.

  11. 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.

  12. Hawai'i Island Health Workforce Assessment 2008.

    Science.gov (United States)

    Withy, Kelley; Andaya, January; Vitousek, Sharon; Sakamoto, David

    2009-12-01

    Anecdotal reports of a doctor shortage on the Big Island have been circulating for years, but a detailed assessment of the health care workforce had not previously been accomplished. The Hawai'i Island Health Workforce Assessment used licensure data, focus groups, telephone follow up to provider offices, national estimates of average provider supply and analysis of insurance claims data to assess the extent of the existing medical and mental health workforce, approximate how many additional providers might be effectively utilized, develop a population-based estimate of future demand and identify causes and potential solutions for the challenges faced. As of February 2008, the researchers were able to locate 310 practicing physicians, 36 nurse practitioners, 6 physician assistants, 51 psychologists, 57 social workers and 42 other mental health providers. Based on national averages, claims analysis and focus groups, the Island could use approximately 45 additional medical professionals to care for the 85% of the population that is medically insured; a larger number to care for the entire population. Ascertaining a complete roster of mental health professionals was not possible using this methodology. The researchers compared the current supply of physicians with the national average of physicians to population and the number of visits to different specialists for the year 2006 and found specific regional shortages of providers. The focus groups concentrated on solutions to the workforce crisis that include the formation of a well-organized, broad collaboration to coordinate recruitment efforts, expand and strengthen retention and renewal activities, and reinvigorate the health profession pipeline and training opportunities. The researchers recommend collaboration between the community, government, business, health center care providers, hospitals and centers to develop a plan before the tenuous state of healthcare on the Big Island worsens. In addition, continued

  13. Measuring research impact in medical research institutes: a qualitative study of the attitudes and opinions of Australian medical research institutes towards research impact assessment frameworks.

    Science.gov (United States)

    Deeming, Simon; Reeves, Penny; Ramanathan, Shanthi; Attia, John; Nilsson, Michael; Searles, Andrew

    2018-03-16

    The question of how to measure, assess and optimise the returns from investment in health and medical research (HMR) is a highly policy-relevant issue. Research Impact Assessment Frameworks (RIAFs) provide a conceptual measurement framework to assess the impact from HMR. The aims of this study were (1) to elicit the views of Medical Research Institutes (MRIs) regarding objectives, definitions, methods, barriers, potential scope and attitudes towards RIAFs, and (2) to investigate whether an assessment framework should represent a retrospective reflection of research impact or a prospective approach integrated into the research process. The wider objective was to inform the development of a draft RIAF for Australia's MRIs. Purposive sampling to derive a heterogeneous sample of Australian MRIs was used alongside semi-structured interviews with senior executives responsible for research translation or senior researchers affected by research impact initiatives. Thematic analysis of the interview transcriptions using the framework approach was then performed. Interviews were conducted with senior representatives from 15 MRIs. Participants understood the need for greater research translation/impact, but varied in their comprehension and implementation of RIAFs. Common concerns included the time lag to the generation of societal impacts from basic or discovery science, and whether impact reflected a narrow commercialisation agenda. Broad support emerged for the use of metrics, case study and economic methods. Support was also provided for the rationale of both standardised and customised metrics. Engendering cultural change in the approach to research translation was acknowledged as both a barrier to greater impact and a critical objective for the assessment process. Participants perceived that the existing research environment incentivised the generation of academic publications and track records, and often conflicted with the generation of wider impacts. The potential to

  14. Environmental impacts assessment of industrial estate providing with managerial process

    Energy Technology Data Exchange (ETDEWEB)

    Nouri, J.; Mahvi, A.H.; Younesian, M.; Nabizadeh, R.; Hashemi, I. [Univ. of Tehran (Iran)

    2007-07-01

    The existence of balance, coordination and required order among natural elements is one of the key factors in the ecosystem. If this balance is disturbed under certain circumstances, it will damage the structure of living existences and more specifically human beings. Since a half century ago, factors such as important economical and industrial activites, advanced technologies together with growing population and lack of concordance among different couhntries to take optimal advantage of the existing natural resources have distrubed the balance in the ecosystem. As a result, man has caused many problems such as high death tolls and arduous diseases due to the different pollutions in water, air, land, sound, temperature, etc and factors such as erosion, desert, expansion, floods, extinction of plant and animal species, ozone layer destruction, global warming, sea level rise and greenhouse gases increase. Environmental Impact Assessment (EIA) is to recognize and assess systematic consequences of projects and programs on elements like physicochemical, biological, cultural, economical and social phenomena in th environment; in other words it is a way or method to determine the direction of predication and assessment of environmental impacts of activities on the environmental health of the ecosystem affecting human lives. In this study, and environmental impact assessment of the establishment of the Shahzand Industrial Estate in Arak at the central part of Iran was investigated. After collection of data and analysis of the findings, the positive and negative impacts resulting from establishment of the indutrial estate were investigated using the Leopold Matrix and Scaling checklist methods providing the managerial solutions in order to minimize the harmful environmental impacts. The existing environmental situation was investigated and then environmental impact alternatives were determined. This was done in regard to the amount and kind of predicted pollution for the

  15. Socioeconomic Disparities and Health: Impacts and Pathways

    Science.gov (United States)

    Kondo, Naoki

    2012-01-01

    Growing socioeconomic disparity is a global concern, as it could affect population health. The author and colleagues have investigated the health impacts of socioeconomic disparities as well as the pathways that underlie those disparities. Our meta-analysis found that a large population has risks of mortality and poor self-rated health that are attributable to income inequality. The study results also suggested the existence of threshold effects (ie, a threshold of income inequality over which the adverse impacts on health increase), period effects (ie, the potential for larger impacts in later years, specifically after the 1990s), and lag effects between income inequality and health outcomes. Our other studies using Japanese national representative survey data and a large-scale cohort study of Japanese older adults (AGES cohort) support the relative deprivation hypothesis, namely, that invidious social comparisons arising from relative deprivation in an unequal society adversely affect health. A study with a natural experiment design found that the socioeconomic gradient in self-rated health might actually have become shallower after the 1997–98 economic crisis in Japan, due to smaller health improvements among middle-class white-collar workers and middle/upper-income workers. In conclusion, income inequality might have adverse impacts on individual health, and psychosocial stress due to relative deprivation may partially explain those impacts. Any study of the effects of macroeconomic fluctuations on health disparities should also consider multiple potential pathways, including expanding income inequality, changes in the labor market, and erosion of social capital. Further studies are needed to attain a better understanding of the social determinants of health in a rapidly changing society. PMID:22156290

  16. Socioeconomic disparities and health: impacts and pathways.

    Science.gov (United States)

    Kondo, Naoki

    2012-01-01

    Growing socioeconomic disparity is a global concern, as it could affect population health. The author and colleagues have investigated the health impacts of socioeconomic disparities as well as the pathways that underlie those disparities. Our meta-analysis found that a large population has risks of mortality and poor self-rated health that are attributable to income inequality. The study results also suggested the existence of threshold effects (ie, a threshold of income inequality over which the adverse impacts on health increase), period effects (ie, the potential for larger impacts in later years, specifically after the 1990s), and lag effects between income inequality and health outcomes. Our other studies using Japanese national representative survey data and a large-scale cohort study of Japanese older adults (AGES cohort) support the relative deprivation hypothesis, namely, that invidious social comparisons arising from relative deprivation in an unequal society adversely affect health. A study with a natural experiment design found that the socioeconomic gradient in self-rated health might actually have become shallower after the 1997-98 economic crisis in Japan, due to smaller health improvements among middle-class white-collar workers and middle/upper-income workers. In conclusion, income inequality might have adverse impacts on individual health, and psychosocial stress due to relative deprivation may partially explain those impacts. Any study of the effects of macroeconomic fluctuations on health disparities should also consider multiple potential pathways, including expanding income inequality, changes in the labor market, and erosion of social capital. Further studies are needed to attain a better understanding of the social determinants of health in a rapidly changing society.

  17. Impact of Publicly Financed Health Insurance Schemes on Healthcare Utilization and Financial Risk Protection in India: A Systematic Review.

    Science.gov (United States)

    Prinja, Shankar; Chauhan, Akashdeep Singh; Karan, Anup; Kaur, Gunjeet; Kumar, Rajesh

    2017-01-01

    Several publicly financed health insurance schemes have been launched in India with the aim of providing universalizing health coverage (UHC). In this paper, we report the impact of publicly financed health insurance schemes on health service utilization, out-of-pocket (OOP) expenditure, financial risk protection and health status. Empirical research studies focussing on the impact or evaluation of publicly financed health insurance schemes in India were searched on PubMed, Google scholar, Ovid, Scopus, Embase and relevant websites. The studies were selected based on two stage screening PRISMA guidelines in which two researchers independently assessed the suitability and quality of the studies. The studies included in the review were divided into two groups i.e., with and without a comparison group. To assess the impact on utilization, OOP expenditure and health indicators, only the studies with a comparison group were reviewed. Out of 1265 articles screened after initial search, 43 studies were found eligible and reviewed in full text, finally yielding 14 studies which had a comparator group in their evaluation design. All the studies (n-7) focussing on utilization showed a positive effect in terms of increase in the consumption of health services with introduction of health insurance. About 70% studies (n-5) studies with a strong design and assessing financial risk protection showed no impact in reduction of OOP expenditures, while remaining 30% of evaluations (n-2), which particularly evaluated state sponsored health insurance schemes, reported a decline in OOP expenditure among the enrolled households. One study which evaluated impact on health outcome showed reduction in mortality among enrolled as compared to non-enrolled households, from conditions covered by the insurance scheme. While utilization of healthcare did improve among those enrolled in the scheme, there is no clear evidence yet to suggest that these have resulted in reduced OOP expenditures or

  18. Practitioners, professional cultures, and perceptions of impact assessment

    International Nuclear Information System (INIS)

    Morgan, Richard K.; Hart, Andrew; Freeman, Claire; Coutts, Brian; Colwill, David; Hughes, Andrew

    2012-01-01

    The very nature of impact assessment (IA) means that it often involves practitioners from a very wide range of disciplinary and professional backgrounds, which open the possibility that how IA is perceived and practised may vary according to the professional background of the practitioner. The purpose of this study is to investigate the extent to which a practitioner's professional background influences their perceptions of the adequacy of impact assessment in New Zealand under the Resource Management Act (RMA). Information gathered concerned professional affiliations, training, understanding of impact assessment practise, and perceptions of adequacy in relation to impact assessment. The results showed a dominance of a legalistic, operational perspective of impact assessment under the Resource Management Act, across all the main professions represented in the study. However, among preparers of impact assessments there was clear evidence of differences between the four main professional groups – surveyors, planners, engineers and natural scientists – in the way they see the nature and purpose of impact assessment, the practical steps involved, and what constitutes adequacy. Similarly, impact assessment reviewers – predominantly planners and lawyers – showed variations in their expectations of impact assessment depending on their respective professional affiliation. Although in many cases the differences seem to be more of a matter of emphasis, rather than major disputes on what constitutes a good process, even those differences can add up to rather distinct professional cultures of impact assessment. The following factors are seen as leading to the emergence of such professional cultures: different professions often contribute in different ways to an impact assessment, affecting their perception of the nature and purpose of the process; impact assessment training will usually be a secondary concern, compared with the core professional training, which will be

  19. Holistic impact assessment and cost savings of rainwater harvesting at the watershed scale

    Directory of Open Access Journals (Sweden)

    Santosh R. Ghimire

    2017-03-01

    Full Text Available We evaluated the impacts of domestic and agricultural rainwater harvesting (RWH systems in three watersheds within the Albemarle-Pamlico river basin (southeastern U.S. using life cycle assessment (LCA and life cycle cost assessment. Life cycle impact assessment (LCIA categories included energy demand, fossil fuel, metals, ozone depletion, global warming, acidification, smog, blue and green water use, ecotoxicity, eutrophication, and human health effects. Building upon previous LCAs of near-optimal domestic and agricultural RWH systems in the region, we scaled functional unit LCIA scores for adoption rates of 25%, 50%, 75%, and 100% and compared these to conventional municipal water and well water systems. In addition to investigating watershed-scale impacts of RWH adoption, which few studies have addressed, potential life cycle cost savings due to reduced cumulative energy demand were scaled in each watershed for a more comprehensive analysis. The importance of managing the holistic water balance, including blue water (surface/ground water, green water (rainwater use, and annual precipitation and their relationship to RWH are also addressed. RWH contributes to water resource sustainability by offsetting surface and ground water consumption and by reducing environmental and human health impacts compared to conventional sources. A watershed-wide RWH adoption rate of 25% has a number of ecological and human health benefits including blue water use reduction ranging from 2–39 Mm3, cumulative energy savings of 12–210 TJ, and reduced global warming potential of 600–10,100 Mg CO2 eq. Potential maximum lifetime energy cost savings were estimated at $5M and $24M corresponding to domestic RWH in Greens Mill and agricultural RWH in Back Creek watersheds.

  20. Health-related quality of life assessments in osteoarthritis during NSAID treatment.

    Science.gov (United States)

    de Bock, G H; Hermans, J; van Marwijk, H W; Kaptein, A A; Mulder, J D

    1996-08-01

    There is some evidence that nabumetone (1000 mg once daily) in comparison with piroxicam (20 mg once daily) in patients with OA in general practice is associated with a lower incidence and less severe occurrence of stomach pain but with more withdrawals due to lack of efficacy. The aim of this analysis was to investigate whether these differences are reflected in health-related quality of life assessments. Patients (n = 198) included in this study were selected in general practice according to a protocol. The patients were randomized and treated for a period of six weeks. Clinical assessments were performed by the general practitioner (CP) during treatment. The Sickness Impact Profile (SIP), the Activities of Daily Living (ADL), and a pain questionnaire were filled out by the patients before and after treatment. As measured with the SIP, the ADL and the pain questionnaire, there were no significant differences between nabumetone and piroxicam. The correlations between (changes in) patient assessments and (changes in) clinical assessments were low. The differences between the two drugs regarding withdrawals and adverse events were not reflected by patient health-related quality of life assessments. There was a low correlation between patient health-related quality of life assessment and clinical assessments. To get a complete picture of the efficacy and safety of a drug, patient health-related quality of life assessments should be a part of a clinical trial.

  1. Social Impact Assessment : Guidance for assessing and managing the social impacts of projects

    NARCIS (Netherlands)

    Vanclay, Francis; Esteves, Ana Maria; Aucamp, Ilse; Franks, Daniel

    2015-01-01

    The purpose of this Guidance Note is to provide advice to various stakeholders about what is expected in good practice social impact assessment (SIA) and social impact management processes, especially in relation to project development. Project development refers to dams, mines, oil and gas

  2. Road ecology in environmental impact assessment

    International Nuclear Information System (INIS)

    Karlson, Mårten; Mörtberg, Ulla; Balfors, Berit

    2014-01-01

    Transport infrastructure has a wide array of effects on terrestrial and aquatic ecosystems, and road and railway networks are increasingly being associated with a loss of biodiversity worldwide. Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) are two legal frameworks that concern physical planning, with the potential to identify, predict, mitigate and/or compensate transport infrastructure effects with negative impacts on biodiversity. The aim of this study was to review the treatment of ecological impacts in environmental assessment of transport infrastructure plans and projects. A literature review on the topic of EIA, SEA, biodiversity and transport infrastructure was conducted, and 17 problem categories on the treatment of biodiversity were formulated by means of a content analysis. A review of environmental impact statements and environmental reports (EIS/ER) produced between 2005 and 2013 in Sweden and the UK was then conducted using the list of problems as a checklist. The results show that the treatment of ecological impacts has improved substantially over the years, but that some impacts remain problematic; the treatment of fragmentation, the absence of quantitative analysis and that the impact assessment study area was in general delimited without consideration for the scales of ecological processes. Actions to improve the treatment of ecological impacts could include improved guidelines for spatial and temporal delimitation, and the establishment of a quantitative framework including tools, methods and threshold values. Additionally, capacity building and further method development of EIA and SEA friendly spatial ecological models can aid in clarifying the costs as well as the benefits in development/biodiversity tradeoffs. - Highlights: • The treatment of ecological impacts in EIA and SEA has improved. • Quantitative methods for ecological impact assessment were rarely used • Fragmentation effects were recognized

  3. Road ecology in environmental impact assessment

    Energy Technology Data Exchange (ETDEWEB)

    Karlson, Mårten, E-mail: mkarlso@kth.se; Mörtberg, Ulla, E-mail: mortberg@kth.se; Balfors, Berit, E-mail: balfors@kth.se

    2014-09-15

    Transport infrastructure has a wide array of effects on terrestrial and aquatic ecosystems, and road and railway networks are increasingly being associated with a loss of biodiversity worldwide. Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) are two legal frameworks that concern physical planning, with the potential to identify, predict, mitigate and/or compensate transport infrastructure effects with negative impacts on biodiversity. The aim of this study was to review the treatment of ecological impacts in environmental assessment of transport infrastructure plans and projects. A literature review on the topic of EIA, SEA, biodiversity and transport infrastructure was conducted, and 17 problem categories on the treatment of biodiversity were formulated by means of a content analysis. A review of environmental impact statements and environmental reports (EIS/ER) produced between 2005 and 2013 in Sweden and the UK was then conducted using the list of problems as a checklist. The results show that the treatment of ecological impacts has improved substantially over the years, but that some impacts remain problematic; the treatment of fragmentation, the absence of quantitative analysis and that the impact assessment study area was in general delimited without consideration for the scales of ecological processes. Actions to improve the treatment of ecological impacts could include improved guidelines for spatial and temporal delimitation, and the establishment of a quantitative framework including tools, methods and threshold values. Additionally, capacity building and further method development of EIA and SEA friendly spatial ecological models can aid in clarifying the costs as well as the benefits in development/biodiversity tradeoffs. - Highlights: • The treatment of ecological impacts in EIA and SEA has improved. • Quantitative methods for ecological impact assessment were rarely used • Fragmentation effects were recognized

  4. Health-Related Quality of Life in Patients with Multiple Sclerosis : Impact of Disease-Modifying Drugs

    NARCIS (Netherlands)

    Jongen, Peter Joseph

    Multiple sclerosis (MS) has a profound impact on health-related quality of life (HRQoL), a comprehensive subjective measure of the patient's health status. Assessment of HRQoL informs on the potential advantages and disadvantages of disease-modifying drugs (DMDs) beyond their effects on

  5. Crisis in the health sector: Impact on nurses' working conditions.

    Science.gov (United States)

    Granero-Lázaro, Alberto; Blanch-Ribas, Josep M; Roldán-Merino, Juan Francisco; Torralbas-Ortega, Jordi; Escayola-Maranges, Ana María

    In a context of economic crisis and policies to reduce the public deficit, the budgets of the Catalan Health Institute (CHI) were cut by 15.33% between 2010 and 2014. To assess the perceived impact on nurses' work conditions of measures to contain health spending. The study design was descriptive and transversal. A sample of 1,760 nurses from the province of Barcelona answered a questionnaire on the perceived impact of health spending containment measures implemented in their workplace during the early years of the crisis. Among the main aspects of the perceived impact of these measures, 86.6% of the nurses identified a pay cut and an increase in the following relevant parameters of their working conditions: number of hours worked (66.7%), final ratio of treated patients (35.2%), task complexity and workload (75.3%), rotation through various departments (31.5%), work shifts (21.4%) or work areas (23.4%), job insecurity (58.4%) and loss of employment by dismissal (6.6%) or non-renewal of contract (9%). The perceived impact of the crisis showed a triple negative component: Pay cut, work overload and job insecurity. As a combined effect of this multiple trend, the nurses acknowledged a deterioration in their working conditions and quality of working life. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  6. Health effects assessment summary tables

    International Nuclear Information System (INIS)

    1999-01-01

    The document is an excellent pointer system to identify current literature or changes in assessment criteria for many chemicals of interest to Superfund. It was prepared for Superfund use by the Environmental Criteria and Assessment Office (ECAO-Cin) in EPA's Office of Health and Environmental Assessment. Chemicals considered are those for which Health Effects Assessment Documents, Health and Environmental Effects Profiles, Health Assessment Documents or Air Quality Criteria Documents have been prepared by ECAO. Radionuclides considered are those believed to be most common at Superfund sites. Tables summarize reference doses (RfDs) for toxicity from subchronic and chronic inhalation, oral exposure, slope factors and unit risk values for carcinogenicity based on lifetime inhalation and oral exposure, and radionuclide carcinogenicity

  7. Life Cycle Impact Assessment

    DEFF Research Database (Denmark)

    Rosenbaum, Ralph K.; Hauschild, Michael Zwicky; Boulay, Anne-Marie

    2018-01-01

    This chapter is dedicated to the third phase of an LCA study, the Life Cycle Impact Assessment (LCIA) where the life cycle inventory’s information on elementary flows is translated into environmental impact scores. In contrast to the three other LCA phases, LCIA is in practice largely automated...

  8. Understanding the impact of the economic crisis on child health: the case of Spain.

    Science.gov (United States)

    Rajmil, Luis; Siddiqi, Arjumand; Taylor-Robinson, David; Spencer, Nick

    2015-10-14

    The objectives of the study were to explore the effect of the economic crisis on child health using Spain as a case study, and to document and assess the policies implemented in response to the crisis in this context. Serial cross-sectional data from Eurostat, the Spanish Health Interview Survey, and the database of childhood hospitalisation were analysed to explore impacts on child health, and key determinants of child health. A content analysis of National data sources/government legislation, and Spanish literature was used to describe policies implemented following the crisis. Unemployment rates in the general population (8.7% in 2005 and 25.6% in 2013), and children living in unemployed families (5.6% and 13.8%) increased in the study period. The percentage of children living under the poverty line, and income inequalities increased 15-20% from 2005 to 2012. Severe material deprivation rate has worsened in families with Primary Education, while the number of families attending Non-Governmental Organisations has increased. An impact on children's health at the general population level has not currently been detected; however an impact on general health, mental health and use of healthcare services was found in vulnerable groups. Investment in social protection and public policy for children showed a reduction as part of austerity measures taken by the Spanish governments. Despite the impact on social determinants, a short-term impact on child health has been detected only in specific vulnerable groups. The findings suggest the need to urgently protect vulnerable groups of children from the impact of austerity.

  9. Health impact assessment and monetary valuation of IQ loss in pre-school children due to lead exposure through locally produced food.

    Science.gov (United States)

    Bierkens, J; Buekers, J; Van Holderbeke, M; Torfs, R

    2012-01-01

    A case study has been performed which involved the full chain assessment from policy drivers to health effect quantification of lead exposure through locally produced food on loss of IQ in pre-school children at the population level across the EU-27, including monetary valuation of the estimated health impact. Main policy scenarios cover the period from 2000 to 2020 and include the most important Community policy developments expected to affect the environmental release of lead (Pb) and corresponding human exposure patterns. Three distinct scenarios were explored: the emission situation based on 2000 data, a business-as-usual scenario (BAU) up to 2010 and 2020 and a scenario incorporating the most likely technological change expected (Most Feasible Technical Reductions, MFTR) in response to current and future legislation. Consecutive model calculations (MSCE-HM, WATSON, XtraFOOD, IEUBK) were performed by different partners on the project as part of the full chain approach to derive estimates of blood lead (B-Pb) levels in children as a consequence of the consumption of local produce. The estimated B-Pb levels were translated into an average loss of IQ points/child using an empirical relationship based on a meta-analysis performed by Schwartz (1994). The calculated losses in IQ points were subsequently further translated into the average cost/child using a cost estimate of €10.000 per loss of IQ point based on data from a literature review. The estimated average reduction of cost/child (%) for all countries considered in 2010 under BAU and MFTR are 12.16 and 18.08% as compared to base line conditions, respectively. In 2020 the percentages amount to 20.19 and 23.39%. The case study provides an example of the full-chain impact pathway approach taking into account all foreseeable pathways both for assessing the environmental fate and the associated human exposure and the mode of toxic action to arrive at quantitative estimates of health impacts at the individual and

  10. GIS based procedure of cumulative environmental impact assessment.

    Science.gov (United States)

    Balakrishna Reddy, M; Blah, Baiantimon

    2009-07-01

    Scale and spatial limits of impact assessment study in a GIS platform are two very important factors that could have a bearing on the genuineness and quality of impact assessment. While effect of scale has been documented and well understood, no significant study has been carried out on spatial considerations in an impact assessment study employing GIS technique. A novel technique of impact assessment demonstrable through GIS approach termed hereby as 'spatial data integrated GIS impact assessment method (SGIAM)' is narrated in this paper. The technique makes a fundamental presumption that the importance of environmental impacts is dependent, among other things, on spatial distribution of the effects of the proposed action and of the affected receptors in a study area. For each environmental component considered (e.g., air quality), impact indices are calculated through aggregation of impact indicators which are measures of the severity of the impact. The presence and spread of environmental descriptors are suitably quantified through modeling techniques and depicted. The environmental impact index is calculated from data exported from ArcINFO, thus giving significant importance to spatial data in the impact assessment exercise.

  11. Assessing the effects of noise abatement measures on health risks: A case study in Istanbul

    International Nuclear Information System (INIS)

    Ongel, Aybike; Sezgin, Fatih

    2016-01-01

    In recent decades, noise pollution caused by industrialization and increased motorization has become a major concern around the world because of its adverse effects on human well-being. Therefore, transportation agencies have been implementing noise abatement measures in order to reduce road traffic noise. However, limited attention is given to noise in environmental assessment of road transportation systems. This paper presents a framework for a health impact assessment model for road transportation noise emissions. The model allows noise impacts to be addressed with the health effects of air pollutant and greenhouse gas emissions from road transportation. The health damages assessed in the model include annoyance, sleep disturbance, and cardiovascular disease in terms of acute myocardial infarction. The model was applied in a case study in Istanbul in order to evaluate the change in health risks from the implementation of noise abatement strategies. The noise abatement strategies evaluated include altering pavement surfaces in order to absorb noise and introducing speed limits. It was shown that significant improvements in health risks can be achieved using open graded pavement surfaces and introducing speed limits on highways. - Highlights: • Transportation noise has a significant effect on health. • Noise should be included in the environmental assessment of transportation systems. • Traffic noise abatement measures include noise reducing pavements and speed limits. • Noise abatement measures help reduce the health risks of transportation noise. • Speed limit reduction on uncongested roads is an effective way to reduce health risks.

  12. Assessing the effects of noise abatement measures on health risks: A case study in Istanbul

    Energy Technology Data Exchange (ETDEWEB)

    Ongel, Aybike, E-mail: aybike.ongel@eng.bahcesehir.edu.tr [Bahcesehir University, Department of Civil Engineering, Istanbul 34353 (Turkey); Sezgin, Fatih, E-mail: fatih.sezgin@ibb.gov.tr [Istanbul Metropolitan Municipality, Environmental Protection Agency, Istanbul 34169 (Turkey)

    2016-01-15

    In recent decades, noise pollution caused by industrialization and increased motorization has become a major concern around the world because of its adverse effects on human well-being. Therefore, transportation agencies have been implementing noise abatement measures in order to reduce road traffic noise. However, limited attention is given to noise in environmental assessment of road transportation systems. This paper presents a framework for a health impact assessment model for road transportation noise emissions. The model allows noise impacts to be addressed with the health effects of air pollutant and greenhouse gas emissions from road transportation. The health damages assessed in the model include annoyance, sleep disturbance, and cardiovascular disease in terms of acute myocardial infarction. The model was applied in a case study in Istanbul in order to evaluate the change in health risks from the implementation of noise abatement strategies. The noise abatement strategies evaluated include altering pavement surfaces in order to absorb noise and introducing speed limits. It was shown that significant improvements in health risks can be achieved using open graded pavement surfaces and introducing speed limits on highways. - Highlights: • Transportation noise has a significant effect on health. • Noise should be included in the environmental assessment of transportation systems. • Traffic noise abatement measures include noise reducing pavements and speed limits. • Noise abatement measures help reduce the health risks of transportation noise. • Speed limit reduction on uncongested roads is an effective way to reduce health risks.

  13. Assessment of mercury health risks to adults from coal combustion

    Energy Technology Data Exchange (ETDEWEB)

    Lipfert, F.W.; Moskowitz, P.D.; Fthenakis, V.M.; DePhillips, M.P.; Viren, J.; Saroff, L.

    1994-05-01

    The U.S. Environmental Protection Agency (EPA) is preparing, for the U.S. Congress, a report evaluating the need to regulate mercury (Hg) emissions from electric utilities. This study, to be completed in 1995, will have important health and economic implications. In support of these efforts, the U.S. Department of Energy, Office of Fossil Energy, sponsored a risk assessment project at Brookhaven National Laboratory (BNL) to evaluate methylmercury (MeHg) hazards independently. In the BNL study, health risks to adults resulting from Hg emissions from a hypothetical 1000 MW{sub e} coal-fired power plant were estimated using probabilistic risk assessment techniques. The approach draws on the extant knowledge in each of the important steps in the calculation chain from emissions to health effects. Estimated results at key points in the chain were compared with actual measurements to help validate the modeled estimates. Two cases were considered: the baseline case (no local impacts), and the impact case (maximum local power-plant impact). The BNL study showed that the effects of emissions of a single power plant may double the background exposures to MeHg resulting from consuming fish obtained from a localized area near the power plant. Many implicit and explicit sources of uncertainty exist in this analysis. Those that appear to be most in need of improvement include data on doses and responses for potentially sensitive subpopulations (e.g., fetal exposures). Rather than considering hypothetical situations, it would also be preferable to assess the risks associated with actual coal-fired power plants and the nearby sensitive water bodies and susceptible subpopulations. Finally, annual total Hg emissions from coal burning and from other anthropogenic sources are still uncertain; this makes it difficult to estimate the effects of U.S. coal burning on global Hg concentration levels, especially over the long term.

  14. Linguistic Adaptation and Psychometric Properties of Tamil Version of General Oral Health Assessment Index-Tml.

    Science.gov (United States)

    Appukuttan, D P; Vinayagavel, M; Balasundaram, A; Damodaran, L K; Shivaraman, P; Gunasshegaran, K

    2015-01-01

    Oral health has an impact on quality of life hence for research purpose validation of a Tamil version of General Oral Health Assessment Index would enable it to be used as a valuable tool among Tamil speaking population. In this study, we aimed to assess the psychometric properties of translated Tamil version of General Oral Health Assessment Index (GOHAI-Tml). Linguistic adaptation involved forward and backward blind translation process. Reliability was analyzed using test-retest, Cronbach alpha, and split half reliability. Inter-item and item-total correlation were evaluated using Spearman rank correlation. Convenience sampling was done, and 265 consecutive patients aged 20-70 years attending the outpatient department were recruited. Subjects were requested to fill a self-reporting questionnaire along with Tamil GOHAI version. Clinical examination was done on the same visit. Concurrent validity was measured by assessing the relationship between GOHAI scores and self-perceived oral health and general health status, satisfaction with oral health, need for dental treatment and esthetic satisfaction. Discriminant validity was evaluated by comparing the GOHAI scores with the objectively assessed clinical parameters. Exploratory factor analysis was done to examine the factor structure. Mean GOHAI-Tml was 52.7 (6.8, range 22-60, median 54). The mean number of negative impacts was 2 (2.4, range 0-11, median 1). The Spearman rank correlation for test-retest ranged from 0.8 to 0.9 (P Tamil speaking population.

  15. Assessing the impact of aviation on climate

    Directory of Open Access Journals (Sweden)

    Karen Marais

    2008-04-01

    Full Text Available We present an assessment of the marginal climate impacts of new aviation activities. We use impulse response functions derived from carbon-cycle and atmospheric models to estimate changes in surface temperature for various aviation impacts (CO2, NOx on methane, NOx on ozone, sulfates, soot, and contrails/induced cirrus. We use different damage functions and discount rates to explore health, welfare and ecological costs for a range of assumptions and scenarios. Since uncertainty is high regarding many aviation effects, we explicitly capture some uncertainty by representing several model parameters as probabilistic distributions. The uncertainties are then propagated using Monte Carlo analysis to derive estimates for the impact of these uncertainties on the marginal future climate impacts. Our goal is to provide a framework that will communicate the potential impacts of aviation on climate change under different scenarios and assumptions, and that will allow decision-makers to compare these potential impacts to other aviation environmental impacts. We present results to describe the influence of parametric uncertainties, scenarios, and assumptions for valuation on the expected marginal future costs of aviation impacts. Estimates of the change in global average surface temperature due to aviation are most sensitive to changes in climate sensitivity, the radiative forcing attributed to short-lived effects (in particular those related to contrails and aviation-induced cirrus, and the choice of emissions scenario. Estimates of marginal future costs of aviation are most sensitive to assumptions regarding the discount rate, followed by assumptions regarding climate sensitivity, and the choice of emissions scenario.

  16. A class of non-linear exposure-response models suitable for health impact assessment applicable to large cohort studies of ambient air pollution.

    Science.gov (United States)

    Nasari, Masoud M; Szyszkowicz, Mieczysław; Chen, Hong; Crouse, Daniel; Turner, Michelle C; Jerrett, Michael; Pope, C Arden; Hubbell, Bryan; Fann, Neal; Cohen, Aaron; Gapstur, Susan M; Diver, W Ryan; Stieb, David; Forouzanfar, Mohammad H; Kim, Sun-Young; Olives, Casey; Krewski, Daniel; Burnett, Richard T

    2016-01-01

    The effectiveness of regulatory actions designed to improve air quality is often assessed by predicting changes in public health resulting from their implementation. Risk of premature mortality from long-term exposure to ambient air pollution is the single most important contributor to such assessments and is estimated from observational studies generally assuming a log-linear, no-threshold association between ambient concentrations and death. There has been only limited assessment of this assumption in part because of a lack of methods to estimate the shape of the exposure-response function in very large study populations. In this paper, we propose a new class of variable coefficient risk functions capable of capturing a variety of potentially non-linear associations which are suitable for health impact assessment. We construct the class by defining transformations of concentration as the product of either a linear or log-linear function of concentration multiplied by a logistic weighting function. These risk functions can be estimated using hazard regression survival models with currently available computer software and can accommodate large population-based cohorts which are increasingly being used for this purpose. We illustrate our modeling approach with two large cohort studies of long-term concentrations of ambient air pollution and mortality: the American Cancer Society Cancer Prevention Study II (CPS II) cohort and the Canadian Census Health and Environment Cohort (CanCHEC). We then estimate the number of deaths attributable to changes in fine particulate matter concentrations over the 2000 to 2010 time period in both Canada and the USA using both linear and non-linear hazard function models.

  17. Assessment of the Ehlanzeni District health transport and logistics function: Enhancing rural healthcare delivery systems

    CSIR Research Space (South Africa)

    Mashiri, MAM

    2009-07-01

    Full Text Available This paper seeks to establish a baseline against which to assess the impacts of the ‘Ehlanzeni District Health Transport Function’ for the district’s healthcare service delivery output, and by extension, health and welfare outcomes. The main...

  18. Healthy Vinton: A Health Impact Assessment Focused on Water and Sanitation in a Small Rural Town on the U.S.-Mexico Border

    Directory of Open Access Journals (Sweden)

    William L. Hargrove

    2015-04-01

    Full Text Available We conducted a Health Impact Assessment (HIA focused on water and sanitation in Vinton, TX, a small rural town on the U.S./Mexico Border. We present the Vinton HIA as a case study to inform the practice of HIA in rural limited resource communities with higher than average levels of unemployment and poverty, and limited infrastructure. Household surveys, focus groups, and interviews provided quantitative and qualitative data on water sources and quality, sanitation practices, and community health. We found that some of the current water sources in Vinton did not meet drinking water standards for total dissolved solids and arsenic; the majority of septic tanks were not managed properly; and there was a short-term risk of water scarcity due to prolonged drought in the region. Prevalent ailments reported by participants included stomach problems, diarrhea, and skin problems. These ailments can be related to arsenic and/or biological organisms in water. The positive direct and indirect health impacts of improved water and sanitation in Vinton included: reduced gastrointestinal illnesses and skin disorders; improved water quality, quantity, and pressure; reduced risks from failing septic systems; increased property value; potential economic growth; and enhanced quality of life. The negative direct and indirect impacts included: residents’ initial and monthly costs; increased property taxes; increased debt by local government; and the need for ongoing support from changing elected decision makers. The unique challenges in completing this HIA included: (a limited available data; (b a culture of fear and distrust among residents; (c residents’ lack of education, awareness, and civic discourse regarding water and sanitation issues and their impact on public health; and (d lack of civic discourse and participation in the democratic process. An important outcome of the HIA was the characterization of local water supplies, which motivated and empowered

  19. Hospital support services and the impacts of outsourcing on occupational health and safety.

    Science.gov (United States)

    Siganporia, Pearl; Astrakianakis, George; Alamgir, Hasanat; Ostry, Aleck; Nicol, Anne-Marie; Koehoorn, Mieke

    2016-10-01

    Outsourcing labor is linked to negative impacts on occupational health and safety (OHS). In British Columbia, Canada, provincial health care service providers outsource support services such as cleaners and food service workers (CFSWs) to external contractors. This study investigates the impact of outsourcing on the occupational health safety of hospital CFSWs through a mixed methods approach. Worker's compensation data for hospital CFSWs were analyzed by negative binomial and multiple linear regressions supplemented by iterative thematic analysis of telephone interviews of the same job groups. Non-significant decreases in injury rates and days lost per injury were observed in outsourced CFSWs post outsourcing. Significant decreases (P outsourcing. Outsourced workers interviewed implied instances of underreporting workplace injuries. This mixed methods study describes the impact of outsourcing on OHS of healthcare workers in British Columbia. Results will be helpful for policy-makers and workplace regulators to assess program effectiveness for outsourced workers.

  20. Indigenous Child Health in Brazil: The Evaluation of Impacts as a Human Rights Issue.

    Science.gov (United States)

    Coates, Anna R; Del Pino Marchito, Sandra; Vitoy, Bernardino

    2016-06-01

    Improving the health status of indigenous children is a long-standing challenge. Several United Nations committees have identified the health of indigenous peoples as a human rights concern. Addressing the health of indigenous children cannot be separated from their social, cultural, and historic contexts, and any related health program must offer culturally appropriate services and a community perspective broad enough to address the needs of children and the local worlds in which they live. Evaluations of programs must, therefore, address process as well as impacts. This paper assesses interventions addressing indigenous children's health in Brazil, ranging from those explicitly targeting indigenous children's health, such as the targeted immunization program for indigenous peoples, as well as more generalized programs, including a focus upon indigenous children, such as the Integrated Management of Childhood Illness. The paper discusses the tensions and complexities of ethnically targeted health interventions as well as the conceptual and methodological challenge of measuring the processes employed and their impact. The lessons learned, especially the need for countries to more systematically collect data and evaluate impacts using ethnicity as an analytical category, are drawn out with respect to ensuring human rights for all within health sector responses.