International Journal of Environmental Research and Public Health

Research

16 pages, 1638 KiB

Open AccessArticle

Public Health Impacts of Ambient Particulate Matter Pollution in Libya from 1990 to 2019: An Analysis of the 2019 Global Burden of Disease (GBD) Study

by David Rojas-Rueda, Sandhya Lamsal, Mohini Kak, Sameh El-Saharty and Christopher H. Herbst

Int. J. Environ. Res. Public Health 2024, 21(6), 667; https://doi.org/10.3390/ijerph21060667 - 23 May 2024

Viewed by 1488

Abstract

Air pollution is recognized as a critical global health risk, yet there has been no comprehensive assessment of its impact on public health in Libya until now. This study evaluates the burden of disease associated with ambient particulate matter (PM_2.5) in [...] Read more.

Air pollution is recognized as a critical global health risk, yet there has been no comprehensive assessment of its impact on public health in Libya until now. This study evaluates the burden of disease associated with ambient particulate matter (PM_2.5) in Libya, drawing on data from the Global Burden of Disease Study 2019. By integrating satellite-based estimates, chemical transport models, and ground-level measurements, PM_2.5 exposure and its effects on mortality and disability-adjusted life years (DALYs) across the different sexes and all age groups from 1990 to 2019 are estimated. Our findings reveal that the annual population-weighted mean PM_2.5 concentration in Libya was 38.6 μg/m³ in 2019, marking a 3% increase since 1990. In the same year, PM_2.5 was responsible for approximately 3368 deaths, accounting for 11% of all annual deaths in the country. Moreover, a total of 107,207 DALYs were attributable to PM_2.5, with ischemic heart disease being the leading cause, representing 46% of these DALYs. The analysis also highlights a significant burden of years of life lost (YLLs) at 89,113 and years lived with disability (YLDs) at 18,094, due to PM_2.5. Given the substantial health risks associated with air pollution, particularly from ambient particulate matter, Libyan authorities must implement effective policies aimed at reducing air pollution to enhance healthcare outcomes and preventive services. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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10 pages, 709 KiB

Open AccessArticle

Health Impact Assessment (HIA) of a Daily Physical Activity Unit in Schools: Focus on Children and Adolescents in Austria Up to the 8th Grade

by Madlene Movia, Sandra Macher, Gabriele Antony, Verena Zeuschner, Gabriela Wamprechtsamer, Judith delle Grazie, Helmut Simi and Bianca Fuchs-Neuhold

Int. J. Environ. Res. Public Health 2022, 19(11), 6428; https://doi.org/10.3390/ijerph19116428 - 25 May 2022

Cited by 3 | Viewed by 3027

Abstract

Physical activity has a variety of health benefits for young people. The World Health Organization (WHO) recommends that children and adolescents aged 5–17 years should be physically active for at least 60 min a day. This Health Impact Assessment (HIA) examined the potential [...] Read more.

Physical activity has a variety of health benefits for young people. The World Health Organization (WHO) recommends that children and adolescents aged 5–17 years should be physically active for at least 60 min a day. This Health Impact Assessment (HIA) examined the potential impact of a daily physical activity unit in Austrian schools, with a focus on children and adolescents up to eighth grade. The HIA methodology systematically followed several stages: screening and scoping, appraisal, and formulation of recommendations. A literature review, an online survey (n = 712), focus group discussions (n = 4), and appraisal workshops (n = 2) have been carried out. The analyzed results indicate a primarily positive impact on the individual health of children and adolescents, on social and community-related networks, on living and working conditions, and on the system level. Recommendations for the implementation include ensuring equal opportunities and support for disadvantaged children and schools. Furthermore, the comprehensible selection of pilot regions and the nationwide resource planning should be considered. Additional important factors include the education and further training of pedagogical staff and coaches, and the availability of sufficient infrastructure. In the long term, the fixed integration of five additional teaching units of physical activity per week, and an increased focus on the elementary/nursery school sector were identified as significant. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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22 pages, 2206 KiB

Open AccessArticle

Has the Volume-Based Drug Purchasing Approach Achieved Equilibrium among Various Stakeholders? Evidence from China

by Qian Xing, Wenxi Tang, Mingyang Li and Shuailong Li

Int. J. Environ. Res. Public Health 2022, 19(7), 4285; https://doi.org/10.3390/ijerph19074285 - 3 Apr 2022

Cited by 4 | Viewed by 3671

Abstract

Volume-based drug purchasing by China’s health insurance system currently represents the largest group purchasing organization worldwide. After exchanging the market that accounted for nearly half of the volume of the healthcare system for the ultra-low-price supply of limited drugs, what are the effects [...] Read more.

Volume-based drug purchasing by China’s health insurance system currently represents the largest group purchasing organization worldwide. After exchanging the market that accounted for nearly half of the volume of the healthcare system for the ultra-low-price supply of limited drugs, what are the effects on patient and funding burdens, drug accessibility, and clinical efficacy? We aimed to verify the effectiveness of the policy, explore the reasons behind the problem and identify regulatory priorities and collaborative measures. We used literature and reported data from 2019 to 2021 to conduct a stakeholder analysis and health impact assessment, presenting the benefit and risk share for various dimensions. The analysis method was a multidimensional scaling model, which visualized problematic associations. Seventy-nine papers (61 publications and 18 other resources) were included in the study, with 22 effects and 36 problems identified. The results indicated favorable affordability and poor accessibility of drugs, as well as high risk of reduced drug quality and drug-use rationality. The drug-use demand of patients was guaranteed; the prescription rights of doctors regarding clinical drug use were limited; unreasonable evaluation indicators limited the transformation of public hospitals to value- and service-oriented organizations; the sustainability of health insurance funds and policy promotion were at risk; and innovation by pharmaceutical companies was accelerated. The problems associated with high co-occurrence frequencies were divided into the following clusters: cost control, drug accessibility, system rationality, policy fairness, drug quality, and moral hazards. These findings suggested that China has achieved short-term success in reducing the burden on patients and reducing fund expenditure. However, there were still deficiencies in guaranteed supply, quality control, and efficacy tracking. The study offers critical lessons for China and other low- and middle-income countries. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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10 pages, 883 KiB

Open AccessArticle

Health and Economic Impacts Assessment of O₃ Exposure in Mexico

by José Luis Texcalac-Sangrador, Magali Hurtado-Díaz, Eunice Elizabeth Félix-Arellano, Carlos Manuel Guerrero-López and Horacio Riojas-Rodríguez

Int. J. Environ. Res. Public Health 2021, 18(21), 11646; https://doi.org/10.3390/ijerph182111646 - 5 Nov 2021

Cited by 5 | Viewed by 2287

Abstract

Health effects related to exposure to air pollution such as ozone (O₃) have been documented. The World Health Organization has recommended the use of the Sum of O₃ Means Over 35 ppb (SOMO35) to perform Health Impact Assessments (HIA) for [...] Read more.

Health effects related to exposure to air pollution such as ozone (O₃) have been documented. The World Health Organization has recommended the use of the Sum of O₃ Means Over 35 ppb (SOMO35) to perform Health Impact Assessments (HIA) for long-term exposure to O₃. We estimated the avoidable mortality associated with long-term exposure to tropospheric O₃ in 14 cities in Mexico using information for 2015. The economic valuation of avoidable deaths related to SOMO35 exposure was performed using the willingness to pay (WTP) and human capital (HC) approaches. We estimated that 627 deaths (95% uncertainty interval (UI): 227–1051) from respiratory diseases associated with the exposure to O₃ would have been avoided in people over 30 years in the study area, which confirms the public health impacts of ambient air pollution. The avoidable deaths account for almost 1400 million USD under the WTP approach, whilst the HC method yielded a lost productivity estimate of 29.7 million USD due to premature deaths. Our findings represent the first evidence of the health impacts of O₃ exposure in Mexico, using SOMO35 metrics. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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16 pages, 903 KiB

Open AccessArticle

Health Impact Assessments of Health Sector Proposals: An Audit and Narrative Synthesis

by Nelius Wanjiku Wanjohi, Reema Harrison and Ben Harris-Roxas

Int. J. Environ. Res. Public Health 2021, 18(21), 11466; https://doi.org/10.3390/ijerph182111466 - 31 Oct 2021

Cited by 2 | Viewed by 3299

Abstract

Background: Health impact assessment (HIA) is a tool used to assess the potential health impacts of proposed projects, programs, and policies. The extent of the use of HIAs conducted on health sector proposals, and what they focus on, is currently largely undocumented. This [...] Read more.

Background: Health impact assessment (HIA) is a tool used to assess the potential health impacts of proposed projects, programs, and policies. The extent of the use of HIAs conducted on health sector proposals, and what they focus on, is currently largely undocumented. This paper reviews HIAs conducted on health sector proposals, their characteristics and describes the settings in which they were conducted. Methods: A systematic review was conducted, including peer-reviewed journals and grey literature utilizing keywords, synonyms, and subject headings relevant to HIA and the health sector. Eligibility criteria were independently applied to the identified works and data appraisal conducted using the Critical Appraisal Skills Programme qualitative checklist tool. Results: 19 HIAs were identified and included in the review, including 13 rapid, three intermediate, and two comprehensive HIAs. The HIAs use was evident across a range of health service contexts, though all but one had been conducted in developed countries. Conclusion: The use of HIAs in the health sector is limited. There were various benefits attributed to the HIAs analysed including and not limited to the allocation of resources, reducing inequalities, and identification of possible negative consequences of a project. There is an opportunity to improve the use and reporting of HIAs across health settings internationally to enhance the consideration of broader determinants of health, influence decision making, and use of evidence in health sector planning for the future. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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12 pages, 1534 KiB

Open AccessArticle

Projecting Health Impacts of Future Temperature: A Comparison of Quantile-Mapping Bias-Correction Methods

by Weijia Qian and Howard H. Chang

Int. J. Environ. Res. Public Health 2021, 18(4), 1992; https://doi.org/10.3390/ijerph18041992 - 18 Feb 2021

Cited by 24 | Viewed by 4672

Abstract

Health impact assessments of future environmental exposures are routinely conducted to quantify population burdens associated with the changing climate. It is well-recognized that simulations from climate models need to be bias-corrected against observations to estimate future exposures. Quantile mapping (QM) is a technique [...] Read more.

Health impact assessments of future environmental exposures are routinely conducted to quantify population burdens associated with the changing climate. It is well-recognized that simulations from climate models need to be bias-corrected against observations to estimate future exposures. Quantile mapping (QM) is a technique that has gained popularity in climate science because of its focus on bias-correcting the entire exposure distribution. Even though improved bias-correction at the extreme tails of exposure may be particularly important for estimating health burdens, the application of QM in health impact projection has been limited. In this paper we describe and apply five QM methods to estimate excess emergency department (ED) visits due to projected changes in warm-season minimum temperature in Atlanta, USA. We utilized temperature projections from an ensemble of regional climate models in the North American-Coordinated Regional Climate Downscaling Experiment (NA-CORDEX). Across QM methods, we estimated consistent increase in ED visits across climate model ensemble under RCP 8.5 during the period 2050 to 2099. We found that QM methods can significantly reduce between-model variation in health impact projections (50–70% decreases in between-model standard deviation). Particularly, the quantile delta mapping approach had the largest reduction and is recommended also because of its ability to preserve model-projected absolute temporal changes in quantiles. Full article

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16 pages, 4558 KiB

Open AccessArticle

Health Impact of Air Pollution from Shipping in the Baltic Sea: Effects of Different Spatial Resolutions in Sweden

by Nandi S. Mwase, Alicia Ekström, Jan Eiof Jonson, Erik Svensson, Jukka-Pekka Jalkanen, Janine Wichmann, Peter Molnár and Leo Stockfelt

Int. J. Environ. Res. Public Health 2020, 17(21), 7963; https://doi.org/10.3390/ijerph17217963 - 29 Oct 2020

Cited by 7 | Viewed by 3521

Abstract

In 2015, stricter regulations to reduce sulfur dioxide emissions and particulate air pollution from shipping were implemented in the Baltic Sea. We investigated the effects on population exposure to particles <2.5 µm (PM_2.5) from shipping and estimated related morbidity and mortality [...] Read more.

In 2015, stricter regulations to reduce sulfur dioxide emissions and particulate air pollution from shipping were implemented in the Baltic Sea. We investigated the effects on population exposure to particles <2.5 µm (PM_2.5) from shipping and estimated related morbidity and mortality in Sweden’s 21 counties at different spatial resolutions. We used a regional model to estimate exposure in Sweden and a city-scale model for Gothenburg. Effects of PM_2.5 exposure on total mortality, ischemic heart disease, and stroke were estimated using exposure–response functions from the literature and combining them into disability-adjusted life years (DALYS). PM_2.5 exposure from shipping in Gothenburg decreased by 7% (1.6 to 1.5 µg/m³) using the city-scale model, and 35% (0.5 to 0.3 µg/m³) using the regional model. Different population resolutions had no effects on population exposures. In the city-scale model, annual premature deaths due to shipping PM_2.5 dropped from 97 with the high-sulfur scenario to 90 in the low-sulfur scenario, and in the regional model from 32 to 21. In Sweden, DALYs lost due to PM_2.5 from Baltic Sea shipping decreased from approximately 5700 to 4200. In conclusion, sulfur emission restrictions for shipping had positive effects on health, but the model resolution affects estimations. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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15 pages, 633 KiB

Open AccessArticle

Measuring Burden of Disease Attributable to Air Pollution Due to Preterm Birth Complications and Infant Death in Paris Using Disability-Adjusted Life Years (DALYs)

by Séverine Deguen, Guadalupe Perez Marchetta and Wahida Kihal-Talantikite

Int. J. Environ. Res. Public Health 2020, 17(21), 7841; https://doi.org/10.3390/ijerph17217841 - 26 Oct 2020

Cited by 4 | Viewed by 2829

Abstract

Several studies have found maternal exposure to particulate matter pollution was associated with adverse birth outcomes, including infant mortality and preterm birth. In this context, our study aims to quantify the air pollution burden of disease due to preterm birth complications and infant [...] Read more.

Several studies have found maternal exposure to particulate matter pollution was associated with adverse birth outcomes, including infant mortality and preterm birth. In this context, our study aims to quantify the air pollution burden of disease due to preterm birth complications and infant death in Paris, with particular attention to people living in the most deprived census blocks. Data on infant death and preterm birth was available from the birth and death certificates. The postal address of mother’s newborn was converted in census block number. A socioeconomic deprivation index was built at the census block level. Average annual ambient concentrations of PM₁₀ were modelled at census block level using the ESMERALDA atmospheric modelling system. The number of infant deaths attributed to PM₁₀ exposure is expressed in years of life lost. We used a three-step compartmental model to appraise neurodevelopmental impairment among survivors of preterm birth. We estimated that 12.8 infant deaths per 100,000 live births may be attributable to PM₁₀ exposure, and about one third of these infants lived in deprived census blocks. In addition, we found that approximately 4.8% of preterm births could be attributable to PM₁₀ exposure, and approximately 1.9% of these infants died (corresponding to about 5.75 deaths per 100,000 live birth). Quantification of environmental hazard-related health impacts for children at local level is essential to prioritizing interventions. Our study suggests that additional effort is needed to reduce the risk of complications and deaths related to air pollution exposure, especially among preterm births. Because of widespread exposure to air pollution, significant health benefits could be achieved through regulatory interventions aimed at reducing exposure of the population as a whole, and particularly of the most vulnerable, such as children and pregnant women. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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19 pages, 2119 KiB

Open AccessArticle

Integrated Impact Assessment of Active Travel: Expanding the Scope of the Health Economic Assessment Tool (HEAT) for Walking and Cycling

by Thomas Götschi, Sonja Kahlmeier, Alberto Castro, Christian Brand, Nick Cavill, Paul Kelly, Christoph Lieb, David Rojas-Rueda, James Woodcock and Francesca Racioppi

Int. J. Environ. Res. Public Health 2020, 17(20), 7361; https://doi.org/10.3390/ijerph17207361 - 9 Oct 2020

Cited by 26 | Viewed by 6927

Abstract

The World Health Organization’s Health Economic Assessment Tool (HEAT) for walking and cycling is a user-friendly web-based tool to assess the health impacts of active travel. HEAT, developed over 10 years ago, has been used by researchers, planners and policymakers alike in appraisals [...] Read more.

The World Health Organization’s Health Economic Assessment Tool (HEAT) for walking and cycling is a user-friendly web-based tool to assess the health impacts of active travel. HEAT, developed over 10 years ago, has been used by researchers, planners and policymakers alike in appraisals of walking and cycling policies at both national and more local scales. HEAT has undergone regular upgrades adopting the latest scientific evidence. This article presents the most recent upgrades of the tool. The health impacts of walking and/or cycling in a specified population are quantified in terms of premature deaths avoided (or caused). In addition to the calculation of benefits derived from physical activity, HEAT was recently expanded to include assessments of the burden associated with air pollution exposure and crash risks while walking or cycling. Further, the impacts on carbon emissions from mode shifts to active travel modes can now be assessed. The monetization of impacts using Value of Statistical Life and Social Costs of Carbon now uses country-specific values. As active travel inherently results in often substantial health benefits as well as not always negligible risks, assessments of active travel behavior or policies are incomplete without considering health implications. The recent developments of HEAT make it easier than ever to obtain ballpark estimates of health impacts and carbon emissions related to walking and cycling. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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13 pages, 10639 KiB

Open AccessArticle

An Assessment of Annual Mortality Attributable to Ambient PM_2.5 in Bangkok, Thailand

by Nathaniel R. Fold, Mary R. Allison, Berkley C. Wood, Pham T. B. Thao, Sebastien Bonnet, Savitri Garivait, Richard Kamens and Sitthipong Pengjan

Int. J. Environ. Res. Public Health 2020, 17(19), 7298; https://doi.org/10.3390/ijerph17197298 - 6 Oct 2020

Cited by 44 | Viewed by 6597

Abstract

Multiple studies indicate that PM_2.5 is the most deleterious air pollutant for which there are ambient air quality standards. Daily concentrations of PM_2.5 in Bangkok, Thailand, continuously exceed the World Health Organization (WHO) and the Thai National Ambient Air Quality Standards [...] Read more.

Multiple studies indicate that PM_2.5 is the most deleterious air pollutant for which there are ambient air quality standards. Daily concentrations of PM_2.5 in Bangkok, Thailand, continuously exceed the World Health Organization (WHO) and the Thai National Ambient Air Quality Standards (NAAQSs). Bangkok has only recently begun to measure concentrations of PM_2.5. To overcome this paucity of data, daily PM_2.5/PM₁₀ ratios were generated over the period 2012–2018 to interpolate missing values. Concentration-response coefficients (β values) for PM_2.5 versus non-accidental, cardiopulmonary, and lung cancer mortalities were derived from the literature. Values were also estimated and were found to be comparable to those reported in the literature for a Chinese population, but considerably lower than those reported in the literature from the United States. These findings strongly suggest that specific regional β values should be used to accurately quantify the number of premature deaths attributable to PM_2.5 in Asian populations. Health burden analysis using the Environmental Benefits Mapping and Analysis Program (BenMAP) showed that PM_2.5 concentration in Bangkok contributes to 4240 non-accidental, 1317 cardiopulmonary, and 370 lung cancer mortalities annually. Further analysis showed that the attainment of PM_2.5 levels to the NAAQSs and WHO guideline would reduce annual premature mortality in Bangkok by 33%and 75%, respectively. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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14 pages, 302 KiB

Open AccessArticle

Process, Practice and Progress: A Case Study of the Health Impact Assessment (HIA) of Brexit in Wales

by Liz Green, Kathryn Ashton, Nerys Edmonds and Sumina Azam

Int. J. Environ. Res. Public Health 2020, 17(18), 6652; https://doi.org/10.3390/ijerph17186652 - 12 Sep 2020

Cited by 9 | Viewed by 3799

Abstract

Health impact assessment (HIA) is a systematic and flexible tool, which is advocated by the World Health Organisation as a method through which to consider the impact of policies on the health and well-being of a population, and the inequalities that may arise [...] Read more.

Health impact assessment (HIA) is a systematic and flexible tool, which is advocated by the World Health Organisation as a method through which to consider the impact of policies on the health and well-being of a population, and the inequalities that may arise because of it. In 2018, the HIA support unit in Wales carried out a comprehensive and unique HIA on the impact of Brexit in Wales. The aims were to understand the differential impacts that Brexit would have on the health and well-being of the population and to provide evidence to inform decision makers across a range of public bodies. It followed a five-step process for HIA and utilised a wide range of evidence sources and health intelligence including both quantitative and qualitative evidence. This paper reflects on the process of carrying out the HIA and the methods used. It discusses the stages of the HIA, and shares the findings and reflections of implementation which will be beneficial to other HIA practitioners and policy makers. It does not concentrate on the findings of the HIA in detail, but focusses on what worked and any challenges encountered. It has been used to progress the practice of HIA in Wales and demonstrates the value of HIA as a method to inform and influence complex decisions. Full article

(This article belongs to the Special Issue Health Impact Assessment)

18 pages, 1425 KiB

Open AccessArticle

A Comparative Analysis of Health Impact Assessment Implementation Models in the Regions of Montérégie (Québec, Canada) and Nouvelle-Aquitaine (France)

by Françoise Jabot, Emile Tremblay, Ana Rivadeneyra, Thierno Amadou Diallo and Geneviève Lapointe

Int. J. Environ. Res. Public Health 2020, 17(18), 6558; https://doi.org/10.3390/ijerph17186558 - 9 Sep 2020

Cited by 15 | Viewed by 3317

Abstract

Many countries have introduced health impact assessment (HIA) at the national, regional, or local levels. In France and in Québec, there is increasing interest in using HIA to inform decision-makers and influence policies, programs, and projects. This paper aims to compare HIA implementation [...] Read more.

Many countries have introduced health impact assessment (HIA) at the national, regional, or local levels. In France and in Québec, there is increasing interest in using HIA to inform decision-makers and influence policies, programs, and projects. This paper aims to compare HIA implementation models in two regions: Nouvelle-Aquitaine (France) and Montérégie (Québec, Canada) using a case study methodology. The objective is to gain a better understanding of the similarities and differences in the approaches used to achieve the operationalization of HIA. The methodological approach involves four steps: (1) design of an analytical framework based on the literature; (2) exchanges within the research team and review of documents concerning the two implementation strategies under study; (3) development of the case studies based on the proposed framework; and (4) cross-comparison analysis of the case studies. The findings show that the two regions share certain similarities, including the strong commitment and political will of the public health organizations involved and a well-established culture of engaging in intersectoral action with municipal partners. Differences mainly concern their different approaches to implementing HIAs in accordance with the regional policies and the organizational and administrative contexts in place. This study identifies potential avenues for supporting the practice of HIA at the municipal level. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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15 pages, 1830 KiB

Open AccessArticle

The Potential Impacts of Urban and Transit Planning Scenarios for 2031 on Car Use and Active Transportation in a Metropolitan Area

by Patrick Morency, Céline Plante, Anne-Sophie Dubé, Sophie Goudreau, Catherine Morency, Pierre-Léo Bourbonnais, Naveen Eluru, Louis-François Tétreault, Marianne Hatzopoulou, Naveen Chandra Iraganaboina, Tanmoy Bhowmik and Audrey Smargiassi

Int. J. Environ. Res. Public Health 2020, 17(14), 5061; https://doi.org/10.3390/ijerph17145061 - 14 Jul 2020

Cited by 2 | Viewed by 4618

Abstract

Land use and transportation scenarios can help evaluate the potential impacts of urban compact or transit-oriented development (TOD). Future scenarios have been based on hypothetical developments or strategic planning but both have rarely been compared. We developed scenarios for an entire metropolitan area [...] Read more.

Land use and transportation scenarios can help evaluate the potential impacts of urban compact or transit-oriented development (TOD). Future scenarios have been based on hypothetical developments or strategic planning but both have rarely been compared. We developed scenarios for an entire metropolitan area (Montreal, Canada) based on current strategic planning documents and contrasted their potential impacts on car use and active transportation with those of hypothetical scenarios. We collected and analyzed available urban planning documents and obtained key stakeholders’ appreciation of transportation projects on their likelihood of implementation. We allocated 2006–2031 population growth according to recent trends (Business As Usual, BAU) or alternative scenarios (current planning; all in TOD areas; all in central zone). A large-scale and representative Origin-Destination Household Travel Survey was used to measure travel behavior. To estimate distances travelled by mode, in 2031, we used a mode choice model and a simpler method based on the 2008 modal share across population strata. Compared to the BAU, the scenario that allocated all the new population in already dense areas and that also included numerous public transit projects (unlikely to be implemented in 2031), was associated with greatest impacts. Nonetheless such major changes had relatively minor impacts, inducing at most a 15% reduction in distances travel by car and a 28% increase in distances walked, compared to a BAU. Strategies that directly target the reduction of car use, not considered in the scenarios assessed, may be necessary to induce substantial changes in a metropolitan area. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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20 pages, 4206 KiB

Open AccessArticle

Inclusion of Health in Impact Assessment: A Review of Current Practice in Sub-Saharan Africa

by Dominik Dietler, Ruth Lewinski, Sophie Azevedo, Rebecca Engebretsen, Fritz Brugger, Jürg Utzinger and Mirko S. Winkler

Int. J. Environ. Res. Public Health 2020, 17(11), 4155; https://doi.org/10.3390/ijerph17114155 - 10 Jun 2020

Cited by 20 | Viewed by 3921

Abstract

Natural resource extraction projects, including those in the mining sector, have various effects on human health and wellbeing, with communities in resource-rich areas in sub-Saharan Africa (SSA) being particularly vulnerable. While impact assessments (IA) can predict and mitigate negative effects, it is unclear [...] Read more.

Natural resource extraction projects, including those in the mining sector, have various effects on human health and wellbeing, with communities in resource-rich areas in sub-Saharan Africa (SSA) being particularly vulnerable. While impact assessments (IA) can predict and mitigate negative effects, it is unclear whether and to what extent health aspects are included in current IA practice in SSA. For collecting IA reports, we contacted 569 mining projects and 35 ministries regulating the mining sector. The reports obtained were complemented by reports identified in prior research. The examination of the final sample of 44 IA reports revealed a heavy focus on environmental health determinants and included health outcomes were often limited to a few aspects, such as HIV, malaria and injuries. The miniscule yield of reports (1.6% of contacted projects) and the low response rate by the contacted mining companies (18%) might indicate a lack of transparency in the IA process of the mining sector in SSA. To address the shortcomings identified, policies regulating IA practice should strengthen the requirements for public disclosure of IA reports and promote a more comprehensive inclusion of health in IA, be it through stand-alone health impact assessment or more rigorous integration of health in other forms of IA. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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15 pages, 2524 KiB

Open AccessArticle

Community Health Impacts of the Trident Copper Mine Project in Northwestern Zambia: Results from Repeated Cross-Sectional Surveys

by Astrid M. Knoblauch, Andrea Farnham, Hyacinthe R. Zabré, Milka Owuor, Colleen Archer, Kennedy Nduna, Marcus Chisanga, Leonard Zulu, Gertrude Musunka, Jürg Utzinger, Mark J. Divall, Günther Fink and Mirko S. Winkler

Int. J. Environ. Res. Public Health 2020, 17(10), 3633; https://doi.org/10.3390/ijerph17103633 - 21 May 2020

Cited by 15 | Viewed by 4605

Abstract

The application of a health impact assessment (HIA) for a large-scale copper mining project in rural Zambia triggered the long-term monitoring and evaluation of determinants of health and health outcomes in communities living in proximity to the mine. Three consecutive cross-sectional surveys were [...] Read more.

The application of a health impact assessment (HIA) for a large-scale copper mining project in rural Zambia triggered the long-term monitoring and evaluation of determinants of health and health outcomes in communities living in proximity to the mine. Three consecutive cross-sectional surveys were conducted at intervals of four years; thus, at baseline (2011), four (2015) and eight (2019) years into the project’s development. Using the same field and laboratory procedures, the surveys allowed for determining changes in health indicators at the household level, in young children (<5 years), school attendees (9–14 years) and women (15–49 years). Results were compared between communities considered impacted by the project and communities outside the project area (comparison communities). The prevalence of Plasmodium falciparum infection increased in both the impacted and comparison communities between 2011 and 2019 but remained consistently lower in the impacted communities. Stunting in children < 5 years and the prevalence of intestinal parasite infections in children aged 9–14 years mostly decreased. In women of reproductive age, selected health indicators (i.e., anaemia, syphilis, underweight and place of delivery) either remained stable or improved. Impacted communities generally showed better health outcomes than comparison communities, suggesting that the health interventions implemented by the project as a consequence of the HIA have mitigated potential negative effects and enhanced positive effects. Caution is indicated to avoid promotion of health inequalities within and beyond the project area. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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16 pages, 1775 KiB

Open AccessArticle

Current Global Health Impact Assessment Practice

by Mirko S. Winkler, Peter Furu, Francesca Viliani, Ben Cave, Mark Divall, Geetha Ramesh, Ben Harris-Roxas and Astrid M. Knoblauch

Int. J. Environ. Res. Public Health 2020, 17(9), 2988; https://doi.org/10.3390/ijerph17092988 - 25 Apr 2020

Cited by 53 | Viewed by 12311

Abstract

Health impact assessment (HIA) practice has expanded across the world, since it was established more than two decades ago. This paper presents a snapshot of current global HIA practice based on the findings of an online questionnaire survey. HIA practitioners from all world [...] Read more.

Health impact assessment (HIA) practice has expanded across the world, since it was established more than two decades ago. This paper presents a snapshot of current global HIA practice based on the findings of an online questionnaire survey. HIA practitioners from all world regions were invited to participate. A total of 122 HIA practitioners from 29 countries completed the survey, following a broad international outreach effort. The large variety in the types of HIAs conducted, and the application of HIA in various fields reported by respondents, demonstrates that HIA practice has evolved over the past two decades. Although differences in the use of HIA were reported across world regions, an overall increasing trend in global HIA practice can be observed. In order to sustain this upward trend, efforts are needed to address the main barriers in the utilisation of HIA. The establishment of new national and international HIA teaching and training offerings seems to be an obvious strategy to pursue along with the strengthening of policies and legal frameworks that specify the circumstances, under which HIA is required, and to what extent. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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18 pages, 544 KiB

Open AccessArticle

Health Impact Assessments in Spain: Have They Been Effective?

by Maite Morteruel, Amaia Bacigalupe, Elena Aldasoro, Isabel Larrañaga and Elena Serrano

Int. J. Environ. Res. Public Health 2020, 17(8), 2959; https://doi.org/10.3390/ijerph17082959 - 24 Apr 2020

Cited by 10 | Viewed by 3507

Abstract

Background: Health impact assessment (HIA) has scarcely been developed in Spain, in comparison with other European countries. Moreover, little is known about the effectiveness of HIA, taking into account direct impacts—changes on the decision-making process—as well as indirect impacts or those related to [...] Read more.

Background: Health impact assessment (HIA) has scarcely been developed in Spain, in comparison with other European countries. Moreover, little is known about the effectiveness of HIA, taking into account direct impacts—changes on the decision-making process—as well as indirect impacts or those related to the process outcomes. From this broad perspective of HIA usefulness, the purpose was to assess the effectiveness of five HIAs carried out in Spain at the local level, and the role played by context and process factors on these impacts. Methods: We carried out a qualitative study based on 14 interviews to HIAs participants from different sectors. A documentary review and nonparticipant observation techniques were implemented for an in depth understanding. Results: The direct effectiveness of the HIAs was partial, but they had indirect effectiveness in all cases. The institutional and socio-political context, however, was not favorable to effectiveness. The elements of the process were largely determined by the context, although their influence, mediated by the role of proactive individuals, favored the effectiveness of the HIAs. Conclusions: When assessing HIA effectiveness, it is important to take into account a broad perspective on the nature of impacts and those factors influencing direct and indirect effectiveness. In Spain, the institutional and sociopolitical context was less favorable to HIA effectiveness than process-related factors. In order to implement the Health in All Policies strategy, will be necessary to improve context-related factors, such as institutional facilitators for HIA and democratic quality. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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12 pages, 1338 KiB

Open AccessArticle

Assessment of Potential Health Risks Associated with the Intake of Heavy Metals in Fish Harvested from the Largest Estuary in Colombia

by Carlos H. Pinzón-Bedoya, Martha L. Pinzón-Bedoya, José Pinedo-Hernández, Iván Urango-Cardenas and José Marrugo-Negrete

Int. J. Environ. Res. Public Health 2020, 17(8), 2921; https://doi.org/10.3390/ijerph17082921 - 23 Apr 2020

Cited by 29 | Viewed by 4156

Abstract

This study assesses the potential human health risks posed by six heavy metals (Hg, As, Pb, Cd, Cu, and Zn) found in five of the most consumed fish species (Mugil incilis, Centropomus undecimalis, Cathorops mapale, Eugerres plumieri, and Elops smithi) collected [...] Read more.

This study assesses the potential human health risks posed by six heavy metals (Hg, As, Pb, Cd, Cu, and Zn) found in five of the most consumed fish species (Mugil incilis, Centropomus undecimalis, Cathorops mapale, Eugerres plumieri, and Elops smithi) collected by the riverine population living in Ciénaga Grande de Santa Marta (CGSM), the largest estuary in Colombia. Metal concentrations were low compared with those reported in other regions around the world and the maximum value established by international monitoring organizations. The estimation of the potential risk (HQ) indicated that Cu and Hg could generate negative effects in groups of women of childbearing age (WCA) and the remaining population (RP), because they exceeded their related reference doses, with HQ values > 1; however, Cu and Hg concentrations were not high in fish and EWI, MFW, or MeHgPSL values shows that there is no evidence of a potential health risk from MeHg exposure in the study population. Therefore, the recommendations are to establish continuous monitoring of heavy metals together with strategies that address the high fish consumption, as well as to implement mechanisms for the mitigation of contamination of the watershed, to ensure the safety of organisms in the ecosystem and human health, not only of populations who depend on aquatic resources in the area but also of those that market and consume these resources in the Colombian Caribbean. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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17 pages, 30085 KiB

Open AccessArticle

Systematic Assessment of Health Risk from Metals in Surface Sediment of the Xiangjiang River, China

by Huan Li, Liyuan Chai, Zhihui Yang, Weichun Yang, Qi Liao, Zhe Cao and Yanchun Peng

Int. J. Environ. Res. Public Health 2020, 17(5), 1677; https://doi.org/10.3390/ijerph17051677 - 4 Mar 2020

Cited by 11 | Viewed by 2900

Abstract

The common empirical screening method is limited to a preliminary screen target from vast elements for human health risk assessments. Here, an element screening procedure was developed for assessing the human health risk of the elements in the sediment of the Xiangjiang River. [...] Read more.

The common empirical screening method is limited to a preliminary screen target from vast elements for human health risk assessments. Here, an element screening procedure was developed for assessing the human health risk of the elements in the sediment of the Xiangjiang River. Ninety-six surface sediment samples from eight sampling stations were collected and 27 elements of each sample were investigated. Thirteen of the 27 elements were screened for human health risk assessments through the three-run selections by calculating anthropogenic factors, building element maps, and the removal of unnecessary elements. Pb posed the greatest health risk and exhibited a potential noncarcinogenic risk for adults at the stations S4 and S5, although no visible noncarcinogenic and carcinogenic risk for adults and children in the Xiangjiang River. Our study also suggested that the chalcophile elements were associated with greater health risk, compared to the lithophile and siderophile ones. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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28 pages, 3058 KiB

Open AccessArticle

The Agglomeration of Manufacturing Industry, Innovation and Haze Pollution in China: Theory and Evidence

by Zhidong Liu, Yang Cai and Xiaojing Hao

Int. J. Environ. Res. Public Health 2020, 17(5), 1670; https://doi.org/10.3390/ijerph17051670 - 4 Mar 2020

Cited by 17 | Viewed by 4435

Abstract

Haze pollution in China is a serious environmental issue, which does harm both to people’s health and to economic development. Simultaneously, as an important industrial development law, agglomeration may result in the increased concentration of manufacturing firms and, consequently, an increase in haze [...] Read more.

Haze pollution in China is a serious environmental issue, which does harm both to people’s health and to economic development. Simultaneously, as an important industrial development law, agglomeration may result in the increased concentration of manufacturing firms and, consequently, an increase in haze pollution. However, the positive externalities of agglomeration can also improve the efficiency of regional innovation, which curbs haze pollution. In this paper, we construct both theoretical and empirical models to investigate the effects of industrial manufacturing agglomeration on haze pollution. The results reveal the following: (1) By incorporating the effect of agglomeration and haze pollution into a general endogenous growth model, we show an inverted-U relationship between agglomeration and haze pollution on the balance growth path. (2) Based on data concerning haze pollution (PM_2.5) and data from 285 Chinese cities, the empirical results verify the findings of the theoretical model. Further, we calculated the values of agglomeration variables, with respect to the inflection points of the inverted-U, which the cities need to reach in order to gain the specific agglomeration values required to enjoy the inhibition effect of agglomeration on haze pollution. (3) A heterogeneity analysis shows that the inverted-U relationship is more obvious among the cities in the middle and northeastern areas of China, as well as medium-size cities. (4) Cities’ environmental regulation policies and high-quality institutional environments can restrain the positive effect of agglomeration on haze pollution. (5) Using three measures of innovation, it is also empirically found that innovation is the mechanism (mediator) between agglomeration and haze pollution. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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16 pages, 376 KiB

Open AccessArticle

Health Impact Assessment (HIA) of a Fluvial Environment Recovery Project in a Medium-Sized Spanish Town

by Cristina Casajuana Kögel, Tània Rodríguez Peña, Isabel Sánchez, Montserrat Tobella, José Alonso López, Fernando Girón Espot, Francesc Pedrol Claramunt, Gemma Rabal and Angelina González Viana

Int. J. Environ. Res. Public Health 2020, 17(5), 1484; https://doi.org/10.3390/ijerph17051484 - 25 Feb 2020

Cited by 5 | Viewed by 3171

Abstract

Introduction: The Interdepartamental Public Health Plan of Catalonia (2014) seeks to enforce Health in All Policies (HiAP) at the regional and local levels. Within this context, the City Council of Sant Andreu de la Barca (SAB), the Metropolitan Area of Barcelona (MAB), and [...] Read more.

Introduction: The Interdepartamental Public Health Plan of Catalonia (2014) seeks to enforce Health in All Policies (HiAP) at the regional and local levels. Within this context, the City Council of Sant Andreu de la Barca (SAB), the Metropolitan Area of Barcelona (MAB), and the Public Health Agency of Catalonia started a Health Impact Assessment (HIA) of an urbanistic redesign of the Llobregat fluvial area in SAB, the results of which are presented in this paper. Methodology: In 2018, after a HIA screening, a prospective nonquantitative HIA was conducted. Politicians, professionals, and citizens participated in identifying potential impacts. Impacts were prioritized and linked to health determinants, scientific evidence, and potentially affected social groups. Afterwards, recommendations were formulated in order to improve the health impacts of the project. Finally, indicators were selected to evaluate HIA implementation. Results: The HIA was successfully implemented with the participation of technicians and citizens of SAB. The health impacts identified were mainly related to environmental, public safety, lifestyle, socioeconomic, and political contexts. Ten recommendations were defined to minimize the potential negative health impacts of the project, with six of them directly included and only one dismissed due to incompatibility. Conclusion: A HIA was successfully carried out in the medium-sized town of Catalonia, promoting Health in all Policies at a local level and improving health impacts of an urbanistic project. Full article

(This article belongs to the Special Issue Health Impact Assessment)

18 pages, 3160 KiB

Open AccessArticle

Burden of Disease Assessment of Ambient Air Pollution and Premature Mortality in Urban Areas: The Role of Socioeconomic Status and Transportation

by Soheil Sohrabi, Joe Zietsman and Haneen Khreis

Int. J. Environ. Res. Public Health 2020, 17(4), 1166; https://doi.org/10.3390/ijerph17041166 - 12 Feb 2020

Cited by 28 | Viewed by 4908

Abstract

With recent rapid urbanization, sustainable development is required to prevent health risks associated with adverse environmental exposures from the unsustainable development of cities. Ambient air pollution is the greatest environmental risk factor for human health and is responsible for considerable levels of mortality [...] Read more.

With recent rapid urbanization, sustainable development is required to prevent health risks associated with adverse environmental exposures from the unsustainable development of cities. Ambient air pollution is the greatest environmental risk factor for human health and is responsible for considerable levels of mortality worldwide. Burden of disease assessment (BoD) of air pollution in and across cities, and how these estimates vary according to socioeconomic status and exposure to road traffic, can help city planners and health practitioners to mitigate adverse exposures and promote public health. In this study, we quantified the health impacts of air pollution exposure (PM_2.5 and NO₂) at the census tract level in Houston, Texas, employing a standard BoD assessment framework to estimate the premature deaths (adults 30 to 78 years old) attributable to PM_2.5 and NO₂. We found that 631 (95% CI: 366–809) premature deaths were attributable to PM_2.5 in Houston, and 159 (95% CI: 0-609) were attributable to NO₂, in 2010. Complying with the World Health Organization air quality guidelines (annual mean: 10 μg/m³ for PM_2.5) and the US National Ambient Air Quality standard (annual mean: 12 μg/m³ for PM_2.5) could save 82 (95% CI: 42–95) and 8 (95% CI: 6–10) lives in Houston, respectively. PM_2.5 was responsible for 7.3% of all-cause premature deaths in Houston, in 2010, which is higher than the death rate associated with diabetes mellites, Alzheimer’s disease, or motor vehicle crashes in the US. Households with lower income had a higher risk of adverse exposure and attributable premature deaths. We also showed a positive relationship between health impacts attributable to air pollution and road traffic passing through census tracts, which was more prominent for NO₂. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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13 pages, 1196 KiB

Open AccessArticle

The ARTEMIS Center: An Environmental Health Prevention Platform Dedicated to Reproduction

by Fleur Delva, Guyguy Manangama, Patrick Brochard, Raphaëlle Teysseire and Loïc Sentilhes

Int. J. Environ. Res. Public Health 2020, 17(3), 694; https://doi.org/10.3390/ijerph17030694 - 21 Jan 2020

Cited by 3 | Viewed by 2517

Abstract

In France, a new approach is being developed through the ARTEMIS Center, which is a prevention platform for environmental health dedicated to reproduction. The objective is to describe the clinical management of patients in the ARTEMIS center. Couples with a condition affecting reproduction [...] Read more.

In France, a new approach is being developed through the ARTEMIS Center, which is a prevention platform for environmental health dedicated to reproduction. The objective is to describe the clinical management of patients in the ARTEMIS center. Couples with a condition affecting reproduction are referred to the ARTEMIS center. Management includes a medical consultation and a standardized interview. Current exposure is assessed by a questionnaire that includes exposure circumstances to reproductive risk factor and on the basis of which it is possible to implement preventive action in clinical practice without prejudging the role of such exposure in the onset of disease. From 16 February 2016 to 2 May 2019, 779 patients were seen in the ARTEMIS center. On the day of the consultation, 88.3% men and 72.2% women were employed. Among employed men, 61.5% had at least one instance of occupational exposure to a reproductive risk factor, and among employed women, 57.8%. The main nonprofessional circumstances of exposure identified were proximity of the residence to an agricultural area (35.3%) and domestic pesticide exposure (79.7%). The preventive actions implemented by the ARTEMIS center are targeted to the individual practices of patients. However, patient care also allows their physicians to become familiarized with environmental health. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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12 pages, 1134 KiB

Open AccessArticle

by Zhiguang Qu, Xiaoying Wang, Fei Li, Yanan Li, Xiyao Chen and Min Chen

Int. J. Environ. Res. Public Health 2020, 17(2), 620; https://doi.org/10.3390/ijerph17020620 - 18 Jan 2020

Cited by 25 | Viewed by 4090

Abstract

On the basis of PM_2.5 data of the national air quality monitoring sites, local population data, and baseline all-cause mortality rate, PM_2.5-related health economic benefits of the Air Improvement Action Plan implemented in Wuhan in 2013–2017 were investigated using health-impact [...] Read more.

On the basis of PM_2.5 data of the national air quality monitoring sites, local population data, and baseline all-cause mortality rate, PM_2.5-related health economic benefits of the Air Improvement Action Plan implemented in Wuhan in 2013–2017 were investigated using health-impact and valuation functions. Annual avoided premature deaths driven by the average concentration of PM_2.5 decrease were evaluated, and the economic benefits were computed by using the value of statistical life (VSL) method. Results showed that the number of avoided premature deaths in Wuhan are 21,384 (95% confidence interval (CI): 15,004 to 27,255) during 2013–2017, due to the implementation of the Air Improvement Action Plan. According to the VSL method, the obtained economic benefits of Huangpi, Wuchang, Hongshan, Xinzhou, Jiang’an, Hanyang, Jiangxia, Qiaokou, Jianghan, Qingshan, Caidian, Dongxihu, and Hannan District were 8.55, 8.19, 8.04, 7.39, 5.78, 4.84, 4.37, 4.04, 3.90, 3.30, 2.87, 2.42, and 0.66 billion RMB (1 RMB = 0.1417 USD On 14 October 2019), respectively. These economic benefits added up to 64.35 billion RMB (95% CI: 45.15 to 82.02 billion RMB), accounting for 4.80% (95% CI: 3.37% to 6.12%) of the total GDP of Wuhan in 2017. Therefore, in the process of formulating a regional air quality improvement scheme, apart from establishing hierarchical emission-reduction standards and policies, policy makers should give integrated consideration to the relationship between regional economic development, environmental protection and residents’ health benefits. Furthermore, for improving air quality, air quality compensation mechanisms can be established on the basis of the status quo and trends of air quality, population distribution, and economic development factors. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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10 pages, 709 KiB

Open AccessArticle

A Transport Policy Whose Injury Impacts May Go Unnoticed: More Walking, Cycling and Use of Public Transport

by Rune Elvik

Int. J. Environ. Res. Public Health 2019, 16(19), 3668; https://doi.org/10.3390/ijerph16193668 - 29 Sep 2019

Cited by 2 | Viewed by 2892

Abstract

It is an objective of transport policy in many countries and cities to promote walking, cycling and the use of public transport. This policy seeks to improve public health and reduce emissions contributing to global warming. It is, however, very likely that more [...] Read more.

It is an objective of transport policy in many countries and cities to promote walking, cycling and the use of public transport. This policy seeks to improve public health and reduce emissions contributing to global warming. It is, however, very likely that more walking, cycling and use of public transport will be associated with an increase in traffic injury. Moreover, it is likely that most of this increase will go unnoticed and not be recorded in official road accident statistics. Official statistics on traffic injury are known to be very incomplete as far as injuries to pedestrians, cyclists and public transport passengers are concerned. This incompleteness is a problem when assessing health impacts of more walking, cycling and travel by public transport. In this paper, studies made in the city of Oslo, Norway (population 700,000) are used to develop numerical examples showing how the estimated real and recorded number of injuries may change when 10% of person km of travel performed by car are transferred to walking, cycling or public transport. It is shown that not more than about 2% of the estimated change in the actual number of injured road users will be recorded by official statistics on traffic injury. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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18 pages, 3313 KiB

Open AccessArticle

Health Effects of Energy Intensive Sectors and the Potential Health Co-Benefits of a Low Carbon Industrial Transition in China

by Tingru Yang and Wenling Liu

Int. J. Environ. Res. Public Health 2019, 16(17), 3022; https://doi.org/10.3390/ijerph16173022 - 21 Aug 2019

Cited by 9 | Viewed by 3383

Abstract

Background: The issues of environmental pollution and its effects on health have become increasingly serious in China. Energy intensive sectors are not only the main energy consumers, but also the main sources of air pollution. Analyzing the health effects of energy intensive sectors [...] Read more.

Background: The issues of environmental pollution and its effects on health have become increasingly serious in China. Energy intensive sectors are not only the main energy consumers, but also the main sources of air pollution. Analyzing the health effects of energy intensive sectors and the potential health co-benefits of a low carbon industrial transition is of great importance for promoting China’s air pollution control. Methods: This study used the exposure-response (ER) relationship model and inhalation factor methods to quantitatively analyze the health effects of air pollution and forecast the potential health co-benefits in the power and steel sectors. Results: The results showed that in 2016 SO₂ and PM_2.5 emissions caused about 850,000 premature deaths, and 10 million cases of respiratory diseases and chest discomfort, resulting in health-related economic losses of 1.2 trillion Yuan, accounting for 1.6% of the GDP. Meanwhile, demand control in consumption could significantly reduce SO₂ emissions in the power and steel sectors, thus offering significant health co-benefits. However, there was still some uncertainty regarding the reduction of PM_2.5 emissions in the steel sector. Conclusions: There is a need to take advantage of the health co-benefits of emission reduction in energy intensive sectors and to adopt flexible means to stimulate their green transformation. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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Review

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16 pages, 1115 KiB

Open AccessReview

Effect of Sanitation Interventions on Health Outcomes: A Systematic Review of Cluster-Randomized Controlled Trials in Rural Communities of Low- and Middle-Income Countries

by Artwell Kanda, Esper Jacobeth Ncube and Kuku Voyi

Int. J. Environ. Res. Public Health 2021, 18(16), 8313; https://doi.org/10.3390/ijerph18168313 - 5 Aug 2021

Cited by 5 | Viewed by 3487

Abstract

A systematic review of published literature (2000–2019) evaluating the impact of sanitation interventions on the prevalence of disease, parasite infestation, and/or child growth using randomized controlled trials (RCTs) was done according to the PRISMA checklist. Earlier reviews indicated mixed evidence citing relatively poor [...] Read more.

A systematic review of published literature (2000–2019) evaluating the impact of sanitation interventions on the prevalence of disease, parasite infestation, and/or child growth using randomized controlled trials (RCTs) was done according to the PRISMA checklist. Earlier reviews indicated mixed evidence citing relatively poor quality evidence from mixed designs. Public health policy and practice appear to rely on evidence from RCTs. Records were searched in six electronic databases. The methodological quality of RCTs was assessed using the Cochrane collaboration risk of bias tool. Fifteen records (2.0%) were included for review. Impact trials were done in rural communities of African and Asian countries. The significant effect of sanitation-focus interventions was found in one trial for the prevalence of childhood diarrhea (14.3%), three trials for parasite infestation (37.5%), and two trials (25.0%) for child growth. Results indicate mixed quality evidence from RCT designs. Evidence is limited and suggestive of the impact of sanitation on parasite infestation and child growth. Further rigorous sanitation intervention trials under varying settings are needed to show what really works and under what settings. Future work may explore sanitation behavior change strategies and latrine options to address the challenges of poor latrine use under high sanitation coverage. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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13 pages, 2475 KiB

Open AccessReview

Use of Genomic Information in Health Impact Assessment is Yet to Come: A Systematic Review

by Balázs Ádám, Szabolcs Lovas and Róza Ádány

Int. J. Environ. Res. Public Health 2020, 17(24), 9417; https://doi.org/10.3390/ijerph17249417 - 15 Dec 2020

Cited by 1 | Viewed by 2589

Abstract

Information generated by genetic epidemiology and genomics studies has been accumulating at fast pace, and this knowledge opens new vistas in public health, allowing for the understanding of gene–environment interactions. However, the translation of genome-based knowledge and technologies to the practice of healthcare, [...] Read more.

Information generated by genetic epidemiology and genomics studies has been accumulating at fast pace, and this knowledge opens new vistas in public health, allowing for the understanding of gene–environment interactions. However, the translation of genome-based knowledge and technologies to the practice of healthcare, and especially of public health, is challenging. Because health impact assessment (HIA) proved to be an effective tool to assist consideration of health issues is sectoral policymaking, this study aimed at exploring its role in the translational process by a systematic literature review on the use of genetic information provided by genetic epidemiology and genomics studies in HIA. PubMed, Scopus, and Web of Science electronic databases were searched and the findings systematically reviewed and reported by the PRISMA guidelines. The review found eight studies that met the inclusion criteria, most of them theoretically discussing the use of HIA for introducing genome-based technologies in healthcare practice, and only two articles considered, in short, the possibility for a generic application of genomic information in HIA. The findings indicate that HIA should be more extensively utilized in the translation of genome-based knowledge to public health practice, and the use of genomic information should be facilitated in the HIA process. Full article

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Other

Jump to: Research, Review

16 pages, 577 KiB

Open AccessViewpoint

‘Health in All Policies’—A Key Driver for Health and Well-Being in a Post-COVID-19 Pandemic World

by Liz Green, Kathryn Ashton, Mark A. Bellis, Timo Clemens and Margaret Douglas

Int. J. Environ. Res. Public Health 2021, 18(18), 9468; https://doi.org/10.3390/ijerph18189468 - 8 Sep 2021

Cited by 38 | Viewed by 7601

Abstract

Policy in all sectors affects health, through multiple pathways and determinants. Health in all policies (HiAP) is an approach that seeks to identify and influence the health and equity impacts of policy decisions, to enhance health benefits and avoid harm. This usually involves [...] Read more.

Policy in all sectors affects health, through multiple pathways and determinants. Health in all policies (HiAP) is an approach that seeks to identify and influence the health and equity impacts of policy decisions, to enhance health benefits and avoid harm. This usually involves the use of health impact assessment or health lens analysis. There is growing international experience in these approaches, and some countries have cross-sectoral governance structures that prioritize the assessment of the policies that are most likely to affect health. The fundamental elements of HiAP are inter-sectoral collaboration, policy influence, and holistic consideration of the range of health determinants affected by a policy area or proposal. HiAP requires public health professionals to invest time to build partnerships and engage meaningfully with the sectors affecting the social determinants of health and health equity. With commitment, political will and tools such as the health impact assessment, it provides a powerful approach to integrated policymaking that promotes health, well-being, and equity. The COVID-19 pandemic has raised the profile of public health and highlighted the links between health and other policy areas. This paper describes the rationale for, and principles underpinning, HiAP mechanisms, including HIA, experiences, challenges and opportunities for the future. Full article

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13 pages, 934 KiB

Open AccessConference Report

Recent Advances in Health Impact Assessment and Health in All Policies Implementation: Lessons from an International Convening in Barcelona

by Bethany Rogerson, Ruth Lindberg, Fran Baum, Carlos Dora, Fiona Haigh, Arielle McInnis Simoncelli, Lee Parry Williams, Genandrialine Peralta, Keshia M. Pollack Porter and Orielle Solar

Int. J. Environ. Res. Public Health 2020, 17(21), 7714; https://doi.org/10.3390/ijerph17217714 - 22 Oct 2020

Cited by 14 | Viewed by 4312

Abstract

Health Impact Assessment (HIA) and Health in All Policies (HiAP) are policy tools used to include health considerations in decision-making processes across sectors such as transportation, education, and criminal justice that can play a role in improving health and equity. This article summarizes [...] Read more.

Health Impact Assessment (HIA) and Health in All Policies (HiAP) are policy tools used to include health considerations in decision-making processes across sectors such as transportation, education, and criminal justice that can play a role in improving health and equity. This article summarizes proceedings from an international convening of HIA and HiAP experts held in July 2019 in Barcelona, Spain. The presentations and panel discussions included different models, best practices, and lessons learned, including from government, international banks, think tanks, and academia. Participants discussed ideas from around the world for cross-sector collaboration to advance health. The convening covered the following topics: community engagement, building greater understanding of and support for HiAP, and exploring how mandates for HIA and HiAP approaches may advance health and equity. Full article

(This article belongs to the Special Issue Health Impact Assessment)

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15 pages, 978 KiB

Open AccessBrief Report

The Elaboration of an Intersectoral Partnership to Perform Health Impact Assessment in Urban Planning: The Experience of Quebec City (Canada)

by Stéphanie Gamache, Thierno Amadou Diallo, Ketan Shankardass and Alexandre Lebel

Int. J. Environ. Res. Public Health 2020, 17(20), 7556; https://doi.org/10.3390/ijerph17207556 - 17 Oct 2020

Cited by 9 | Viewed by 3304

Abstract

Health impact assessments (HIA) allow evaluation of urban interventions’ potential effects on health and facilitate decision-making in the urban planning process. However, few municipalities have implemented this method in Canada. This paper presents the approach developed with partners, the process, and the outcomes [...] Read more.

Health impact assessments (HIA) allow evaluation of urban interventions’ potential effects on health and facilitate decision-making in the urban planning process. However, few municipalities have implemented this method in Canada. This paper presents the approach developed with partners, the process, and the outcomes of HIA implementation after seven years of interinstitutional collaborations in Quebec City (ten HIA). Using direct observation and meeting minutes, information includes: perceived role of each institution taking part in HIA beforehand, how the HIA process was implemented, if it was appreciated, and which outcomes were observed. The intersectoral interactions contributed to the development of a common language, which sped up the HIA process over time and fostered positive collaborations in unrelated projects. It was an effective tool to share concerns and responsibilities among independent institutions. This experience resulted in the creation of an informal group of stakeholders from four different institutions that perform HIA to this day in collaboration with researchers. Full article

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14 pages, 1514 KiB

Open AccessProtocol

Study Protocol for the Evaluation of the Health Effects of Superblocks in Barcelona: The “Salut Als Carrers” (Health in the Streets) Project

by Laia Palència, Brenda Biaani León-Gómez, Xavier Bartoll, Juli Carrere, Elia Díez, Laia Font-Ribera, Anna Gómez, María José López, Marc Marí-Dell’Olmo, Roshanak Mehdipanah, Marta Olabarría, Glòria Pérez, Anna Puig-Ribera, Marc Rico, David Rojas-Rueda, Hugo Vásquez-Vera and Katherine Pérez

Int. J. Environ. Res. Public Health 2020, 17(8), 2956; https://doi.org/10.3390/ijerph17082956 - 24 Apr 2020

Cited by 15 | Viewed by 6685

Abstract

Superblocks are currently being introduced in Barcelona to respond to the city’s scarcity of green spaces and high levels of air pollution, traffic injuries, and sedentariness. The aim is to calm the streets by reducing the number of square meters dedicated to private [...] Read more.

Superblocks are currently being introduced in Barcelona to respond to the city’s scarcity of green spaces and high levels of air pollution, traffic injuries, and sedentariness. The aim is to calm the streets by reducing the number of square meters dedicated to private vehicles and to reclaim part of this public space for people. Salut als Carrers (Health in the Streets) is a project to evaluate the potential environmental and health effects of the superblock model with an equity perspective in Barcelona. This study aims to explain the various interventions implemented in different neighborhoods in Barcelona and the methods that will be used to evaluate them in a quasi-experimental and health impact assessment (HIA) approaches. Given the complexity of the intervention evaluated, the project employs mixed methodologies. Quantitative methods include: (a) a pre–post health survey of 1200 people randomly selected from the municipal register asked about self-perceived health and quality of life, social support, mental health, mobility, physical activity, neighborhood characteristics, and housing; (b) pre–post environmental measurements, mainly of nitrogen dioxide (NO₂), particulate matter of less than 10 µm (PM₁₀), and particulate matter of less than 2.5 µm (PM_2.5) and black carbon; (c) pre–post environmental walkability measures using the Microscale Audit of Pedestrian Streetscapes (MAPS) tool; (d) use of public space and physical activity levels using the System for Observing Play and Recreation in Communities (SOPARC), a validated observation tool; (e) pre–post traffic injury measures with a comparison group; and (f) the comparison and integration of pre–post assessment with previous HIAs and the improvement of future HIAs. Qualitative studies will be performed to analyze residents’ perception of these effects by using: (a) various focus groups according to different participant characteristics who are more or less likely to use the superblocks; and (b) a guerrilla ethnography, which is a method that combines ethnographic observation and semi-structured interviews. This study, which evaluates the impact of an ambitious urban-renewal program on health, will help to assess the effectiveness of public policy in terms of health and health inequalities. Full article

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