1. Health in environmental impact assessment
Gabriel Gulis

2. Objectives Discuss why health impacts should be part of EIA/SEA
Present principles of human health risk assessment
Present selected tools for risk assessment

3. Understanding human health and development

4. Investment – influence - impact

5. EIA-SEA-HIA

6. Principles of human health risk assessment
Exposure
Effect – outcome
Population at risk
Dose-response

7. Basic steps of risk assessment
Identify hazard – define exposure(s) – EIA produces a list of hazards
Who might be harmed? – define population, no population = no risk – difference from EIA!
Health outcomes, determinants of health outcomes, risk factors as outcomes
Calculate, assess the risk
Control the risk

8. Risk appraisal Literature search, epidemiological literature
Combine exposure and health data
Baseline
Direction of the effect
Statistical significance
Latency
Duration of the effect (construction – operation phase)
Potential for interaction with other effects?
Prague, 25-26/10/2016

9. Tools Dynamo-HIA Air pollution risk calculator EPA tools WHO
Air pollution risk calculator
EPA tools
WHO
Toxicological, cancer databases
Summary manuscript

10. Esbjerg havn EIA – udkast til scoping
NIRAS report 13. march 2018
Chapter Befolkning og Sundhed
Socioeconomic impacts and changes in recreation, beach quality, sea water quality on beaches analyzed within this chapter
Changes in transport safety, noise, vibrations, air pollution analyzed specifically at each individual chapter
Specific individual chapter analyze whether there is a change in risk factors and add impact of such change on health using methodology on slide 5

11. Socioeconomic impacts
Unemployment rate
Strongly associated with mortality (e.g. Clemens, 2015, de Moortel 2018), but very hard to quantify, often qualitative analysis
Education
Higher education = better health
Income
Social cohesion
Clemens T., Popham F., Boyle P: What is the effect of unemployment on all-cause mortality? A cohort study using propensity score matching, European journal of Public Health, 2015 February; 25(1):
De Moortel D, Hagedoom P, Vanroelen Ch, Gadeyne S: Employment status and mortality in the context of high and low regional unemployment levels in Belgium ( ): A test of the social norm hypothesis across educational levels, 2018,

12. Air pollution
A 10 μg/m3 increase in PM2.5 corresponded to 1.76% all cause mortality increase (
Similar relations exist for major traffic or industrial air pollutants
Quantified risk assessment is possible

13. Conclusion
Close collaboration of EIA/SEA experts with public health experts is needed to complete the human health risk assessment steps.
Epidemiology is the key science to provide information upon exposure – effect relations