1. INTEGRATED INFORMATION E & H Action Plan Implementation

2. Aims of the session  To obtain agreement on the definition of an integrated information system; the objectives of collecting the information; and the priorities for information collection.  To exchange information on the state of the art of information availability, and discuss the implications for the future.  To agree on further steps and the organisation of future work.

3. Overall objectives State and trends of health impacts of environmental contaminants Best assessments on basis of existing information Improving information base for the future Identify emerging issues Possibly others Must specify objectives clearly, identify information needs, and show how they can be integrated.

4. Information framework  Identify exposure  Translate exposure into health impact  Trace exposure back to sources of contamination

5. 5 IndicatorsMonitoringResearch 1 Source emissions EPER, IPPC, WFD, etc. 2 Concentrations in environmental media AAQ, WFD, others 3 Population distribution of exposure at EU level Monitoring of concentrations in food, DW, ambient air, indoor air, and relevant consumption/exposu re Which are the principal exposure routes for a given stressor. 4 Apportionment of exposure between sources (derived from model using information in indicators 1,2 and 3) Development of models for linking exposure to emissions.. 5 Exposure-response relationship Derived from toxicology and/or epidemiology, normally expressed in terms of relative risk. 6 Attributable fraction of disease to environmental exposure (obtained by combining indicators 3 and 5) Refinement of risk assessment methodologies. 7 Incidence/prevalence of outcome at EU level Health monitoring data (surveys or registries) 8 Scale of health problem due to exposure in EU (obtained by combining indicators 6 and 7)

6. State of play on environment and health information  Overview of current environmental monitoring relevant to information objectives: EEA  Overview of health monitoring and indicator development: SANCO/ESTAT  Overview of information and reporting systems existing or under development.

7. Best practices at Member State level  A selection of presentations from Member States particularly engaged in one or other aspect of assessment or monitoring  French pesticides study

8. Orientations for the future  Prioritisation of issues.  Structures for implementing these activities.

9. Prioritisation of issues  On the basis of criteria: Is stressor significant at EU level? Is stressor significant at EU level? Magnitude and severity of potential health impact Magnitude and severity of potential health impact Strength of association between stressor and impact Strength of association between stressor and impact Whether policy responses to the stressors are feasible Whether policy responses to the stressors are feasible  In short term, will use the priorities from E&H Strategy, WHO priorities, and any identified by Member States and stakeholders.

10. WHO Regional Priority Goals  Safe water and sanitation  Accidents (both traffic and other)  Respiratory disease and air quality Ambient air Ambient air Indoor air Indoor air  Disease related to physical and chemical stressors Check against indicators proposed by WHO and those held by the EEA  Need to identify priorities in indoor air quality  Need to identify priorities among physical and chemical stressors (particularly chronic chemical contamination)

11. Relation with risk assessment regimes  Decide how to treat stressors covered under other RA programmes  Where stressors under different regimes contribute to same health problem, co-ordinate under the Action Plan  Promote development and uptake of risk assessment methodology, on issues such as treatment of mixtures, treatment of vulnerable groups, and uncertainty analysis.

12. Structures for implementing activities  How should the information system itself be organised? IN particular, how should it relate to the WHO system?

13. 13 Relation between EU and WHO data transfers =data transfer WHO EU Member States OtherWHO-Euro States =data transfer WHO EU Member States OtherWHO-Euro =data transfer= WHO EU Member States OtherWHO-Europe

14. 14 Decision-making process Health SANCO/E&H Working party Include in ECHI list? Insert on next review Co-ordinated assessment of information needs: done by Commission on basis of outcome of Conference and ENHIS Environment ENV/EEA Include in revision of Environmental monitoring? Insert in review Food SANCO/EFSA Establish new food Data flow? Implement Housing, accidents and others SANCO/ Working party on accidents Analysis of extent to which they can be met on the basis of existing data flows: done by Commission on basis of German work and ENHIS Proposals for new indicators