1. 1 Environment and Health in EEA assessments and reporting Ecoinformatics meeting 08-11 April 2008, RTP, NC

2. 2 EEA work in Environment and Health 6 th Environmental Action Programme (2002-2012) Climate change Nature and biodiversity Environment and health Natural resources and waste EU Environment and Health Action Plan (2004- 2010) WHO pan-European Environment and Health process (follow up of Budapest conference, 2004)  Both promote information systems and indicators

3. 3 The Commission is invited: - to continue developing a comprehensive environment and health information system to identify hazards, set planning priorities, measure progress, and changes in the environmental quality and health status …to facilitate international comparisons and evaluation of policies Council Conclusions on Environment and Health Council of the European Union, 2007

4. 4 EEA cooperation and partnership in E&H work WHO Europe – EHIS process DG JRC DG Environment DG Sanco DG Research DG Infso other European agencies, e.g. ECDC, ECHA, EFSA …

5. 5 Environment and Health in EEA reporting – recent examples Environment and Health EEA/JRC, 2005 Europe’s Environment: the fourth assessment report (Belgrade report), 2007 indicator based report complemented by sub-regional assessments, where information is limited or gaps exist, and by case studies

6. 6 Environment and Health in the Belgrade report Policy responses to environment and health challenges in Europe are improving Initiatives to address environment and health issues are growing at regional, national, and local levels For many health hazards actions lag behind policies

7. 7 Environment and Health - Air quality

8. 8

9. 9 EEA, 2007

10. 10 Particulate matter and ozone caused 380,000 premature deaths in Europe in 2000 Small particles remain main health threat in EECCA and SEE Loss of statistical life expectancy (months) due to anthropogenic PM 2.5 emitted in 2000 Environment and Health – Air quality Projected emission reductions in WCE and SEE will reduce significantly impacts on public health and ecosystems Loss of statistical life expectancy (months) due to anthropogenic PM 2.5 - projected emission levels for 2020 EEA, 2007

11. 11 WHO, 2007 WHO ENHIS report

12. 12 Work at ETC/ACC (European Topic Centre) on urban population exposure to PM10 and ozone continued – data and maps for the year 2005 available Quantification of health impacts – premature death - by country – attributable to long term exposure to PM10, and to ozone exposure Uncertainty analysis included Environment and Health – Air quality ETC ACC, 2007

13. 13 Environment and Health – Inland Waters

14. 14 More than 100 million people in the region lack access to safe drinking water The quality of water supply and sanitation services has deteriorated over the past 15 years in EECCA and SEE One-third of the pan-European population lives in countries where water resources are under substantial pressure Environment and Health – Inland Waters

15. 15 EEA Core Set Use of freshwater resources Urban wastewater treatment Bathing water quality Chlorophyll in transitional, coastal and marine waters Nutrients in freshwater Nutrients in transitional, coastal and marine waters Oxygen consuming substances in rivers WHO, ENHIS Public water supply and access to safe water Wastewater treatment and access to improved sanitation Bathing water quality Outbreaks of waterborne diseases

16. 16 Environment and Health – Inland Waters EEA, 2007

17. 17 The indicator shows that in seven European countries surveyed there were 75 outbreaks of waterborne diseases related to drinking- water resulting in over 12 000 episodes of illness between 2000 and 2005 The data must be interpreted cautiously, as differences between countries are likely to reflect the efficiency of surveillance systems rather differences in outbreaks, and data were only available for a few countries. This underlines the need for more widespread and effective surveillance systems. Outbreaks of waterborne diseases WHO, 2007

18. 18 Wastewater treatment coverage and bathing water quality WHO, 2007

19. 19 Environment and Health – Hazardous chemicals

20. 20 Concern is growing about impacts of exposure to low levels of chemicals, in complex mixtures, for long time Relevant data and information are lacking to assess whether serious threats from chemicals to human health and the environment have been reduced New agreements and legislation are in place that address the safer handling and management of chemicals to protect both human health and the environment Environment and Health – Hazardous chemicals

21. 21 EEA, 2007 WHO ENHIS Exposure of children to chemical hazards in food POPs in human milk Blood lead in children Belgrade report

22. 22 Chemicals and human health – what indicators? Human biomonitoring initiatives under the EU Environment and Health Action Plan Use of human and environmental biomonitoring data Other ….

23. 23 E&H related indicator initiatives in Europe EEA – health relevant subset of CSI WHO – E&H indicators (EHIS process) DG Sanco - ECHI process Eurostat – SDI – subset of public health indicators OECD health indicators EDEN project - Emerging Diseases in a Changing European Environment other indicators projects (e.g. urban health…)

24. 24 Are these indicator initiatives complementary? Are they sufficient for comprehensive E&H assessments? Are they sustainable? How can they be linked to SEIS?

25. 25  financially supported by the DG "Public Health and Consumer Protection" (DG Sanco) of the European Commission  a clear and coherent picture of the health status of the European population and related time-trends and determinants  EEA and JRC - main contributors to the chapter ‘Environmental determinants and settings’

26. 26 Environmental determinants and settings - Contributions from EEA, JRC and WHO Introduction (EEA/RIVM) Air pollution (EEA/JRC) Drinking and recreational water (RIVM/JRC/EEA) Soil contamination and waste (EEA) Selected chemical contaminants (EEA) Use of pesticides (EFSA) Food safety (EFSA) Physical stressors – noise, radon, UV (EEA/JRC) Human settlements (WHO) Extreme weather events and health (WHO)

27. 27 DriversDemography Globalisation Inequalities Climate change Urbanisation Land use Transport Ecosystems State of public healthLife expectancy Mortality trends ImpactNon-communicable diseases Communicable disease Accident and injuries Rare diseases Reproductive health Specific population groups Health determinantsBehaviour Environmental determinants and settings Socio-economic determinants Psycho-social determinants ResponsesHealth systems EU and MS roles and initiatives, including health research EUGLOREH assessment framework

28. 28 Challenges ahead for E&H information / indicator development – to address complex environmental issues Climate change impacts and adaptation Biodiversity and ecosystem services

29. 29 Climate Change and Health Source: A. McMichael et al, The Lancet 2006; 367: 859-869.

30. 30 Heat wave events - the past and future in Europe EEA, 2007

31. 31 Climate change impacts and adaptation – E&H relevant activities at EEA ‘Climate change impacts in Europe’ - EEA/JRC/WHO report (due Sept 2008), including human health indicators Further cooperation with WHO on health indicators in the context of EEA work on climate change adaptation

32. 32 Climate change impacts and adaptation – E&H relevant activities at EEA Expanding partnership – cooperation with the ECDC, Stockholm Joint workshop ECDC/WHO/JRC/EEA on Environmental Change and Infectious Disease, March 2007 Technical workshop EEA/ECDC on networking, information exchange, March 2008 Initiated cooperation on climate change / environmental change and infectious diseases – linking environmental and epidemiological data

33. 33 Biodiversity and ecosystem services – E&H context MA, 2005

34. 34 MA, 2005

35. 35 Biodiversity and ecosystem services – EEA activities the Belgrade report Biodiversity decline and the loss of ecosystem services continue to be a major concern in the pan-European region. The target of halting biodiversity loss by 2010 will not be achieved without additional efforts. The main pressures on biodiversity continue to be urban sprawl, infrastructure development, acidification, eutrophication, desertification, overexploitation, intensification of agriculture and land abandonment.

36. 36 Biodiversity and ecosystem services – current EEA activities The European biodiversity indicators ( SEBI 2010) The EURECA project – the European ecosystem assessment for selected ecosystems (in 2012) – with the improved and expanded status and trend monitoring of biodiversity to support a wider assessment of ecosystem services and socio-economic impacts

37. 37 Biodiversity and ecosystem services – Environment and health aspects Availability of studies on biodiversity and human health, including economic valuation Possible impacts of biodiversity loss on human health and wellbeing mechanisms health endpoints scale of assessment Positive impacts on human wellbeing of maintaining biodiversity / ecosystem services

38. 38 - to gather information on environmental determinants with positive health impacts, such as biodiverse environments, non-motorized means of transport and housing conditions Council Conclusions on Environment and Health, Dec 2007

39. 39 Communicating environment (and health) information – responding to public interest/concerns

40. 40 The link between environmental concerns and lack of information on environmental topics Eurobarometer, March 2008 Attitudes of European citizens towards the environment

41. 41 Three main sources of information about the environment Eurobarometer, March 2008 Attitudes of European citizens towards the environment

42. 42 Responsibility for protecting the environment Eurobarometer, March 2008 Attitudes of European citizens towards the environment

43. 43 Environment and health indicator OECD, 2004 As proposed by Corvalán et al. (1997), an environmental health indicator may be defined as “An expression of the link between the environment and human health, targeted at an issue of specific policy or management concern and presented in a form which facilitates interpretation for effective decision-making”. An environment and health indicator has two major characteristics: embody a link between environment and health; the element that turns a simple environmental or health indicator into an environment and health indicator is the knowledge of the relationship between exposure to environment factors and health effects. Any environment and health indicator must therefore be based on a clear and firm relationship between the environmental hazard and the health effect. The further removed the indicator is from the health effect, the weaker this link is liable to be. be associated with policy - to be effective and useful to decision makers, an indicator should relate to aspects of environment-related health which are of high relevance to decision makers, understandable by concerned people and amenable to control. An environment and health indicator should be expressed in terms of the health risk associated with a specific environmental hazard. Indicators should tend to provide a better early warning, both of impending environmental problems and of the effects of intervention. The main objective of environment and health indicators is to support the decision-making process in environmental health: for highlighting problems, identifying trends, tracking of policy progress.