Integrating Health Impact Assessment with Environmental Impact - Report Example

Integrating Health Impact Assessment with Environmental Impact Assessment: Advantages and Disadvantages Environmental Impact Assessment (EIA) has gone a long way since the ‘50s, when the impact of development projects on the environment has gained attention for social concern (Turnbull 2001, 3). Today, not only has EIA become a well-established process internationally (Bond 2004; Glasson, Therivel and Chadwick 2005, cited in Harris and Spickett 2010, 1); it is also currently evolving into a more comprehensive environmental impact assessment tool, highlighting health as a vital concern (Wathem 1990). Particularly in Australia, initial efforts to integrate Health Impact Assessment (HIA) with EIA are proceeding (Spickett and Graham 2005; Harris et al. 2009, cited in Harris and Spickett 2010, 1) EHIA: Evolution The development of EIA’s methodologies and procedures originated in North America, later in Europe, mainly by ecologists whose concern in assessing the impacts of development activities focused more on human health. Similar efforts were then made for the development of health impact assessment methodologies and procedures, but this had not been as smooth as EIA’s. The (1) ‘lack of epidemiological knowledge regarding dose-response relationships’ and the (2) ill-preparedness of concerned government authorities to release documents showing in concrete figures the impact of development on the incidences of death and diseases made the latter job difficult. The first problem made it difficult to determine the effect of environmental changes on health, for example, the release of pollutants; whereas, the second problem denied hard evidences on the adverse health impacts of development. (Giroult1990, 259) Resultantly, the health components have become the main limitations of many EIA studies. A WHO commissioned study of 15 EIAs testified to this saying: “... off-site health effects generally have been given a low priority and have not been treated systematically” (cited in Giroult1990, 259). To ensure that health will be consciously considered in EIAs against these difficulties, a new approach, namely Environmental Health Impact Assessment (EHIA) was proposed. (Giroult1990, 259) EHIA Defined To understand this new approach, the key term – environmental health – that differentiates it from the current approach has to be defined. From Listorti and Doumani’s (2001) noted environmental health’s definition, it essentially means, as that which prevents health hazards, namely ‘increasing human diseases, injury, and premature death’, while pursuing development activities (349). Main health hazards are classified as: traditional hazards, namely unsafe water, inadequate sanitation, waste disposal, indoor air pollution, and vector-borne diseases (malaria, dengue, and others), of which poor nations are most vulnerable; modern hazards, namely urban pollution and agro-industrial chemicals and wastes, of which industrialised nations are most vulnerable; and other health hazards such as food contamination, occupational safety, and natural disasters (350). And the main agents of diseases are classified as: biological (bacteria, viruses), chemical (toxic wastes), and physical (dusts, noise) (Giroult 1990, 259-60; Lisella 1994, cited in Listorti and Doumani 2001.) The interrelationships between environmental factors and human health can be easily understood on the impact of environmental health factors as demonstrable in two ways: (1) as agents of disease, for example, toxic wastes are known to cause physical disease, and even emotional problems (Brown and Mikkelsen 1997, 2); and (2) most commonly, as facilitators of disease, injury or death (Giroult 1990, 260), for example, continuous exposure to pollutants emitted by an industry may cause the weakened lungs, or may distort sense of smell. From this perspective, health is perceived as the healthy interactions of the three key areas of human life – “the natural environment, the social environment (‘community’) and human ecology through which natural resources necessary for sustenance and well-being are managed” (Labonte 1991, cited in Spickett and Murray 1994, 5). These clear interrelationships of the two important factors for assessment in pursuing development projects: environmental impact and health impact, illustrate the need and practicality of integrating the two into the new paradigm – EHIA. As Giroult (1990) noted, “The purpose of environmental health impact assessment is not to prevent economic developments; indeed, these are often a vital means for raising health standards” (260). EHIA in Developed and Developing Countries As industrialised countries have become more aware and as the public has demanded more for a pro-environment and pro-health development paradigms, there is now “a shift from an attitude of ‘prevent and control’ of public health problems to one of ‘anticipate and prevent’ (Spickett and Murray 1994, 6). However, the equal importance of both environment and health in screening development projects is not yet well-established; efforts are being made to address these issues of concern. For example, the Australian Charter for Environmental Health states: “Protect human health by identifying threats posed by environmental hazards as early as possible and by introducing appropriate safeguards. Ideally, these should be sustainable and cost-effective.” (enHealth 1999, cited in enHealth 2001, 36) Furthermore, EHIA’s framework on the interrelationships between economic, health and environment, is recognised: “Economic development, human health and environmental protection are inextricably linked. Economic development should proceed hand-in-hand with measures to protect the environment and promote high standards of environmental health.” (enHealth 1999, cited in enHealth 2001, 36) While the US’s Risk Management Framework defines risk management as “the process of identifying, evaluating, selecting, and implementing actions to reduce risk to human health and to ecosystems” (The presidential/Congressional Commission on Risk Assessment and Risk Management 1997, 1). Whereas, the Luton Borough Council’s HIA upholds two perspectives, which essentially integrate development’s environmental and health impact: (1) broad perspective (social model of health), and (2) tight perspective (derived from EIA) (Egbutah and Churchill 1). Thus practices of industrialised countries clearly give importance to both EIA and HEI. Although, following WHO’s new paradigm in assessing the impacts of development, Harris and Spickett (2001) correctly observed: “HIA should not be a parallel process to EIA but be integrated into an overall Environmental and Health Impact Assessment process” (1). As Waddington (1984) explained, “Without an adequate environmental impact assessment system, predictions of health effects are likely to be incomplete” (xiv). Good thing though is the fact that assessment of development impacts on environment and health is not only well-established in industrialised countries, but more significantly, refining their integration is currently on going. At the centre of the spectrum are the industrialising countries which are yet in the process of meeting their development challenge – “poverty alleviation through environmentally sound development” (Lohani 1997, 2). To achieve this, industrialising countries, specifically in Asia have acknowledged the vitality of integrating EIA processes into development planning. Increasingly, these countries have enacted the need for all major development projects to pass through EIA. Moreover, with most development projects financed by industrialised nations, review of the project’s EIA is mandatory. Thus EIA takes effect at all stages of the project cycle: project concept, prefeasibility, feasibility, design and engineering, implementation, and monitoring and evaluation, with most EIAs during the second and third stages of the project (5-6), at which stage the EIA process satisfies site selection, screening, initial assessment, and scoping of significant issues. This requires a project’s feasibility to ‘include a detailed assessment of significant impacts, including gathering of baseline information; the prediction and quantification of effects; and review of the EIA by a review agency’. (Lohani 1997, 4-6) Thus EIA in developing countries is in its evolving stage and is observed more in compliance with financing requirements than its importance. The various stages of EHIA – hazard identification, exposure assessment, exposure-response relationship, estimation of risks to health, and communication of these risks to all concerned, determination of potential or actual health costs and option appraisal (Agius 2009) – are no different from the stage-cycles in EIA – screening, consideration of possible alternatives, preliminary assessment, scoping, main EIA study (International Institute for Environment and Development n.d., 2-3) and HIA – screening, scoping, establish evidence base for health impacts, report and recommendations, and disseminate, review after implementation, examination of committee report policy (Egbutah and Churchill 2002, 7) – being currently practised. EHIA: Advantages and Disadvantages The advantages and disadvantages of EHIA would differ in industrialised and industrialising countries, as each confronts varying types at varying degrees of health risks and as each is capacitated differently (Turnbull 2001, 2). Concretely, for developing countries which health hazards are characterised by basic health issues – inadequate shelter, sanitation and safe water supplies; soil, water, and air pollution – and which government does not have enough resources, worst lacks political power, to control the perceived environmental health impacts of development, “health impact assessments within EIA would enable controls to be introduced on a case-to-case basis to prevent serious deterioration in health conditions” (Turnbull 2001, 2). While for developed countries EHIA would further involve the far much vocal and conscious public in realistic public debate, thereby increasing EHIA importance and strengthening basis for policy-making. On the other hand, the disadvantage of EHIA in developing countries can be attributed both on the policy makers and the public. Corruption would slow down the process, thus stalling the project; bribes would hasten the process ignoring the points of assessment, thus mitigation of the projects adverse effect is disregarded. This makes the process ineffective, forfeiting the very purpose of EHIA. It becomes a tool for the enrichment of those in authority. On the other hand, in industrialised countries, EHIA could be manipulated to exaggerate health hazards for whatever profitable reason it may be – one possibility is to sabotage a competitor; another possibility is to justify a legislation that needs data-based back-up. Conclusion Balancing development with environmental protection and human health condition and well-being is vital. Thus EHIA is a process that should be in placed in every country. However, to achieve its intention, determination of its process should intentionally safeguard its objective from possible threat coming from specific conditions. For example in the case of developing countries, how corruption could be prevented from corrupting EHIA? IN the case of developed countries, how could it not be subjected to manipulation? Reference List Agius, Raymond. 2009. Environmental Health Impact Assessment. Health, Environment & Work. Accessed 15 September 2010. Available from http://www.agius.com/hew/copyrght.htm. Internet. Brown, Phil, and Edwin J. Mikkelsen. 1997. No Safe Place: Toxic Waste, Leaukemia, and Community Action. US: University of California Press, Ltd. Giroult, E. 1990. “WHO interest in environmental health impact assessment.” In P. Wathern (Ed.), Environmental impact assessment: theory and practice 257-271. New York, NY: Routledge. Egbutah, Chimeme, and Keith Churchill.2002. An Easy Guide for Health Impact Assessments for Local Authorities. Luton Borough Council: Health Action Zone. enHealth. 2001. “Appendix 2: The Australian Charter for Environmental Health.” In Health Impact Assessment Guidelines. 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