ENHIS uses two principal tools to assess the impact of the environment on health and the effectiveness of mitigating policies: environmental health indicators and health impact assessment (HIA).
Indicators assess the current environment and health situation and are useful for identifying problems, monitoring trends and communicating this information. HIA focuses on the impacts of policy – either planned or implemented - on health.
Both tools are based on the state-of-the art scientific evidence whenever available, for example to identify and quantify the relationship between an exposure and a health outcome, and to provide guidance on effective policies. At times, however, the often complex relationship between health and the environment limited the availability of causative evidence. When evidence was often lacking, such as in the case of policy effectiveness, it was replaced by the use of expert opinions.
At their first release in 2007, the ENHIS indicators helped building a baseline assessment of the situation in the WHO European Region in the context of Children’s Environment and Health Action Plan for Europe. Then, as new data is collected and the topics considered possibly expand, the indicators will allow monitoring progress and developments. It is important to note that the indicators can be adapted to national situations, meeting the specific needs of a country, and providing guidance on effective actions.
About indicators: methodology, frameworks and initiatives
A major use of HIA is the assessment of the likely health impacts of a policy before it is implemented. This takes into consideraton the distribution of impacts, for example on children. The usual process involves quantifying the relationship between an exposure and a health outcome, estimating the impact of a policy on the exposure, and then assessing the likely changes in health status.
A number of HIAs were carried out as part of ENHIS. Methods and tools were developed and applied to selected pollutants for outdoor (PM10 particles and ozone) and indoor (e.g. environmental tobacco smoke and mould and damp at home) air pollution as well as noise.
About Health Impact Assessment: definitions, references, feasibility studies and guidelines
ENHIS aims to present European environment and health information in a structured and well-informed manner.
The ENHIS assessments, which are available for every indicator, are presented as factsheets. These factsheets include information on the environment and health context, on the policy relevance and context, an assessment of the situation in the WHO European Region, suggestions for further monitoring and meta-information.
In order to harmonize reporting, guidelines for structuring factsheets and webtexts have been developed.
Guidelines for factsheets
Guidelines for webtexts
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