Health and environmental impact assessment: an integrated approach
British Medical Association
Board of Science and Education
1998
Environmental impact assessments
This report has examined the development of the environmental impact assessment process, and the rationale and procedures which should be followed when an EIA is undertaken. Some of the failings of the current procedures have been outlined and explored. The most significant of these is that although EIAs should take a holistic approach, including human health, the focus is primarily confined to the physical, chemical and biological environment, while human health is only referred to, if at all, indirectly.
Despite these limitations, environmental impact assessments could provide a valuable means for ensuring that a consideration of the impact on public health is included within the decision-making criteria of developers, planners, officials, councillors and ministers. Not only have EIAs been required by legislation in many parts of the world, but the methodology of EIAs should include an integrated analysis of complex, cross-sectoral issues which affect all components of the environment, including human health. Considerable progress has already been made in some countries in integrating formal procedures for health impact assessments within EIA processes. We have considered in detail some of the ways in which positive and negative aspects of health, and the expertise of health specialists, can be more fully integrated into the EIA processes.
There is increasing pressure for EIAs to be applied to the highest levels of the policy-making and planning processes, such as to ministerial policies, national, regional and sectoral plans and programmes through what is coming to be called 'strategic environmental assessment' (SEA). SEA can provide a framework within which wider issues of natural resource conservation and sustainability can be addressed. An EU Directive on SEA is under consideration, but further drafting is likely to be required before the scope of the draft Directive contains adequate provision for dealing with the implications of policy, plans and programmes for human health, safety and risk.
The issue of when an environmental hazard becomes a health issue is difficult to define. The range of consequences for human health may cover an individual whose quality of life has been compromised by the development of a new road in a rural area, to the dispersal of a toxic agent which can lead to acute and/or chronic illness amongst some members of the general public.
The complexity of many environmental hazards demands cross-sectoral approaches to safeguard health. One of the main difficulties in incorporating human health more directly in environmental impact assessments, however, has been a lack of an adequate dialogue between those in the health care professions and those concerned with environmental regulation.
There are now many organisations with an interest in health and environmental issues and it is not easy to identify precisely where responsibilities for environmental health lie. There is no single government department which is responsible for the whole environmental health function, and there is no clear framework for addressing many of the more complex environmental health issues, particularly those of a cumulative or trans-boundary nature. However, the BMA welcomes the appointment of a Minister for Public Health and the restructured Department of the Environment, Transport and the Regions and the improved liaison between the Agriculture, Environment and Health Departments. In the past there has been a tendency for governments to try to reduce environmental hazards by focusing on reducing specific emissions in a piecemeal fashion, without addressing the overall implications. An integrated approach to environmental and health impact assessment can better take account of interactions between different pollutants, cumulative effects of low-level releases, levels of exposure for people in the receiving environment and their relative vulnerabilities to adverse effects. Both the Environment Agency and the recently proposed Food Standards Agency will have a crucial role in further protecting public health.