Establishing and extending EPHT capacity in England: governance and operational aspects

Abstract

Within Public Health England (PHE), an Environmental Public Health Tracking (EPHT) programme was established that includes several activities on surveillance of environmental hazards, exposures and health outcomes. We aim to account for key aspects of EPHT governance and operations in England. We describe the process for selecting topics to be included in EPHT and managing its data. This core infrastructure of EPHT within PHE has delivered capacity to support activities on ongoing concerns regarding hazardous pollutants and chemicals in drinking water, land, food and air, as well as linking with novel interpretative frameworks derived from research programmes in collaboration with external research groups. The English EPHT programme has adopted an approach providing common governance for disparate themes, this includes a EPHT board accountable to PHE’s executive via an environmental hazards programme board, a strategic advisory group, stakeholder consultations, and PHE working groups with the remit to establish surveillance structures and functions appropriate to specific information needs. This process has produced activities on population exposure estimation of arsenic in private water supplies, the burden of disease of carbon monoxide poisoning, lead exposure in children, fluoridation monitoring, and guidance for investigating non-infectious disease clusters from potential environmental causes. Recent developments include national systems for enhanced air pollution exposure surveillance and access to weather data for public health use. Studies of distribution of vectors, climate variability and infectious disease, coastal changes and toxin-producing algae, social factors affecting use of green spaces and related health benefits, all illustrate novel interpretative frameworks that were first tested and documented in a research setting, and having been co-designed and co-produced with public health agencies, their relevance for EPHT can more easily be considered. In conclusion, EPHT in England is a programme that enables both activities on well-known environmental factors, and the capacity to integrate emerging concerns.