Monitoring the environmental health status in the Swedish population 1999-2019

Abstract

BACKGROUND AND AIM Since 1999, self-reported environmental health status and exposure has been monitored by questionnaires to the Swedish population in order to to follow up and act on emerging environmental health risks. This data, which is compiled in comprehensive environmental health reports, is unique and cannot be retrieved from any national register. The survey is administered by the Public Health Agency of Sweden, in close collaboration with the regions. METHODS Large random samples of the Swedish population (alternating between adults and children) have every 4th year since 1999 received a questionnaire about environmentally related diseases, exposures, annoyance and symptoms. The data has been completed with registry data, e.g. type of housing, educational level, income and country of birth. The last questionnaire (2019) was administered to caretakers of children, thereby completing two time series for adults and children, respectively, over a 20-year period. A focus on environmental health equity has been included in the data analysis of the results in recent years. RESULTS The number of administered questionnaires has increased from 15,750 in 1999 to 114,500 in 2019. However, the response rate has declined from 72% to 42% where it has stabilized, but due to the large sample sizes, the results are representative of the target populations. Among the noticeable trends are increasing annoyance from traffic noise and pollen allergies. A positive trend is a rapid decrease in indoor exposure to environmental tobacco smoke. New fields are also emerging, like urbanization, green space and climate change. In the last survey, inequity in exposures was especially elucidated. CONCLUSIONS Environmental health surveys are important as a complementary tool to other forms of monitoring environmental health and can be used for decision making at national and regional levels. Inequities can be identified and hence appropriate measures taken. KEYWORDS Survey, environmental exposure, equity