Health Impact Assessment Approach Research Articles

Health impact assessment in Australia: A review and directions for progress

This article provides an overview of Health Impact Assessment (HIA) within Australia. We discuss the development and current position of HIA and offer some directions for HIA's progression. Since the early 1990s HIA activity in Australia has increased and diversified in application and practice. This article first highlights the emergent streams of HIA practice across environmental, policy and health equity foci, and how these have developed within Australia. The article then provides summaries of current practice provided by each Australian state and territory. We then offer some insight into current issues that require further progression or resolution if HIA is to progress effectively in Australia. This progress rests both on developing broad system support for HIA across government, led by the health sector, and developing system capacity to undertake, commission or review HIAs. We argue that a unified and clear HIA approach is required as a prerequisite to gaining the understanding and support for HIA in the public and private sectors and the wider community.

Pesticide Impact Assessment via Using Enzyme-linked Immunosorbent Assay (ELISA) Technique in the Lower Rio Grande River Basin, Texas

This paper presents a field survey using health impact assessment approach trying to: (1) demonstrate a basic soil and groundwater survey/sampling, (2) investigate any possible long-term pesticide contamination in connection with citrus orchard pesticide application, and (3) conduct an assessment review of possible pesticide impacts on public health in the Lower Rio Grande Valley (LRGV), Texas. A sampling plan was prepared to collect samples that include soil from a citrus orchard of Texas A&M Agricultural Research and Extension Center, Weslaco, located in the Hidalgo county and groundwater from domestic and public wells located in the neighboring LRGV region. Field investigation of the contamination was performed using enzyme-linked immunosorbent assay (ELISA) technique and the analytical results indicated that there is no considerable concentration of simazine pesticide in soil and groundwater. All of the measurements are below the maximum contamination limit (MCL) value provided by US EPA. A statistical assessment was also performed on the cancer mortality rates in the LRGV region to identify any significant health concerns in this region. After reviewing several relevant reports, it is inferred that there are no apparent health issues in the LRGV region in relation to such pesticide impact and the mortality rates in the valley are lower than the average mortality rates in Texas during the period 1992–2002. T-test confirmed the absence of any significant difference between the three counties in the Lower Rio Grande Valley (Webb, Cameron and Hidalgo) in terms of the cancer mortality rates.

Assessing health impacts in complex eco-epidemiological settings in the humid tropics: Advancing tools and methods

In the developing world, large-scale projects in the extractive industry and natural resources sectors are often controversial and associated with long-term adverse health consequences to local communities. In many industrialised countries, health impact assessment (HIA) has been institutionalized for the mitigation of anticipated negative health effects while enhancing the benefits of projects, programmes and policies. However, in developing country settings, relatively few HIAs have been performed. Hence, more HIAs with a focus on low- and middle-income countries are needed to advance and refine tools and methods for impact assessment and subsequent mitigation measures. We present a promising HIA approach, developed within the frame of a large gold-mining project in the Democratic Republic of the Congo. The articulation of environmental health areas, the spatial delineation of potentially affected communities and the use of a diversity of sources to obtain quality baseline health data are utilized for risk profiling. We demonstrate how these tools and data are fed into a risk analysis matrix, which facilitates ranking of potential health impacts for subsequent prioritization of mitigation strategies. The outcomes encapsulate a multitude of environmental and health determinants in a systematic manner, and will assist decision-makers in the development of mitigation measures that minimize potential adverse health effects and enhance positive ones.

Lung Cancer Risk Assessment in Relation With Personal Exposure to Airborne Particles in Four French Metropolitan Areas

The objective of this study was to quantify the total number of lung cancer deaths attributable to chronic exposure to fine particles (pm2.5) among adult populations of four French urban populations (Grenoble, Rouen, Paris, and Strasbourg). A geographic information system (GIS) was used to extrapolate personal average exposures to the total population of each metropolitan area across three sectors contrasted in terms of local sources of pollutants. We followed a health impact assessment approach by using the risk estimates in the CSP II study. The annual number of lung cancer cases attributable to pm2.5 chronic exposure ranged from 12 to 404 according to the city. Among these deaths, up to 60% occurred, in the Paris metropolitan area in the urban sector most exposed to traffic emissions. The health impact of chronic exposures to urban air pollution in metropolitan areas of developed countries warrants further efforts to abate sources of toxicants and to reduce exposure. Traffic emissions still contribute significantly to the total lung cancer burden in France.

Evaluating health impact assessment

Health impact assessment (HIA) is a developing approach that assesses the health impacts of a proposal on a population, and produces a practical set of recommendations to inform the decision-making process of the proposal. The purpose is to influence decision makers to increase positive health impacts of a proposal and decrease negative impacts. Most work within the HIA field to date has focused on methodological development and actually carrying out HIAs. Little attention has been paid to the formal evaluation of the HIA approach and whether or not HIA works (if and how the HIA approach informs the decision-making process and, in particular, if it contributes to improving health and reducing inequalities). With the drive towards evidence-informed policy, HIA also needs to show whether it adds value to the decision-making process, given the significant resources often involved in carrying out an HIA. A suggested approach to evaluating HIAs is presented, as well as its relationship with monitoring, drawing on the significant public health evaluation literature that already exists. Methodologies appropriate for use, and examples of indicators suitable for HIA evaluation, are provided. We suggest that typical HIA evaluations should focus on the process of the HIA and the impact that it has on the decision-making process, rather than attempting to evaluate long-term health outcomes or whether predicted impacts actually occurred.

Evaluation as a key part of health impact assessment: the English experience.

Health impact assessment (HIA) is an approach that has experienced increased activity and wide support within England. This is reflected in the large number of HIAs being undertaken at local and regional levels, by the advocacy of HIA in many national policy documents, and by the setting up of specialized HIA posts and centres. To continue this level of support, and to justify any increase, the approach of HIA must show whether and how the HIA approach informs the decision-making process and, in particular, whether it improves health and reduces health inequalities. The first steps in answering these questions have been taken by the partial evaluation of some completed HIAs within England. A description of these evaluations is presented. Work is also progressing on promising practice guidance for practitioners on the topic of evaluating HIAs. The further development of evaluation within HIA is required, at both a practitioner and research level, and provides an exciting opportunity for people and groups to advance the evidence base for HIA, while also proving its place as an effective public health intervention.