Health Impact Assessment Methods Research Articles

Health impact assessment of the surface water pollution in China

China suffers from severe surface water pollution. Health impact assessment could provide a novel and quantifiable metric for the health burden attributed to surface water pollution. This study establishes a health impact assessment method for surface water pollution based on classic frameworks, integrating the multi-pollutant city water quality index (CWQI), informative epidemiological findings, and benchmark public health information. A relative risk level assignment approach is proposed based on the CWQI, innovatively addressing the challenge in surface water-human exposure risk assessment. A case study assesses the surface water pollution-related health impact in 336 Chinese cities. The results show (1) between 2015 and 2022, total health impact decreased from 3980.42 thousand disability-adjusted life years (DALYs) (95 % Confidence Interval: 3242.67–4339.29) to 3260.10 thousand DALYs (95 % CI: 2475.88–3641.35), measured by total cancer. (2) The annual average health impacts of oesophageal, stomach, colorectal, gallbladder, and pancreatic cancers added up to 2621.20 thousand DALYs (95 % CI: 2095.58–3091.10), revealing the significant health impact of surface water pollution on digestive cancer. (3) In 2022, health impacts in the Beijing-Tianjin-Hebei and surroundings, the Yangtze River Delta, and the middle reaches of the Yangtze River added up to 1893.06 thousand DALYs (95 % CI: 1471.82–2097.88), showing a regional aggregating trend. (4) Surface water pollution control has been the primary driving factor to health impact improvement, contributing −3.49 % to the health impact change from 2015 to 2022. It is the first city-level health impact map for China's surface water pollution. The methods and findings will support the water management policymaking in China and other countries suffering from water pollution.

How to improve the impact of healthcare campaigns by introducing methods of health impact assessment among students and health professionals

The development of health brigades in vulnerable populations constitutes a fundamental role for the approach of students to clinical practice and allows professionals to attend to basic needs in small and specific populations. Health impact assessment tools are essential to choose the populations and pathologies to study through the implementation of well-defined objectives that reduce the knowledge gap between the clinical and administrative fields of health between students and professionals, and thus, establish a scientific research and monitoring exercise.

Human health effects of recycling and reusing food sector consumer plastics: A systematic review and meta-analysis of life cycle assessments

Global transitions to circular economies of plastic could pose both risks and opportunities for human health. Life Cycle Assessment (LCA) can help to quantify possible health effects across plastic life cycles, syntheses of which could inform policy. This systematic review assessed LCA evidence for health effects of increased plastic recycling and reuse in the food sector. Scientific databases including Web of Science, Scopus, MEDLINE, Embase, Global Health, GreenFile and grey literature websites were searched for peer-reviewed LCA of consumer-level food sector plastics that compared virgin or single-use plastics with scenarios of increased recycling and reuse. Data on Human Health impacts and related midpoint impacts were extracted, converted to Disability-Adjusted Life Years (DALYs), and analysed using meta-regression. Forty-nine eligible LCAs were identified, only five of which related to low- and middle-income countries (China: n = 1 and Thailand: n = 4). Meta-regression showed strong evidence for a linear trend in reducing DALYs with increasing percentage recycled content compared to virgin plastic (Coefficient = −1.96E-5; 95% CI = −2.69E-5 to −1.24E-5; p < 0.0001) and increasing end-of-life recycling rate compared to landfill and/or incineration (Coefficient = −2.1E-5; 95% CI = −2.60E-5 to −1.63E-5; p < 0.0001), equating to almost a day of healthy life saved globally per tonne of plastic recycled. On average, reusable plastics reduced climate-related health impacts associated with single-use plastics after 30 uses. Global assessment was limited by data deficits, but meta-analyses suggested that health risks from linear economies of food sector plastics could be reduced by increasing recycling and reuse rates, though some reusable plastics would need to be used many more times than current norms. Encouraging greater geographical coverage in LCA, increasing uptake of health impact assessment methods, and incorporating emerging health data will strengthen future public health evaluations of circular economies.

Sources of air pollution-related health impacts and benefits of radially applied transportation policies in 14 US cities

As the world becomes increasingly urbanized, growing populations are exposed to poor ambient air quality and at risk of the associated health outcomes. Urban air quality is affected both by local sources of air pollution and sources outside city borders. Policy-makers who develop air quality policies need to know whether it is most effective to focus on local policies or to spend resources fostering larger regional air quality management cooperation. Identifying the fraction of air pollution exposure from emissions as a function of distance from the city is a critical element of air quality management design. We estimate the health burden associated with exposure to fine particulate matter (PM2.5), ozone (O3), and nitrogen dioxide (NO2) from county-level anthropogenic sources in and around 14 US cities; this analysis is a test-bed to conduct future global analyses. We use adjoint sensitivities calculated from the chemical transport model GEOS-Chem, high resolution satellite-derived surface concentrations of PM2.5 and NO2, and health impact assessment methods. For the 70.2 million people living in these cities, we estimate that 27,740 PM2.5- and O3-related premature deaths and 126,600 NO2-related new asthma cases were attributable to air pollution exposure in 2011. Development within the GEOS-Chem adjoint framework enables sectoral attribution and policy analysis in addition to the rote assessment of impact. We find that 70% of deaths and nearly 100% of these asthma cases were attributable to anthropogenic emissions. There is great variability in the sources of the anthropogenically-related health impacts; within-urban emissions make up 5% in Austin to 56% in Los Angeles and Phoenix (median: 31%) of urban premature deaths and 18% in Austin to 82% in Los Angeles (median: 59.5%) of new asthma cases, with the remaining portions attributable to emissions from outside the urban area. For each city, we estimate the air quality related health benefits associated with the adoption of a vehicle-miles-traveled fee in that city and in multiple spatial regions surrounding the city. The findings suggest that the proportion of urban air pollution that is regional is greater for premature deaths than new asthma cases and for the eastern US than the western US.

Reflections on burden of disease and health impact assessment methods for noise

Burden of Disease (BoD) assesses the noise impact on health at a given time and in a given population, whereas Health Impact Assessments (HIA) are conducted in the frame of decision-making to evaluate health effects of a policy, programme or project. In a 2020 report, the European Environmental Agency estimates transportation noise exposure in Europe annually results in 22 million highly annoyed, 6.5 million highly sleep disturbed, 48,000 cases of ischemic heart diseases and 12,000 deaths, and 12,400 children with cognitive impairments. These are based on END exposure assessment and exposure-response functions from the WHO noise guidelines 2018. Many more regional or national HIA and BoD studies have been conducted, and common methods across future assessments for consistent communication are needed. Given the rapid developments in noise research, current BoD and HIA are also partly outdated. Critical methodological issues will be discussed using national and regional examples with a focus on Switzerland. This includes the selection of noise sources, relevant health outcomes and corresponding exposure-response functions. Derivation of the lowest effect noise threshold, potential double-counting, and communication of results are also discussed with the aim toward a common understanding for the conduct of future BoD and HIA.

Mortality burden of heatwaves in Sydney Australia is exacerbated by the urban heat island and climate change: can tree cover help mitigate the health impacts?

Health Impact Assessment methods were applied to quantify the mortality burden of heatwaves in Sydney Australia, and assess the contribution of the Urban Health Island (UHI) effect to this burden. Using high resolution satellite observations to calculate UHI air temperature excesses and green cover, effects on heat-related mortality were determined. From future climate projections, mortality reduction benefits were estimated from green tree cover. Results show that &amp;#x3e;90% of heatwave-deaths could be prevented by removing the UHI. Tree canopy reduces urban heat and widespread tree planting could offset the increases in heat attributable deaths as climate warming.

Assessing the health impacts of transnational corporations: a case study of Carlton and United Breweries in Australia

BackgroundThe practices of transnational corporations (TNCs) affect population health through unhealthy products, shaping social determinants of health, or influencing the regulatory structures governing their activities. There has been limited research on community exposures to TNC policies and practices. The aim of this paper was to adapt existing Health Impact Assessment methods that were previously used for both a fast food and an extractives industry corporation in order to assess Carlton and United Breweries (CUB) operations within Australia. CUB is an Australian alcohol company owned by a large transnational corporation Asahi Group Holdings. Data identifying potential impacts were sourced through document analysis, including corporate literature; media analysis, and 12 semi-structured interviews. The data were mapped against a corporate health impact assessment framework which included CUB’s political and business practices; products and marketing; workforce, social, environmental and economic conditions; and consumers’ adverse health impacts. We also conducted an ecological study for estimating alcohol attributable fractions and burdens of death due to congestive heart disease, diabetes mellitus, stroke, breast cancer, bowel cancer and injury in Australia. Beer attributable fractions and deaths and CUB’s share were also estimated.ResultsWe found both positive and adverse findings of the corporation’s operations across all domains. CUB engage in a range of business practices which benefit the community, including sustainability goals and corporate philanthropy, but also negative aspects including from taxation arrangements, marketing practices, and political donations and lobbying which are enabled by a neoliberal regulatory environment. We found adverse health impacts including from fetal alcohol spectrum disorder and violence and aggression which disproportionately affect Indigenous and other disadvantaged populations.ConclusionOur research indicates that studying a TNC in a rapidly changing global financialised capitalist economy in a world which is increasingly being managed by TNCs poses methodological and conceptual challenges. It highlights the need and opportunity for future research. The different methods revealed sufficient information to recognise that strong regulatory frameworks are needed to help to avoid or to mediate negative health impacts.

Enabling Long-term Predictions and Cost-benefit Analysis Related to Housing Adaptation Needs for a Population Aging in Place: Protocol for a Simulation Study.

BackgroundPolicies that promote aging in place are common in Sweden and many other countries. However, the current housing stock cannot sufficiently accommodate a population aging in place considering how functional capacity and housing needs change as people age. To be suitable for all regardless of their functional ability, housing should be designed or adapted to facilitate the performance of activities of daily living. Long-term planning and plausible projections of development 20 to 30 years into the future are needed.ObjectiveThe overall aim is to develop simulation models that enable long-term predictions and analysis of potential consequences in terms of societal gains and costs for different large-scale measures and interventions in the ordinary housing stock.MethodsThis study is designed as a simulation study and will broadly apply health impact assessment methods in collaboration with five municipalities in Sweden. Individual interviews and research circles were used to identify current and prioritize potential new policies to improve the accessibility of the housing stock. We will run a series of simulations based on an estimated willingness to pay from discussions with the municipalities. Two to three different prioritized policies will be compared simultaneously using Markov cohort analysis to estimate the potential costs and health impact on the population. Using data from a systematic review and existing population-based data sets with individual-level data on home and health variables, we will calculate parameter estimates for the relations between housing accessibility and health outcomes. The potential impact of selected policy interventions will be estimated in several microsimulations representing people living in the community. Sensitivity analyses will be conducted for each simulation.ResultsAs of April 2022, open access data was collected, and a systematic review was underway and expected to be completed by November 2022. Collaboration with five municipalities was established in autumn 2020. In spring 2021, the municipalities developed a list of prioritized policy interventions to be tested and used in the simulation models. Inventories of barrier frequencies in ordinary housing started in spring 2022 and are expected to be completed in autumn 2022. Data gathering and analyses for simulation inputs will be completed during 2022 followed by the simulation modeling analyses to be completed in 2023.ConclusionsImproved accessibility of the ordinary housing stock has the potential to maintain or improve the health of the aging population. This study will generate tools that enable long-term predictions and reliable cost-benefit estimates related to the housing adaptation needs for a population aging in place, thus providing support for the best-informed policy decisions.International Registered Report Identifier (IRRID)DERR1-10.2196/39032

Health Benefits and Costs of Clean Heating Renovation: An Integrated Assessment in a Major Chinese City.

China has been promoting one of the world's largest campaigns for clean heating renovation since 2017. Here, we present an integrated cost-benefit analysis in a major prefecture-level city by combining a large-scale household energy survey and PM2.5 exposure measurement, high-resolution chemical transport simulation, and health impact assessment. We find that the completed renovation decreases the share of solid fuels in the heating energy mix from 96 to 6% and achieves a concomitant reduction of cooking solid-fuel use by 70%. The completed renovation decreases the ambient PM2.5 concentration in Linfen by 0.5-5 μg m-3 (2.4 μg m-3 on average) and decreases the integrated PM2.5 exposure by 4.2 (3.5-5.0) μg m-3. The renovation is estimated to avoid 162 (125-225) and 328 (254-457) premature deaths annually based on two health impact assessment methods. The ratios of monetized health benefits to cost are 1.51 (0.73-2.59) and 3.06 (1.49-5.23) based on the above two methods. The benefit-to-cost ratio is projected to remain high if the renovation is further expanded. More polluted and less wealthy households enjoy larger health benefits but also experience a higher expense increase, suggesting that a more carefully designed subsidy policy is needed to protect low-income households.

ECONOMIC ASSESSMENT OF ENVIRONMENTAL EFFECTS ON PUBLIC HEALTH: A REVIEW OF METHODS

This paper presents a review of national and international theoretical and applied research on methods of health impact assessment. We focuse on two main methodological concepts of health impact monetization, namely, calculation of illness costs and assessment of willingness to pay to minimize the risk of negative heath consequences. The theoretical grounds and principles of application for both approaches are presented. An example of calculation using the data on of the willingness to pay to reduce the risk of death from hazardous environmental influences is presented. The internal structure of the approach to the assessment of health impact based on calculation of illness's cost is also presented. Calculation of costs, research perspectives and competing approaches to estimate indirect costs are given using the human capital method and the frictional cost method. Possible areas of application of various methodologies for assessing environmental health impact are described, their advantages and disadvantages are identified from the point of view of their applicability in various settings. Conclusions on the basic principles of choosing and adjusting the methodology for determining the economic burden of the disease for solving various research problems are presented.

The challenge of assessing social cohesion in health impact assessment.

Health impact assessment (HIA) is a method by which a policy, programme or project falling outside traditional health fields, may be judged as to its potential effects on the health of a population to mitigate negative impacts and strengthen the positive ones. Proposals are analysed from the perspective of all the determinants of health. In France, HIAs are mainly applied to urban development projects where social cohesion (SCo) is a major issue. Although the HIA method is well structured as a step-by-step process, there are no guidelines for assessing SCo. This article opens with literature review to clarify the concept of SCo and to understand how the built environment influences SCo and how social environment influence health. Drawing on this work, this paper presents an analytical framework to assess SCo, integrating both the spatial and physical dimensions of urban design and the perceptions of the neighbourhood characteristics. Following a brief overview of the key findings from applying this framework to HIA of an urban development project, the paper discusses its related strengths and weaknesses. The framework could be a useful tool for HIA as it embraces knowledge from both urban planning and social sciences. It also allows for an overall analysis of all the indicators without relying on a checklist. Nevertheless, it should be tested further to improve its validity.

Using epidemiology to estimate the impact and burden of exposure to air pollutants.

This paper focuses on the use of results of epidemiological studies to quantify the effects on health, particularly on mortality, of long-term exposure to air pollutants. It introduces health impact assessment methods, used to predict the benefits that can be expected from implementation of interventions to reduce emissions of pollutants. It also explains the estimation of annual mortality burdens attributable to current levels of pollution. Burden estimates are intended to meet the need to communicate the size of the effect of air pollution on public health to policy makers and others. The implications, for the interpretation of the estimates, of the assumptions and approximations underlying the methods are discussed. The paper starts with quantification based on results obtained from studies of the association of mortality risk with long-term average concentrations of particulate air pollution. It then tackles the additional methodological considerations that need to be addressed when also considering the mortality effects of other pollutants such as nitrogen dioxide (NO2). Finally, approaches that could be used to integrate morbidity and mortality endpoints in the same assessment are touched upon. This article is part of a discussion meeting issue 'Air quality, past present and future'.

Geographical Information System for Health Impact Assessment and urban planning

Abstract The use of methods of geographic information systems and cartography is common in the processes of spatial planning and Health Impact Assessment. As part of the research team of the Technical University of Liberec (Czech Republic) and in cooperation with the Liberec City Hall and the Regional Hygiene Authority of the Liberec Region, we propose a procedure for the implementation of HIA in spatial planning. The project aims to propose and verify the methodological procedure of comprehensive assessment of health determinants in the area following the method of HIA in the territory of Liberec and the municipalities of the Liberec region. The main area of research and the applicability of results is in spatial and urban planning and public health protection, where the methodology will contribute to the identification of the main impacts on the health of the population, health inequalities and the proposed measures to eliminate or reduce negative or strengthen positive impacts. Multicriterial analysis with outputs in GIS will be used to define impacts. Project activities: the design of the concept of the data model, data analysis, evaluation of the methodology and proposal of measures supporting health. The project includes the design of the concept and logical structure of the data model of health determinants. This is the basis for multicriterial analyzes of health determinants. Its proposal will use methods of health impact assessment (HIA, especially scoping) and qualitative research methods. GIScience and geoinformatics methods will be used to solve the model structure. Last but not least, the methodology for analytical processing is elaborated: the activity will focus on the design and testing of multi-criteria analysis of health determinants. Key messages Geographic information systems enable efficient creation, analysis and communication of data model of health determinants. Spatial planning is a concrete tool for the implementation of health impact assessment objectives into practice.

Experiences and needs of licensed health risk assessors conducting health impact assessment in the Czech Republic.

The main aim of this study is to discover and analyse the utilization of health impact assessment (HIA) among HIA certificate holders, and to ascertain their opinions on the current situation in the Czech Republic and on the possible future nationwide implementation of health impact assessment. The target group of the research was identified as holders of professional competence certificates in the field of public health impact assessment. A structured questionnaire was developed. The first part mapped the recent use of HIA in the Czech Republic, the second addressed the issue of linking HIA to regional policies and to the national strategy, the third aimed to gain information about the preparedness of the Czech Republic for the full implementation of HIA, and the last part focused on quality assessment and capacity building for HIA. The results of the survey point to the inconsistencies in the perception of the whole concept of HIA in the Czech Republic by the professional public, and also to a shortage of experts in this area. There is only a narrow circle of experts, especially in the field of health care. It also lacks an informational base, which assist in the unification of processes in this area. As the results of the questionnaire showed, the problems are the lack of interest in the application of the HIA method and, subsequently, the lack of demand. The collected data showed obstacles and gaps in the implementation of the HIA methodology in the Czech Republic. At the same time it has revealed possible ways to change the current situation, based on the opinions of those who practice this methodology in the Czech Republic.

Quantitative Health Impact Assessment Methodology for Societal Initiatives: A Scoping Review

Abstract Background Promoting health rather than treating disease is gaining popularity and promotion initiatives are increasingly situated in the societal domain. In this scoping review, the literature on quantitative health impact assessment (HIA) practice and methodology is explored in order to provide an overview of methods that have been used or proposed for estimating societal initiatives’ health outcomes. Methods Systematic searches were done in PubMed and Web of Science in order to identify relevant literature. A set of selection criteria ensured that studies held useful quantitative HIA methodology and a societal approach. Reference lists of all selected studies were then examined for other studies. After literature selection, quantifiable features of interest were recorded and general observations on the composition of the current literature were made. Results The literature selection process yielded 54 included studies, most of which focus on lifestyle-related determinants. Of different health outcome measurements, deaths (averted) was most frequently used, followed by life years and quality- and disability-adjusted life years. Equity is frequently mentioned, but not often estimated. Most studies made estimates based on simulation models, notably with Monte Carlo, Markov and system dynamics models (simulation period mean 46 years; median 50 years). Inputs for the models such as relative risks, transition probabilities and price elasticities were taken from census and register data, survey data, evidence from previous (scientific) studies and outcomes from stakeholder sessions. Conclusions HIA holds a wide range of practices with some overlap. Different methods’ strengths and weaknesses partly depend on the phenomenon of interest. Some policy types have standard approaches, but there is no one universal optimal method and therefore having a grasp of multiple methods is useful. Furthermore, estimating health effect distributions could make an important addition to HIA. Key messages Quantitative HIA can be conducted using various methodological bases and most studies use some form of simulation modelling. Different simulation methods are distinct, but do show some overlap. Quantitative HIA topics often relate to individual behaviour (micro-level proximal determinants). There is room for HIA method development for determinants with indirect connections to the individual.

Source-specific impacts of PM2.5 on mortality in the Greater Metropolitan Region of Sydney, Australia

PDS 76: Source specific outdoor air pollution studies, Exhibition Hall (PDS), Ground floor, August 26, 2019, 4:30 PM - 5:30 PM Background: Quantifying the health impacts of air pollution sources is important for policy making as interventions to reduce air pollution are generally source-specific. We assessed the impact on mortality of major sources of particulate air pollution less than 2.5 micrometres in diameter (PM2.5) in Sydney, Australia. Methods: We used a Chemical Transport Model (CTM) to estimate source specific exposure to primary and secondary PM2.5 for the year July 2010 to June 2011. Health Impact Assessment methods were used to estimate the burden of attributable mortality from PM2.5 as well as the number of life-years that would be gained if emissions from major sources were reduced. Results: Wood heaters were the largest source of PM2.5 exposure, responsible for around 24% of total anthropogenic PM2.5 while on-road sources were responsible for 17% of anthropogenic PM2.5. Around 1.2% (5,900 YLL) of all mortality was attributable to long term exposure to all sources of anthropogenic PM2.5 and of this, 0.3% (1,400 YLL) was attributable to wood heater–related PM2.5, with 0.2% (990 YLL) attributable to on-road sources and 0.1% (620 YLL) attributable to power stations. Compared to ongoing emissions at 2010/11 levels a sustained reduction in emissions from wood heaters that complied with a certified emission standard of 1.5 grams of particles per kilogram of wood burned would produce an estimated 90,000 life-years among the cohort of people alive in 2010/11. Conclusions: Eight sources are responsible for more than 60% of exposure to anthropogenic PM2.5 in Sydney, Australia. While the burden of mortality attributable to each PM2.5 source is relatively small, interventions that achieve sustained reductions in emissions from these sources, particularly wood heater, could provide substantial health benefits in Sydney that are likely to outweigh costs.

The global burden of transportation tailpipe emissions on air pollution-related mortality in 2010 and 2015

Emissions from the transportation sector are a major contributor to ambient air pollution, the leading environmental health risk factor globally. This study aims to quantify the contribution of tailpipe emissions from global transportation, disaggregated by four sub-sectors, to the global disease burden associated with ambient fine particulate matter (PM2.5) and ground-level ozone in 2010 and 2015. We use the GEOS-Chem global chemical transport model to simulate transportation-attributable PM2.5 and ozone concentrations, combined with epidemiological health impact assessment methods consistent with the Global Burden of Disease 2017 study to estimate the associated burden of disease. We estimate that emissions from the transportation sector were associated with 361 000 (95% CI, 258 000–462 000) PM2.5 and ozone deaths in 2010 and 385 000 (95% CI, 274 000–493 000) in 2015. These results translate into 11.7% of total global ambient PM2.5 and ozone deaths in 2010 and 11.4% in 2015. Together, PM2.5 and ozone concentrations from transportation tailpipe emissions resulted in an estimated 7.8 million years of life lost and approximately $1 trillion (2015 US$) in health damages globally in 2015. Among transportation sub-sectors, on-road diesels contributed most to the health burden from transportation tailpipe emissions in nearly all trade blocs, for both PM2.5 and ozone, though other sub-sectors also contributed substantially (particularly on-road non-diesel vehicles for ozone mortality, and shipping and non-road mobile sources for PM2.5 mortality). These results indicate that despite recent adoption of more stringent vehicle emission regulations in many countries, the transportation sector remains a major contributor to the air pollution disease burden globally. Future work may explore the degree to which currently adopted policies, as well as expected growth in the transportation sector in India, Africa, and other rapidly developing locations, will influence future transportation-attributable public health burdens.

Quantifying health impacts and economic costs of PM2.5 exposure in Mexican cities of the National Urban System.

To estimate avoidable mortality, potential years of life lost and economic costs associated with particulate matter PM2.5 exposure for 2years (2013 and 2015) in Mexico using two scenarios of reduced concentrations (i.e., mean annual PM2.5 concentration < 12µg/m3 and mean annual PM2.5 concentration < 10µg/m3). The health impact assessment method was followed. This method consists of: identification of health effects, selection of concentration-response functions, estimation of exposure, quantification of impacts quantification and economic assessment using the willingness to pay and human capital approaches. For 2013, we included data from 62 monitoring sites in ten cities, (113 municipalities) where 36,486,201 live. In 2015, we included 71 monitoring sites from fifteen cities (121 municipalities) and 40,479,629 inhabitants. It was observed that reduction in the annual PM2.5 average to 10μg/would have prevented 14,666 deaths and 150,771 potential years of life lost in 2015, with estimated costs of 64,164 and 5434 million dollars, respectively. Reducing PM2.5 concentration in the Mexican cities studied would reduce mortality by all causes by 8.1%, representing important public health benefits.

The health impacts of extractive industry transnational corporations: a study of Rio Tinto in Australia and Southern Africa

BackgroundOperations of transnational corporations (TNCs) affect population health through production methods, shaping social determinants of health, or by influencing regulation of their activities. Research on community exposures to TNC practices and policies has been limited. Our research on extractive industries examined Rio Tinto in Australia and Southern Africa to test methods for assessing the health impacts of corporates in high and middle income jurisdictions with different regulatory frameworks.MethodsWe adapted existing Health Impact Assessment methods. Data identifying potential impacts were sourced through media analysis, document analysis, company literature and semi-structured interviews. The data were mapped against a corporate health impact assessment framework (CHIA) which included Rio Tinto’s political and business practices; productions; and workforce, social, environmental and economic conditions.ResultsBoth positive and detrimental aspects of Rio Tinto’s operations were identified. Requirements imposed by Rio Tinto on its global supply chain are likely to have positive health impacts for workers. However, political lobbying and membership of representative organisations can influence government policy in ways that are unfavourable to health and equity. Positive impacts include provision of direct employment under decent working conditions, but countered by an increase in precariousness of employment. Commitments to upholding sustainable development principles are undermined by limited site remediation and other environmental impacts. Positive contributions are made to national and local economies but then undermined by business strategies that include tax minimisation.ConclusionOur study confirmed that it is possible to undertake a CHIA on an extractive industry TNC. The different methods provided sufficient information to understand the need to strengthen regulations that are conducive to health; the opportunity for Rio Tinto to extend corporate responsibility initiatives and support their social licence to operate; and for civil society actors to inform their advocacy towards improving health and equity outcomes from TNC operations.

Modelling the air quality for assessing the health benefits of urban regeneration: a case of Tallinn city Centre, Estonia

Concentrations of nitrogen dioxide and particulate matter were modelled to assess the health benefits of an urban regeneration scenario for the central part of Tallinn, where the traffic on two of the main streets will be reduced to create a more friendly space for active commuters. To model the air quality the stationary Gaussian plume model AEROPOL was used with a 25 m grid resolution. The model was validated against a stationary air quality monitoring station in the domain. The health benefits of the scenarios were calculated based on the changes in air pollution exposures for residents and daily visitors, using methods of health impact assessment. This research predicts that each year the reduction of exhaust (indicated by NO2) and road dust (indicated by PM10) exposure in the city centre would prevent up to 0.29 premature deaths (−27%) among the general population, 0.57 deaths (−3.6%) among daily visitors, 0.18 deaths (−21.2%) among pedestrians, and 0.03 deaths (−24.7%) among people public transport users.