Housing and health in Europe: preliminary results of a pan-European study.

OBJECTIVES: The World Health Organization's Regional Office for Europe has undertaken a large study to evaluate housing and health in 7 European cities. METHODS: Survey tools were used to obtain information about housing and living conditions, health perception, and health status from a representative sample of the population in each city. RESULTS: In Forli, Italy, the first city studied, preliminary findings indicate some important potential links between housing and health. CONCLUSIONS: These findings, when combined with those from the remaining European cities, will likely generate concrete recommendations for the allocation of resources to programs that can improve housing and health.

Environmental health services in Europe 3: professional profiles

Since the adoption of the European Charter on Environment and Health in Frankfurt-am-Main in 1989, the countries of the WHO European Region have been placing greater emphasis on the role of their environmental health services in the protection of public health and the environment. The introduction of the Environmental Health Action Plan for Europe, in Helsinki in 1994, further enhanced the need for strong national and local environmental health services. The aim of this book is to provide guidance on key issues relating specifically to staffing that should be considered in the reform of environmental health services in the WHO European Region. The development of staffing policy for these services must be considered within the wider context of a country’s political, social and economic situation, as well as national environmental health needs. This book is intended to assist Member States in adapting the general principles of environmental health to addressing these political, social and economic needs.

Environmental health services in Europe 2: policy options

This is the second in a series of publications relating to environmental health services in the WHO European Region. It serves to complement closely the first book, which provides factual descriptions and partial analysis of the existing provision of environmental health services in the Region, and is based on the same format and principles. The information for both of these publications was collected through a series of 27 country reviews carried out by international consultants between March 1993 and March 1994 (Annexes 1 and 2).

Drinking-water disinfection / Principal adviser : Antoine Montiel

Each year, 3 million people throughouth the world die as a direct result of drinking unsafe water. This colossal figure is particularly worrying when seen in conjunction with the 120 million people in WHO's European region who do not currently enjoy an uninterrupted supply of microbiologically safe drinking-water. Local authorities have the prime responsibility for eliminating this risk and dealing with instances of contamination which, even when minimal, may result in catastrophic epidemics. It is up to them to do everything in their power to provide the population with a continuous supply of safe water. High-quality water can be guaranteed if certain simple rules are followed. One of these is disinfection of the resource by chlorine. This must continue to be a priority in every case, taking precedence over pre-treatment of water using highly specialized and often expensive techniques

Green cities, blue cities / technical adviser : A. Vilalta

Public spaces have a range of roles to play in a town or city. They are places where many things can happen - exchanges, meetings, even conflicts. They are an ideal setting for recreation and sport, as well as for cultural and social events, and for simple relaxation. Thy are open spaces, often embellished with plants and water, helping to maintain a balanced urban environment, with all the benefits that can bring for the well-being of the inhabitants. Public spaces should be evenly distributed across every neighourhood of the city. If mixed use in public spaces is achieved, it can be an important tool in combating social segregation. A long-term approach to planning, an equitable geographical spread, proper development and regular maintenance will allow authorities to spread their financial burden over a longer period. Various aspects of planning and management are discussed here. Action plans are suggested which will allow open spaces to become genuine public spaces once more, making the city a little more green, and a little more blue

Environmental health services in Europe 5: guidelines for evaluation of environmental health services

This publication aims to fill a gap identified by Member States: to provide a practical introduction for environmental health professionals and managers to evaluate their services. The first task is to review the most critical components and aim of an evaluation, to see how these relate to the overall framework of environmental health service management. Evaluation of health services is an established field. Several books and reports have been published on the subject, both inside and outside of WHO. This publication does not intend to rewrite these documents or restate their arguments. Its goal is to introduce environmental health professionals to evaluation principles, tools and examples from which they can pick and choose elements to suit their specific needs. The book is designed to guide practitioners towards questions that must be answered to evaluate and improve services. With this in mind, references and suggestions for further reading appear at the end of each chapter, and key recommendations are presented in boxes throughout the text.

Water and health / scientific adviser : Francois Mansotte

On the eve of the twenty-first century, and despite the fact that many countries in WHO's European Region are among the most developed in the world, water distribution still causes problems : more than 10 millions Europeans do not have a piped supply of water (whether drinkable or not) in their home; cholera, thought to be a disease of the past, is reappearing and causing major epidemics; ten of millions of people are supplied with water which does not meet either WHO's recommendations or national and international standards. In many countries, local authorities ensure the distribution of drinking-water. In this context, they bear a heavy responsibility for public health. This document is designed to: point out the links between water and health; make easier to set priorities; demonstrate how important it is to ensure a continuous supply of good quality water to the whole population, including the poorest groups

Waste collection / principal adviser : Juha Kaila

An efficient and comprehensive waste collection system is essential to protect the health of the population. The entire waste management plan for a city or region depends on the standard of the collection service. A modern well-managed waste collection and transport system not only protects the general public from disease but is also safe and hygienic for everyone working in, or in connection with, the system. This includes waste generators; collection, transport, and treatment personnel; children and scavengers; and indirectly all inhabitants of the city. Waste collection costs can account for as much as half, or even more of the total waste management budget. Therefore good management is beneficial in economic terms as well as in environmental and health terms

Solid waste and health / principal adviser, Maggie Thurgood

Most human activities create waste. The majority of those wastes are not, in themselves, a potential threat to health but their correct management can help to minimise or avoid associated risks. There is no single "correct" way to collect, handle and dispose of wastes, but rather a range of options. These must be tailored to local circumstances, such as the amount and type of waste, regional geology and climate, and economic conditions. Local authorities must encourage the minimisation of both the quantity and toxicity of waste as an important first stage. Sound management of the remaining wastes will help to protect the local and global environment. This booklet provides an overview of solid waste management

Protection of water resources / Scientific adviser : Jean-Luc Potelon

In general, local authorities are responsible for the quality of water distributed to the population. They must ensure that this water is always fit for consumption. It is easier to supply the public with water of a satisfactory quality if you are sure that the resources used are, at the outset, free from pollution. One of the requirements for maintaining the natural quality of water sources is to engage in a pro-active policy of protection of water sources. The difficulties encountered when establishing protection zones are very similar from one country to another; they may be technical administrative or financial. The aim of this document is to provide practical guidance which will make it easier to establish such protection zones

Lead and health / principal adviser : Ian Calder

Lead is toxic to humans. In children continual exposure at low levels has been shown to cause mental retardation and behavioural problems. Due to use of lead in pipes for water distribution, widespread use of lead-based paint, extensive use of lead additives in gasoline and other industrial uses of lead, lead has become a general environmental contaminant. There is no safe level of lead in the body. Urgent action by local government will help prevent problems to human health and the environment. This will involve undertaking a survey of blood levels of the young children in the area and then carrying out the appropriate intervention required. When blood lead levels are above 15ug/dl action should be taken to reduce exposure