Health Risk Assessment of Indoor Air Quality, Socioeconomic and House Characteristics on Respiratory Health among Women and Children of Tirupur, South India.

Background: Indoor air pollution is still considered as one of the leading causes of morbidity and mortality worldwide and especially in developing countries, including India. This study aims to assess social, housing, and indoor environmental factors associated with respiratory health among mothers and children. Methods: The study was conducted in the city of Tirupur, South India. We quantitatively assessed the indoor exposure to fine particulate matter (PM2.5) and carbon monoxide in relation to respiratory health among women and children. Information on health status, household characteristics and socioeconomic factors was collected using a modified standardised questionnaire. Results: This study demonstrates the significant health impact of housing and socioeconomic characteristics on the burden of respiratory illness among women and children in urban South India. Increased respiratory symptoms were recorded among women and children from low income households, and those who allowed smoking inside. The mean PM2.5 concentration measured in this study was 3.8 mg/m³ which exceeded the World Health Organization (WHO) 24 h guideline value of 0.025 mg/m³. Conclusions: This study is the first to our knowledge carried out in urban South India and the findings can be used for future intervention studies.

Health Impacts of Climate Change in Pacific Island Countries: A Regional Assessment of Vulnerabilities and Adaptation Priorities.

BACKGROUND: Between 2010 and 2012, the World Health Organization Division of Pacific Technical Support led a regional climate change and health vulnerability assessment and adaptation planning project, in collaboration with health sector partners, in 13 Pacific island countries-Cook Islands, Federated States of Micronesia, Fiji, Kiribati, Marshall Islands, Nauru, Niue, Palau, Samoa, Solomon Islands, Tonga, Tuvalu, and Vanuatu. OBJECTIVE: We assessed the vulnerabilities of Pacific island countries to the health impacts of climate change and planned adaptation strategies to minimize such threats to health. METHODS: This assessment involved a combination of quantitative and qualitative techniques. The former included descriptive epidemiology, time series analyses, Poisson regression, and spatial modeling of climate and climate-sensitive disease data, in the few instances where this was possible; the latter included wide stakeholder consultations, iterative consensus building, and expert opinion. Vulnerabilities were ranked using a "likelihood versus impact" matrix, and adaptation strategies were prioritized and planned accordingly. RESULTS: The highest-priority climate-sensitive health risks in Pacific island countries included trauma from extreme weather events, heat-related illnesses, compromised safety and security of water and food, vector-borne diseases, zoonoses, respiratory illnesses, psychosocial ill-health, non-communicable diseases, population pressures, and health system deficiencies. Adaptation strategies relating to these climate change and health risks could be clustered according to categories common to many countries in the Pacific region. CONCLUSION: Pacific island countries are among the most vulnerable in the world to the health impacts of climate change. This vulnerability is a function of their unique geographic, demographic, and socioeconomic characteristics combined with their exposure to changing weather patterns associated with climate change, the health risks entailed, and the limited capacity of the countries to manage and adapt in the face of such risks. Citation: McIver L, Kim R, Woodward A, Hales S, Spickett J, Katscherian D, Hashizume M, Honda Y, Kim H, Iddings S, Naicker J, Bambrick H, McMichael AJ, Ebi KL. 2016. Health impacts of climate change in Pacific island countries: a regional assessment of vulnerabilities and adaptation priorities. Environ Health Perspect 124:1707-1714; http://dx.doi.org/10.1289/ehp.1509756.

Health impact assessment: improving its effectiveness in the enhancement of health and well-being.

Most countries in the world have Environmental Impact Assessment (EIA) processes and procedures to evaluate the potential impact of development projects on the environment. This process, which attempts to predict the potential adverse effects of the proposed development project on the environment, is normally legislated and is part of the approval process for the project. Although these processes have been effective in reducing the adverse impacts on the environment they have been limited in their ability to provide protection for the health and well-being of people affected by the development. [...].

A health impact assessment framework for assessing vulnerability and adaptation planning for climate change.

This paper presents a detailed description of an approach designed to investigate the application of the Health Impact Assessment (HIA) framework to assess the potential health impacts of climate change. A HIA framework has been combined with key climate change terminology and concepts. The fundamental premise of this framework is an understanding of the interactions between people, the environment and climate. The diversity and complexity of these interactions can hinder much needed action on the critical health issue of climate change. The objectives of the framework are to improve the methodology for understanding and assessing the risks associated with potential health impacts of climate change, and to provide decision-makers with information that can facilitate the development of effective adaptation plans. While the process presented here provides guidance with respect to this task it is not intended to be prescriptive. As such, aspects of the process can be amended to suit the scope and available resources of each project. A series of working tables has been developed to assist in the collation of evidence throughout the process. The framework has been tested in a number of locations including Western Australia, Solomon Islands, Vanuatu and Nauru.

Health impacts of climate change in the Solomon Islands: an assessment and adaptation action plan.

The Pacific island countries are particularly vulnerable to the environmental changes wrought by global climate change such as sea level rise, more frequent and intense extreme weather events and increasing temperatures. The potential biophysical changes likely to affect these countries have been identified and it is important that consideration be given to the implications of these changes on the health of their citizens. The potential health impacts of climatic changes on the population of the Solomon Islands were assessed through the use of a Health Impact Assessment framework. The process used a collaborative and consultative approach with local experts to identify the impacts to health that could arise from local environmental changes, considered the risks associated with these and proposed appropriate potential adaptive responses. Participants included knowledgeable representatives from the biophysical, socio-economic, infrastructure, environmental diseases and food sectors. The risk assessments considered both the likelihood and consequences of the health impacts occurring using a qualitative process. To mitigate the adverse effects of the health impacts, an extensive range of potential adaptation strategies were developed. The overall process provided an approach that could be used for further assessments as well as an extensive range of responses which could be used by sectors and to assist future decision making associated with the Solomon Islands' responses to climate change.

Health impacts of climate change in Vanuatu: an assessment and adaptation action plan.

Climate change is one of the greatest global challenges and Pacific island countries are particularly vulnerable due to, among other factors, their geography, demography and level of economic development. A Health Impact Assessment (HIA) framework was used as a basis for the consideration of the potential health impacts of changes in the climate on the population of Vanuatu, to assess the risks and propose a range of potential adaptive responses appropriate for Vanuatu. The HIA process involved the participation of a broad range of stakeholders including expert sector representatives in the areas of bio-physical, socio-economic, infrastructure, environmental diseases and food, who provided informed comment and input into the understanding of the potential health impacts and development of adaptation strategies. The risk associated with each of these impacts was assessed with the application of a qualitative process that considered both the consequences and the likelihood of each of the potential health impacts occurring. Potential adaptation strategies and actions were developed which could be used to mitigate the identified health impacts and provide responses which could be used by the various sectors in Vanuatu to contribute to future decision making processes associated with the health impacts of climate change.

Preparing health services for climate change in Australia.

Although the implications of climate change for public health continue to be elucidated, we still require much work to guide the development of a comprehensive strategy to underpin the adaptation of the health system. Adaptation will be an evolving process as impacts emerge. The authors aim is to focus on the responses of the Australian health system to health risks from climate change, and in particular how best to prepare health services for predicted health risks from heat waves, bushfires, infectious diseases, diminished air quality, and the mental health impacts of climate change. In addition, the authors aim to provide some general principles for health system adaptation to climate change that may be applicable beyond the Australian setting. They present some guiding principles for preparing health systems and also overview some specific preparatory activities in relation to personnel, infrastructure, and coordination. Increases in extreme weather-related events superimposed on health effects arising from a gradually changing climate will place additional burdens on the health system and challenge existing capacity. Key characteristics of a climate change-prepared health system are that it should be flexible, strategically allocated, and robust. Long-term planning will also require close collaboration with the nonhealth sectors as part of a nationwide adaptive response.

The potential role of health impact assessment in tackling the complexity of climate change adaptation for health.

Managing an issue of the magnitude, scope and complexity of climate change is a daunting prospect, yet one which nations around the world must face. Climate change is an issue without boundaries--impacts will cut across administrative and geographical borders and be felt by every sector of society. Responses to climate change will need to employ system approaches that take into account the relationships that cross organisational and sectoral boundaries. Solutions designed in isolation from these interdependencies will be unlikely to succeed, squandering opportunities for long-term effective adaptation. Health Impact Assessment (HIA) provides a structural approach to identify, evaluate and manage health impacts of climate change that is inclusive of a wide range of stakeholders. Climate change will affect decision-making across every government level and sector and the health implications of these decisions can also be addressed with HIA. Given the nature of the issue, HIA of climate change will identify a large number of variables that influence the type and extent of health impacts and the management of these impacts. In order to implement the most effective adaptation measures, it is critica that an understanding of the interactions between these variables is developed. The outcome of HIA of climate change can therefore be strengthened by the introduction of system dynamics tools, such as causal loop diagrams, that are designed to examine interactions between variables and the resulting behaviour of complex systems.