Waste is part of the agenda of the European Environment and Health Process and included among the topics of the Sixth Ministerial Conference on Environment and Health. Disposal and management of ...hazardous waste are worldwide challenges. We performed a systematic review to evaluate the evidence of the health impact of hazardous waste exposure, applying transparent and a priori defined methods. The following five steps, based on pre-defined systematic criteria, were applied. 1. Specify the research question, in terms of "Population-Exposure-Comparators-Outcomes" (PECO).
people living near hazardous waste sites; Exposure: exposure to hazardous waste; Comparators: all comparators; Outcomes: all diseases/health disorders. 2. Carry out the literature search, in Medline and EMBASE. 3. Select studies for inclusion: original epidemiological studies, published between 1999 and 2015, on populations residentially exposed to hazardous waste. 4. Assess the quality of selected studies, taking into account study design, exposure and outcome assessment, confounding control. 5. Rate the confidence in the body of evidence for each outcome taking into account the reliability of each study, the strength of the association and concordance of results.Fifty-seven papers of epidemiological investigations on the health status of populations living near hazardous waste sites were selected for the evidence evaluation. The association between 95 health outcomes (diseases and disorders) and residential exposure to hazardous waste sites was evaluated. Health effects of residential hazardous waste exposure, previously partially unrecognized, were highlighted. Sufficient evidence was found of association between exposure to oil industry waste that releases high concentrations of hydrogen sulphide and acute symptoms. The evidence of causal relationship with hazardous waste was defined as limited for: liver, bladder, breast and testis cancers, non-Hodgkin lymphoma, asthma, congenital anomalies overall and anomalies of the neural tube, urogenital, connective and musculoskeletal systems, low birth weight and pre-term birth; evidence was defined as inadequate for the other health outcomes. The results, although not conclusive, provide indications that more effective public health policies on hazardous waste management are urgently needed. International, national and local authorities should oppose and eliminate poor, outdated and illegal practices of waste disposal, including illegal transboundary trade, and increase support regulation and its enforcement.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The detection of SARS-CoV-2 in water environments has predominantly focused on wastewater, neglecting its presence in oceanic waters. This study aimed to fill this knowledge gap by investigating the ...occurrence of SARS-CoV-2 in remote sea and oceanic waters, at large distances from the coastline. Forty-three 500-liter samples were collected between May 2022 and January 2023 from the Atlantic Ocean, the Mediterranean Sea, the Arctic region, the Persian Gulf and the Red Sea. Using molecular detection methods including real-time RT-qPCR and nested PCR followed by sequencing, we successfully detected SARS-CoV-2 RNA in 7 of the 43 marine water samples (16.3 %), and specifically in samples taken from the Atlantic Ocean and the Mediterranean Sea. The estimated concentrations of SARS-CoV-2 genome copies in the positive samples ranged from 6 to 470 per 100 l. The presence of mutations characteristic of the Omicron variant was identified in these samples by amplicon sequencing. These findings provide evidence of the unforeseen presence of SARS-CoV-2 in marine waters even at distances of miles from the coastline and in open ocean waters. It is important to consider that these findings only display the occurrence of SARS-CoV-2 RNA, and further investigations are required to assess if infectious virus can be present in the marine environment.
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•An investigation into the presence of SARS-CoV-2 RNA in distant sea and oceanic waters is presented.•The study reveals the existence of SARS-CoV-2 RNA in 16.3 % of samples, including remote oceanic waters.•The Omicron variant was detected in samples from the Atlantic Ocean and the Mediterranean Sea.•The findings emphasize the need for studies on virus circulation dynamics in marine environments.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Objectives: Waste management in the Campania region has been characterised, since the 1980s, by widespread uncontrolled and illegal practices of waste dumping, generating concerns over the health ...implications. The objective of this study was to evaluate possible adverse health effects of such environmental pressure. Methods: The health effects of waste-related environmental exposures in Campania were assessed in a correlation study on nine causes of death (for the years 1994–2001) and 12 types of congenital anomaly (CA) (1996–2002) in 196 municipalities of the provinces of Naples and Caserta. Poisson regression was used to analyse the association between health outcomes and environmental contamination due to waste, as measured through a composite index, adjusting for deprivation. Results: Statistically significant excess relative risks (ERR, %) in high-index compared with low-index (unexposed) municipalities were found for all-cause mortality (9.2 (95% CI 6.5 to 11.9) in men and 12.4 (9.5 to 15.4) in women and liver cancer (19.3 (1.4 to 40.3) in men and 29.1 (7.6 to 54.8) in women). Increased risks were also found for all cancer mortality (both sexes), stomach and lung cancer (in men). Statistically significant ERRs were found for CAs of the internal urogenital system (82.7 (25.6 to 155.7)) and of the central nervous system (83.5 (24.7 to 169.9)). Conclusion: Although the causal nature of the association is uncertain, findings support the hypothesis that waste-related environmental exposures in Campania produce increased risks of mortality and, to a lesser extent, CAs.
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BFBNIB, CMK, NMLJ, NUK, PNG, SAZU, UL, UM, UPUK
Abstract
The adoption of the 2030 Agenda for Sustainable Development in 2015 opened new opportunities to work towards healthy environments through ‘whole of government’ and ‘whole of society’ ...approaches. It created a strong policy platform that acknowledges health as a result and an enabler of sustainable policies across all sectors of government. Five years into the process, an initial analysis of emerging trends indicates that, despite some encouraging developments in policy as well as overall progress in economy and technology, there remains a gap between rhetoric, ambition and reality. In particular, the monitoring system for environment and health-related sustainable development goals (SDGs) and targets requires further development; inequalities in environment and health persist and in some areas have increased; equity is not yet a central element of implementation and reporting on the achievement of the SDGs; and, most worrying of all, trends in key environmental indicators that are vital to the survival of the human species, such as those related to climate change and biodiversity, are still on an overall negative path. In summary, governments must significantly and rapidly increase action to secure the habitability and safety of planet Earth. The public health community assumes an unprecedented role in placing and maintaining health and equity at the heart of the political agenda. This demands new governance models conferring on the health sector a clear mandate and legitimacy to operate across sectors. It also requires enhancing capacities among health professionals to embrace this new level of complexity, understand the multiple links between sectoral policies and health, and successfully engage with other government sectors and stakeholders.
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NUK, OILJ, UL, UM, UPUK, VSZLJ
Abstract
WHO, along with other health agencies, has been long promoting intersectoral action between health and all sectors of society, so as to address major, “upstream” determinants of health. ...Sectors as environment, transport, energy, agriculture etc, influence countless, powerful such determinants, mostly out of reach for the health sector; health-friendly (or at least health-minded) decisions on those determinants can result in a strong leverage for health advocates to achieve primary prevention.
This undertaking requires: the establishment of a common language to be used with other sectors; the recognition of the complex web of causation between health determinants and health outcomes; commitment to working with a broad model of health combined with a preparedness to prioritise where necessary; a sound comprehension of the reality of decision making in different political environments; realistic expectations on what can and cannot be achieved through cross-sectoral dialogue; willingness to listen to stakeholders; constant attention towards health equity.
Health Impact Assessment (HIA) is an established approach towards these goals. HIA describes a broad range of methods and tools, building on different disciplines and expertise. HIA aims at estimating and predicting consequences and impacts of proposed policies and plans, with the ultimate goal of influencing decisions, making them more health friendly, equitable, legitimate and sustainable.
The practice of HIA has been evolving in the last 20 years. Many years of application have been instrumental in identifying strengths and weaknesses, opportunities and threats in different settings. HIA has delivered handsomely in some countries or regions, while it struggles to become established in others. A continued critical evaluation of successes and failures remain important to make further progress in this domain. In this presentation, WHO will present recent progress and open questions on the practice of HIA in Europe.
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NUK, OILJ, UL, UM, UPUK, VSZLJ
Abstract
Background and objectives
Climate change is one of the biggest health threats facing humanity. It can be considered as a syndemic, interacting with social determinants of health and ...pre-existing chronic conditions, exacerbating their effects on human health. Healthcare sector should play a key role in mitigating the climate crisis considering its mission of protecting and promoting health. Despite this, its climate footprint is equivalent to 4.4% of global net carbon emissions, making it a major contributor to the climate crisis. In this context, healthcare sector needs to lead the way to the net zero carbon emissions. The aim of this paper is to identify key actions for reducing the carbon footprint of the healthcare system and develop a framework for emission reduction actions.
Methods
The study consists of two phases: i) conduction of a rapid review of the literature, through which studies on healthcare carbon footprint published worldwide until April 2022 will be collected, screened by title and abstract and analysed; ii) identification of hubs as main causes for CO2 emissions and development of a framework for adopting practical solutions aimed at carbon reduction actions.
Results
From the rapid review of the literature 747 records have been retrieved. Of this, 21 have been selected after screening by title and abstract.
Conclusions
The climate crisis is increasingly compromising human health, so urgent actions are needed. As the healthcare system contribution to the climate crisis is expected to increase in the next years, efforts must be undertaken to mitigate this and become sustainable and climate-smart. Healthcare system and healthcare professionals should be the ones leading the front by reducing its own pressures to climate. The entire scientific community is called to recognise this issue as a high priority.
Key messages
• Climate crisis as a high priority for healthcare professionals.
• Development of a framework for carbon reduction actions.
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NUK, OILJ, UL, UM, UPUK, VSZLJ
Background: The scientific evidence on the health effects of waste-related exposure is not conclusive. Differential exposure to waste by socio-economic status (SES) is often documented, but the ...interplay between environmental and social factors, crucial for policy making, is not well known. This review aims at investigating the role of health inequalities and inequities in waste management. Methods: Grey and peer-reviewed literature, published after 1983, was reviewed from Europe and the USA. Results: Available data provide consistent indications that waste facilities are often disproportionally more located in areas with more deprived residents, or from ethnical minorities. This applies to waste incinerators, landfills, hazardous waste sites, legal and illegal. In studies considering health effects (mainly from Europe), risks are estimated with standardization for SES. Such standardization almost always decreases risk estimates for several cancers and reproductive outcomes. However, effect modification is not investigated in these studies. Conclusions: The patterns of association between waste-related environmental pressures and SES suggest that some of the observed inequalities in exposure and health represent a case of environmental injustice as they are the result of social processes and may be prevented, at least partly. Disentangling the possible health effects remains difficult, due to limitations in the methodology. It seems important to investigate if disadvantaged people are more vulnerable, i.e. risks differ in different social groups living in the same area. Notwithstanding these open questions, public health officers and decision makers should identify waste management policies to minimize their potential health impacts and their unequal distribution.
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NUK, OILJ, UL, UM, UPUK, VSZLJ
The aim of the present study is to investigate cancer mortality and residence in the neighbourhood of the petrochemical plant located in Brindisi, South-eastern Italy. Cases were all subjects ...resident in Brindisi and in three neighbouring municipalities who died in the study area in 1996-1997 from lung cancer, pleural neoplasm, bladder cancer and lymphohematopoietic malignancies. Controls were subjects resident in the same area and deceased in 1996-1997 for any cause except those listed for the cases. Next of kin's of all study subjects were visited by an interviewer who collected anamnestic information. The main residence of each subject, defined as the longest held residence with exclusion of the last 10 years, was reported on a digitalized map of the study area (MapInfo). The study included 144 cases and 176 controls; response rate was 98%. Residence within 2 km from the centre of the petrochemical plant was associated with a 3 fold increase of the Odds ratios (OR) for lung cancer, which did not reach statistical significance. Living close to the petrochemical plant was associated with moderate increase of OR for bladder cancer and lymphohematopoietic neoplasms which did not reach statistical significance. In conclusion the present study has shown moderate increases in risk for lung, bladder and lymphohematopoietic neoplasms in the population resident within 2 km from the centre of the petrochemical plant in Brindisi. These figures were confirmed after adjusting for smoking habit, occupation and school level. Random misclassification may have somehow resulted in risk underestimation.
Many epidemiological studies have demonstrated the importance of air pollution as a risk factor and characterised dose-response relationships between health endpoints and pollutants. The association ...between particulate matter (PM) and health is generally regarded as causal, and a nonthreshold linear relationship with, for example, mortality and hospital admission has been observed in several settings. The ubiquitous PM air pollution is likely to have a large overall impact on human health, even if risks are relatively small. There have recently been a large number of papers reporting quantitative estimations of the health impact of PM on health, as measured by the proportion of excess events that are attributable to PM exposures in the general population, mainly in industrialised countries. For example, in the eight largest Italian cities it has been estimated that concentrations beyond 30 microg x m(-3) are responsible for about 3,500 extra deaths per year. A similar study has been carried out for France, Austria and Switzerland. These evaluations fill a knowledge gap between the laboratory and clinical studies on the pathophysiological mechanisms, the epidemiological research on the nature and strength of the association at the population level, and the risk management needs for developing appropriate preventive policies. Some limitations in the methodology deserve further research, however health impact assessment type studies are informative and effective tools of communication with the general public and policy makers.
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