The European approach to health and the environment

The link between health and the environment is reflected in the burden of current diseases linked to environmental factors. Indoor and outdoor air pollution is considered to be the most important factor impacting health, with 20 million Europeans suffering from respiratory problems every day.

The overall cost to society of asthma, an growing problem all over Europe, has been estimated at 3 billion euros per year. Many other health issues, such as cancer, the neurodevelopmental effects of exposure to heavy metals, exposure to electromagnetic fields or different types of chemicals, are concerns for Europeans, and children in particular. A 2004 study published in The Lancet estimates that 26.5 per cent of deaths in children under the age of five in Europe are due to environmental causes. There are pronounced differences between the regions of Europe, with a much higher burden in eastern European countries.

While the development of European environment legislation was given explicit legal basis in the Single European Act in 1987, the EU environmental agenda really developed in the 1990s, covering topics such as pollution control and waste management, as well as nature conservation and the use of environmental impact assessments. In 1997, a new article was introduced in the Treaty of Amsterdam that called for environmental protection requirements to be integrated into the definition and implementation of other policies. This new Article 6 links such integration to the promotion of sustainable development, therefore recognizing the relationship between environmental protection, economic development, and social cohesion. In 2003, the European Commission adopted an EU Strategy on Environment and Health, with the overall aim of reducing diseases caused by environmental factors in Europe. This was followed up by the European Environment and Health Action Plan 2004-2010, which proposes an integrated information system on environment and health as well as a coordinated approach to human biomonitoring between member states to render the assessment of the environmental impact on human health more efficient. The EU now has a considerable body of environmental legislation, expressed in a series of environmental action programmes, which are being brought together in an integrated Environmental Health Action Plan.

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Further Definitions

Environment and Health:

The environment can be defined as the complex of physical and social conditions that affect the growth, development and survival of organisms-including mankind. Sustainability is meeting the needs of the present without compromising the ability of future generations to meet their needs.

Human health is connected in many ways to the environment. Environmental health problems stem from the degradation or lack of mankind’s most basic needs, such as clean water and sanitation, safe housing, clean air and nutrition. Today global problems of climate change, air pollution, hazardous waste, or unsafe use of chemicals threaten those very basic needs of human beings. Sustainability demands that these issues are addressed before they create problems of a nature and magnitude that may mean future generations are unable to address them. For example, climate change is likely to be irreversible by future generations and its health consequences may be unaffordable. This is a problem of global governance because its remedy requires collective action beyond the nation-state. The quality of and changes to the environment are paramount determinants of human health today and for the generations yet to come. Climate change and environmental policy are the natural allies of global health policy. It is essential to draw together the European agendas for health, climate change, environmental protection and sustainability.

European Environmental Action Programmes and Legislation:

The EU now has a considerable body of environmental legislation, expressed in a series of Environmental Action programmes. The latest one, the Sixth Environment Action programme of the European Community 2002-2012 (6EAP) was adopted in 2001. This programme recognises the importance of sustainable development, and focuses on areas most in need of action and where European initiatives will have a real impact. It identifies four areas to be tackled urgently: climate change, the protection of nature and wildlife, environment and health issues, and the preservation of natural resources and waste management. The strategic approach of the new programme seeks to be innovative and widely inclusive of the different actors of society, including citizens themselves through their consumption patterns, and businesses through more eco-efficient processes and the development of “greener goods”. The programme also seeks to include environmental concerns in all aspects of European external relations with international organisations and through the support of international environmental conventions. In early 2007 the Commission published the 6th EAP Mid-term review. While the review sites the environmental programme as one of the EU’s greatest successes, it also reproaches the Union for not being ambitious enough and failing to set Europe on the path towards true sustainability by integrating environmental concerns into other policy areas and improving the enforcement of EU legislation. As environmental pressures increase, the review places health alongside climate change, resource management, and biodiversity as Europe’s most pressing environmental issues.

In addition to the 6th EAP four pieces of legislation form the foundation of the EU’s approach to limiting environmental threats to human health: the Water Framework Directive (adopted in 2000), the 2006 Regulation on the Registration, Evaluation and Authorisation of Chemicals (REACH), the directive on ambient air quality and cleaner air for Europe (adopted in 2008), a framework directive on pesticides (to be adopted in 2009). In practice, concern for human health has been a major driving force behind the political priority given to environmental issues as it is an area where the tangible effects of an improved environmental policy can be seen.

The Environmental Health Action Plan:

Although the quality of water and air has seen improvements since the inception of environmental programmes and the control of chemical through REACH has progressed, as mentioned above there is still much to be done to reduce the environmental impact on health in Europe. The Environment and Health Action Plan was designed to provide scientific information to limit the environmental impact on health and to promote better cooperation between the environmental, health, and research sectors while improving communication on environmental issues.

While additional knowledge of the multi-causal environmental factors of ill health is necessary, this can only constitute a first step in an environmental approach and strategy for Europe. Given the complexity of environmental issues, health policies that address environmental determinants such as transport, urbanisation, use of pesticides and energy policies are essential. For that, an integrated approach is required, with enhanced cooperation between the health and other relevant sectors. Mechanisms to coordinate this cooperation should be put in place, possibly involving the European Centre for Disease Prevention and Control.

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