Review

A framework for integrated environmental health impact assessment of systemic risks

David J Briggs

Environmental Health 2008, 7:61doi:10.1186/1476-069X-7-61

Published:	27 November 2008

Abstract (provisional)

Traditional methods of risk assessment have provided good service in support of policy, mainly in relation to standard setting and regulation of hazardous chemicals or practices. In recent years, however, it has become apparent that many of the risks facing society are systemic in nature - complex risks, set within wider social, economic and environmental contexts. Reflecting, this, policy-making too has become more wide-ranging in scope, more collaborative and more precautionary in approach. In order to inform such policies, more integrated methods of assessment are needed. Based on work undertaken in two large EU-funded projects (INTARESE and HEIMTSA), this paper reviews the range of approaches to assessment now in use, proposes a framework for integrated environmental health impact assessment (both as a basis for bringing together and choosing between different methods of assessment, and extending these to more complex problems), outlines some of the advantages of adopting a more integrated approach to assessment, and discusses some of the challenges that this implies. Integrated environmental health impact assessment is defined as a means of assessing health-related problems deriving from the environment, and health-related impacts of policies and other interventions that affect the environment, in ways that take account of the complexities, interdependencies and uncertainties of the real world. As such, it both encompasses and extends many of the existing approaches to assessment, such as risk assessment, health impact assessment and comparative risk assessment. It also requires the use of both qualitative methods, to frame issues, select an appropriate approach to assessment, and develop relevant scenarios, and quantitative techniques to model the causal pathways between source and health impact, under these scenarios. This approach to assessment inevitably faces many difficulties. Chief amongst these are the difficulties in ensuring effective stakeholder participation, in dealing with the multicausal and non-linear nature of many of the relationships between environment and health, and in taking account of adaptive and behavioural changes that characterise the systems concerned.