Research

Dealing with uncertainties in environmental burden of disease assessment

Anne B Knol¹ , Arthur C Petersen² , Jeroen P van der Sluijs^3,4,5 and Erik Lebret^1,5

¹  National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands

²  Netherlands Environmental Assessment Agency (PBL), Bilthoven, the Netherlands

³  Copernicus Institute for Sustainable Development and Innovation, Utrecht University, the Netherlands

⁴  Centre d'Economie et d'Ethique pour l'Environnement et le Développement, Université de Versailles Saint-Quentin-en-Yvelines, France

⁵  Institute for Risk Assessment Sciences (IRAS), Utrecht University, the Netherlands

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Environmental Health 2009, 8:21doi:10.1186/1476-069X-8-21

Published:	28 April 2009

Abstract

Disability Adjusted Life Years (DALYs) combine the number of people affected by disease or mortality in a population and the duration and severity of their condition into one number. The environmental burden of disease is the number of DALYs that can be attributed to environmental factors. Environmental burden of disease estimates enable policy makers to evaluate, compare and prioritize dissimilar environmental health problems or interventions. These estimates often have various uncertainties and assumptions which are not always made explicit. Besides statistical uncertainty in input data and parameters – which is commonly addressed – a variety of other types of uncertainties may substantially influence the results of the assessment. We have reviewed how different types of uncertainties affect environmental burden of disease assessments, and we give suggestions as to how researchers could address these uncertainties. We propose the use of an uncertainty typology to identify and characterize uncertainties. Finally, we argue that uncertainties need to be identified, assessed, reported and interpreted in order for assessment results to adequately support decision making.