Feature articleRethinking human health impact assessment
Introduction
Humans affect the environment, and the environment affects humans. Recognizing this interconnection, the environmental impact assessment movement has sought to promote more environmentally sound and informed decisions for the sake of human welfare. Meanwhile, the public health movement has long considered the environment to be a primary determinant of human health. So it's not surprising that most EIA programs around the world encourage the consideration of human health impacts (Sutcliffe 1995). What is surprising, however, is that EIA documents often omit health impacts.
Even though, historically, the environment and human health have been linked in concept, they have been paradoxically separated in EIA practice in the U.S. Instead of analyzing health impacts, EIAs often just refer to an environmental standard. If health impacts are analyzed, the focus is typically narrow: a single health outcome (cancer), due to exposure to a single toxin, over a single lifetime, represented by a single number, calculated by a quantitative risk assessment methodology (e.g., NRC 1983; EPA 1984). But this focus misses a range of other significant health concerns, such as endocrine disruption (Colborn et al. 1994), neurotoxicity (Silbergeld 1990), chemical sensitivity (Ashford and Miller 1998), non-toxicological social impacts (Burge and Vanclay 1995), intergenerational genetic damage (Fan et al. 1995) and exposures to combinations of chemical, biological, or physical agents—the types of exposures that humans face.
This article investigates the role of EIA for reuniting the environment and human health, for preventing and reducing significant health risks, and for improving human health impact assessment (HHIA). It begins with an overview of human health impact assessment within EIA. It follows with the research approach and results from analyses of 42 environmental impact statements from the U.S. Then, drawing upon the empirical results and interviews with environmental and public health professionals, the article analyzes why human health impacts are often neglected in EIAs. Finally, the article discusses problems with traditional methods of HHIA, and provides recommendations to improve both HHIAs and our understanding of connections between environmental systems and human health. This understanding has an added benefit: showing how changes in the environment affect human health can create support for efforts to protect and promote environmental quality.
Section snippets
Evolution of human health impact assessment within EIA
The legislative origins and implementation of EIA in the U.S. provide insights into the role of human health impact assessment. Environmental impact assessment is required in more than half the countries around the world (Canter 1996). The U.S. National Environmental Policy Act of 1969 (NEPA) provided one of the earliest sets of EIA requirements, and many countries modeled their requirements after NEPA. NEPA grew from public concern that federal projects were significantly harming the
Research approach
A goal of this research was to investigate how, why, and to what extent EIA addressed human health impacts. To do that, a two-phase study was performed.9 The first phase involved a content analysis of 42 environmental impact statements produced in the U.S. under NEPA.10 The EISs were selected according to two main criteria: the proposed actions were likely to
Improving human health impact assessment
The results of this study suggest a need to take a harder look at human health impacts, and use EIA as an opportunity to prevent or reduce health risks. It's not enough to say, “Well, just do the analyses.” The needs are more than analytic. And more analyses do not necessarily mean better decisions. What is needed is a rethinking of human health impact assessments, and the ways they can improve environmental decision-making.
Recognizing significant health impacts—and sources of health impacts—is
Acknowledgements
I thank Janeane Gilbreath for her valuable research assistance. I am grateful to Richard Carpenter for his helpful comments, and to Dinah Bear and Ray Clark for their insights and direction. This research received support, in part, from the National Science Foundation, under grant CMS 9874391. Any opinions, findings or conclusions are those of the author and do not necessarily reflect the views of the National Science Foundation.
References (47)
Social impact assessmentpolitically oriented approaches and applications
Environ Impact Assess Review
(1990)Social impact assessmentpolitically oriented approaches and applications
Environ Impact Assess Review
(1990)Decision-making in human health impact assessmentsa clinician's perspective
Environ Impact Assess Review
(1994)Environmental health impact assessmentmethods and sources
Environ Impact Assess Review
(1986)Toxic hazardsbeyond cancer to other health effects priorities
Environ Impact Assess Review
(1990)- et al.
Risk assessment principles in environmental impact studies
Environ Prof
(1992) A conceptual framework for the use of the precautionary principle in law
- et al.
Chemical exposureslow levels and high stakes
(1998) Public Health in Environmental Assessments
The health impact assessment of development projects
(1995)
Health and environmental impact assessmentan integrated approach
Social impact assessment
Environmental impact assessment
Health risk impact in environmental impact statements
Keep EIA focused
Environ Impact Assess Review
Risk assessment
An interview with editors of EIA review
Environ Impact Assess Review
Developmental effects of endocrine-disrupting chemicals in wildlife and humans
Environ Impact Assess Review
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