environment and health indicators · instituto de salud carlos iii/ escuela nacional de sanidad...

Draft Baseline Report on

”Environment & Health Indicators”

under the framework of the European Environment and Health Strategy (COM 2003)338 final)

Produced by the Technical Working Group on Indicators & Priority diseases

subgroup Environment & Health Indicators

05 December 2003

1

This report reflects the opinions of the members of the Working Group and it highlights the

different opinions contained within the group where appropriate. It should not be considered as an official statement of the position of the European Commission.

Further information relating to this work is available on the project website: www.brussels-conference.org or from the Technical Secretariat: Dr. Anke Joas BiPRO GmbH Grauertstr. 12 81545 Munich Germany Telephone +49 89 18979050 Facsimile +49 89 18979052 Email: [email protected]

2

List of members TWG Dafina Dalbokova* WHO European Centre for Environment and Health, Bonn Office

Marie-Christine De Wolf* EPHA, Environmental Network, Belgium

Antonio Doronzo DG Sanco

Ingeborg Fiala Ministry of the Agriculture, Forestry, Environment and Water Management, Austria

Michael Hübel DG Sanco

Patricia Koundakjian EUROFER, Belgium

Michal Krzyzanowski WHO, Regional Office for Europe

Paloma Martin ENSP European Network for smoking Prevention

Mark McCarthy* European Public Health Association, University College London,UK

Antoni Montserrat DG Sanco

Monica Nordberg* Institute Environmental Medicine, Karolinska Institutet, Sweden

Anna Páldy National Centre for Public Health, Hungary

Dirk Pallapies* BASF AG

Philippe Pirard* INVS, National Institute of Public Health Surveillance, France

Cesaltina Ramos Portugal

D. Benjamin Sanchez Fernandez-Murias

Instituto de Salud Carlos III/ Escuela Nacional de sanidad

Ulrike Ravens-Sieberer Robert Koch Institut, Germany

Luciana Sinisi* APAT, National Environment Agency, Italy

Vesna Smaka Kincl Municipality of Maribor - Environmental Protection Agency, Slovenia

Brigit Staatsen* RIVM, National Institute of Public Health and Environment, The Netherlands

David Stanners EEA

Jürgen Thelen* Federal Environmental Agency, Germany

Ronan Uhel* EEA

Friedrich Wiebel ENSP European Network for Smoking Prevention

Chair: Vesna Smaka Kincl Co- Chair: Brigit A.M. Staatsen Contractor: BiPRO GmbH, Munich * main authors of the report

3

Additional contacts: Marguerite Cammilleri Environment and Planning Authority, Malta Alexandra Cucu Ministry of Health, Romania Helga Grønnegaard Danish Environmental Protection Agency, Denmark Dorata Jaroskinska Institute of Occupational Medicine and Environmental Health,

Poland Ruzena Kubinova National Institute of Public Health, Czech Republic Francisco Marques Sanidad Ambiental y Salud Laboral, Spain Hristina Mileva State Health Control, Promotion & Diseases Prevention,

Ministry of Health Bulgaria Ingrida Zurlyte Environmental Health Centre, Lithuania Inga Turk Ministry of Environment, Slovenia Peter Otorepec

Slovenia

4

Table of Contents Executive summary .................................................................................................................... 6

1 Introduction: background and objective of EH Indicators .............................................. 10

2 Use and construction of Environment and Health Indicators, framework for linkages............................................................................................................................ 11

2.1 Definitions and different approaches to Indicators for Health and Environment...................................................................................................... 11

2.2 Use of indicators ............................................................................................... 12

2.3 Construction of indicators ................................................................................. 13

2.4 Considerations for selection of Environmental Health issues and indicators ........................................................................................................... 14

OECD ....................................................................................................................................... 15

3 Overview on knowledge and activities on Environment & Health Indicators................ 16

3.1 Current systems to collect data for the development of Environment & Health Indicators ............................................................................................... 16

3.1.1 International projects......................................................................................... 16

3.1.2 WHO-‘Environmental Health Indicator System’ (EHIS) ................................. 17

3.1.3 Public Health Indicator projects (ECHI)........................................................... 19

3.1.4 The Child Health Indicators of Life and Development (CHILD) Project ........ 21

3.1.5 European Environmental Information System (EEIS)...................................... 22

Legend 25

ISTAT: National Statistical Institute............................................................................... 25

3.1.6 Indicator projects at local level (Sustainable cities).......................................... 26

3.1.7 Sustainable development-EUROSTAT ............................................................ 27

3.2 Overview of national initiatives in Europe ....................................................... 27

4 Problems and deficits ...................................................................................................... 33

4.1 General problems .............................................................................................. 33

4.2 Specific problems of the existing environment and health information systems .............................................................................................................. 34

5

4.2.1 Problems and deficits related to operational definitions ................................... 34

4.2.2 Problems and deficits related to indicators where data collection is difficult.............................................................................................................. 34

4.2.3 Problems and deficits related to data knowledge gaps...................................... 35

4.2.4 Problems and deficits related to the geographical scope of existing systems. ............................................................................................................. 35

5 Conclusions and recommendations ................................................................................. 36

5.1 Advantages and limitations of harmonised EH indicators................................ 36

5.2 Requirements for development of a harmonised EU-indicator set ................... 38

5.3 Missing links/data ............................................................................................. 38

5.4 Guidance for further development of international indicator set ...................... 39

Annex I: Questionnaires........................................................................................................... 41

Annex II: Tables....................................................................................................................... 85

Annex III: Exemplary International and National Indicator sets ........................................... 156

Executive summary

This report gives an overview of current activities with regard to environment and health indicator sets and (inter)national agencies and projects that collect data on environment and health. The scope of this report (environmental health issues covered) is wider than the priority areas mentioned in the SCALE- initiative, taking into account a broad definition of the living-environment (physical, chemical and biological factors) and looking at those factors with the highest burden of disease (in adults AND children). Food safety and working place indicators are discussed only when part of existing environment and health activities.

The information provided in this report is based on a summary of recent literature and international programmes on Environment and Health indicators. An inventory has been of national activities by sending out questionnaires and tables (see annex) to national contacts in EU and accession countries. Fifteen countries responded to this request for information. Due to the limited timeframe for reporting, this review is not complete. The most relevant projects are described though and the countries covered reflect a good mix of both EU and accessing countries.

Information is needed by decision-makers and the public to identify and quantify existing environmental health impacts, set priorities and develop and evaluate policies to prevent or diminish these problems. Indicators can play a role in turning data into relevant information. Environmental health (E&H) indicators are an expression of the link between environment and health, targeted at an issue of specific policy or management concern and presented in a form which facilitates interpretation for effective decision-making.

Before the construction of E&H indicators along a conceptual framework (preferably a multi-exposure multiple-effect framework) can take place, one has to decide which issues or key problems need to be addressed. In the area of environmental health there is no broad consensus about the key problems though, making the definition of a core set of indicators difficult. The most obvious method for selecting environmental health issues and indicators is by looking at the (estimated) burden of disease. Other important criteria for selecting and defining indicators are: fitness to a purpose (which issue to address, who will use it and why, eg high policy relevance), sensitivity to factor of interest (i.e. valid environment and health relationship), data-availability and comparability between countries/regions and methodological criteria (validity, sensitivity, timeliness, accuracy).

The weight of these criteria may differ depending on the scale or situation to cover. Since construction of indicators that meet all the abovementioned criteria is rather difficult a reasonable compromise should be made i.e. a set of ‘core’ indicators.

Problems and deficits of current systems

Current indicator systems (e.g. EEA-EEIS) are typically driven from the environmental perspective, mainly due to the fact that most environment-related diseases have a multi-exposure origin. An exception is the Environmental Health Information System project of WHO-Europe (WHO-EHIS). The WHO Europe approach is to provide a harmonised methodology of integrating environment and health information, which serves country needs and, at the same time allows for reliable international comparisons. Indicators have been developed for the following environmental issues: air (ambient and indoor ) quality, housing, traffic, noise, radiation, waste and contaminated lands, water and sanitation, food safety and chemical emergencies. Selection and further development of indicators was based on the

evidence for health-environment links, scale and severity of the problem, policy relevance, evidence for effective interventions and possibilities for actions. The current system of the WHO needs further development in order to provide comparable information, which can be regularly updated according to state-of-the art evidence and guidance on integrated health-environment assessments. Some of the topics included in the WHO-EHIS project are relevant for children (eg indoor/outdoor air pollution, water pollution). The SCALE priority diseases are not addressed in the current core indicator set. Current indicator systems or databases (HFA, ECHI, CHILD) address a broader range of issues than the priority diseases discussed in the SCALE-Initiative.

The main problems encountered in (inter)national data-collection and reporting activities are:

• differences in indicator definitions (geographical scale, age groups, time periods)

• differences in data collection/ reporting systems;

• lack of data quality control

• limitations of international reporting mechanisms in providing EH relevant data;

• many different dataholders;

• organizational aspects (mandates, roles and responsibilities).

Mechanisms for interagency cooperation and a shared information infrastructure such as EIONET and REPORTNET of EEA are urgently needed. EEA and WHO are already collaborating in the WHO-EHIS project, but the EHIS database and data-processing is no part of the EEA infrastructure.

Advantages and limitations of using harmonised environment and health indicators

Indicators play a valuable role in highlighting problems, identifying trends, and contributing to the process of priority setting, policy formulation and evaluating progress.

Indicators alone cannot identify cause-effect relationships between risk factors and health outcomes. If there is scientific evidence for a dose response relationship and population exposure estimates are available, quantitative health impact assessments can be carried out which may illustrate the environment-related health burden. Health impact assessments (HIA) can be included as part of the assessment of a specific indicator in the context of reporting (e.g. years of life lost due to air pollution). The results of these assessments have to be judged carefully though, since health status is also influenced by other risk factors.

There are numerous indicator sets available at local, national and international level which contain one or more indicators relevant to environment and health. Information about changes in time or between/within- countries may be more important than the absolute levels of the indicators. Thus, comparability of the underlying databases is of the utmost importance. Unfortunately, the indicators in the current international databases and indicator sets vary in operational definitions (age, diagnosis), geographical scale and quality. In addition, countries have to report to different organizations on the same issues, but sometime using slightly other indicator definitions. Thus, the development and use of a harmonised E&H indicator set to enhance data-comparability is recommended, taking into account different user needs at different levels, i.e. by developing different subsets or user-windows as has been done in the ECHI-project. The development of a harmonised indicator set and data-warehouse will enable

bench-marking, save resources, stimulate better use of existing data, increase comparability of data and enhance, easier and better communication to stakeholders and to the public and identification and prioritisation of research areas.

The added value of using EH indicators to address policy questions is in the combined analysis of both exposure and effect to obtain an expression, understandable by the decision-makers of the health risk associated with a specific environmental hazard. The purpose of the indicators to be selected/developed should be clearly defined (e.g. which policy aims should be evaluated).

It is important that the existing international agencies developing environment and health indicators (WHO, EEA, EUROSTAT) should cooperate to ensure the development of a harmonised set that can serve the different purposes of the organizations and countries.

Prerequisites for the development of a set of indicators which can be used to examine overall trends in health and environment in the EU are:

• Clear definitions of issues of current or future interest or concern • Standardisation of definitions • Establishment of centralized data base/information system • Standardisation of data collection (e.g. surveys or biomonitoring programmes) • Quality control for sampling and analytical control • Wide share of know how and access to data for countries and NGOs • Sufficient resources (personal and technical resources for data analysis and reporting) • Technical support for the development of an information exchange platform • Prevention of unnecessary reporting burdens for the countries to enhance compliance • Definition of the level (local, regional, national, EU) at which respective indicators

should be analysed Research and data needs

EH indicators are currently provided for areas such as air pollution, water, noise where the evidence of health impacts is widely accepted and appropriate epidemiological measures for health impact assessment exist. When the health–environmental linkages are less well understood e.g. health effects of housing conditions or long-term exposure to chemicals the priorities, including research, are in identifying appropriate health outcomes and epidemiological measures as well as in harmonising the methods applied. An important missing link in the data-analysis is the lack of socio-demographic data which could be delivered from other databases (e.g. Eurostat New Chronos).

The countries who responded to our inventory mentioned the following priorities for development and standardisation of indicators (in order of frequency of nomination): Noise, Water, Food, Housing, Air pollution, allergy and asthma, traffic. Most countries stress the need for harmonisation of indicators for asthma and allergy. Improvement and harmonisation of health surveillance and survey methods is needed in order to assess exposures in the living environment, their determinants and related effects on health.

The development of E&H indicators for the EU strategy for environment and health has to focus on the objectives of the strategy. Because no specific or quantitative objectives have been formulated so far, indicators cannot be proposed at this stage. The results of the different TWGs looking at the SCALE-priority diseases should be examined for the need of specific indicators that are not regarded yet in current information systems.

It will be extremely difficult to get more insight in the effects and interactions of combined exposures while using monitoring systems. Well- designed and population-based multicentre-studies will probably yield more insight in that complex question than the outcomes of monitoring programmes.

Guidance for further development of international indicator set

• An organisational framework should be set up, including a steering group with representatives from EU, WHO, EEA and Eurostat and a project group with representatives from the countries, NGOs and international projects. Main tasks of the steering group could be to ensure cooperation between the different agencies and relevant projects on the further development of EH indicators and enhance harmonised data-collection and exchange.

• Selection of priority areas to focus on, depending on the policy questions (eg transport, air quality, water quality, housing, food safety and the priority diseases mentioned in the EH strategy).

• Selection and definition of indicators. For the selection of European Union relevant indicators the set of WHO recommended indicators can be a starting point. Countries in different stages of development will need to focus on different indicator sets or specific selections out of the indicator sets. Since construction of indicators that meet all the criteria described in 2.3 is rather difficult, a reasonable compromise should be made i.e. a set of ‘core’ indicators.

• Testing of indicators for data-availability should only be done for newly-developed indicators. For the others the results of recent feasibility studies should be taken into account

• Development of data-exchange and data-control procedures as well as an information system structure. For this, the experience and data warehouse-infrastructure from EEA may be a basis. The WHO website under preparation could be basis for a web-based portal of EH information system. It would be extremely helpful if this portal can be linked to both the EU (EUPHIN) and EEA information systems.

In conclusion, the indicator activities of different organisations – WHO, EEA, European institutions and projects funded by them, OECD, UN-ECE – should be brought together and made compatible

1 Introduction: background and objective of EH Indicators

Environmental health is an important challenge facing decision-makers in the public health arena, balancing possible impacts on health and quality of life against costs of measures.

Information is needed by decision-makers and the public to identify and quantify existing and potential environmental health impacts, set priorities and develop and evaluate policies to prevent or diminish these problems. Indicators can play a role in turning data into relevant information. Information currently available from monitoring and surveillance programmes is of varying quality, not always comparable and not always in a form relevant for decision-makers to set policies. Based on the experience of the National Environmental Health Action Plans in Central and Eastern Europe, there is an urgent need for strengthening (inter)national environment and health information systems improving the quality of information, reporting and policy evaluation.

The European Commission’s recent ‘European Environment and Health strategy’ aims at describing the relationship between environmental factors and adverse health effects and will provide the information for a Community policy dealing with sources, impacts and pathways of health stressors. The Strategy has been launched as the SCALE-initiative. It comprises the development of information systems as well as the compilation of adequate political measures. Its themes are: Scientific evidence, focus on Children, raise Awareness, improve the situation by use of Legal instruments and allow Evaluation of the progress made. An Action Plan 2004-2010 is to be developed which will be the Commission’s contribution to the Fourth Ministerial Conference on Environment and Health in Budapest in 2004. Technical Working Groups have been established to contribute to the development of the Action Plan and priorities identified in the strategy.

This report is prepared by the Working group on Environment and Health Indicators. Our overview provides information on current Environment and Health (E&H) indicator sets and (inter)national projects that collect data on health, environment or general statistics, with a special focus on projects at a European scale. Problems and deficits of current systems are discussed, as well as the advantages of developing and using harmonised environment and health indicators.

International indicator systems may enable international comparisons, but should also reflect country-specific environmental health problems. National initiatives have also been evaluated, taking into account a broad definition of the living-environment (physical, chemical and biological factors). However, food safety and working place indicators are discussed only when part of an E&H project. Specific attention is paid when possible to children and the priority diseases mentioned in the SCALE-strategy (respiratory diseases, childhood cancer, neurodevelopmental diseases). The report concludes with requirements and guidance for the development of harmonised E&H indicators and the possibilities for integration of existing activities and programmes.

The information provided in this report is based on a summary of recent literature and international programmes on (E&H) indicators. An inventory of national activities has been realised by sending out questionnaires and tables to national contacts in EU and accession countries. About 15 countries (60% of Accession Countries and Member States contacted ) responded to this request for information. Due to the limited timeframe this review is not complete. The most relevant projects are described though and the countries covered reflect a good mix of both EU and accessing countries.

2 Use and construction of Environment and Health Indicators, framework for linkages

Environmental health (EH) indicators are an expression of the link between environment and health, targeted at an issue of specific policy or management concern and presented in a form which facilitates interpretation for effective decision-making. Criteria for selecting and defining indicators are: the (estimated) burden of disease, fitness to the purpose (which issue to address, who will use it and why), sensitivity to factor of interest (i.e. .valid environment and health relationship), methodological criteria (validity, sensitivity, timeliness, accuracy), understandable and usable.

2.1 Definitions and different approaches to Indicators for Health and Environment

Indicators for Environment and Health are information tools regarding the link between environment and health. Therefore their design depends largely on the target group for which the information is provided.

Indicators give statistics or primary data added value by converting them into information which is of direct use to the target group. This may be political decision-makers as well as the public. In general, a specific indicator is designed because of, or reflecting, a political question (issue).

Indicators can be used for monitoring changes over time and space. But they cannot replace carefully maintained monitoring systems and scientific analysis, neither are they meant to establish cause-effect relations. Moreover, indicator systems are dynamic and flexible. They should be open to emerging new issues or environmental factors of concern.

The OECD describes indicators as: ‘parameters which describe the state of a certain environment/area with a significance extending beyond that directly associated with a parameter value’, e.g. measurements of air pollution results in raw data which can be aggregated. These statistics can be analysed and combined with population data in the form of indicators such as the number of days on which air quality guidelines are exceeded or the share of the population exposed to certain air pollutant concentrations.

According to the EEA and WHO, environmental health (EH) indicators are an expression of the link between environment and health, targeted at an issue of specific policy or management concern and presented in a form which facilitates interpretation for effective decision-making. Environmental indicators represent indicators, which describe the environment without any explicit or direct implications for health; health indicators are those, which describe the status of, or trends in health without any direct reference to the environment.

As such, an EH indicator can be seen as a 'measure' which summarises in easily understandable and relevant terms some aspect of the relationship between the environment and health which is amenable to action. To be useful EH indicators must relate to an issue of current or future interest or concern. This implies that we know what purpose we want them for and who will use them in order to define and design them accordingly (Briggs).

According to EEA different types of indicators can be distinguished (EEA):

descriptive: baseline information on spatial and temporal trends in environment or human health (e.g. biomonitoring of Persistent Organic Pollutants (POP) or Heavy Metals (HM))

performance: linked to reference value or policy target, illustrating how far the indicator is from a desired level (e.g. exposure indicators)

efficiency: illustrates efficiency of political measures (e.g. reduction of air pollutant emissions)

total welfare indicators (e.g. perceived quality of life)

2.2 Use of indicators

Some indicators are more relevant to national or international/global issues while others are more relevant locally. The roles and responsibilities of different tiers of government in managing various health and environment problems, the degree of decentralization of powers and factors such as data availability and quality will influence the extent to which data for indicators at different level should be examined (WHO).

Current indicator systems address a broader range of issues than the priority diseases discussed in the SCALE-Initiative. They are typically driven from the environmental perspective (e.g. air quality, water quality, housing (eg indoor air quality) and sanitation, noise, radiation, chemical safety, hazardous waste and contaminated lands, traffic accidents) and do not focus on specific health outcomes (endpoints) that are associated with environmental factors.

This is mainly due to the fact that health outcomes (e.g. priority diseases in SCALE) are a result of combined exposure to several health determinants (endogenous and exogenous: physical and social environment, life style). Not only environment is relevant. Moreover the association between exposure and health effect show a considerable time-lag so that indicators, even if defined properly, may not be sensitive enough to provide timely information.

Illustrative scheme for environmental determinants of health Host State → Exposures → Health effects Genetics Age Gender Individual Susceptibility

Air pollutants (e.g. PM10/2.5, Ozone, NOx) Noise Chemicals (e.g. PCDD, ED, HM) Radiation (e.g. UV, Radon) Biological vectors

Quality of Life Morbidity Mortality

EH indicators are currently provided for areas such as air pollution, water, noise where the evidence of health impacts is widely accepted and appropriate epidemiological measures for health impact assessment exist. When the health–environmental linkages are less well understood e.g. health effects of housing conditions or long-term exposure to chemicals the priorities, including research, are in identifying appropriate health outcomes and epidemiological measures as well as in harmonising the methods applied.

2.3 Construction of indicators

There are many requirements as to how indicators should be selected and defined in order to be useful. Current indicator sets are typically constructed in a certain framework. These frameworks try to resemble the cause-effect chain by linking the exposure of a population to the conditions that lead to the observed situation. They can be used to assess the efficiency of political actions implemented to respond to these problems. Several conceptual frameworks are used currently.

Environmental Information Systems in Europe adopted the DPSIR conceptual model (Driving forces, Pressure, State, Impact, Responses) derived by the PSR model (Pressure, State, Responses) of OECD.

The WHO developed a somewhat similar framework: DPSEEA (Driving force, Pressure, State, Exposure, Effect, Action; Figure 1). These models provide a useful framework for setting a system (set) of EH indicators within the decision-making context.

Figure 1: The DPSEEA framework (source EEA)

The health and environment cause-effect concept (DPSEEA, WHO) links measurable indicators to environment-related diseases, causes and actions. The authors of the Global Burden of Disease study recommend the use of causal webs for the comparative quantification of health risks. Causal webs are models linking distal and proximal causes of diseases, all causes may interact and mathematical functions can be linked to each link. Causal webs may be better suited for modelling the complexity of multiple interacting causes in view of a quantitative evaluation of health effects. In many cases exposure occurs to a number of different pollutants, in combination, and thus environmental concentrations of one pollutant do not always give a good indication of potential health effects. Further elaboration of the DPSEEA chain is needed in order to account for set of exposures and set of health

effects rather than a single pollutant exposure – effect model. A multiple-exposure, multiple-effect (MEME) framework has been proposed, which focuses on a situation with multiple exposures to environmental risk factors (Fig. 2 Briggs, 2003).

It will be extremely difficult though to get more insight in the effects and interactions of combined exposures while using monitoring systems. Well- designed and population-based multicentre-studies will probably yield more insight in that complex question than the outcomes of monitoring programmes.

FFig. 3 The MEME framework

A conceptual framework can be useful where information about determinants of an environmental condition is not available.

If this information is already available it can be used to reduce the amount of data analysis and reporting. Most of the indicator projects discussed in Chapter 3, however, underline the need for groups of indicators for policy analysis (pressure, state of environment, health and socio-demographic indicators/data).

2.4 Considerations for selection of Environmental Health issues and indicators

The construction of E&H indicators along a conceptual framework faces one more challenge: the definitions of issues to address. In some areas of application, such as environment and economy, a broad consensus exists about what the key problems are. Core set of indicators can thus be developed on this basis. In the area of environmental health, however, this consensus is less established, and this makes their definition more difficult.

The most obvious method for selecting environmental health issues and indicators is by looking at the (estimated) burden of disease. In the Netherlands around 2-5% of the total disease burden (expressed in DALYs) may be attributed to environmental risk factors. The main contributors to the environment-related disease burden in the Netherlands are air pollution, noise and the indoor environment (Melse & de Hollander; RIVM, 2000). The environmental burden of diseases in high-income countries in the OECD-region is 1-4 % and in low-income countries 4-7 %. In non-OECD countries the burden of disease is much higher (8-12%). Based on this burden of disease approach the following (tentative) prioritisation of diseases and issues can be made (RIVM, 2001):

OECD

High income Lower income Diseases Cardiopulmonary diseases Communicable diseases Cancer Cardiopulmonary diseases Depression Cancer Issues Air pollution Sanitation/food/housing Chemicals Air pollution Noise / quality living

environment Chemicals

Sectors Transport Public hygiene/housing Industry/agriculture Transport/energy Housing Industry/agriculture

Criteria and guidelines for Indicators

The following criteria are important in identifying and developing environmental health indicators. In general, the indicators should:

• Relate directly to the specific environmental health issue and to environmental and/ or health conditions that are amenable to action (‘fitness to a purpose’)

• Allow addressing specific policy questions related to environmental health impacts in vulnerable groups, in particular children.

• Consistent and comparable over time and space, hence appropriateness for monitoring • Be based on a valid environmental exposure – health outcome relationship according to

the best available scientific evidence and at the same time allowing for some flexibility according to the “precautionary principle”.

• Prevent duplication of efforts by taking closer account of national and international work and related indicator sets in practice

• Be clearly defined hence understandable and usable at different levels • Be measurable – based as much as possible on existing routinely collected and quality-

controlled data and accessible (input/ output of the information system) at different levels (e.g. national, regional, municipal)

• Meet a number of general methodological criteria concerning validity, sensitivity, timeliness, accuracy.

• Transparent (e.g. composite indicators are less transparent, useful for comparison, less useful for disentangling influence of actions)

• Acceptable for all stakeholders involved

The weight of these criteria may differ depending on the scale or situation to cover. Since construction of indicators that meet all the abovementioned criteria is rather difficult a reasonable compromise should be made i.e. a set of ‘core’ indicators.

3 Overview on knowledge and activities on Environment & Health Indicators

This chapter gives an overview of international (3.2.1) and national (3.2.2) experiences of existing environmental, statistical and health information systems (indicators, databases, data-exchange and reporting mechanisms). Detailed description of the main indicators for a given set is described in annex II and III. Comparability of the indicators and underlying datasets is important. Based on the questionnaires and tables returned by the international contacts we evaluated the (inter)national activities and systems with regard to the following major issues:

1. Indicators identified: the main groups are identified. Information on the operational definition is presented in the annex.

2. Relevance/usefulness of the indicators identified: relation to a policy objective or existing standards, ease of understanding and interpretation, with an action orientation.

3. Data quality and reliability: use of standardised methodology for data collection and quality control/ quality assurance system, spatial coverage and spatial resolution concerning sources/ pollutants and population concerned, stratification/ aggregation (age, gender, area, time), existence of regular population-based surveys;

4. Collecting tools and accessibility: existence of inter-institutional framework for data access/exchange, accessibility through electronic networks in common, simple format, accessibility of the data at central level, resources data collection;

5. Problems, benefits and priorities for further harmonisation of indicators

3.1 Current systems to collect data for the development of Environment & Health Indicators

3.1.1 International projects

The international indicator sets and databases can be divided in the following areas:

1. Environment & Health: the Environment and Health Information System (EHIS) of WHO-Europe.

2. Public health: the Health For All (HFA) database of the WHO, European Community Health Indicators programme (ECHI – EU), the project CHILD dedicated to children’s health and the OECD Health;

3. Environment: with OECD and EEA as the main responsible agencies

4. Sustainable development: with UN CSD, OECD, World bank as main organisations.

5. Local: A number of international initiatives exist with a particular focus on local scale such as WHO Healthy cities, European sustainability cities and Local agenda 21.

6. General: Eurostat indicators address different areas based on the statistics reported/collected by them.

The public health indicator systems are built mainly according to the following structure: socio-demographic, health status, health determinants and health care systems. The EHIS project of WHO is one of the few projects specifically aimed at developing an information system for environment and health problems.

3.1.2 WHO-‘Environmental Health Indicator System’ (EHIS)

The WHO Europe approach is to provide a harmonised methodology of integrating environment and health information, which serves country needs and, at the same time allows for reliable international comparisons. The indicators and main tools have been developed and tested by an internationally coordinated network of experts (http://www.euro.who.int/EHindicators ).

15 WHO-Member States and the EEA participate in the WHO-EHI project:

EU Member States: Finland, Germany, The Netherlands, Spain, Sweden (technical support);

Accession Countries: Armenia, Bulgaria, Czech Republic, Estonia, Hungary, Lithuania, Romania, Slovak Republic

and Switzerland.

Between 1999 and 2003, project activities aimed at combining dispersed results, experiences and analyses into a comprehensive and practical framework.

Indicators/Relevant issues:

10 health-relevant environmental issues were selected:

• air (ambient and indoor ) quality

• housing

• traffic

• noise

• radiation

• waste and contaminated lands

• water and sanitation

• food safety

• chemical emergencies and

• workplace conditions.

Selection and further development of indicators was based on the evidence for health-environment links, scale and severity of the problem, policy relevance, evidence for effective interventions and possibilities for actions. Indicators are constructed as interlinked in terms of upstream determinants, environmental risks and health effects, actions according to the

DPSEEA structure (chapter 2). A feasibility study to test data-availability was carried out in some of the participating countries to reach a multinational consensus among experts on a set of “core” indicators, allowing assessment of the environment and health situation in the countries and across Europe. An extended set was also developed with indicators which need further development (see Table 1 Annex III).

Testing:

Pilot testing took place in 12 WHO Member States participating in the project to identify and analyse the national databases, test the mechanisms of data exchange & integration, processing, information analysis as well as reporting for selected indicators. A clearly structured indicator fact-sheet was adopted as the basic reporting tool.

Collection tools:

Tools and methods for the technical system infrastructure have been developed consisting of specialized software for uniform collection, processing and exchange of environment and health data at the sub-national, national and international levels. A web-based ‘portal’ for the EH information system is currently under development. It will provide a common forum for data exchange and information sharing, and facilitate access to information of different levels of details depending on the user needs.

Reporting:

An International Indicator-based Report demonstrating the system (including chapters on air pollution, water and sanitation, noise and traffic accidents, guidance on the national implementation and software tools for system operation) for the Budapest Conference in 2004 is under preparation.

ECOEHIS:

In 2002 WHO/Europe launched the project ‘Environmental Health Indicators for European Union’ which is co-funded by DG Sanco. Participating EU Member States are Austria, Sweden, Germany, Italy, Spain, Portugal, Finland, Belgium, The Netherlands, Denmark and France.

The ECOEHIS scope is set in Annex II of the decision No. 1400/97/EC and comprises Housing conditions: Home and leisure activities (the subset “accidents at home”); Transport: Road accidents; External environment: air pollution, water pollution, radiation and other types of pollution, including noise but excluding food safety. The main objective is to propose an EH indicator set applicable in supporting national policies and action on protecting health and preventing risk across the European Union.

Substantial part of the work is the verification of the EH indicators compatibility with the European Community legislation to assess applicability in supporting national policies and action on protecting health and preventing risk across the European Union. A substantial part of the WHO-developed EH indicators can be based on the existing reporting systems required by current EC legislation. Health related indicators for housing conditions, noise and road transport safety will be further developed. The refined indicator set as a part of the ECHI framework is to serve the European Community Health Monitoring system. The proposal for a refined indicator set will be discussed with the participating MS in January 2004. The proposed indicators will be assessed for feasibility and pilot tested.

Relevance, problems, benefits of the system and priorities for further development

The current system of the WHO needs further development in order to provide comparable information, which can be regularly updated according to state-of-the art evidence and guidance on integrated health-environment assessments. It allows use and re-use of existing information and where necessary guidance for setting priorities for data collection and monitoring (e.g.of WHO when dealing with environmental monitoring).

Some of the topics included in the system are relevant for children (eg indoor/outdoor air pollution, water pollution). Specific age groups are currently not analysed. The SCALE priority diseases are not addressed in the current core indicator set, since they require major work on harmonistion of the methodological approaches. Several survey methods on e.g. respiratory health, exposure to indoor air pollution – have been selected and recommended (WHO, 2002). For housing, tools are under development.

The main problems encountered are:

• differences in data collection/ reporting systems;

• limitations of international reporting mechanisms in providing EH relevant data;

• data exchange with many holders;

• organizational aspects (mandates, roles and responsibilities).

Mechanisms for interagency cooperation; priority data-flow and a shared information infrastructure (together with EEA) are urgently needed. Improving health surveillance and survey methods have to be considered in order to assess exposures in the living environment, their determinants and related effects on health.

3.1.3 Public Health Indicator projects (ECHI)

Indicators/relevant issues

The European Community Health Indicator project (ECHI) has presented a proposal for a set of Health Indicators. The set covers the public health priority areas of the EU Member States and the Commission (including items such as inequity and children’s health). Indicators are included on demographic and socio-economic factors, health status, determinants of health (including physical environment) and health systems. Driving forces are not included in the set. Selection of disease categories has been primarily based on the size of population impacts (expressed as DALYs). In addition, diseases have been selected because they are related to specific determinants or may be an emerging threat. Table 6 in Annex III gives an overview of the proposed diseases and their data source.

Data collection

In the second phase of the project the implementation of these indicators is enhanced. No new databases are being developed. The project takes place in close cooperation with all relevant EU-HMP projects and Eurostat. All MS and Acceding Countries are involved in the project. The statistical results will be directly loaded in the database NewCronos of Eurostat. The project deliverables as well as all databases from other international organisations will be

directly accessible via the EUPHIN (European Union Public Health Information Network) currently developed by DG SANCO.

Relevance and benefits of the indicator set:

At present the ECHI indicator list is based on available data existing in WHO, OECD, Eurostat, plus results of some HMP projects. The WHO-ECOEHIS set is part of the ECHI-project. Harmonisation of the operational definition of selected EH diseases (eg age breakdown) with the ECHI-set is currently under way. The ECHI set is flexible. It has developed a concept of ‘User-Windows’ which allows to work with interest-oriented subsets of indicators (e.g. EH indicators). For different purposes different sets of indicators can be studied (eg environmental health). ECHI is increasingly used as focus for co-ordination between HMP projects in different areas. The project also gives guidance for the stratification of data by age, gender and (if possible) by SES and region. In the HMP project on regional use of data regional levels are recommended for each MS.

3.1.4 The Child Health Indicators of Life and Development (CHILD) Project

The Child Health Indicators of Life and Development (CHILD) Project is a third-wave project in the European Union Community Health Monitoring Programme. It is the first project to cover a particular population group, namely children. The project philosophy was underscored by recognition of the multiplier effect of the burden of ill health in children, when compared with that upon adults. It can have not only a much longer life-time effect given the greater lifespan ahead for a child, but will also have an extended impact upon parents, families, and society. In essence, ill health in children, particularly when it is medium to long term or produces impairment and disabling effects, has the following potential generation of burden:

• Burden of discomfort and pain on the child

• Burden of anxiety, distress, and possibly loss of earnings for the parent(s) looking after the sick child

• Burden on society funding the health services, and on occasion special education and social services support

• Burden in more severe cases on the social welfare system, potentially for a lifetime.

• Burden caused by medium or long term illness causing loss of normal play and socialisation, thus impeding normal development with potential life long effects

• Burden caused by lost education which may jeopardise career and thus income potential for a lifetime

• Burden on future generations, as the child with an extended ill health burden becomes a parent with restrictions on their parenting skills, and becomes an older family member dependent on their successor generation.

In essence, the responsibility of child health services is an exponential one – not just to maintain and protect the health of the child for the immediate benefit of health in childhood, but with recognition that failure in this respect can have life-long health, lifestyle, social and economic impacts. Whilst Disability Adjusted Life Years (DALYs) have been postulated as a means of calculating ongoing burden of illness or accident, they are not adequate alone in the child health context.

3.1.5 European Environmental Information System (EEIS)

Indicators/relevant issues:

The European Environmental Agency (EEA) has, since 1999, given higher priority to the development and publication of policy relevant indicator-based reports including Environmental Signals reports, and sector-specific reports on transport (TERM), and energy (EERM). These experiences suggest indicators should be replicated for the other sectors and the environmental issues that the Agency supports through its work programme. The added value of a core set of indicators explicitly linked to policy objectives, includes:

• stability to data flows with EIONET and elsewhere

• a solid basis for the use of Reportnet (see below) infrastructure and tools

• improved data quality and comparability due to more stable data flows

• policy relevant assessment support to EU policy processes, promoting the use of the same information for many purposes.

In 2002 EEA launched a European consultation asking countries and NGOs to comment on the overall EEA set and the individual indicators. EEA has revised the core set based on the country comments and other considerations, like high priority score, the consistency and linkage in the indicator sets or the linkage between the EEA core set and other international environmental indicator activities. A 2nd round consultation was launched (ended on October 2003) asking clients to comment on the proposed indicators and their coherence/balance across environmental issues and sectors and the “short-term indicators’ identified within the core set. A short term-indicator implied:

• High policy relevance + existing fact sheet; • Methodology well developed and in many cases also in other international sets. • Indicator can illustrate temporal trend and comparability between countries. • Data are available for most countries in 2003. • Data expected for all countries 2004/05. This is the basis for the development of the 2003 EEA core set of policy-relevant indicators for six environmental issues (air pollution, climate change, water, waste and material flows, biodiversity and terrestrial environment) and five sectors (transport, energy, agriculture, tourism and fisheries). The proposed EEA core set (available on www.eea.eu.int) contains in total 354 indicators. The indicators relevant for environment and health are shown in table 4 in Annex III. Indicators describe exceedance days of air quality targets; increased ultraviolet radiation due to ozone layer depletion; potential impact of climate change on human health; aspects related to water, sanitation and the quality of drinking and bathing water and shellfish poisoning due harmful algae blooms and the quality of fish for human consumption. In addition, there are indicators covering the impact of transport such as people affected by transport noise and transport accidents, fatalities and number of people injured.

European Environment Information System

There is a wide international and European environmental reporting community, i.e., a network of environmental information providers. Their joint networks can be called the European Environment Information System (EEIS). The community that makes the EEIS also consists of other networks such as Eurostat and its data providers, or the various permanent or ad-hoc networks which are built around European and national scientific organisations or

NGOs. All these are providers or users of reported environmental data. Inside EEIS, the European Environmental Agency (EEA) leads the necessary standardisation and harmonisation efforts. The heart of the European Environment Information System is a shared information infrastructure that enables information exchange and dissemination.

The information provided by the EEA focuses in particular on assessing the current and future state of the environment across Europe and the pressures upon it. The Agency's tasks also include disseminating best practice in environmental protection and technologies, and supporting the European Commission in diffusing information on the results of environmental research. The Agency both gathers and distributes its data and information through the European environment information and observation network (EIONET), which brings together just over 300 environment bodies, agencies, public and private research centres and centres of expertise across Europe. The EEA is responsible for coordinating the EIONET. EIONET is only one network contributing to the shared information pool. EEA networking activities recognizes several partners: EIONET partners in the 31 member Countries, EC services and programmes and international organizations (UNEP, UNECE, WHO, OECD, WMO).

Data collection, exchange and reporting infrastructure

Reportnet is the new architecture and application suite proposed by EEA to support the development of a European Environment Information System (EEIS). This new system is conceived as a shared information infrastructure that should allow better use and reuse of the reporting information, leading to reduction of the reporting burden at the national level, while providing the international community with better, faster and more policy-relevant information.

The EEA long-term vision is to get agreement between countries and international institutions (both EU and non-EU) on a common core set of indicators and underlying data flows. These would then be implemented through the EEIS, so that data would be reported once by countries (e.g. through Reportnet’s content repositories) and are made accessible to all the institutions and networks that form the EEIS, for their own institutional purposes. Reportnet will have components for reporting obligations, metadata, directory services, data repositories, and process monitoring, and would be built using - and contributing to - IDA (Interchange of Data between Administrations) common tools and techniques. EEA – with the support of the IDA Programme – has already developed a basic technical infrastructure for a network for environmental data exchange (e-EIONET).

This basic infrastructure will be further extended to cover also data harmonisation. It will be supported by a framework of data standards, data exchange formats, communication protocols, and directories that form an information infrastructure enabling information sharing and interoperability of applications and tools. More tools are on their way and soon form an integrated suite that covers most functions required from a data collection network. These tools and the applications they make will be implemented more and more in Open Source allowing for better exchangeability and maintenance. EEA aims at showing a best practice example to be shared with other stakeholders through the development of the EEIS concept, the supporting information infrastructure and its implementation through Reportnet. While the architecture shall serve the immediate EIONET needs on one hand, it is open to interface with other networks’ technical solutions.

Data-exchange

National repositories are a stable location for national data deliveries instead of ad-hoc data transmission in form of e-mail attachments. Systematic implementation of data repositories for EIONET Priority Data Flows started in 2002 when countries were offered the following two options for the storage of national data:

• distributed national data repositories implemented in CIRCA • the Central Data Repository (CDR) at EEA. The basic requirement for a successful implementation of this core element of the Reportnet framework is that every country clearly identifies and uses one of the proposed repository options. In both cases, countries have the responsibility for uploading their data. 23 countries have chosen CDR as the place for storing their data files, 7 countries have decided to use their national CIRCA for this purpose. This is linked to a content registry that enables transparent tracking of data delivered under the EIONET Priority Data Flows. Meta-information about data uploads is harvested every night and searchable through a web-interface.

Besides networking activities to develop and interconnect the means for Europe-wide environmental data gathering and processing, a major activity of the EEA is offering a reliable, cohesive, simple, low cost routine monitoring to reporting system on the environment. It seeks to deliver timely, comparable, harmonised data and integrated environmental assessments. To support policy action EEA is also acting as a centre of excellence and as a single clearing house for environmental data by encouraging harmonisation of methods of measurement and providing uniform assessment criteria.

EIONET is a collaborative network of the European Environment Agency and its Member Countries, connecting National Focal Points (NFP, responsible for coordination of national activties related to EEA work programme) in the EU and accession countries, European Topic Centres (multi-national consortia responsible for data collection in their topic area) and National Reference Centres (NRC, providers of national environmental data). These organisations jointly provide the information that is used for making decisions for improving the state of environment in Europe and making EU policies more effective.

An example of Integration and data-exchange between European and National Systems:

EIONET and the Italian Environmental Information and Monitoring System

Legend

ISTAT: National Statistical Institute

SINAnet : The Italian Environmental Information and Monitoring System APAT: National Environmental Protection Agency (RFPs)Regional Focal Points RFPs are the territorial partners within the System. PFRs are appointed by the Italian Regions and Autonomous Provinces to ensure data-flows and information relevant to national and European level, as a result of monitoring and inspection activities performed in their territories. (NTCs)National Topic Centres NTCs are the thematic nodes of the System with reference to specific environmental topics; they are operated by a group of ARPA/APPA, and integrated by selected MRIs. NTCs support APAT in the role of National Reference Centre of EIONET. The work programmes are defined on a multi-annual basis. (MRIs)Main Reference Institutions MRIs are Institutions or public organisations having - at the national and European level - knowledge relevant to NTCs’ environmental topics.

Benefits, problems and priorities for further development

The EEA has the following priorities with regard to indicator production and data collection: To confirm with other organisations respective responsibilities on indicator production and data flows, in particular with Eurostat, but also with OECD and international conventions interested in co-operation on common approaches to indicators.

• To build into the EIONET Priority data flows for those indicators for which the EEA has responsibility and put these on a regular cycle, either annual or regular.

• To link the EEA indicator management system to those managed by others e.g. Eurostat as a component of the “shared information system” envisaged as part of the streamlining process.

• To produce regular (non-annual) thematic and sector indicator-based reports.

• To review the core set of indicators in three years time after the publication of the next EEA State and Outlook report.

Moreover the EEA has announced the establishment of a methodological framework in which to analyse environment and health issues and the development of a set of environment and health indicators to track key environmental stressors, such as air quality and indoor pollution on human health, in consultation with EEA member countries and the World Health Organization (EEA Strategy 2003). The EEA is fully involved in and benefits from the WHO Regional Office for Europe-EHIS approach (see 3.2 andWHO document EUR/03/5045637/8). The main tools and methods have been developed and tested through internationally coordinated work in the framework of the WHO Regional Office for Europe project on environmental health indicators, carried out in collaboration with the EEA and the EC (DG SANCO), as well as 22 Member States. At present, internally to EEA own developments, there are already a number of relevant environment and health indicators in the EEA core set (Annex III). Most of these indicators are state or health-relevant exposure indicators; a few environment-related health indicators (noise annoyance, transport accidents) are included.

3.1.6 Indicator projects at local level (Sustainable cities)

WHO Healthy Cities Project collected indicators in phases I and II of the project from 47 cities. In phase I there were 53 indicators, with definitions, method of calculation and unit of measurement, in four domains -health, health services, environment, socio-economic. A report 'Healthy Cities Indicators' was published by WHO (Copenhagen) in 1996. No full report has been made of the phase II indicators. The work stimulated collection of indicators by the European Sustainable Towns and Cities Campaign, which has these published on http://www.sustainable-cities.org/home.html.

Indicators/relevant issues

The scope of the EC-project 'European common indicators – Towards a local sustainability profile' is to develop an information system about sustainable development in the city. Up till now there are 150 towns from 22 countries involved in the project. The indicators devloped (see table 8 Annex III) are programmed special for the use at the local (city) level.

Datacollection and reporting

The coordination of data collection is done through city administrations (local level). Citizens, NGO, enterprises and city administrations are involved in the local projects. Public accessibility is crucial. The results are presented through pressconferences, web sites, and regular reports, in the booklet European Common Indicators and on the web site www.sustainable-cities.org/indicators. The results are reported at least once per two years or more frequenty depending on nesessity. The project is payed from municipal budgets. The cost of collecting an indicator set is around 40.000 EUR for cities up to half million inhabitants.

Relevance, problems and benefits of the indicators for local level

A major benefit of the project is that cities measure impacts of urban activities and monitor progress on Local Agenda 21 with the same methodology. The exchange of experiences between the cities and cities network is also important. There is no established processing methodology for data control, except for the indicators on local contribution to global climate change, air quality and noise pollution. There are no specific indicators for children except the children's journeys to and from school (6 – 15 years).

3.1.7 Sustainable development-EUROSTAT

Eurostat is developing environmental and health indicators as part of the sustainable development indicators set. It includes 4 sets of indicators related to human health protection, food safety and quality, chemicals management and environmental quality affected to life.

(see table 7 Annex III). The objectives of these sustainable development indicators are to address some themes developed in the 6 European Action Program or other policies such as:

• contribution to a better quality of life,

• the enhancement of health education,

• tackling issues related to outbreak of infectious diseases and resistance to antibiotics,

• safety of food at all levels in the food chain,

• the production and usage of chemicals,

• air quality aspects,

• water quality aspects,

• noise

It includes short and long term environmental and health indicators. The methodology to collect the different indicators or the availability of the information is not clear and should be further identified.

3.2 Overview of national initiatives in Europe

16 countries responded to the request for information: 10 from EU member states, 6 from accession countries (see annex I & II). In these countries the domain of environmental health is very broad and concerns many issues ranging from air pollution to infectious diseases related to water and food safety. All the countries who responded are partners of the EEA, and provide information on the indicators in the EEA set. But although the EEA set includes many indicators that are relevant to health they are not constructed as E & H indicators.

Indicators/Relevant issues (developing or in use)

In 1999 countries in the WHO-Europe region agreed to implement National Environmental Health Action Plans (NEHAPs) stressing priorities and action targets before 2003.

Many countries except some Mediterranean ones (e.g. not Italy, Spain, Portugal) did this effort.

Denmark has developed a national strategy for sustainable development, for which the main target is the constant decrease of pollutant levels in products, food, working environment, traffic and indoor conditions. One of the targets of the Dutch NEHAP is to develop a permanent monitoring and information system based on a centralised manageable set of indicators illustrating the relationship between environmental factors and health.

For the Netherlands, the main goal of the NEHAP is a healthy, safe, clean and attractive living environment, integrating environmental health in urban renewal plans. Thus, for the Netherlands the current WHO-EHIS set of indicators is not sufficient to evaluate their EH policies.

Germany published the NEHAP in 1999. The Federal Environmental Agency (UBA) and the Federal Ministry of Environment in 2002 started an initiative to develop a core indicator system that gives information according to the thematic structure given by the 6th Environmental Action Plan of the EU. It includes 11 indicators for environmental health, some where derived from the WHO-EHI project. The indicator based trend report will be published biannually starting in 2004.

In the United Kingdom national initiatives focus mainly on EH indicators for the topics housing and water.

Most countries collect data and produce information for their specific national laws. At the same time most countries have or are in the process of translating the European Directives on Air, Water, Food Quality and radiation protection in national laws.

As a consequence following indicators are available at a central organisation in every country:

• Air quality indicators are collected in most cities of Europe.

• Drinking water and bathing water quality monitoring and

• Food quality

• Traffic and noise indicators (usually annoyance)

(see tables in Annex II).

For the different environmental issues the following indicators are most often used:

1. Noise The main indicator is the % of population exposed to noise annoyance.

2. Water % of results above national legal limits (or rates) cases of diarrhoea among children attributed to water pollution. France is actually implementing practical research in order to link gastro-enteritis and diarrhoea syndromes detected by medical insurance reimbursement with water measurements coming from water monitoring systems.

3. Housing Most indicators concern housing quality, e.g. number of persons per flat, satisfaction with/perception of housing quality (e.g. in the Netherlands). Some countries also monitor the amount of pollutants in indoor air using surveys at permanent or at irregular intervals (e.g. France, Germany).

France has recently implemented a surveillance system on carbon monoxide accidents in home since most of those accidents can be avoided and they are severe.

Member States seem to base their monitoring system on the measurement of air pollution, whereas Accession countries also focus on health monitoring (number of children with respiratory diseases).

France, the Netherlands and other countries target their surveillance on the measurement of the correlations between air pollution indices and effects (hospital admissions) on the basis of time series.

Data quality and control

Most of the national data described in the tables are considered to be adequately controlled for quality. Nevertheless for some Accession countries that have to implement a new monitoring network (e.g. Czech Republic, Bulgaria) the quality of some indicators is not yet adequately controlled.

In the new surveillance monitoring projects such as “surveillance of 9 cities air pollution” in France, evaluation of the data quality and reliability is an ongoing and continuous process.

Data collection and exchange

In almost all countries environment and health data are located at different organisations that up to now are also the data-holders.

• Food measurements are very often the responsibility of Ministries of Agriculture.

• Air and water quality measurements are often under the responsibility of the Ministry of Environment,

• Effect-indicators are almost always under responsibility of the Ministry of Health.

• For radiation measurements some countries (France, Germany, UK, Sweden) have established specific institutes which collects information concerning radioprotection and ionising radiation.

In many countries information is currently still divided among various organisations which produce different parts of the EH information.

Additional problems occur due to the federal structure of some countries.

In Countries like e.g. Belgium, Germany with a strong federal structure or structured autonomous regions centralised information at the national level is not available or difficult to collect.

Furthermore in most countries, except perhaps at the European level (WHO-EHIS), there is no central data warehouse or network with centralisation of the data. This can lead to the curious situation that in some cases information from one organisation passes to the other one via European databases such as HFA or Eurostat.

To tackle the problem in France specific agencies have been created in the last time to co-ordinate the information collection or centralisation of the data.

The AFSSE (French National Agency for Environmental Sanitary Security) is in charge of co-ordinating the environmental health expertise but is not a data producer in itself.

The InVS (National Institute for Health Surveillance) has the mission of implementing surveillance of environmental health problems to support policy strategies and of launching the alert for urgent environmental events dangerous for public health.

In the Netherlands one of the actions in the NEHAP is to develop such a central data-warehouse as part of the Environmental Health information system.

In Italy specific laws define reporting obligations and rules for data collection for the different institutions (health, statistical and environmental) belonging to the National Statistical information network SISTAN.

In Belgium, initiatives are being developed at different levels. An integrated project has been developed in the Flemish region and is in its implementation phase. The “Steunpunt project” in Flanders has identified a list of 42 indicators. Part of those indicators is already integrated in the annual yearly environmental report (MIRA report).

In Wallonia, the recent development of the environmental and health platform is aimed to give an overview on existing initiatives, identify specific local needs and to develop and implement the collection processes and relation between the existing data banks.

Problems and Deficits of existing Systems

Considering environmental and health monitoring systems, the current situation in European countries is the result of historic developments.

As a consequence even in Countries with established environment and health information systems the data often are divided among many data-holders and collected for very different purposes.

One the other hand even in those countries that do not have an integrated and centralised environment and health information system (eg UK, Austria), information would be available at different data-holders.

While Member States often have indicator systems based on national indicators sets most Accession countries are adopting new indicators in the framework of the EEA and WHO-EHIS (definition of indicators, and collecting process).

Analysing and clarifying the possibility of obtaining more information by parallel processing databases containing environmental and geographical information with health databases is a great challenge (data comparability and legal applications).

Every country stresses that data- availability is a critical issue. Often experts complain about the number of data-holders and the difficulties of data availability due to technical and legal constraints.

The division of information sources also causes the problem of technical comparability (for example different geographical scales, age or time periods). The amount of data collection can also cause a problem of reliability and compliance to quality control. Some experts indicate that maintenance of the monitoring systems at long term is at risk due to budget cuts.

When implementation of a monitoring system is new the experts try to propose indicators in EU and WHO indicators framework. The national programs enable the ministries to examine possible ways of attaining more relevant information to assess health risks.

Centralisation of data can save money and human resources on the long term, and help the production of relevant indicators for environmental health problems. In that regard the WHO-ECOEHIS program is considered to be very useful.

Priorities for further development/harmonisation

The most frequently mentioned issues for priorities of action, monitoring, and development and standardisation of indicators are (in order of frequency of nomination):

1. Noise

2. Water

3. Food

4. Housing

5. Air pollution

6. Allergy and asthma

7. Traffic

Most countries stress the need for harmonisation of indicators for asthma and allergy. Agreement is needed at an European level on the definition of asthma cases, and indicators used (prevalence of asthma, of hospitalisation for asthma, of deaths linked to asthma).

Other issues of concern reported at national level in the ECOEHIS project are:

• Health effects related to transport in non urban dwellers

• Radon exposure

• Hearing impairment and cognitive development related to noise exposure

• Indoor air and housing indicators as (e.g.CO, NOx, dampness, mould growth, winter death and high temperature)

• Common definitions of traffic injuries

• Access to green areas

• Chemicals indicators (Nickel, Cadmium, heavy metals and pesticides, everyday life indicators)

Targeting the harmonisation efforts on a limited amount of indicators should be cost effective. When delineating new indicators to meet these new targets, harmonising the definition and methodology of collection of these indicators is a very important issue. These new indicators should be compliant with the WHO list, and if a new set of indicators is necessary it should be discussed between experts from different countries and with WHO working groups.

Relevance of national activities for SCALE

Up to now only few indicators in the national sets are directly related to children.

Whereas with respect to Air pollution indicators already exist in most countries, although not measured with focus on children cancer and neurodevelopmental diseases are not mentioned in the questionnaires as priority areas for the E&H indicator systems. Indicators on air pollution and housing can give useful information on respiratory diseases. It’s more difficult to delineate the specific position of children. But background information (urban air pollution) can be also useful for children.

Childhood cancer

Limited knowledge exists on the relation between childhood cancer and environmental factors (apart from UV-radiation) and the perhaps different mechanisms from adult cancers. Furthermore the lag time between exposure to an environmental risk factor and fully manifest cancer might be less long than compared to the cancer in adults, thus investigations and research might be easier than with adults. Even if the number/incidence of childhood cancer is lower than of adult cancer, monitoring systems of childhood cancer are very relevant.

Some information on determinants could be centralised: e.g. housing distance from power line, exposure to mobile phones and exposure to pesticides to help research mainly.

Endocrine disruptors

Hormonal disruptors are suspected of causing congenital malformations. Thus, organisation of surveillance systems on congenital malformations is necessary. France stressed the existence of such registers at the regional level in the country. The German Environmental Survey (GerES) is a representative population study conducted since mid-1980s. At present the GerES IV is conducted, the first survey for children only (www.kiggs.de).The results of this survey can contribute substantially to the development of indicators for the exposure of children to environmental strains. The GerES IV-survey is currently investigating the level of internal and external exposure to selected endocrine disrupting compounds (e.g. DEHP). The results will enable a description of the current background burden.

Pesticides use mapping, pesticide exposure surveys and more specifically exposure of children to pesticides could be relevant indicators.

Neurodevelopment

Only limited knowledge is available about the impact of environmental factors on neurodevelopmental disorders. Most of the factors under suspicion are still subject to exploratory research. Because neurodevelopmental disorders are not specifically defined in the Communication on the E&H strategy, no statement on the availability of monitoring systems could be made. Nevertheless, lead and metal mercury are known to have effects on the central nervous systems, particularly on children whose brain development is not finished. Furthermore PCB is highly suspected to have an effect on neurodevelopment. Therefore indicators and monitoring systems on lead level in blood, PCB in blood, or methyl mercury (hair, blood) are important. Measurements can be based on regular surveys or real alert and monitoring systems (e.g. for lead in France, Germany, Czech Republic). Available indicators demonstrate that policy measures aiming at the reduction of lead emissions have lead to a significant reduction of blood lead levels. Monitoring surveys of lead in blood in children in the Netherlands have been stopped after the introduction of unleaded gasoline in the Netherlands, based on information from inidcators showing decreasing trends in lead emissions, lead exposure and lead blood levels.

4 Problems and deficits

Major problems are the lack of harmonisation of existing indicator systems as well as the definition of indicators (geographical scale, age groups, time periods, disease coding). This increases the difficulty of comparing indicators internationally or at other geographical levels.

4.1 General problems

There are many valuable environment indicators used worldwide to measure progress and trends towards a clean and healthy environment such as measures of air quality, water quality, traffic and industry emissions etc. The indicator activities of different organisations – WHO, EEA, European institutions and projects funded by them, OECD, UN-ECE – should be brought together and made compatible.

Many environmental health outcomes are thought to be affected by several, often interacting risk factors. These are genetic as well as environment-related which could be defined broadly to include physical, chemical, biological, economic, social and psychosocial factors. Examples are infectious agents, behavioural risks, ultraviolet radiation, tobacco smoke, chemicals in the environment, food-borne illness, poverty, and temperature extremes. For several of these factors, well-defined indicators still have to be developed. For example, concentrations of pollutants are often measured as peak or average exposures at a specific site which is not necessarily relevant and representative for children’s exposure.

Harmonisation of already existing indicators between different geographical entities is necessary for comparisons on a geographical scale. For example, if in one geographical area average concentrations of a pollutant are measured, and in another area number of hours per year during which this pollutant exceeds standards, comparability of the data is limited.

If it comes to measures, reducing or avoiding an environmental factor does not necessarily mean that an associated health outcome will be reduced similarly. A difficulty for comparing environmental indicators with health indicators is that the effect on health may be later rather than contemporaneous. Thus, a current environmental exposure to radiation will have its effect as cancer up to several decades later. Sometimes the length of this time lag is not well understood.

There are many examples of traditional health indicators that have been used successfully for many years in the public health arena. These include measures such as lifespan, infant mortality, birth parameters, and mortality rates for specific diseases. These measures are generally not controversial because there are standardized and agreed criteria for information collection and reporting. However, for more subjective indicators, such as well being, there is less information available, even though people themselves may give these greater attentions. Currently, representative population surveys on quality of life are available for Germany and European social population surveys are developing similar instruments for the European Scale (Euromodule). Also, obtaining comparable data on more specific health outcomes like cryptorchidism or asthma prevalence is much more difficult, evaluation / registration does not occur at the same age of the children, or registration is passive and depending on individual physicians. Nevertheless, the standardised ICD coding and regular surveillance of children’s health status (e.g. preventive examinations of children and adolescents in Germany and the Netherlands) provide a valuable data source for the investigation of the health status.

An aspect of environmental exposure is that the risk to an individual may be low, but if there is wide population exposure then the cumulative social impact is of concern. In some cases, environmental factors might only be of relevance for particularly susceptible/vulnerable groups.

Environmental and health indicators often represent populations. A link on population level does not mean that such a link exists within individuals of the population.

4.2 Specific problems of the existing environment and health information systems

4.2.1 Problems and deficits related to operational definitions

The lack of harmonisation in the definition of indicators as well as the variation in national interpretation increase the difficulty of comparing indicators internationally. There can also be difficulty in harmonisation between systems in the age groups and time periods covered. When environmental and health indicators depend on surveys (in comparison with routinely collected data) time series data may be missing. Due to different languages and databases used, the information exchange between various regions may be significantly limited. There can be some difficulty in relating environmental exposure to distinct populations, and in making comparisons when different sized populations are affected. Perhaps from a user’s point of view, a concern may be that data collection may delay available results, while users want the latest year.

4.2.2 Problems and deficits related to indicators where data collection is difficult

When data are difficult to collect, there is a possibility that inappropriate data are used instead. For example, there is a concern that the sperm count of males is being reduced because of EDCs. Information from unrepresentative samples may be used instead of truly representative populations, giving false results.

In several European countries, data protection limitations restrict the collection of potentially relevant public health data. It may be difficult to link data on individuals to make necessary analyses. Data on, or linkage with, individual characteristics may not be available.

Tissue sampling requires the agreement and participation of both children and parents. However, their willingness to provide samples depends on various factors such as particular concerns about exposures or health problems, ethnicity, socio-economic status. Thus, samples might not be representative for the whole population.

Differences in the system of data collection between the different countries is another major problem.

4.2.3 Problems and deficits related to data knowledge gaps

Focusing on indicators and data availability for the four priority areas of the EU E&H strategy:

• data on childhood cancer are more complete on the health indicator side, and the number of children concerned relatively small; on the other hand the environmental causes are not well understood.

• indicators for child neurodevelopment are not well developed on a population basis

• for respiratory health (in particular asthma) diagnostic criteria differ between countries; indicators proposed have been hospital admissions of children for respiratory problems or absence in school (the latter is difficult to relate to respiratory issues). Better information may come from specific multicentre studies like ISAAC. There are difficulties in defining true prevalence of asthma, in comparision with diagnosis rates, since the medical care system has incentives to increase the diagnosis rate (e.g. sales of drugs).

• perinatal/infantile conditions like hypospadia and cryptorchidism (perhaps related to EDCs) can be more accurately measured if children are assessed at a defined age by physicians aware of standardised diagnostic criteria.

In general, there is a lack of understanding/gap in knowledge how to use environmental and health indicators for decision making at national and local levels. This is implied by the differences in approach currently being used by international bodies.

4.2.4 Problems and deficits related to the geographical scope of existing systems.

The available data may refer to health and environmental conditions at different levels of resolution. It may be difficult to link data which is only available at different levels of resolution. Data for different geographical areas may be available only for limited time periods. Indicators may be a starting point for considering disease ‘clusters’ suspected to be associated with specific local exposure situations; epidemiological studies and studies of mechanisms (e.g. toxicological) are then needed to examine the problem further.

In order to identify environmental or health problems associated with a particular geographical area, indicators with a more local focus may be required. If children’s environmental health is addressed explicitly, one has to be aware that indicators based on the general population might be inadequate.

Children may be at a higher risk of developing adverse health effects than adults when exposed to environmental pollution. Children have a higher intake of food per kg body weight than adults and for some toxic agents also a higher absorption, e.g. children absorb 25 to 50% of lead in food compared to 5-25% for adults.

For some countries or regions it might not be feasible or cost-effective to collect information on some indicators with complete coverage; under such circumstances, focussing on a specific region or population is recommended.

5 Conclusions and recommendations

5.1 Advantages and limitations of harmonised EH indicators

Indicators play a valuable role in highlighting problems, identifying trends, and contributing to the process of priority setting, policy formulation and evaluating progress. Indicators can help to simplify a complex array of information concerning health and environment.

Some indicators are direct measures of environmental quality (e.g. levels of contaminants in drinking water) or public health (e.g. infant mortality rates). Recent indicator reports, however, have begun to use environmental levels (e.g. environmental exposure, environmental release data) juxtaposed with health effects data (e.g. rates of disease, years of life lost) and attempted to link one to the other. While it is necessary for governments to collect, use and publish data that reflect national or regional progress toward improving public health and environmental quality, such cause-and-effect extrapolations should be done with great care. For example, general population exposures do not necessarily reflect childhood exposures. Furthermore, given the complexity of the factors that influence health, it is in most cases not scientifically justified to link environmental information to specific health effects, while not takinginto account other risk factors such as life style. As a result, indicators that attempt to do so, do not provide a sufficiently rigorous basis for either regulatory or non-regulatory activities. The information gathered from such indicator efforts can be useful as input to developing hypotheses for further study in the fields of epidemiology, toxicology, exposure assessment, risk assessment. However they should not be used as a basis for action or policy making, unless the scientific linkages are well understood.

If the link is not quite fully defined and an environmental factor is suspicious of causing serious health effects it is recommended to apply the ALARP (as low as reasonably possible) principle in the meantime.

Indicators alone cannot identify cause-effect relationships between risk factors and health outcomes. They have to rely on scientific evidence that such a causal link exists. If there is scientific evidence for a dose response relationship and population exposure estimates are availabe, quantitative health impact assessments can be carried out which may illustrate the environment-related health burden. Health impact assessments (HIA) can be included as part of the assessment of a specific indicator in the context of reporting (e.g. years of life lost due to air pollution). The results of these assessments have to be judged carefully though, since health status is more influenced more by risk factors such as life style than the environment.

If narrowly focused on only a subset of potential risk factors, indicators may fail to identify the most relevant risk factors. The identification of potential risk factors therefore has to be guided by scientific evidence. Otherwise interventions may be misguided and public health resources misallocated.

Health indicators can be useful for better understanding of changes over time or differences between regions in the incidence or prevalence of health effects in populations. Indicators can shift the focus from debate and speculation about disease trends to improved understanding of disease trends, based on scientific evidence.

Both environment and health indicators together can be useful to generate hypotheses for broader research on risk factors for health effects in children and adults. The information

provided by the indicators can help prioritise children’s environment and health issues and guide the development of policies that aim at the reduction of child specific exposures to health relevant environmental factors and the allocation of necessary resources.

There are numerous indicator sets available at local, national and international level which contain one or more indicators relevant to environment and health. Information about changes in time or between/within- countries may be more important than the absolute levels of the indicators. Thus, comparability of the underlying databases is of the utmost importance. Unfortunately, the indicators in the different sets vary in operational definitions (age, diagnosis), geographical scale and quality. In addition, countries have to report to different organizations on the same issues, but sometime using slightly other indicator definitions. Thus, the development and use of a harmonised E&H indicator set to enhance data-comparability is recommended, taking into account different user needs at different levels, i.e. by developing different subsets or user-windows as has been done in the ECHI-project.

Advantages of a harmonised EH indicator set are the following:

• saving of resources

The development of a harmonised indicator set can save resources in the member states as well as in the Commission services which analyse and assess the data and convert them into information. Currently different authorities and experts are involved in the different processes and effective cooperation can release some manpower.

• better use of existing data

Much information about the state of the environment and health is already present in the Member States. Efforts should be supported to use these data for environment and health indicators.

• increased comparability

The standardisation of environmental and health monitoring has made enormous progress during the last decade. If common measures (health and environment monitoring, chemical and physical measurements, standards and guidelines for assessments) were further harmonised the comparability of the data would be enhanced.

• Benchmarking

International comparisons can be useful in the assessment of country differences in a specific area. They can help national authorities to identify priority areas and to elaborate their own policy taking into account the experiences from other countries.

• relevance for public health and environment policy

Well-defined indicators that rely on a scientific sound basis can help public health authorities to communicate the effects of environmental risks and to assess the actions implemented to reduce these risks.

• easier and better communication to stakeholders and to the public

When the indicators are widely accepted they can serve as a valuable tool for information strategies (e.g. as a component for the E&H Strategy).

• identification and prioritisation of research areas

• increased understanding of local environmental threats

(e.g. near old landfills or specific activities) A harmonised collection process can allow comparisons and eventually transpose observations and actions (preventive or corrective actions) from one local emerging threat to another one.

• Increased understanding of the cause–effect relationships

5.2 Requirements for development of a harmonised EU-indicator set

The added value of using EH indicators to address policy questions is in the combined analysis of both exposure and effect to obtain an expression, understandable by the decision-makers of the health risk associated with a specific environmental hazard. The purpose of the indicators to be selected/developed should be clearly defined (e.g. which policy aims should be evaluated). It is important that the existing international agencies developing environment and health indicators (WHO, EEA, EUROSTAT) should cooperate to ensure the development of a harmonised set that can serve the different purposes of the organizations and countries.

Prerequisites for the development of a set of indicators which can be used to examine overall trends in health and environment in the EU are:

• Clear definitions of issues of current or future interest or concern

• Integration of the many already existing programmes within the EU with WHO, EEA and EUROSTAT

• Standardisation of definitions

• Establishment of centralized data base/information system

• Standardisation of data collection (e.g. harmonisation of surveys or biomonitoring programmes)

• Quality control for sampling and analytical control

• Wide share of know how and access to data for countries and NGOs

• Sufficient resources (personal and technical resources for data analysis and reporting)

• Technical support for the development of an information exchange platform

• Prevention of unnecessary reporting burdens for the countries to enhance the compliance

• Definition of the level (local, regional, national, EU) at which respective indicators should be analysed

5.3 Missing links/data

EH indicators are currently provided for areas such as air pollution, water, noise where the evidence of health impacts is widely accepted and appropriate epidemiological measures for health impact assessment exist. When the health–environmental linkages are less well understood e.g. health effects of housing conditions or long-term exposure to chemicals the priorities, including research, are in identifying appropriate health outcomes and epidemiological measures as well as in harmonising the methods applied. An important missing link in the data-analysis is the lack of socio-demographic data which could be delivered from other databases (e.g. Eurostat New Chronos).

Environmental information, which can be derived from the reporting obligations within the existing (mostly environmental) legislation, is mostly about compliance e.g. number of exceedance days of air quality targets is of limited use for health-relevant assessments. When information on the state of the environment is available (e.g. the EEA AirBase which contains the air pollution levels in the European cities http://etc-acc.eionet.eu.int/databases/dobris.html) and the appropriate methodology is in place, environment and health indicators can be produced to quantify potential health benefits from reducing environmental pollution. Establishing, maintaining and making accessible of such databases should be encouraged and supported.

The countries who responded to our inventory mentioned the following priorities for development and standardisation of indicators (in order of frequency of nomination): Noise, Water, Food, Housing, Air pollution, allergy and asthma, traffic. Most countries stress the need for harmonisation of indicators for asthma and allergy.

The development of E&H indicators for the EU strategy for environment and health has to focus on the objectives of the strategy. Because no specific or quantitative objectives have been formulated so far, indicators cannot be proposed at this stage. The results of the different TWGs looking at the SCALE-priority diseases should be examined for the need of specific indicators that are not regarded yet in current information systems. A preliminary analysis of the available data for the four priority areas of the EH strategy indicates that:

• Data on childhood cancer are rather complete on the health indicator side, the environmental causes are not well understood.

• Indicators for child neurodevelopment are not well developed on a population basis.

• For respiratory health (in particular asthma) diagnostic criteria differ between countries. Agreement is needed at an European level on the definition of asthma cases, and indicators used (prevalence of asthma, of hospitalisation for asthma, of deaths linked to asthma).

• Perinatal/infantile conditions like hypospadia and cryptorchidism (perhaps related to EDCs) are currently not accurately measured. Measurements of pharmaceuticals in the environment should be considered because of potential human effects, for example hormonal effects of contraceptives.

For some areas, e.g. housing and noise, harmonised data collection methods are missing or not used. Further development of harmonised survey methods should be reinforced in collboration with the TWG on priority diseases.

5.4 Guidance for further development of international indicator set

The following steps should be taken to enhance further development of a harmonised international EH indicator set

• An organisational framework should be set up, including a steering group with representatives from EU, WHO, EEA and Eurostat and a projectgroup with representatives from the countries, NGOs and international projects. Main tasks of the steering group could be to ensure cooperation between the different agencies and relevant projects on the further development of EH indicators and enhance harmonised data-collection and exchange.

• Selection of priority areas to focus on, depending on the policy questions (eg transport, air quality, water quality, housing, food safety and the priority diseases mentioned in the EH strategy).

• Selection and definition of indicators. For the selection of European Union relevant indicators the set of WHO recommended indicators can be a starting point. Countries in different stages of development will need to focus on different indicator sets or specific selections out of the indicator sets. Selecting and applying indicators should follow a dynamic process starting with something ‘doable’ and iteratively improving according to new evidence, data and metrics to better meet the informed decision-making and priority issues of concern. This will also assure continuity in harmonisation of the data collection and data processing and gradual fill of the priority data-gaps. Since construction of indicators that meet all the criteria described in 2.3 is rather difficult, a reasonable compromise should be made i.e. a set of ‘core’ indicators. When data on exposure cannot be obtained “proxies” of exposures relating to the upper links in the framework (e.g. distance of dwellings to roads) can also be included. The indicators should be selected based on the “magnitude” (in terms of population number) of the potential health effects. Indicators higher-up the framework e.g. driving forces can also be useful as early warning signals.

• Testing of indicators for data-availability should only be done for newly-developed indicators. For the others the results of recent feasibility studies should be taken into account

• Harmonisation of data collection methods

• Development of data-exchange and data-control procedures as well as an information system structure. For this, the experience and datawarehouse-infrastructure from EEA may be a basis. The WHO website under preparation could be basis for a web-based portal of EH information system. It would be extremely helpful if this portal can be linked to both the EU (EUPHIN) and EEA information systems.

Annex I: Questionnaires

Austria

Bulgaria

Czech Republic

Denmark

Germany

Italy

Lithuania

Netherlands

Poland

Portugal

Romania

Slovenia

Sweden

United Kingdom

European Environmental Agency

Austria

Question Answer

1 Please fill in your name and address Name: Ingeborg Fiala

Email: [email protected]

Address: Bundesministerium für Land- und Forstwirtschaft, Umwelt und Wasserwirtschaft

Stubenbastei 5

A-1010 Wien

ÖSTERREICH

2 For which country/ project are you answering? Austria

3 Do you have indicator-based environment and health information?

No

4 Where is it located? Health or environment services?

5 Is environmental health an issue in the regular public health or environmental reporting?

No

6 Which specific issues (environment: eg air, water, health: eg respiratory diseases, annoyance) are being addressed?

Noise annoyance

7 What scale do your projects have? (local/regional/national/ international)

National

8 Can you name the E&H indicators you are using for the reporting? If yes, please fill in the names and methodology in the table attached

9 What is the purpose of the use of the indicators?

(e.g. Monitoring actions, awareness raising, warning, Planning actions)

10 Which methods for data collection do you use? (eg. Air quality surveillance, drinking and bathing water surveillance, surveys with environmental health questions, community noise surveys, mortality or morbidity statistics)

Survey with the question whether people feel heavily to not annoyed by noise in their flat (scale with 5 classes)

11 Do you specify age groups? No

12 Are there gender specifications? No

Question Answer

13 Do you see a link to the topics addressed in the commission initiative (respiratory diseases, childhood cancer, neurodevelopmental disorders)?

No

14 Which difficulties do you face with your system?

15 Where do you see major benefits?

16 If you still don't have an established indicator based E&H information system, are there initiatives to start such a project?

No, but we are following the processes on EU-level

17 Please name those environmental factors and health endpoints for which you believe development/standardisation of indicators has the highest priority. Examples might be : noise exposure metrics, noise annoyance, asthma, education on indoor air ventilation etc. Can you propose indicators for these factors/endpoints?

18 In your view, which of your national agencies/authorities should be involved in the development of an EU-wide indicator system? If possible give names and e-mail addresses of contact people

19 Do you know other projects than the ones mentioned above and the international ones listed at the annexed table which are related to the field of environment and health?

Bulgaria Question Answer 1 Please fill in your name and address Name: Hristina Mileva

Email: [email protected] Address: Ministry of Health, Sveta Nedelya sq.5, Sofia 1000, Bulgaria

2 For which country/ project are you answering?

Bulgaria, Environmental Health Indicator System; WHO


Yes. We are at the beginning in establishing such a system by participating in the above project


Health services


Yes. Again we are at the beginning. For this year it will be a part from the environmental reporting. After adoption of the new Public Health Low which is forthcoming it will be part from the health reporting


Environmental issues: ambient air quality, drinking and bathing water quality, food safety, traffic accidents, workplace, noise, waste, radiation, housing and settlements. Health issues: air pollution related diseases, traffic injuries, skin cancer, occupational diseases, water-born and food-borne diseases.


National and international


Yes

9 What is the purpose of the use of the indicators? (e.g. Monitoring actions, awareness raising, warning, Planning actions)

Monitoring, planning actions, environmental impact assessment, policy making


Ambient air surveillance, drinking and bathing waters surveillance, food safety surveillance, occupational health surveillance, communicable diseases surveillance, mortality and morbidity statistics, population census data

11 Do you specify age groups? Yes 12 Are there gender specifications? Yes 13 Do you see a link to the topics addressed in

the commission initiative (respiratory diseases, childhood cancer, neurodevelopmental disorders)?

Yes

Question Answer 14 Which difficulties do you face with your

system? Too many dataholders. Lack of quality assurance. Lack of human and financial resources in order to ensure the necessary data for the whole environment and health indicators

15 Where do you see major benefits? Very useful for assessment the environment and health situation at regional, national and international level, helps for problems prioritisation and more effective allocation of the limited resources available, allow international comparisons, gives possibility for relevant and timely information to the citizens



Ambient air quality, allergies (asthma in children), skin cancer, noise


Ministry of Health Dr.Snezana Altankova, Director Tel.: + 359 2 9301 250 e-mail: [email protected] National Centre of Hygiene, Medical Ecology and Nutrition, Nikolai Rizov, Director Tel: + 359 2 5812 274 Ministry of Environment Fatme Iliaz, Deputy minister Tel: + 359 2 940 62 57 Environmental Agency Dimitar Vergiev, Director Tel: + 359 2 955 90 11


No

Czech Republic

Question Answer

1 Please fill in your name and address Name: Dr. Ruzena Kubinova


Address: National Institute of Public Health, Srobarova 48, 100 49 Praha 10, Czech Republic

2 For which country/ project are you answering? Environmental Health Monitoring System in the Czech Republic


Yes


Health


Yes


Air, drinking water, bathing water (since 2003), quality of food in relation to the exposure, community noise annoyance and sleep disturbances, acute respiratory diseases, allergy incl. asthma in children, water-borne and alimentary diseases, occupational diseases, bio-monitoring, health status, socio-economic factors, health and life perception


Local (urban), national


Yes



Monitoring, planning actions, priority settings, using in HIA process, awareness raising


Air quality surveys, drinking and bathing water surveillance data collecting, surveys with environmental health questions, community noise surveys, medical records from physicians, notification systems ( EPIDAT, Register of occupational

Question Answer diseases), morbidity statistics

11 Do you specify age groups? Partly

12 Are there gender specifications? Partly


Yes


So far no fatal problems

15 Where do you see major benefits? Time trends describing, objectification of the health threats, tool for identification of the main health risks, knowledge of the health status and people perception for preventive programmes setting and health risk communication



Allergy incidence incl. asthma in children, noise annoyance level, urban air quality, life style and health perception indicators


Ministry of Health Karla Rihova [email protected] National Institute of Public Health Ruzena Kubinova [email protected] Ministry of Environment Karel Blaha [email protected] Transport Research Centre Milan Brich [email protected] Czech Statistical Office Dep.of international cooperation

Question Answer Hana Slegrova tel. +4202 266107776 +4202 266107775 Institute for Health Information and Statistics [email protected]


Some of EH indicators are collected and reported in the frame of plenty of national and regional systems within Ministry of Environment, M. of Agriculture, M. of Transport, M. for Municipal Development, and several agencies (Czech ecological institute, Centre for environment by Charles University, Czech Statistical Office, Institute for Health Information and Statistics etc.).

But there is no other comprehensive EH indicator system in the contemporary sense.

Denmark

Question Answer

For which country/ project are you answering? Denmark

Do you have indicator-based environment–health information?

Yes, a chapter in Denmark’s national Indicator Report for sustainable development concerns environment and health containing indicators for

- Chemicals

- Environmental quality and other environmental factors

- Food

- Health and safety

Where is it located? Health or environment services?

Both the Danish Environmental Protection Agency, the Danish Ministry of Food, Agriculture and Fisheries, the Ministry of Employment and the National Board of Health are responsible for collecting data for environment and health indicators.

Is environmental health an issue in the regular public health or environmental reporting?

Yes, Denmarks national strategy for sustainable development and the related yearly indicator report contain environment and health chapters.

Which specific issues (air, water, etc.) are addressed?

Harmful effects (asthma), chemicals, air, soil contamination, drinking water, food, and bathing water.

What scale do your projects have? (local/regional/national/ international)

National

Can you name the E&H indicators you are using? If yes, please fill in the table

Please, see table

What is the purpose of the use of the indicators?


In Denmark’s national strategy for sustainable development the goal is that Denmark should be a country where pollution from products, food, working environment, traffic, and physical indoor conditions affecting the population’s quality of life and health is constantly falling. The development of indicators for health and the environment will be carefully monitored with a view to using relevant new indicators to elucidate the objectives.

Question Answer

In Denmark’s national strategy for Environment and Health one goal is to develop a comprehensive set of indicators illustrating the relationship between environmental factors and health. Among other things the objective is to establish a permanent system for monitoring environment-related health risk.

Which methods for data collection do you use? (survey, measurement, etc.)

It depends on the specific indicator. Both survey and measurement are used.

Do you specify age groups? Yes, for some data collections.

Are there gender specifications? Not for the current indicator set.

Do you see a link to the topics addressed in the commission initiative (respiratory diseases, childhood cancer, neurodevelopmental disorders)?

Yes, the national work on developing environment and health indicators will be closely related to both the commission initiative and work with indicators in the EU and the WHO indicators

Which difficulties do you face with your system? It is a great challenge to analyse and clarify the possibility of obtaining more information by parallel processing databases containing environmental and geographical information with health databases (data comparability and legal implications).

Where do you see major benefits? Initiatives to achieve better indications on the relationship between environmental factors and health.

Relevant ministries will examine possible ways of attaining more end better information about the relationship between environmental factors and health via parallel processing of databases within the different areas.

If you still don't have an established indicator based E&H information, are there initiatives to start such a project?

Do you know other projects than your above mentioned ones and the international ones listed at the annexed table which are related to the field of environment and health?

France

Question Answer

1 Please fill in your name and address Name: Philippe PIRARD Email: [email protected] Address: Philippe PIRARD INVS 12 rue du Val d’Osnes 94415 Saint-Maurice FRANCE


FRANCE


Yes


Health, Environmental, Agriculture, National Institute of Radioprotection and Nuclear Safety, InVS…


Yes


Environmental 1- Air quality, admissions and mortality

linked with air quality 2 - Drinking /Swimming water and

sanitation, Outbreaks of water-borne

diseases/Diarrhoea morbidity 3 - Radiations (Air, water, soil..)

exposures 4 - Food Toxics and bacteriae in flesh and

vegetables and outbreaks of specific diseases

5 – Waste and contaminated land 6 - Housing 7 – lead level in blood mortality, congenital malformations, cancers (national for childhood, regional for adults), asthma, traffic accident


National or regional it depends


Yes (see table attached)

Question Answer

9 What is the purpose of the use of the indicators? (e.g. Monitoring actions, awareness raising, warning, Planning actions)

Planning, Warning and Monitoring actions, research,


Several: mandatory declarations, administrative automatic registrations, surveillance plans, community surveys, statistics, medical registries, accident registration

11 Do you specify age groups? Only in demographic, mortality or morbidity statistics and in Community surveys

12 Are there gender specifications? Only in demographic, mortality or morbidity statistics and in Community surveys


Yes for respiratory diseases and asthma , yes for cancer in childhood, Yes for neurodevelopmental disorders ( lead level in blood) Not for endocrine disruptors


To establish a link, after collecting data, between environmental exposure and health status, with an or several indicators Haronisation and sharing of the data collected from different sources

15 Where do you see major benefits? Standardisation of indicators, in various settings


Yes


1. Asthma and respiratory diseases 2. Housing conditions 3. Drinking /Swimming Water and

sanitation


InVS: National Institute of Public HealthMinistry of Heath, Environment Ministry Agence Française de Sécurité Sanitaire de l’Environnement and Ministry of Agriculture

Question Answer


No

Germany

Question Answer

1 Please fill in your name and address Name: Jürgen Thelen


Address: Federal Environmental Agency, Germany, Correnplatz 1, 14195 Berlin


Germany


Information System operating on Federal and Federal State Level; mainly Environmental Indicators with link to health;

Participant in WHO-EHI and WHO-ECOEHIS Project;


Federal Information Systems: Environment: Federal Environmental Agency http://www.env-it.de/umweltdaten/jsp/dispatcher?event=WELCOME Health: Robert Koch-Institute and Federal Statistical Office www.gbe-bund.de

Federal State Systems: Environmental or Public Health Authorities (in some States e.g. NRW, Bavaria)


Both, in Environment and Public Health reporting; Environmental Trend Report of the MoE scheduled for Autum 2004


Drinking and bathing water quality, outdoor and indoor air quality (Radon), Human Biomonitoring (HM, POP), Noise Annoyance,


Mainly National and Federal State Level, Participant in international projects


National Level: yes


Environmental performance Indicators (e.g. SD, Climate Protection), Public Information, Stakeholder Information; Monitoring of time

Question Answer


trends, Warning systems


Environmental Surveys, Community Surveys with environmental questions, Surveillance (Air Quality, Water, Radiation, Food), Registers, Mortality and morbidity statistics

11 Do you specify age groups? For some purposes; environmental Survey: adults; Environmental Survey for children and adolescent

12 Are there gender specifications? For some issues


Respiratory diseases are investigated in the ongoing children and adolescence health and environment survey, Register on Childhood cancer operating at the University of Mainz,


Connection of environmental and health data due to different resolution (geographical), assessment of health effects uncertain (lack of evidence); Responsibilities distributed; no Resources

15 Where do you see major benefits? For known impacts of env. factors, assessment of development is possible, Communication is proactive, Policy Evaluation partly possible



s. table


Federal Environmental Agency Robert Koch-Institute Federal Radiation Protection Agency Federal Institute for Risk Assessment Federal Office for Consumer Protection and Food Safety

Question Answer


Italy

Question Answer

1 Please fill in your name and address Name: Luciana Sinisi Email: [email protected] Address: APAT National Environmental Protection Agency Via Vitaliano Brancati, 48 – 00144 Rome, Italy



A)No, yet. Environment and health information system are self-governing and not linked in a common structure for environmental health issues.

Environmental indi ators are developed on DPSIR model.

B) Two specific projects are in initial phase to develop E&H indicators:

1. participation feasibility ECOEHIS WHO Project,

2. Environmental and health project of the Dept. of the State of the Environment of National Environmental Agency


A) Information system: 1) National Environment information

system (EIS) cooperating to EIONET and Regional EIS. –( Env. Agency

2) Health information system – (Min. of Health)

3) National Statistical Institute Many environmental health issue of the Health information system collate to national statistical system

B)Projects b) projects 1&2 APAT (National Environmental Protection Agency) .


Reporting are basically independent but many of them regard environmental health issues


See annex table of main indicators on E&H relevance


National/International


See annex table where has been reported also the referring institutions for developed indicators



Monitoring and planning actions, planning investments and funding, address research needs on data collections and measurements


Generally Environmental ones are based on direct measurements.

There is also a system to collect mortality data and hospital dismissions diagnosis of all national territory.

Methods of collection are specified for each indicators in the annex table

11 Do you specify age groups? See annex

12 Are there gender specifications? See annex


There are already developed indicators in all information system (health statistical and environment) that can be useful, but there is a need of ad hoc adjustment and planning


Many data holders, lack of a specific E&H informative system, that is linkage and overlapping of exposure and effects indicators, although we have good organized informative systems

15 Where do you see major benefits? Added value for health prevention policy and health promotion in environmental policy both for local management and for overall European monitoring.


Projects already mentioned of the National Environmental Protection Agency :

a)participation as NFP to ECOEHIS WHO Project,

b) “Environment and health project “of the Dept. of the State of the Environment of the Agency

17 Please name those environmental factors and health endpoints for which you believe development/standardisation of indicators has

In general I would refer to the environmental determinants of health evidence-base indicated by WHO

the highest priority. Examples might be : noise exposure metrics, noise annoyance, asthma, education on indoor air ventilation etc. Can you propose indicators for these factors/endpoints?

(www.who.int/hia/evidence/doh/en/index5.html)

Biomonitoring of children must be stressed


1) Ministry of Environment

Ministero dell’Ambiente e tutela del territorio Viale Cristoforo Colombo, 44 – 00147 Rome, Italy www.minambiente.it e-mail: [email protected]

2) APAT

National Environmental Protection Agency

General Director

Via Vitaliano Brancati, 48

00144 Rome, Italy

www.apat.it

3) Ministry of Health Ministero della Salute Piazzale dell'Industria, 20 - 00144 ROMA www.ministerosalute.it 4) National Institute of Health Istituto Superiore di Sanità. Viale Regina Elena 299 00161 - Roma Italy www.iss.it 5) National Statistical Office

ISTAT - Istituto Nazionale di Statistica

Via Cesare Balbo 16 00184 – Rome, Italy

www.istat.it


no other the ones already mentioned

Lithuania

Question Answer

1 Please fill in your name and address Name: Ingrida Zurlyte


Name: Aida Laukaitiene


Address:

Environment and Health Division

State Environmental Health Centre

Kalvariju street 153,

LT-2042 Vilnius, Lithuania


Lithuania


Yes

(initial phase)

Participating in the WHO/ECEH Project “Environmental Health Indicator System”


State Environmental Health Centre, Ministry of Health

Data from Environmental Protection Agency, Lithuanian Health Information Centre, Statistical Department and other institutions according to specific topics are collected and processed.


No.

Recently, environmental health became part of health statistics reports, but to a very limited extent.

As initial stage pilot testing of core set of Environmental Health Indicators (developed within the WHO/ECEH project) has been carried out.

National list of Environmental Health indicators (based on core set of EH indicators developed within the WHO/ECEH project) was established by

Question Answer the order of the Minister of Health in 2002. Procedure for data collection, processing, analysis and distribution is under development.

Draft National Public Health Monitoring Programme is developed. It includes environmental health part too (limited).


Ten environmental issues according the WHO/ECEH Environmental Health Indicator system project: Air Quality, Housing and Settlements, Traffic Accidents, Noise, Waste and Contaminated Lands, Radiation, Water and Sanitation, Food Safety, Chemical Emergencies, Workplace; and related health issues: respiratory diseases, circulatory diseases, accident related traumas, injuries, skin cancer, communicable diseases transmitted by food, occupational diseases / injuries.


International, national.

It is planned to pilot it on regional and local levels in the future.


Yes (but at the moment they are used separately for environmental reporting and for health reporting, synthesized (integrated) reporting on environmental health is not developed). Information provided in the table is based on WHO/ECEH EH indicators project feasibility study report.



Evidence on environment and health links, possible use for environmental health impact assessment, monitoring actions, planning actions.


Air quality surveillance, drinking and bathing water surveillance, mortality and morbidity statistics, population census data, household surveys, communicable disease surveillance, waste generation statistics, environmental radiation activity surveillance, food safety surveillance, chemical incidents surveillance,

Question Answer occupational health surveillance, routine statistical data.

11 Do you specify age groups? Yes, for health indicators

12 Are there gender specifications? Yes, for health indicators


Yes. Direct link. Additional health and environmental data would be available.


- lack of cooperation between stakeholders (data holders) and inadequate data exchange mechanisms;

- lack of human and financial recourses for management of integrated environmental health information system;

- insufficient resources/capacities for producing data on human exposure (for all specific issues);

- no resources for specific environmental health population surveys.

15 Where do you see major benefits? System based on Environmental Health Indicators is an effective tool for synthesis of those data, in detecting the major environmental health problems and in suggesting the best political solutions.


Establishment of indicators based environmental health information system is one of the objectives of the National Environmental Health Action Programme (2003 – 2006) of Lithuania adopted by the Government.

Lithuania is in the first stage of development of indicator based E&H information system by participating in the WHO/ECEH Project on Environmental Health Indicator System.

17 Please name those environmental factors and health endpoints for which you believe development/standardisation of indicators has the highest priority. Examples might be: noise exposure metrics, noise annoyance,

Air pollution exposure (WHO E&H ind. Exposure to ambient air pollutants (urban)), noise annoyance (WHO E&H ind. Population annoyance by certain sources of noise, Sleep disturbance by

Question Answer asthma, education on indoor air ventilation etc. Can you propose indicators for these factors/endpoints?

noise), noise exposure (Population exposed to various noise level ranges per source (air, road, rail, industrial, others)), housing indicators (WHO E&H ind. Population living in substandard housing), traffic injuries (WHO E&H ind. Rate of injuries by traffic accidents), incorporation of children environmental health indicators into the core set.


1. Ministry of Health, Head of Public Health Division, Mr. Romualdas Sabaliauskas, [email protected]

2. State Environmental Health Centre, Deputy Director, Ms. Ingrida Zurlyte, [email protected]

3. Ministry of Environment, Secretary, Mr. Aleksandras Spruogis, [email protected]

4. Environmental Protection Agency, Director, Mr. Liutauras Stoskus, [email protected]

19 Do you know other projects than the ones mentioned above and the international ones listed at the annexed table, which are related to the field of environment and health?

No

The Netherlands

Question Answer

1 Please fill in your name and address Name: Brigit Staatsen


Address: PO.box 1, 4720 BA Bilthoven, Netherlands

2 For which country/ project are you answering? The Netherlands


Information System on national level; mainly Environmental Indicators with link to health;

Participant in WHO-EHI and WHO-ECOEHIS Project


National Information Systems: National Institute of Public health and Environment (RIVM:www.rivm.nl Health: Kompas Environment: Milieucompendium (in English)

Environmental health: in development at RIVM

Regional information Systems: Environmental or Public Health Authorities (eg Rijnmondregion DCMR)


Both, in Environment and Public Health reporting; Environmental Balance with new environmental health impact assessment scheduled for Spring 2004


Drinking and bathing water quality, outdoor and indoor air quality (Radon), Human Biomonitoring (POP, breast milk), Noise exposure and Annoyance/sleep disturbance, Quality of living environment (satisfaction surroundings, risk perception, % green or quiet areas etc). health status: resp and cardiovasc diseases, Calculations of environment-related health loss (mort, morb, DALYs) Regional hot spots: eg Schiphol and Rijnmond region

Question Answer


Mainly National and Regional, Participant in international projects


National level: yes



Evaluation of policy measures (mainly by monitoring environmental quality)

Monitoring of time and (sometimes) spatial trends, priority setting

Basis for health impact assessment

Public Information

Warning system


Limited biomonitoring (POP-breast milk), Community Surveys with environmental health questions. Community noise surveys, Surveillance (Air Quality, Drinking and bathing water, Radiation, Food), Health Registries: Mortality and morbidity statistics (hospital records, physicians)

11 Do you specify age groups? Sometimes

12 Are there gender specifications? Sometimes


Respiratory diseases in children are investigated in several research projects and some regional children and adolescent health surveys, Childhood cancer registered at regional cancer registries but not an environmental issue

Cognition and behavioural aspects studied in relation to noise in Health Monitoring Programme Schiphol (RANCH)


Difficult to link environmental and health data due to different resolution (geographical), privacy restrictions, assessment of health effects uncertain (lack of data on important confounders); Responsibilities distributed; very limited Resources

Question Answer

15 Where do you see major benefits? For known impacts of env. factors, assessment of time trends and policy evaluation . Tool for identifying possible emerging risks (sentinel function). But risk of ecological fallacy. Data on confounders at small area level needed for better analysis of trends in less well-known risks



Noise exposure, annoyance/sleep disturbance

Asthma in children

Urban air quality

Perceived health

Action indicators


RIVM

Central Bureau of Statistics

Ministry of Environment

Ministry of Public Health


Eurostat

Poland

Question Answer

1 Please fill in your name and address Name: Dorota Jarosińska

Email:[email protected]

Address: Institute of Occupational Medicine and Environmental Health,

13 Koscielna, 41-200 Sosnowiec, Poland


Poland


There is no integrated E&H information based on indicators. However, there are data collection systems for several environmental and for health indicators


Indicator based information on health and environment is located in the respective sectors


No

EH issues are not subject to regular public health or environmental reporting yet. However, the relevance of this issue is recognized, and there are attempts to incorporate EH topics in regular reporting. In 2001, many-year governmental programme “Environment and health” has been established, with one of the objectives to implement integrated E&H information system.


For environmental reporting: ambient air, surface water, drinking water,

For the health reporting: respiratory diseases, cardiovascular diseases, diarrhoeal diseases, cancer (mortality/morbidity); traffic accidents


Poland participates in the project on Environmental Health Indicators led by the WHO Europe, ECEH Bonn Office. This is collaborative international project,

Question Answer

aiming to establish indicator based E&H information system useful on the local, regional, national and international levels.


Currently, no E&H indicators are regularly reported. Several of the EH indicators from the core set of the WHO developed indicators are pilot tested in Poland.



To monitor, to plan and/or to modify actions

Once the comprehensive EH indicator system with the well structured “information modules” (fact sheets) is implemented, its awareness raising function is expected to increase.


Ambient air quality surveillance, drinking and bathing water surveillance, mortality and morbidity statistics

Census data

11 Do you specify age groups? For some of the health indicators

12 Are there gender specifications? For some of the health indicators


Yes.

Respiratory diseases are included in the WHO Europe project on EH indicator (with the potential to extend information using survey methods).

Based on the growing scientific evidence, neurodevelopmental disorders and childhood cancer are considered relevant E&H issues; in terms of indicators, development of the adequate and feasible tools may be a serious challenge.


The E&H indicator system is pilot tested now. At this stage the main difficulties are: availability and accessibility of data;

Question Answer

availability and reliability of additional information necessary for the indicator interpretation and assessment; consistency of currently collected data with the proposed indicator methodology; in some cases insufficiency of the existing data collection systems for E&H indicators

Not clearly set responsibilities for E&H indicator based information system. Lack of the organizational mechanisms, within and across the sectors providing data and involved in the EH indicator system operation.

15 Where do you see major benefits? Better use of the systematically collected data on environment and health. Generation of the relevant EH information which will be used for policy making on different levels (sub-, and national).

Identification of the relevant data needs and gaps in the existing reporting systems; potential for improvement, aiming at the system allowing for a comprehensive “view” of the EH situation in the country

Gradual improvement of the E&H data collection and reporting systems, resulting from application of the harmonized methodology, facilitating reliable international comparisons


Yes – Implementation of the governmental program “Environment and Health”, and participation in the WHO Europe ECEH Bonn Office, currently at the stage of pilot testing, are the most relevant initiatives to establish and implement indicator based E&H information system in Poland.

17 Please name those environmental factors and health endpoints for which you believe development/standardisation of indicators has the highest priority. Examples might be :

Asthma/ respiratory health (mild health effects), taking into account susceptible sub-populations (mainly standardization/harmonization)

Question Answer

noise exposure metrics, noise annoyance, asthma, education on indoor air ventilation etc. Can you propose indicators for these factors/endpoints?

Exposure to microbiological/chemical factors in the indoor environment (development/harmonization)

Annoyance to noise and other factors in the immediate living environment (harmonization/development)

Housing standard and the perceived housing quality (development/harmonization)

ETS exposure in different subgroups (mainly standarization/harmonization)


For development of the system, Institute of Occupational Medicine and Environmental Health could be a national partner: a state managed research institute, the national partner in the WHO EHI project and leading institution in the governmental program “Environment and Health”.

Director: JA Sokal



No

Portugal

Question Answer

1 Please fill in your name and address Name: Cesaltina Ramos


Address: Alameda D. Afonso Henriques, 45

1049-055 LISBOA


Portugal


Yes


Health, Environmental and other services


Yes


1- Drinking /Swimming water and sanitation

Outbreaks of water-borne diseases/Diarrhoea morbidity


National


Yes ( see table)



Planning, Warning and Monitoring actions


Several: Surveillance plans, community surveys, statistics, medical registries, accident registration

11 Do you specify age groups? Only in demographic, mortality or morbidity statistics and in Community surveys

Question Answer

12 Are there gender specifications? Only in demographic, mortality or morbidity statistics and in Community surveys


Yes


To establish a link, after collecting data, between environmental exposure and health status, with an or several indicators

15 Where do you see major benefits? Standardisation of indicators, in various settings


Yes


Drinking /Swimming Water and sanitation


Ministry of Heath,

Environment Ministry and

Ministry of Agriculture.


No

Romania

Question Answer

1 Please fill in your name and address Name: Alexandra Cucu



ROMANIA, “Environmental Health Indicators for the WHO European Region” Project


Yes


Health


Yes


Air quality, Housing and settlements, Traffic accidents, Noise, Waste, Radiation, Water and sanitation, Food safety, Workplace


National and International

(for some indicators there are also data at local and regional level)


See the attached table



Monitoring, risk management, risk communication, development of intervention plans, policy making


Routine data collection (mortality and morbidity statistics)

Surveillance systems for: air quality, drinking water, food safety, noise, housing

Census and household surveys for housing

11 Do you specify age groups? Yes

12 Are there gender specifications? Yes, in surveys

13 Do you see a link to the topics addressed in the commission initiative (respiratory

Respiratory diseases and possibly childhood cancer

Question Answer diseases, childhood cancer, neurodevelopmental disorders)?


Lack of data quality assurance

Too many information sources

15 Where do you see major benefits? EHIS Is a very useful managerial tool, able to meet real needs of communication and transparency.

This core set of indicators provides useful information for policy

making at local and national level, and facilitates international comparability and data exchange.



Noise, noise annoyance, indoor air ventilation


National Institute of Statistics

Institute of Public Health Bucharest

Ministry of Agriculture, Forests, Water and Environment

Ministry of Internal Affairs


ENHIS

Slovenia

Question Answer

1 Please fill in your name and address Name: Inga Turk


Address:Ministry of the Environment,

Spatial Planning and Energy,

Dunajska 48,

Ljubljana 1000

Slovenia

Name: Peter Otorepec


Address:IVZ Trubarjeva 2 Ljubljana 1000

2 For which country/ project are you answering? Slovenia Institute of public health of the republic of Slovenia


no no



Yes/no

Different topics are included in different reports.

Yes/no

Different topics are included in different reports.


Environment:

- list of environmental indicator (attached)

Environment:

Water (drinking and bathing water, waterborne outbreaks)

Food (microbiological foodborne diseases)

Health: most of HFA indicators


national/ international regional/national/ international


No



Monitoring actions, awareness raising, warning, Planning actions

Monitoring actions, awareness raising, warning, Planning actions

10 Which methods for data collection do you use? (eg. Air quality surveillance, drinking and bathing water surveillance, surveys with environmental health questions, community noise surveys,)

EEA methodology

(fact sheets for indicators of the European Environmental Agency)

Drinking and bathing water surveillance,

mortality and morbidity statistics,

WHO methodology.

11 Do you specify age groups? / Yes for some data

12 Are there gender specifications? / Yes for some data

13 Do you see a link to the topics addressed in the commission initiative (respiratory diseases, childhood cancer, neurodevelopmental

/ Yes

disorders)?

14 Which difficulties do you face with your system? accessibility of data

lack of methodology for indicators, harmonization of the methodology

Different bases,

accessibility of data.

15 Where do you see major benefits? Time trend analysis, plan for action Time trend analysis, plan for action.


Yes Yes


/ - Noise (no. of people especially children exposed harmful levels of noise and time of exposure)

- indoor air


Ministry of Health and Ministry of Environment, Spatial Planning and Energy

Ministry of Health,

Ministry of Environment,

Institute of public health

Cancer registry

Ministry of internal affairs (traffic accidents)


/ APHEIS

PHEWE

PEOPLE

Sweden Question Answer

For which country/ project are you answering? Sweden/ indicators


Yes


National Board of health and Welfare;

www.sos.se

Swedish Environmental Protection Agency

www.environ.se


Yes, both


Metals (lead, mercury, cadmium) concentration in blood, PCB, dioxin mothers milk, benzene in air


Both, Swedish national monitoring programme concerning human exposure


Yes see table



Monitoring actions, exposure current, ongoing

awareness raising

Planning actions


measure and estimate human exposure to substances that are hazardous to health.

Do you specify age groups? To some extent

Are there gender specifications?


Respiratory diseases (airpollution), neurobehavioral disorders (related to Methyl mercury and/or PCB),

Which difficulties do you face with your system?

Economical resources

Where do you see major benefits? Knowledge about exposure to humans, both current and ongoing


Ongoing

Do you know other projects than your above National Environmental Health related

Question Answer mentioned ones and the international ones listed at the annexed table which are related to the field of environment and health?

report , National Board of Health and Welfare;

National health related report –children underway, Institute of Environmental Medicine, Karolinska Institutet and National Board of Health and Welfare;

United Kingdom Question Answer

1 Please fill in your name and address Name: Mark McCarthy


Address: Department of Epidemiology and Public Health

University College London

London WC1E 6BT

UK

2 For which country/ project are you answering? UK / EUPHA


No


There is no systematic collection of environment and health information together in UK, nor does EUPHA collect


no



none





11 Do you specify age groups?

12 Are there gender specifications?


Question Answer


15 Where do you see major benefits?


Not at the moment



The central point for contact in department of environment, food and rural affairs is

[email protected]


European Environmental Agency

Question Answer

For which country/ project are you answering?

European Environment Agency

www.eea.eu.int


- In development with WHO and EC

- At present, EEA information system mainly contains data on environment conditions and very few exposure data (focus on air and water, limited on chemicals, none on in-door pollution)


Environment


Regular environment reporting (Assessment reports/publications)

http://themes.eea.eu.int/Environmental_issues/human


All health environment-related issues are tentatively addressed in the assessments but this is not backed up at the moment by a comprehensive and structured health& environment indicator-based system


European region (up to WHO-Europe coverage)

EEA membership covers 31 countries but cooperation is in place with Western Balkans and EECCA (Eastern Europe, Caucasus & Central Asia countries)


The EEA core set of indicators (under review – see link below) includes many indicators that are relevant to health but are not as such constructed as E&H indicators. This is being done in partnership with WHO - see http://www.euro.who.int/eprise/main/WHO/Progs/EHI/Methodology/20030528_1

http://eea.eionet.eu.int:8980/Public/irc/eionet-circle/core_set/library?l=/material2&vm=detailed&sb=Title (Section 5.1 & 5.2)


To answer in a structured and repeatable way policy questions and progress (trends) over time related as far as possible to targets,

Question Answer


environmental objectives or (sustainability) reference values.

Indicators help organise the structuring and logic of the regular reporting system. This is approached with MDIAK chain of EEA system and production processes (the logical iterative flows in Monitoring – Data – Information – Assessment – Knowledge).

Indicators are thus used both to answer policy questions and to streamline monitoring needs while at the same time raising awareness and supporting policy analysis (use of the analytical framework DPSIR)


Data is coming from national systems or international data bases, which means methods are depending on the national processes. EEA & WHO are focusing on harmonization of methods and comparability of data from national sources.

Do you specify age groups? Not as a rule - In some specific case studies

Indicators for Children, health & environment are under development (WHO, EEA)

http://www.euro.who.int/childhealthenv/Monitoring/20030627_1

Are there gender specifications? Not as a rule - In some specific case studies


Yes, a direct link as our indicator development is to cover causality

Which difficulties do you face with your system?

Difficulties are being overcome thanks to the positive development of indicator work, which identification and organisation underpin the system structure and contents.

Where do you see major benefits? (see point above). The link with national capacities and systems brings in the necessary discussion on harmonization, compatibility and inter-operability.

The partnership with WHO and EC (as well as in consultation with Eurostat, UNEP, OECD) also brings the appropriate implementation of

Question Answer a shared information system.


Partnership with WHO & EC (SANCO & ENV)

http://www.euro.who.int/EHindicators

http://www.euro.who.int/EHindicators/Methodology/20030527_12

Do you know other projects than your above mentioned ones and the international ones listed at the annexed table which are related to the field of environment and health?

Not for Europe

Annex II: Tables

Belgium

Czech Republic

Denmark

France

Germany

Italy

Lithuania

Poland

Portugal

Romania

Slovenia

Spain

Sweden

Bel

gium

Nam

e: D

ewol

f Mar

ie-C

hris

tine

–

Dire

ctor

of H

ECTO

R, H

ealth

and

Env

ironm

enta

l Car

e Te

chni

cal O

rgan

isat

ion

Mem

ber o

f the

Exe

cutiv

e C

omm

ittee

of t

he E

PHA

Env

ironm

enta

l Net

wor

k E-

mai

l: m

cdw

@he

ctor

-asb

l.be

ou m

cdw

@sk

ynet

.be

Te

l: +3

2.10

.81.

07.4

7 A

ddre

ss: R

ue d

e la

Sap

iniè

re, 1

0 –

1340

Otti

gnie

s-Lo

uvai

n-la

-Neu

ve -

BEL

GIU

M

Cou

ntry

or p

roje

ct: B

ELG

IUM

& E

EN (E

urop

ean

Net

wor

k)

Y=

yes,

N=

No

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

de

finiti

on

Purp

ose

use

of

indi

cato

r

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

Air

qua

lity

1. E

nerg

y us

e by

road

traf

fic

(1)

Ex

/hab

itant

M

IRA

repo

rt R

egio

nal

N

w

ww

.mili

eur

appo

rt.be

year

ly

2.

Em

issi

ons o

f SO

2, N

Ox

en

VO

C (1

)

Ex

Kto

n M

IRA

repo

rt R

egio

nal

N

w

ww

.mili

eur

appo

rt.be

Yea

rly

3.

Yea

rly

emis

sion

s of

heav

y m

etal

s (1)

Ex

K to

n/ye

ar

MIR

A re

port

Reg

iona

l N

ww

w.m

ilieu

r

appo

rt.be

Yea

rly

4.

Em

issi

ons o

f 17

dio

xins

(1)

Ex

gTEQ

/yea

r

Reg

iona

l N

ww

w.m

ilieu

r

appo

rt.be

Yea

rly

5.

Yea

rly

aver

age

conc

entra

tion

of

NO

2 (1)

Ex

µg/m

³ M

IRA

repo

rt Lo

cal a

nd

Reg

iona

l N

ww

w.m

ilieu

r

appo

rt.be

Yea

rly

6.

Yea

rly

aver

age

conc

entra

tion

of

PM10

(1)

Ex

µg/m

³ M

IRA

repo

rt Lo

cal a

nd

Reg

iona

l N

ww

w.m

ilieu

r

appo

rt.be

Yea

rly

Som

e th

inki

ng

abou

t de

velo

ping

th

e us

e of

PM

2.5

indi

cato

r is

on g

oing

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

de

finiti

on

Purp

ose

use

of

indi

cato

r

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

7.

Yea

rly

aver

age

conc

entra

tion

of

SO2 (

1)

Ex

µg/m

³ M

IRA

repo

rt Lo

cal a

nd

Reg

iona

l N

ww

w.m

ilieu

r

appo

rt.be

Yea

rly

8.

Ozo

ne

conc

entra

tion

(1)

Ex

Num

ber o

f da

ys w

here

th

e hi

ghes

t oz

one

conc

entra

tion

(ave

rage

d on

8 h

ours

) ex

ceed

ed

MIR

A re

port

Loca

l and

R

egio

nal

N

w

ww

.mili

eur

appo

rt.be

Yea

rly

9.

Exc

eedi

ng o

f re

fere

nce

conc

entra

tion

of

sele

cted

po

lluta

nts i

n ci

ty a

rea’

s (r

epor

ted

to

popu

latio

n) (1

)

Ex

µg/m

³ Se

lect

ed

pollu

ttant

s :

NO

2, PM

10

(yea

rly a

nd

daily

) SO

2, O

zone

, Pb,

TS

P, B

S

R

egio

nal

N

Yea

rly

10

. Yea

rly

aver

age

conc

entra

tion

of

benz

ene

and

1,2-

dich

loro

etha

ne

(1)

Ex

µg/m

³ M

IRA

repo

rt R

egio

nal

N

w

ww

.mili

eur

appo

rt.be

year

ly

11

. Yea

rly

aver

age

conc

entra

tion

of

benz

o(a)

pyre

ne

en 1

0 re

pres

enta

tive

HA

P (1

)

Ex

ng/m

³ M

IRA

repo

rt Lo

cal a

nd

Reg

iona

l N

ww

w.m

ilieu

r

appo

rt.be

Yea

rly

12

. Pol

lutio

n fr

om d

ioxi

nes

(1)

Ex

Pg

TEQ

/m³.d

ay

Lo

cal a

nd

Reg

iona

l N

Y

early

13

. C

once

ntra

tion

of h

eavy

met

als

(1)

Ex

µg/m

³ H

eavy

m

etal

s: A

s, C

d, C

r, Pb

, H

g, N

i

Lo

cal a

nd

Reg

iona

l N

ye

arly

14

. Yea

ly

E N

umbe

r per

Reg

iona

l <

5

ye

arly

- C

hild

ren

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

de

finiti

on

Purp

ose

use

of

indi

cato

r

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

child

ren

mor

talit

y du

e to

ac

ute

resp

irato

ry

dise

ases

(1)

1 00

0 ch

ildre

n (<

5

year

s)

orie

nted

- g

ood

polit

ical

and

aw

aren

ess

rais

ing

indi

cato

r - l

ong

term

in

dica

tor

(non

pr

oact

ive

at

shor

t ter

m)

15

. Yea

rly

mor

talit

y du

e to

ac

ute

resp

irato

ry

dise

ases

(1)

E N

umbe

r per

10

0 00

0 pe

rson

s

R

egio

nal

N

year

ly

- goo

d po

litic

al a

nd

awar

enes

s ra

isin

g in

dica

tor

- lon

g te

rm

indi

cato

r (n

on

proa

ctiv

e at

sh

ort t

erm

)

16. I

ncid

ence

on

lung

can

cer

(1)

E N

umbe

r of

case

s per

100

00

0

R

egio

nal

N

year

ly

17

. DA

LY’s

du

e to

PM

10 (1

) E

Num

ber o

f lif

e ye

ars l

ost

MIR

A re

port

Reg

iona

l N

ww

w.m

ilieu

r

appo

rt.be

year

ly

18

. Lev

el o

f ur

bani

satio

n ?

(ver

sted

elijk

ing

) (1)

Ex

%

R

egio

nal

N

year

ly

19

. im

porta

nce

of p

erso

nal

trans

port

(1)

Ex

Pkm

(typ

e tra

nspo

rt us

e: p

erso

nal

cars

, tra

in,

cycl

es,

pede

stria

ns,

…)/y

ear.h

ead

R

egio

nal

N

year

ly

20

. Dai

ly h

ours

st

ayin

g in

the

cars

(1)

Ex

Hou

rs a

nd

min

utes

Reg

iona

l N

ye

arly

21

. Inc

iden

ce o

f as

thm

a on

E

Num

ber o

f ca

ses o

f

Reg

iona

l <

5

ye

arly

- C

hild

ren

orie

nted

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

de

finiti

on

Purp

ose

use

of

indi

cato

r

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

child

ren

(1)

asth

ma

per

1 00

0 ch

ildre

n <

5 ye

ars o

ld

- sho

rt an

d lo

ng te

rm

indi

cato

r

22

. Yea

rly

mor

talit

y du

e to

C

O (1

)

E N

umbe

r of

deat

h pe

r 10

0 00

0

R

egio

nal

N

year

ly

Ach

ievi

ng

leve

ls o

f air

qual

ity th

at d

o no

t giv

e ris

e to

si

gnifi

cant

ne

gativ

e im

pact

s on

and

risks

to h

uman

he

alth

and

the

envi

ronm

ent

112.

Ex

ceed

ance

of

air q

ualit

y th

resh

olds

(2)

Ex to

E

(fut

ure

wis

hes)

Fu

ture

w

ishe

s:

Res

pira

tory

di

seas

es,

asth

ma

Noi

se

23. t

ypic

al

nois

e em

issi

ons

by c

ivil

airp

orts

(1

)

Ex

No

unit

Es

timat

ion

of th

e le

vel

(pro

porti

on)

MIR

A re

port

Loca

l and

R

egio

nal

N

w

ww

.mili

eur

appo

rt.be

Yea

rly

24

. %

popu

latio

n ex

pose

d to

no

ise

resu

lting

fr

om ro

ad

traff

ic (1

)

E %

M

IRA

repo

rt Lo

cal a

nd

Reg

iona

l N

ww

w.m

ilieu

r

appo

rt.be

Yea

rly

25

. %

popu

latio

n ex

pose

d to

no

ise

resu

lting

fr

om a

irpla

nes

(1)

E %

w

ithin

LA

dn =

65

dB

(A)

MIR

A re

port

Loca

l N

ww

w.m

ilieu

r

appo

rt.be

Yea

rly

26

. Pot

entia

l po

pula

tion

serio

usly

di

stur

bed

by

nois

e nu

isan

ce

(1)

E %

MIR

A re

port

Loca

l and

R

egio

nal

N

w

ww

.mili

eur

appo

rt.be

> ye

arly

Subs

tant

ially

re

duci

ng th

e nu

mbe

r of

peop

le

regu

larly

113.

% o

f ho

useh

olds

ex

pose

d to

no

ise,

a su

rvey

(2)

Ex to

E

(fut

ure

wis

hes)

Fe

asib

le

com

bine

d w

ith %

of

popu

latio

n af

fect

ed b

y

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

de

finiti

on

Purp

ose

use

of

indi

cato

r

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

affe

cted

by

long

-term

av

erag

e le

vels

of

noi

se

nois

e

Was

te a

nd

cont

ami-

nate

d la

nds

Rad

iatio

n

D

rink

ing

/Sw

imm

ing

wat

er a

nd

sani

tatio

n

30. L

evel

of

treat

men

t of

urba

n w

aste

w

ater

(1)

Ex, A

%

of t

he

popu

latio

n w

here

was

te

wat

er is

di

scha

rged

to

sew

age

conn

ecte

d to

w

ater

tre

atm

ent

inst

alla

tion

R

egio

nal

N

Yea

rly

31

. Exc

eedi

ng

of li

mit

valu

e fo

r m

icro

biol

ogic

al

para

met

ers i

n su

rfac

e w

ater

fo

r sw

imm

ing

(1)

Ex

%

R

egio

nal

N

Yea

rly

32

. Per

cent

age

of m

easu

red

plac

es o

f su

rfac

e w

ater

th

at d

o no

t sa

tisfy

to th

e ba

sis q

ualit

y le

vel f

or B

OD

(1

)

Ex

%

R

egio

nal

N

Yea

rly

33

. C

once

ntra

tion

of p

estic

ides

in

surf

ace

wat

er

with

exc

eedi

ng

of b

asis

qua

lity

leve

l (1)

Ex

µg/l

R

egio

nal

N

Yea

rly

34

. C

once

ntra

tion

Ex

µg/l

R

egio

nal

N

Yea

rly

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

de

finiti

on

Purp

ose

use

of

indi

cato

r

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

of p

estic

ides

in

grou

nd w

ater

w

ith e

xcee

ding

of

bas

is q

ualit

y le

vel

(1)

35

. C

once

ntra

tion

of p

estic

ides

in

eel (

1)

E ng

/g fa

t cf

. 300

po

ints

of

mea

sure

R

egio

nal

N

36

. Exc

eedi

ng

of W

HO

gu

idan

ce v

alue

s fo

r drin

king

w

ater

for

mic

robi

olog

ical

pa

ram

eter

s (1)

Ex

%

R

egio

nal

N

Yea

rly

37

. Exc

eedi

ng

of W

HO

gu

idan

ce v

alue

s fo

r drin

king

w

ater

for

chem

ical

pa

ram

eter

s (1)

Ex

Reg

iona

l N

Y

early

38

. Out

brea

ks

of d

isea

ses

rela

ted

to w

ater

co

ntam

inat

ion

(1)

E N

umbe

r of

outb

reak

s/ye

ar

R

egio

nal

N

Yea

rly

Ach

ievi

ng

qual

ity le

vels

of

gro

und

and

surf

ace

wat

er

that

do

not

give

rise

to

sign

ifica

nt

impa

cts o

n an

d ris

ks to

hum

an

heal

th a

nd th

e en

viro

nmen

t

114.

Saf

e dr

inki

ng w

ater

(%

of f

aile

d te

sts)

(2)

Ex, E

Food

Saf

ety

39. r

esid

ues o

f pe

stic

ides

in

food

(1)

Ex

% sa

mpl

es >

M

axim

um

resi

due

limit

R

egio

nal

N

Yea

rly

Mak

e fo

od

safe

ty a

nd

109.

salm

onel

la

case

s (2)

E

Inte

rnat

iona

l an

d R

egio

nal

N

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

de

finiti

on

Purp

ose

use

of

indi

cato

r

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

qual

ity th

e ob

ject

ive

of a

ll pl

ayer

s in

the

food

cha

in

11

0. R

esid

ues

of p

estic

ides

in

food

(tes

ts) (

2)

Ex

Inte

rnat

iona

l an

d R

egio

nal

N

Th

ere

are

regu

lar

chec

k-up

s on

food

in

Euro

pe a

nd

thos

e re

sults

co

uld

indi

cate

food

sa

fety

C

hem

ical

em

erge

ncie

s

Che

mic

al

man

agem

ent:

By

2020

, en

sure

that

ch

emic

als a

re

only

pro

duce

d an

d us

ed in

w

ays t

hat d

o no

t pos

e si

gnifi

cant

th

reat

s to

hum

an h

ealth

an

d th

e en

viro

nmen

t.

111.

Con

tent

s of

toxi

ns in

br

east

milk

, bl

ood,

(fis

h) (2

)

Futu

re

wis

hes:

C

hem

ical

in

dex

Tra

ffic

ac

cide

nts

Hou

sing

G

roun

d 27

. Num

ber o

f gr

ound

s/so

ils

whe

re

sani

tatio

n is

ne

cess

ary

and

whe

re

sani

tatio

n ha

s be

en st

arte

d (1

)

Ex, A

%

M

ina

plan

M

IRA

repo

rt R

egio

nal

N

w

ww

.mili

eur

appo

rt.be

Yea

rly

Was

tes

28. T

otal

am

ount

s of

Ex, A

To

n/ye

ar

(/hab

itant

) M

ina

plan

Reg

iona

l N

Y

early

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

de

finiti

on

Purp

ose

use

of

indi

cato

r

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

was

tes

land

fille

d (1

)

29. T

otal

am

ount

s of

inci

nera

ted

(1)

Ex, A

To

n/ye

ar

(/hab

itant

) M

ina

plan

Reg

iona

l N

Y

early

U.V

40

. U.V

. lig

ht

inde

x (1

) Ex

W

/m²

R

egio

nal

N

Yea

rly

41

. Yea

rly

inci

denc

e of

sk

in c

ance

r or

mel

anom

as (1

)

E N

umbe

r of

case

s per

100

00

0

R

egio

nal

N

Yea

rly

Odo

ur

42. P

erce

ntag

e of

inha

bita

nts

dist

urbe

d by

od

our n

uisa

nce

(1)

E %

of t

he

popu

latio

n

Loca

l and

R

egio

nal

N

Yea

rly

Oth

ers:

C

ontri

butin

g to

a b

ette

r qu

ality

of l

ife

thro

ugh

an

inte

grat

ed

appr

oach

co

ncen

tratin

g on

urb

an a

reas

101.

Ave

rage

lif

e ex

pect

ancy

at

birt

h (2

)

Futu

re

wis

hes:

di

sabi

lity-

free

life

ex

pect

ancy

D

epen

denc

y fr

ee li

fe

10

2. P

rem

atur

e m

orta

lity (

2)

10

3. D

ecla

red

stat

e of

hea

lth

(sur

vey)

, (S

uici

des,

Chi

ldre

n?) (

2)

10

4. A

ccid

ents

at

wor

k or

wor

k re

late

d lo

ng-

term

illn

ess (

2)

10

5. N

ew

canc

ers

diag

nose

d (2

)

Oth

ers:

En

hanc

e he

alth

ed

ucat

ion

with

th

e ob

ject

ive

106.

Bod

y m

ass

inde

x (2

)

Fu

ture

w

ishe

s:

Alc

ohol

co

nsum

ptio

n N

arco

tics

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

de

finiti

on

Purp

ose

use

of

indi

cato

r

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

of a

chie

ving

im

prov

ed

heal

th li

tera

cy

on a

glo

bal

basi

s by

2010

Smok

ing

Oth

ers:

Ta

ckle

issu

es

rela

ted

to

outb

reak

s of

infe

ctio

us

dise

ases

and

re

sist

ance

to

antib

iotic

s

107.

Infe

ctio

us

dise

ases

(tu

berc

ulos

is,

pertu

ssis

) (2)

10

8. R

epor

ted

case

s of

resi

stan

ce to

an

tibio

tics

or

cons

umpt

ion

of

antib

iotic

s by

hum

ans (

2)

Futu

re

wis

hes:

A

ntib

iotic

s in

agr

icul

ture

1 : r

ef. I

ndic

ator

Bel

gium

Fle

mis

h re

gion

(Ste

unpu

nt) (

Indi

cato

rs 1

to 4

2) –

see

docu

men

t atta

ched

+ M

IRA

repo

rt on

ww

w.m

ilieu

rapp

ort.b

e

2 : r

ef. E

uros

tat S

usta

inab

le D

evel

opm

ent I

ndic

ator

s (SD

I) a

ddre

ssin

g th

e fo

llow

ing

sub-

them

es:

* H

uman

hea

lth p

rote

ctio

n

* Fo

od sa

fety

and

qua

lity

* C

hem

ical

s man

agem

ent

* En

viro

nmen

tal q

ualit

y af

fect

ed to

hea

th

Euro

stat

pro

ject

is u

nder

dev

elop

men

t. Th

e lis

ted

indi

cato

rs re

fer t

o th

e re

sults

of t

he E

uros

tat t

ask

forc

e on

sust

aina

ble

deve

lopm

ent i

ndic

ator

s, su

b-gr

oup

publ

ic h

ealth

Se

cond

mee

ting,

Lux

embo

urg

25.1

1.20

03

3 : I

n th

e Fl

emis

h re

gion

, oth

ers u

sed

indi

cato

rs a

re u

sed

at lo

cal l

evel

:

- t

oxin

s in

fishe

s and

milk

- P

CB

’s v

alue

s

- bio

mon

itorin

g

4: In

the

Wal

loon

regi

on, s

ome

indi

cato

rs a

re u

sed

at th

e lo

cal l

evel

:

- min

imum

clin

ical

sum

mar

y (r

epor

ting

all h

ospi

tal a

dmis

sion

s (cf

. int

erna

tiona

l dis

ease

s cla

ssifi

catio

n))

- Mor

talit

y re

gist

ratio

n

Eur

ocat

regi

ster

- Med

ical

regi

ster

s (cf

. def

ined

cod

ifica

tion)

5. N

o in

tegr

ated

dat

a co

llect

ion

seem

s to

be e

xist

ing

yet i

n B

elgi

um. D

iffer

ent d

ata

base

s nee

d to

be

coor

dina

ted

Cze

ch R

epub

lic

Nam

e:

Dr.

Ruz

ena

Kub

inov

a E-

mai

l: ku

bino

va@

szu.

cz

Tel:

+4

202

6708

262

2 A

ddre

ss:

NIP

H, S

roba

rova

48,

100

49

Prah

a 10

, Cze

ch R

epub

lic

Cou

ntry

or p

roje

ct:

Envi

ronm

enta

l Hea

lth M

onito

ring

Syst

em

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

indi

cato

r G

eogr

a-ph

ical

Sca

le

Gen

der

A

ge

Val

idat

ion

Dat

a qu

ality

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

sibi

lity

Rep

ortin

g C

omm

ents

Air

qual

ity

Expo

sure

to

am

bien

t ai

r po

lluta

nts

Ex

% p

opul

atio

n ex

pose

d to

ce

rtain

po

llutio

n

leve

ls

Mon

itorin

g 20

– 3

0 ci

ties

acco

rdin

g to

th

e po

lluta

nt

type

N

Y

Air

pollu

tion

mea

sure

men

ts,

year

ly

Y

Y

ww

w.sz

u.cz

Y

year

ly w

eb

and

repo

rt

A

cute

re

spira

tory

di

seas

es

inci

denc

e

E Tr

eate

d ac

ute

resp

irato

ry

dise

ases

in

cide

nce

Mon

itorin

g 25

citi

es

N

0-1

year

, 1-

5, 6

-14,

14-

18, a

dults

Y

Med

ical

reco

rds

from

phy

sici

ans

and

pedi

atric

ians

, ye

arly

Y

Y

ww

w.sz

u.cz

Y

year

ly w

eb

and

repo

rt

A

llerg

y in

cide

nce

E A

llerg

y in

cide

nce

in

child

ren

Mon

itorin

g,

risk

fact

ors

expl

orin

g

18 c

ities

Y

5,

9, 1

3, 1

7 ye

ars

Y

Med

ical

reco

rds

from

pe

diat

ricia

ns,

ques

tionn

aire

s fr

om p

aren

ts,

once

per

4-5

ye

ars

Y

Y

ww

w.sz

u.cz

Y

web

and

re

port

Noi

se

Expo

sure

to

co

mm

unity

no

ise

Ex

Noi

se le

vels

in

day

and

ni

ght

Mon

itorin

g 21

citi

es, i

n ea

ch o

ne q

uiet

an

d no

isy

loca

lity

N

Y

Com

mun

ity

nois

e m

easu

rem

ents

ye

arly

Y

Y

ww

w.sz

u.cz

Y

year

ly w

eb

and

repo

rt

C

omm

unity

no

ise

anno

yanc

e,

slee

p di

stur

banc

e

E Pe

rcen

tage

of

peop

le

anno

yed

Mon

itorin

g 21

citi

es, i

n ea

ch o

ne q

uiet

an

d no

isy

loca

lity

N

Y

Que

stio

nnai

re

surv

ey, o

nce

per 5

yea

rs

Y

Y

ww

w.sz

u.cz

Y

web

and

re

port

Was

te a

nd

*

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

indi

cato

r G

eogr

a-ph

ical

Sca

le

Gen

der

A

ge

Val

idat

ion

Dat

a qu

ality

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

sibi

lity

Rep

ortin

g C

omm

ents

cont

ami-

nate

d la

nds

Rad

iatio

n

* D

rinki

ng

/Sw

imm

ing

wat

er a

nd

sani

tatio

n

Drin

king

w

ater

qu

ality

in

dica

tors

Ex

Freq

uenc

y of

lim

its

exce

edin

gs,

popu

latio

n ex

posu

re

asse

ssm

ent

Mon

itorin

g,

emer

genc

ies

repo

rting

33 c

ities

and

im

porta

nt

supp

lies

with

in

dist

ricts

N

Y

Not

ifica

tion

from

the

dist

ribut

ors,

publ

. hea

lth

serv

ice,

ca

lcul

atio

n of

ex

posu

re,

year

ly

Y

Y

ww

w.sz

u.cz

Y

year

ly w

eb

and

repo

rt

W

ater

-bo

rne

dise

ases

E W

ater

– b

orne

di

seas

es

prev

alen

ce

Mon

itorin

g 33

citi

es

Y

Y

EPID

AT

data

base

, yea

rly

Y

Y

ww

w.sz

u.cz

Y

year

ly w

eb

and

repo

rt

Food

Saf

ety

Die

tary

ex

posu

re

Ex

Popu

latio

n di

etar

y ex

posu

re

Mon

itorin

g N

atio

nal l

evel

N

Y

A

naly

ses o

f fo

od fr

om

cons

umer

ba

sket

Y

Y

ww

w.sz

u.cz

Y

year

ly w

eb

and

repo

rt

A

limen

tary

di

seas

es

E A

limen

tary

di

seas

es

prev

alen

ce

and

inci

denc

e

Mon

itorin

g N

atio

nal l

evel

Y

Y

EP

IDA

T da

taba

se, y

early

Y

Y

w

ww

.szu.

cz

Y

year

ly w

eb

and

repo

rt

Che

mic

al

emer

genc

ies

*

Traf

fic

acci

dent

s

*

Hou

sing

* O

ther

:

B

io –

m

onito

ring

Le

vels

of

cont

amin

ants

and

be

nefit

el

emen

ts

Le

vels

of

cont

amin

ants

an

d be

nefit

el

emen

ts in

hu

man

s

Mon

itorin

g,

natio

nal

refe

renc

e va

lues

setti

ng

Nat

iona

l lev

el

N

(but

pos

sibl

e)

child

ren

8-10

ye

ars

adul

ts

Y

Surv

eys i

n in

terv

als

acco

rdin

g to

the

cont

amin

ant

and

mat

rix 1

–

2 ye

ars

Y

Y

ww

w.sz

u.cz

Y

year

ly w

eb

and

repo

rt

Occ

upat

iona

l en

viro

nmen

t O

ccup

atio

nal

dis

ease

s E

Occ

upat

iona

l di

seas

es

Prev

alen

ce

and

inci

denc

e

Mon

itorin

g N

atio

nal a

nd

regi

onal

leve

l, Y

Y

R

egis

ter o

f oc

cupa

tiona

l di

seas

es

Y

Y

ww

w.sz

u.cz

Y

year

ly w

eb

and

repo

rt

Hea

lth st

atus

Lo

ng-te

rm

E Fr

eque

nce

of

Mon

itorin

g 27

citi

es

Y

N

Que

stio

nnai

re

Y

Y

Y

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

indi

cato

r G

eogr

a-ph

ical

Sca

le

Gen

der

A

ge

Val

idat

ion

Dat

a qu

ality

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

sibi

lity

Rep

ortin

g C

omm

ents

heal

th

com

plai

nts

long

-term

he

alth

co

mpl

aint

s

Bas

e fo

r pr

even

tive

prog

ram

mes

co

ncep

tion

45 –

54

year

s su

rvey

w

ww

.szu.

cz

ye

arly

web

an

d re

port

R

isk

fact

ors

inci

denc

e

E Fr

eque

nce

of

risk

fact

ors o

f ch

roni

c no

n co

mm

unic

abl

e di

seas

es

Mon

itorin

g B

ase

for

prev

entiv

e pr

ogra

mm

es

conc

eptio

n

27 c

ities

Y

45

– 5

4 ye

ars

N

Que

stio

nnai

re

surv

ey

Y

Y

ww

w.sz

u.cz

Y

year

ly w

eb

and

repo

rt

Life

styl

e Li

fe st

yle

indi

cato

rs

Fr

eque

nce

of

sele

cted

life

st

yle

indi

cato

rs (%

sm

oker

s ac

tive,

pa

ssiv

e,

exce

ssiv

e al

coho

l etc

.)

Mon

itorin

g B

ase

for

prev

entiv

e pr

ogra

mm

es

conc

eptio

n

27 c

ities

Y

45

– 5

4 ye

ars

Y

Que

stio

nnai

re

surv

ey

Y

Y

ww

w.sz

u.cz

Y

year

ly w

eb

and

repo

rt

Perc

eptio

n En

viro

nme

ntal

risk

s pe

rcep

tion

Fr

eque

ncy

of

nega

tive

and

posi

tive

envi

ronm

ent

perc

eptio

n

Mon

itorin

g,

base

for

heal

th ri

sks

com

mun

icat

ion

27 c

ities

Y

45

– 5

4 ye

ars

Q

uest

ionn

aire

su

rvey

Y

Y

w

ww

.szu.

cz

Y

year

ly w

eb

and

repo

rt

Sa

tisfa

ctio

n w

ith o

wn

life

and

with

ow

n he

alth

Pe

rcen

tage

of

peop

le w

ith

nega

tive

or

posi

tive

perc

eptio

n of

th

eir o

wn

life

and

heal

th

Mon

itorin

g,

Bas

e fo

r co

mm

unic

atio

n, p

reve

ntiv

e pr

ogra

mm

es

27 c

ities

Y

45

– 5

4 ye

ars

Q

uest

ionn

aire

su

rvey

Y

Y

w

ww

.szu.

cz

Y

year

ly w

eb

and

repo

rt

* Th

ese

issu

es a

re n

ot in

volv

ed in

the

Mon

itorin

g sy

stem

, som

e in

dica

tors

are

regi

ster

ed a

nd r

epor

ted

by o

ther

dep

artm

ents

– e

nviro

nmen

tal,

trans

port,

radi

atio

n sa

fety

, sta

tistic

al o

ffice

. Als

o he

alth

an

d so

ciod

emog

raph

ic s

tatis

tics

data

are

ava

ilabl

e w

ithin

Cze

ch R

epub

lic. T

he it

ems

pres

ente

d ab

ove

are

colle

cted

exc

lusi

vely

with

in E

H M

onito

ring

Sys

tem

in N

IPH

.

Den

mar

k N

ame:

Hel

ga G

rønn

egaa

rd

Add

ress

: Dan

ish

Envi

ronm

ent P

rote

ctio

n A

genc

y The

me

Indi

cato

r na

me

T

ype

Geo

gra-

phic

al S

cale

Age

ca

tego

ry

Val

idat

ion

Dat

a qu

ality

D

ata

colle

ctio

n D

ata

cont

rol

Dat

a pr

oces

s-si

ng

Acc

es-

sibi

lity

Rep

or-t

ing

Com

men

ts

Air

Emis

sion

s of

SO2,

NO

x,

VO

C, a

nd

NH

3

Pres

sure

na

tiona

l n

Fr

eque

nt

mon

itorin

g

Yea

rly w

eb

O

zone

laye

r th

ickn

ess

Ex

glob

al

Inte

rnat

iona

l m

onito

ring

Y

early

web

Noi

se

W

aste

Con

tam

inat

ed

land

N

umbe

r of

site

s whe

re

rem

edia

tion

of so

il co

ntam

inat

ion

has b

een

carr

ied

out i

n or

der t

o en

able

ho

usin

g an

d/or

dr

inki

ng

wat

er su

pply

Pres

sure

na

tiona

l

Fr

eque

nt

natio

nal

mon

itorin

g

Y

early

web

Drin

king

w

ater

N

umbe

r of

occu

rren

ces

of p

estic

ides

in

gr

ound

wat

er

used

for

drin

king

w

ater

E na

tiona

l

Fr

eque

nt

natio

nal

mon

itorin

g

Y

early

web

Swim

min

g B

athi

ng a

reas

E

natio

nal

Freq

uent

Yea

rly w

eb

The

me

Indi

cato

r na

me

T

ype

Geo

gra-

phic

al S

cale

Age

ca

tego

ry

Val

idat

ion

Dat

a qu

ality

D

ata

colle

ctio

n D

ata

cont

rol

Dat

a pr

oces

s-si

ng

Acc

es-

sibi

lity

Rep

or-t

ing

Com

men

ts

wat

er

whe

re w

ater

qu

ality

is so

po

or th

at

bath

ing

is n

ot

reco

mm

ende

d

natio

nal

mon

itorin

g

Rad

iatio

n

Food

Le

vel o

f se

lect

ed

inci

denc

es o

g ch

emic

al

pollu

tion

in

food

Ex

natio

nal

Freq

uent

na

tiona

l m

onito

ring

Y

early

web

PC

Bs i

n co

d liv

er fr

om

Dan

ish

wat

ers 1

988-

2000

Ex

natio

nal

Surv

ey

Y

early

web

C

onsu

mpt

ion

of 4

hea

vy

met

als i

n D

anis

h di

ets

(all

food

s) in

th

ree

5-ye

ar

mon

itorin

g pe

riods

an

alys

ed in

m

icro

gram

s pe

r day

Ex

natio

nal

Freq

uent

na

tiona

l sur

vey

Y

early

web

Hou

sing

Che

mic

als

Num

ber o

f ch

emic

als

clas

sifie

d

Ex

natio

nal

Freq

uent

na

tiona

l m

onito

ring

Y

early

web

Th

e vo

lum

e of

sale

s of

pest

icid

e ac

tive

Ex/p

ress

ure

natio

nal

Nat

iona

l

Freq

uent

na

tiona

l m

onito

ring

Y

early

web

The

me

Indi

cato

r na

me

T

ype

Geo

gra-

phic

al S

cale

Age

ca

tego

ry

Val

idat

ion

Dat

a qu

ality

D

ata

colle

ctio

n D

ata

cont

rol

Dat

a pr

oces

s-si

ng

Acc

es-

sibi

lity

Rep

or-t

ing

Com

men

ts

subs

tanc

es

clas

sifie

d as

be

ing

parti

cula

rly

haza

rdou

s H

arm

ful

heal

th

effe

cts

Inci

denc

es o

f as

thm

atic

br

onch

itis

and

asth

ma,

al

lerg

ic

cory

za, a

nd

alle

rgic

ec

zem

a in

19

87, 1

994,

an

d 20

00

E N

atio

nal

Nat

iona

l

Surv

ey

Oth

er: …

H

ealth

and

sa

fety

: Se

lect

ed

repo

rted

wor

ks-r

ealte

d di

sord

es

E na

tiona

l

Fr

eque

nt

natio

nal

mon

itorin

g

Y

early

web

NB

1 F

ocus

on

EH in

dica

tors

eg

num

ber o

f cas

es a

ttrib

uted

to a

ir po

llutio

n, n

oise

exp

osur

e et

c; n

umbe

r of p

eopl

e ex

pose

d to

cer

tain

pol

lutio

n le

vels

or e

xced

ance

of l

imits

N

B 2

if th

e in

dica

tor i

s not

ava

ilabl

e, a

dd in

last

col

umn

(com

men

ts) w

heth

er th

ere

is in

tere

st in

such

an

indi

cato

r

Fran

ce

Nam

e: P

hilip

pe P

irard

E-

mai

l: p.

pira

rd@

invs

.sant

e.fr

Te

l: 00

.33.

1.41

.79.

67.6

0 In

stitu

t de

Vei

lle S

anita

ire14

rue

du v

al d

’Osn

es 9

4415

Sai

nt-M

auric

e The

me

Nom

ad

dres

s In

dica

tor

nam

e

Typ

e O

pera

tiona

l de

finiti

on

Purp

ose

use

of

indi

cato

r G

eogr

aphi

cal S

cale

A

ge

cate

gory

E

x =

expo

sure

E

= e

ffec

t A

= a

ctio

n

Nat

iona

l, R

egio

nal,

Loc

al, c

ity o

r po

stal

co

de

age

cate

gori

es

Y/N

A

ir

CIT

EPA

C

ITEP

A

Emis

sion

s Ex

To

ns

prod

ucte

d

Mon

itorin

g em

issi

ons

Nat

iona

l N

S

Air

Su

rvei

llanc

e ai

r et s

anté

9

ville

s In

VS

No2

, TSP

, Bla

ck S

mok

e, O

3 H

ospi

tal a

dmis

sion

s (he

art,

resp

irato

ry,)

Gen

eral

Car

diov

ascu

lar ,

re

spira

tory

dis

ease

s dea

th

EX /

E µg

/m3

Inci

denc

e :

Nb/

1000

00

Mon

itorin

g H

ealth

Ris

k du

e to

Air

Pollu

tion

9 C

ities

in F

ranc

e N

S

Air

B

DQ

A

AD

EME

No2

, TSP

, Bla

ck S

mok

e, O

3 N

i, C

d, A

s, Pb

…

EX

µg/m

3 M

onito

ring

Air

Qua

lity

Nat

iona

l cen

tralis

atio

n of

inf

orm

atio

n fr

om

citie

s,

NS

Noi

se

Cla

ssifi

catio

n of

exp

ositi

on

to n

oise

due

to tr

affic

in

fras

truct

ures

MED

D

Leve

ls o

f mea

n D

ecib

els,

clas

sific

atio

n of

traf

fic

EX

Map

s with

cl

assi

ficat

ion

in fi

ve

cate

gorie

s

Gui

ding

and

m

onito

ring

po

licie

s

Nat

iona

l /D

epar

tmen

tal/

Com

mun

al

NS

Was

te

BA

SOL

B

ASI

AS

MED

D

BR

GM

Met

als,

HO

V, H

AP,

C

yanu

res,

Solv

ants

, Pe

stic

ides

, Oth

ers

Con

tam

inat

ed so

ils a

nd

indu

stria

l site

s

EX/S

tate

Ex

/Sta

te

Qua

lity

not

quan

tity

Kee

p m

emor

y of

an

cien

t site

s Id

entif

y pr

evio

us

indu

stria

l site

s an

d se

rvic

e ac

tiviti

es

Nat

iona

l, Lo

cal

Nat

iona

l, Lo

cal

Cov

erag

e no

t fin

ishe

d

Con

tam

inat

ed

land

/IN

FOSO

L ((

InR

A)

ASP

ITET

(InR

A)

RM

QS

INR

A

AD

EME

S =

agric

ultu

ral a

nd fo

rest

si

tes -

surf

ace

and

deep

ho

rizon

s and

gra

ssla

nd si

tes

(grid

sam

plin

g 16

x 1

6 km

) M

etal

/trac

e el

emen

ts

EX

µg/k

g of

soil

To m

onito

r soi

l qu

ality

N

atio

nal

NS

Dri

nkin

g SI

SE-E

AU

X

DG

S C

OV

–En

viro

nmen

tal c

onte

xt

EX

Dep

ends

of

Mon

itorin

g w

ater

N

atio

nal/D

epar

tmen

tal/

NS

The

me

Nom

ad

dres

s In

dica

tor

nam

e

Typ

e O

pera

tiona

l de

finiti

on

Purp

ose

use

of

indi

cato

r G

eogr

aphi

cal S

cale

A

ge

cate

gory

E

x =

expo

sure

E

= e

ffec

t A

= a

ctio

n

Nat

iona

l, R

egio

nal,

Loc

al, c

ity o

r po

stal

co

de

age

cate

gori

es

Y/N

w

ater

B

RG

M

Org

anol

eptic

cha

ract

eris

tics -

C

hlor

oben

zene

s -

Mic

robi

olog

ic p

rodu

cts -

Pe

stic

ides

–D

esin

fect

ants

–Pl

astic

iser

s

indi

cato

r (>

971

diff

eren

ts)

qual

ity

loca

l

Dri

nkin

g w

ater

H

ealth

risk

due

to w

ater

qu

ality

In

VS

SISE

–Ea

ux in

dica

tors

D

rug

and

med

ical

act

co

nsum

ptio

n

Ex/ E

N

umbe

r of

spec

ific

acts

M

onito

ring

heal

th ri

sk d

ue to

w

ater

qua

lity

Loca

l and

regi

onal

(tes

t) Y

Whe

n po

ssib

le

Swim

min

g w

ater

SI

SE-E

aux

(SIS

E-B

aign

ades

) M

inis

try

of H

ealth

In

dica

tors

of D

irect

ive

76/1

60/C

EE

Ger

ms (

Col

iform

ae

Eshe

richi

a C

oli –

st

rept

ococ

ci),

Oil,

Te

nsio

activ

e su

bsta

nces

Ph

énol

, Tra

npar

ency

, C

olor

atio

n

EX

Dep

ends

of

indi

cato

r Tu

rbid

ity

Mon

itorin

g w

ater

qu

ality

N

atio

nal/L

ocal

N

S

Rad

iatio

n Te

lera

y , h

ydro

ray,

SA

RA

…

(O

PER

A) O

bser

vato

ire

Perm

anen

t Rad

ioac

tivité

N

atio

nal N

etw

ork

of

Rad

ioac

tivity

M

easu

rem

ents

in

Envi

ronm

ent (

RN

SE)

IRSN

R

adon

./gam

ma

EX

B

q.m

-3 –

G

y(Sv

) µG

y.h

(Sv)

Det

ectio

n an

d al

ert s

yste

m

Mon

itorin

g qu

ality

(air,

w

ater

, soi

l, fo

od)

2/de

partm

ent f

or te

lera

y 30

for

hydr

oray

15

for S

AR

A

8 on

mai

nlan

d N

atio

nal/L

ocal

/ D

epar

tmen

tal

NS

Food

N

atio

nal R

egul

ator

y m

onito

ring

Min

istè

re

de

l’Agr

icul

tur

e

Spec

ified

in E

urop

ean

Dire

ctiv

es

Ex

depe

nds o

f in

dica

tor

Mon

itorin

g re

spec

t of

nor

ms

Nat

iona

l // R

egio

nal

NS

Hou

sing

In

door

Air

Qua

lity

perm

anen

t sur

vey

CST

B

Alle

rgen

s, C

O, r

adon

, ga

mm

a, H

OV

, <PM

10,

CO

2, ra

don,

noi

se,

satu

rnis

m

Ex/E

D

epen

ds o

f in

dica

tor

Kno

wle

dge

of

expo

sure

leve

ls

Futu

re

mon

itorin

g

Nat

iona

l Y

Hou

sing

C

O

InV

S H

ospi

tal a

dmis

sion

s for

CO

in

toxi

catio

ns,

Dea

ths f

or C

O in

toxi

catio

n//

Situ

atio

ns a

t ris

k

E //EX

Nb

Mon

itorin

g ris

k,

polic

ies,

D

etec

tion

of

situ

atio

ns a

t ris

k

Nat

iona

l N

S

The

me

Nom

ad

dres

s In

dica

tor

nam

e

Typ

e O

pera

tiona

l de

finiti

on

Purp

ose

use

of

indi

cato

r G

eogr

aphi

cal S

cale

A

ge

cate

gory

E

x =

expo

sure

E

= e

ffec

t A

= a

ctio

n

Nat

iona

l, R

egio

nal,

Loc

al, c

ity o

r po

stal

co

de

age

cate

gori

es

Y/N

L

ead

leve

l in

bloo

d N

atio

nal l

ead

leve

l in

bloo

d m

onito

ring

syst

em

InV

S B

lood

Lea

d Le

vel

EX/E

B

lood

leve

l in

bloo

d in

µg/

l M

onito

ring

lead

le

vel i

n bl

ood

Nat

iona

l 0-

6 an

s

Can

cer

Nat

iona

l reg

istry

of

mal

igna

nt tu

mor

s in

child

hood

INSE

RM

C

ases

of s

olid

tum

ors a

nd

leuk

emia

e E

Cas

es

Mon

itorin

g ca

ncer

inci

denc

e Fa

cilit

atin

g re

sear

ch

Nat

iona

l 0-

14 a

ns

(<20

ans

for

thyr

oïd

canc

er)

Can

cer

N

atio

nal s

urve

illan

ce

syst

em fo

r thy

roïd

can

cer

InV

S C

ases

of t

hyro

ïd c

ance

rs o

n th

e ba

se o

f PM

SI1 a

nd

anat

omop

atho

logi

c sh

ifts

E N

umbe

rs a

nd

in th

e fu

ture

ca

ses

Mon

itorin

g ca

ncer

inci

denc

e N

atio

nal a

nd r

egio

nal

Y

Con

geni

tal

mal

form

atio

ns

Reg

iona

l reg

istri

es o

f co

ngen

ital m

alfo

rmat

ions

In

VS

Con

geni

tal m

alfo

rmat

ions

C

ases

of

Spin

a bi

fida,

an

ence

phal

y, p

alat

ine

mal

form

atio

n, p

lurip

loid

iae,

ge

nita

l mal

form

atio

ns

E N

umbe

r, ra

tes

Mon

itorin

g in

cide

nce

faci

litat

ing

rese

arch

Reg

iona

l B

irth

Rep

rodu

ctio

n Pe

rman

ent s

urve

y on

fe

rtili

ty

INSE

RM

Ex

posu

re to

ioni

sing

ra

diat

ions

, ben

zene

, oth

ers

Del

ays n

eces

sary

to

conc

eive

d, m

edic

al a

ssis

ted

conc

eptio

n

Ex//E

C

ases

, sam

ple

Res

earc

h R

egio

nal (

sam

ple)

Y

Tra

ffic

A

ccid

ents

R

egis

tre

of th

e R

hône

IN

RET

S C

orpo

ral V

ictim

s of T

raff

ic

Acc

iden

ts

E A

ccid

ent c

ases

, le

sion

s,circ

onst

ance

s of

ac

cide

nt

Res

earc

h M

onito

ring

in

cide

nce

Reg

iona

l (de

partm

enta

l) Y

Tra

ffic

A

ccid

ents

B

AA

C

Obs

erva

toire

N

atio

nal

inte

rmin

isté

riel d

e Sé

curit

é R

outiè

re

Cor

pora

l vic

tims o

f Tra

ffic

ac

cide

nts

E N

umbe

r of

ca

ses

Mon

itorin

g

inci

denc

e N

atio

nal

Y

Usu

al li

fe

acci

dent

s E

PAC

In

VS

Cas

ualti

es a

nd d

escr

iptio

n of

ac

cide

nts a

nd c

ause

s EX

//E

Num

ber

of

casu

altie

s M

onito

ring

and

de

scrip

tion

of

acci

dent

s and

th

eir c

ause

10 h

ospi

tals

(3%

of

glob

al h

ospi

tal a

ctiv

ity)

Y

1 P

rogr

amm

e m

édic

alis

é de

s sys

tèm

es d

’info

rmat

ion

(med

ical

ised

pro

gram

of i

nfor

mat

ion

syst

ems

The

me

Nom

ad

dres

s In

dica

tor

nam

e

Typ

e O

pera

tiona

l de

finiti

on

Purp

ose

use

of

indi

cato

r G

eogr

aphi

cal S

cale

A

ge

cate

gory

E

x =

expo

sure

E

= e

ffec

t A

= a

ctio

n

Nat

iona

l, R

egio

nal,

Loc

al, c

ity o

r po

stal

co

de

age

cate

gori

es

Y/N

A

sthm

a Su

rvei

llanc

e sy

stem

In

VS

Self

repo

rted

prev

alen

ce

Ast

hma-

asso

ciat

ed

hosp

italia

stio

ns

Ast

hma-

asso

ciat

ed m

orta

lity

Ast

hma-

asso

ciat

ed e

mer

genc

yD

epar

tmen

t vis

its

Occ

upat

iona

l ast

hma

E N

ot y

et

Mon

itorin

g as

thm

a pr

eval

ence

and

se

verit

y

N

Y

Mor

talit

y C

epi-D

C

INSE

RM

m

orta

lity

E C

ases

M

onito

ring

de

aths

and

thei

r ca

uses

N

Y

The

me

Nom

In

dica

tor

nam

e

Val

idat

ion

Dat

a qu

ality

m

etho

d an

d fr

eque

ncy

Dat

a co

llect

ion

Dat

a co

ntro

l A

cces

sibi

lity

Rep

ortin

g C

omm

ents

Y/

N (e

g in

tern

atio

nal

stan

dard

s suc

h as

IC

D u

sed

or n

ot)

R=

regi

stry

S=

surv

ey

Mo

= m

odel

ling

M=m

easu

rem

ent

C=c

ontin

ue

D=

decl

arat

ions

Y/N

(eg

diag

nosi

s, co

ding

of

dise

ases

ch

ecke

d)

Ava

ilabl

e fo

r oth

ers:

Y/

N, n

ame

web

site

or d

atab

ase

Fre

quen

cy

How

E

g ye

arly

, w

eb

Ben

efits

Pr

oble

ms

Def

icits

R

elev

ance

for

prio

rity

are

as

Air

C

ITEP

A

So2,

NO

2, T

PS

2,5,

10, O

3, fu

rane

s m

etal

s, ot

hers

Y

Cor

inai

r Eur

opea

n M

etho

dolo

gy

S,M

///

ht

tp://

ww

w.c

itepa

.org

Yea

rly

Not

hing

Air

9

ville

s N

o2, T

SP, B

lack

Sm

oke,

O3

// Hos

pita

l ad

mis

sion

s (he

art,

resp

irato

ry),

Gen

eral

C

ardi

ovas

cula

r ,

resp

irato

ry d

isea

ses

deat

h

Yes

M

out

door

s//

PMSI

– D

eath

ce

rtific

ates

Y b

ut n

ot

finis

hed

R

egul

ar b

alan

ces

Not

de

fined

, ea

ch fe

w

year

s

Use

d to

gui

de

Fren

ch la

w o

n A

ir Q

ualit

y

Air

C

O

CO

into

xica

tions

C

O in

toxi

catio

n de

aths

Si

tuat

ions

at r

isk

Yes

D

and

M C

PM

SI

Cep

iDC

R

egio

nal

pilo

t gr

oups

Futu

re w

eb si

te

cont

inue

N

ew st

ruct

ure

exte

nded

to

situ

atio

ns a

t ris

k (s

till t

o be

im

plem

ente

d-

test

s)

Air

B

DQ

A

No2

, TSP

, Bla

ck

Smok

e, O

3, N

i, C

d, A

s, Pb

..

y C

,S

Y

ww

w.a

dem

e.fr

sa

mpl

ing

on fi

lters

pe

rman

ent

,h ,

daily

…

Mon

itorin

g of

la

w e

ffec

ts

Noi

se

Noi

se

map

ping

C

lass

ifica

tion

of

expo

sitio

n to

noi

se

of tr

affic

in

fras

truct

ures

Y

S Y

ht

tp://

ww

w.e

nviro

nnem

ent.g

ouv.

fr/d

ossi

ers/

brui

t/dos

sier

s-br

uit-2

0021

1-br

uits

-tran

spor

ts.h

tm

ex. :

ht

tp://

ww

w.a

ude.

pref

.gou

v.fr

/ser

vice

s/dd

e/ra

yonb

ruit/

Bru

it.ht

m

Each

few

ye

ars

Not

pre

cise

No

dead

line

for

such

im

plem

enta

tion

/ No

freq

uenc

y de

fined

W

aste

B

ASO

L

Met

als,

HO

V,

HA

P, C

yanu

res,

Solv

ants

, Pe

stic

ides

, Oth

ers

Y

D a

nd S

?

http

://ba

sol.e

nviro

nnem

ent.g

ouv.

fr fo

r Bas

ol ;

http

://ba

sias

.brg

m.fr

N

ot

prec

ised

C

ontin

ue ?

No

quot

ed

quan

titie

s for

po

lluta

nts

The

me

Nom

In

dica

tor

nam

e

Val

idat

ion

Dat

a qu

ality

m

etho

d an

d fr

eque

ncy

Dat

a co

llect

ion

Dat

a co

ntro

l A

cces

sibi

lity

Rep

ortin

g C

omm

ents

Y/

N (e

g in

tern

atio

nal

stan

dard

s suc

h as

IC

D u

sed

or n

ot)

R=

regi

stry

S=

surv

ey

Mo

= m

odel

ling

M=m

easu

rem

ent

C=c

ontin

ue

D=

decl

arat

ions

Y/N

(eg

diag

nosi

s, co

ding

of

dise

ases

ch

ecke

d)

Ava

ilabl

e fo

r oth

ers:

Y/

N, n

ame

web

site

or d

atab

ase

Fre

quen

cy

How

E

g ye

arly

, w

eb

Ben

efits

Pr

oble

ms

Def

icits

R

elev

ance

for

prio

rity

are

as

BA

SIA

S C

onta

min

ated

soils

an

d in

dust

rial s

ites

Con

tam

inat

ed

land

/IN

FOSO

L

ASP

ITET

R

MQ

S

S =

agric

ultu

ral a

nd

fore

st si

tes -

su

rfac

e an

d de

ep

horiz

ons

Met

al/tr

ace

elem

ents

Y

M, S

N

S w

ww

.ade

me.

fr

http

://et

m.o

rlean

s.inr

a.fr

/

Not

pr

ecis

ed

Con

tinue

,

Dri

nkin

g w

ater

SI

SE-E

AU

X

CO

V –

Envi

ronm

enta

l co

ntex

t O

rgan

olep

tic

char

acte

ristic

s -

Chl

orob

enze

nes -

M

icro

biol

ogic

pr

oduc

ts -

Pest

icid

es –

Des

infe

ctan

ts –

Plas

ticis

ers

Y

C

Y

SI

SE-E

aux

: Min

istè

re (a

cces

s on

ly f

or m

embe

rs o

f the

M

inis

tery

)

Perm

anen

t N

ot e

noug

h fe

edba

ck u

se

Dri

nkin

g w

ater

H

ealth

risk

du

e to

wat

er

qual

ity

SISE

-EA

UX

in

dica

tors

D

rug

and

med

ical

ac

t con

sum

ptio

n

Y

D,C

,S

Y

C

Te

st fo

r fe

asib

ility

Swim

min

g w

ater

SI

SE-E

AU

X

Ger

ms (

Col

iform

ae

Eshe

richi

a C

oli –

st

rept

ococ

ci),

Oil,

Te

nsio

activ

e su

bsta

nces

, Phé

nol,

Tran

pare

ncy,

co

lora

tion

Y

M,S

Sw

imm

ing

pool

s:

Mon

thly

B

each

es :

befo

re

seas

on a

nd e

very

w

eek

Y

http

://ba

igna

des.s

ante

.gou

v.fr

/ Sw

imm

ing

pool

s:

Mon

thly

B

each

es :

befo

re

seas

on

and

ever

y w

eek

Que

stio

ns fo

r re

leve

nce

of

idic

ator

s

Rad

iatio

n Te

lera

y,

Hyd

rora

y,

Gam

ma,

ra

dion

ucle

ides

Y

M

–S

– C

Y

http

://w

ww

.opr

i.fr/o

pri/h

tml_

opri/

mes

ures

_som

.htm

w

ww

.irsn

.fr

Ever

y 15

m

n EC

RIN

, O

PER

A e

xist

The

me

Nom

In

dica

tor

nam

e

Val

idat

ion

Dat

a qu

ality

m

etho

d an

d fr

eque

ncy

Dat

a co

llect

ion

Dat

a co

ntro

l A

cces

sibi

lity

Rep

ortin

g C

omm

ents

Y/

N (e

g in

tern

atio

nal

stan

dard

s suc

h as

IC

D u

sed

or n

ot)

R=

regi

stry

S=

surv

ey

Mo

= m

odel

ling

M=m

easu

rem

ent

C=c

ontin

ue

D=

decl

arat

ions

Y/N

(eg

diag

nosi

s, co

ding

of

dise

ases

ch

ecke

d)

Ava

ilabl

e fo

r oth

ers:

Y/

N, n

ame

web

site

or d

atab

ase

Fre

quen

cy

How

E

g ye

arly

, w

eb

Ben

efits

Pr

oble

ms

Def

icits

R

elev

ance

for

prio

rity

are

as

SAR

A,

OPE

RA

, EC

RIN

, R

NSE

Rad

on, g

amm

as

Aut

our d

es si

tes

Not

yet

ava

ilabl

e fo

r pub

lic

Var

ious

RN

SE (c

reat

ed

by la

w n

ot y

et

impl

emen

ted)

Hou

sing

O

QA

I SI

SE-H

abita

t

Alle

rgen

s, C

O,

rado

n, g

amm

a,

HO

V, <

PM10

, C

O2,

R

adon

, N

oise

, Sa

turn

ism

Y

S S

Y

http

://w

ww

.air-

inte

rieur

.org

O

rgan

ism

s of t

he M

inis

try o

f Hea

lth

Surv

ey

Var

ious

Obs

erva

tory

us

eful

for

surv

eilla

nce

begi

nnin

g

Satu

rnis

m

Chi

ldho

od

lead

poi

soni

ng

surv

eilla

nce

syst

em

Lead

leve

l in

bloo

d Y

labo

rato

ry

D

Labo

rato

ryR

epor

ts

C

Yea

r

Rec

ently

re

stru

ctur

ed

Can

cer

Nat

iona

l R

egis

try fo

r m

alig

nant

tu

mor

s in

ch

ildho

od

Cas

es o

f sol

id

tum

ors a

nd

leuk

emia

e

Y –

CIM

10

C,D

,S

Y

Spec

ific

dem

and

of e

xtra

ctio

n ne

eded

Fe

w y

ears

In

pro

gres

s

Can

cer

Nat

iona

l su

rvei

llanc

e sy

stem

for

thyr

oïd

canc

er

Cas

es o

f thy

roïd

ca

ncer

s on

the

base

of

PMSI

2 and

fu

ture

an

atom

opat

holo

gic

shift

s

Y (I

CD

10)

C,D

,S

Y

Prop

ositi

ons o

n w

ww

.invs

.fr

Not

yet

pr

ecis

ed

(yea

rly ?

)

Feas

ibili

ty in

te

st

Con

geni

tal

mal

form

atio

nsR

egio

nal

regi

strie

s of

cong

enita

l

Cas

es o

f Sp

ina

bifid

a,

anen

ceph

aly,

Y

C,D

,S

Y

Spec

ific

dem

and

of e

xtra

ctio

n ne

eded

Fe

w y

ears

M

ore

rele

vent

fo

r en

viro

nmen

tal

2 P

rogr

amm

e m

édic

alis

é de

s sys

tèm

es d

’info

rmat

ion

(med

ical

ised

pro

gram

of i

nfor

mat

ion

syst

ems

The

me

Nom

In

dica

tor

nam

e

Val

idat

ion

Dat

a qu

ality

m

etho

d an

d fr

eque

ncy

Dat

a co

llect

ion

Dat

a co

ntro

l A

cces

sibi

lity

Rep

ortin

g C

omm

ents

Y/

N (e

g in

tern

atio

nal

stan

dard

s suc

h as

IC

D u

sed

or n

ot)

R=

regi

stry

S=

surv

ey

Mo

= m

odel

ling

M=m

easu

rem

ent

C=c

ontin

ue

D=

decl

arat

ions

Y/N

(eg

diag

nosi

s, co

ding

of

dise

ases

ch

ecke

d)

Ava

ilabl

e fo

r oth

ers:

Y/

N, n

ame

web

site

or d

atab

ase

Fre

quen

cy

How

E

g ye

arly

, w

eb

Ben

efits

Pr

oble

ms

Def

icits

R

elev

ance

for

prio

rity

are

as

mal

form

atio

ns

pala

tine

mal

form

atio

n,

plur

iplo

idia

e

heal

th if

na

tiona

l

Rep

rodu

ctio

n Pe

rman

ent

surv

ey o

f fe

rtili

ty

Expo

sure

to

ioni

sing

radi

atio

ns,

, oth

ers

Sper

m q

ualit

y,

Con

cept

ion

dela

y

Y

S Y

N

ot y

et a

vaila

ble

In a

few

ye

ars

In c

onst

ruct

ion

Tra

ffic

ac

cide

nts

Reg

istry

of t

he

Rhö

ne

Traf

fic a

ccid

ent

vict

ims

Y

C,S

Y

In

RET

S, sp

ecifi

c de

man

ds, r

epor

ts w

ww

.inre

ts.fr

ye

arly

A

vaila

ble

sinc

e 19

95

Tra

ffic

ac

cide

nts

BA

AC

C

orpo

ral a

ccid

ents

, de

ath

from

traf

fic

acci

dent

s

Y

C, D

N

O

bser

vato

ire N

atio

nal I

nter

min

isté

riel d

e Sé

curit

é R

outiè

re

Rep

ort “

La D

ocum

enta

tion

fran

çais

e”

Yea

rly

//

Usu

al li

fe

acci

dent

s Su

rvei

llanc

e Sy

stem

of

acci

dent

s of

us

ual l

ife

Cor

pora

l Y

C

, D,S

Y

w

ww

.invs

.fr

perm

anen

t A

vaila

ble

sinc

e 19

86

Ast

hma

Surv

eilla

nce

syst

em

Self

repo

rted

prev

alen

ce

Ast

hma-

asso

ciat

ed

hosp

italia

stio

ns

Ast

hma-

asso

ciat

ed

mor

talit

y A

sthm

a-as

soci

ated

em

erge

ncy

Dep

artm

ent v

isits

O

ccup

atio

nal

asth

ma

Y (n

ot f

inis

hed)

C

, S

Y

Not

yet

ava

ilabl

e 5

year

s In

con

stru

ctio

n

Mor

talit

y C

epi-D

C

Spec

ific

mor

talit

y Y

C

, D

Y

http

://sc

8.ve

sine

t.ins

erm

.fr:1

080/

ye

arly

NB

1 F

ocus

on

EH in

dica

tors

eg

num

ber o

f cas

es a

ttrib

uted

to a

ir po

llutio

n, n

oise

exp

osur

e et

c; n

umbe

r of p

eopl

e ex

pose

d to

cer

tain

pol

lutio

n le

vels

or e

xced

ance

of l

imits

N

B 2

if th

e in

dica

tor i

s not

ava

ilabl

e, a

dd in

last

col

umn

(com

men

ts) w

heth

er th

ere

is in

tere

st in

such

an

indi

cato

r

SYN

OPS

IS

AD

EME

Age

nce

de l

’Env

ironn

emen

t et d

e la

Maî

trise

de

l’Ene

rgie

A

FSSE

A

genc

e Fr

ança

ise

de S

écur

ité S

anita

ire d

e l’E

nviro

nnem

ent

AFS

SA

Age

nce

Fran

çais

e de

Séc

urité

San

itaire

de

l’Alim

enta

tion

BA

AC

Bas

e A

nnue

lle d

es A

ccid

ents

Cor

pore

ls

BR

GM

B

urea

u de

s Rec

herc

hes G

éolo

giqu

es e

t Min

ière

s C

ITEP

A

Cen

tre I

nter

prof

essi

onne

l Tec

hniq

ue d

’Etu

des d

e la

Pol

lutio

n A

tmos

phér

ique

C

STB

Cen

tre S

cien

tifiq

ue e

t Tec

hniq

ue d

u B

âtim

ent

ECR

IN

no tr

aduc

tion

EPA

C

En

quêt

e P

erm

anen

te su

r les

Acc

iden

ts d

e la

Vie

Cou

rant

e IN

FOSO

L In

form

atio

n su

r les

élé

men

ts tr

aces

dan

s les

sols

en

Fran

ce

INR

A

In

stitu

t Nat

iona

l de

Rec

herc

he A

gron

omiq

ue

INR

ETS

Inst

itut N

atio

nal d

e R

eche

rche

sur l

e Tr

affic

et l

a Sé

curit

é IN

SER

M

Inst

itut N

atio

nal d

e la

San

té e

t de

la R

eche

rche

Méd

ical

e IN

VS

In

stitu

t Nat

iona

l de

Vei

lle S

anita

ire

IRSN

Inst

itut d

e R

adio

prot

ectio

n et

Sûr

eté

Nuc

léai

re

MED

D

Min

istè

re d

e l’E

nviro

nnem

ent e

t du

Dév

elop

pem

ent D

urab

le

OPE

RA

O

bser

vato

ire P

erm

anen

t de

la R

adio

activ

ité

OQ

AI

O

bser

vato

ire d

e la

Qua

lité

de l’

Air

Inté

rieur

PM

SI

Pr

ogra

mm

e M

édic

alis

é de

s Sys

tèm

es d

’Inf

orm

atio

n R

MQ

S

Rés

eau

de M

esur

es d

e la

Qua

lité

des

Sol

R

NSE

Rés

eau

Nat

iona

l de

Surv

eilla

nce

de l

’Env

ironn

emen

t SI

SE

Sy

stèm

e d’

Info

rmat

ion

en S

anté

Env

ironn

emen

t

Ger

man

y

Nam

e:

Jürg

en T

hele

n E-

mai

l: ju

erge

n.th

elen

@ub

a.de

Te

l:

+49

30 8

903

1280

A

ddre

ss:

Fede

ral E

nviro

nmen

tal A

genc

y, C

orre

nspl

atz

1, D

-141

95 B

erlin

C

ount

ry o

r pro

ject

: Ger

man

y T

hem

e In

dica

tor

nam

e

Typ

e O

pera

tion

al

defin

ition

Purp

ose

use

of

indi

cato

r

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-sib

ility

R

epor

ting

C

omm

ent

s

Air

qual

ity

Expo

sure

Ex

M

odifi

ed

from

WH

O

Met

hodo

loy

Mon

itorin

g, a

ir po

licy

eval

uatio

n,

expo

sure

as

sess

men

t

Nat

iona

l, se

lect

ed c

ities

N

Y

Tr

ansm

issi

on o

f ai

r qua

lity

mea

surin

g da

ta

Y

Onl

ine

Info

rmat

ion

of

stat

ion

data

Pu

blic

/ Que

ries

from

the

natio

nal

data

base

on

requ

est

Y

Web

and

R

epor

ts

(Nat

iona

l an

d Fe

dera

l st

ates

)

Met

hod

not

offic

ially

ap

prov

ed

yet

O

zone

-Ex

posu

reW

arni

ng

S Ex

pect

ed

Ozo

ne

conc

.

War

ning

sy

stem

R

egio

nal

N

forc

ast

fore

cast

ww

w.u

mw

eltb

und

esam

t.de

Ozo

ne-f

orec

ast:

http

://w

ww

.env

-it.

de/lu

ftdat

en/p

rog

nosi

s.fw

d?pr

ogD

ay=0

&pr

ogT

ype=

1TM

AX

Y W

eb

and

Rep

orts

(N

atio

nal,

Reg

iona

l an

d lo

cal),

W

arni

ngs

on ra

dio

and

TV if

lim

it va

lues

are

ex

pect

ed

to b

e ex

ceed

ed

Noi

se

Ann

oyan

ce

Effe

ct

(Ann

oyan

ce)

Perc

enta

ge

of

popu

latio

n th

at is

an

noye

d by

se

vera

l no

ise

sour

ces

(roa

d/ai

r/rai

Eval

uatio

n of

Ef

ficie

ncy

of n

oise

po

licy

Nat

iona

l/Reg

ion

al

(dep

endi

ng o

n th

e sa

mpl

e si

ze)

Cur

rent

ly

only

adu

lts

18-6

5; g

ende

r sp

ecifi

c an

alys

is

poss

ible

Val

idat

ion

of

the

ques

tionn

aire

by

Popu

latio

n Su

rvey

, CA

PI

5-st

ep sc

ale

on a

nnoy

ance

ro

ad, r

ail a

nd

air t

raff

ic,

Indu

stry

and

m

anuf

actu

re,n

Y q

ualit

y ch

eck

for

data

en

try

Y, r

epor

t: w

ww

.um

wel

tbe

wus

stse

in.d

e W

eb :

http

://w

ww

.env

-it.

de/u

mw

eltd

ate

n/js

p/di

spat

cher

?ev

ent=

WEL

CO

ME

Web

and

R

epor

ts

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

de

finiti

on

Purp

ose

use

of

indi

cato

r

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-sib

ility

R

epor

ting

C

omm

ent

s

l tra

ffic

, ei

ghbo

urho

od,

Was

te a

nd

cont

ami-

nate

d la

nds

Num

ber o

f co

ntam

inat

ed si

des

and

aban

done

d pl

ants

Stat

e N

umbe

r of

cont

amin

ated

side

s an

d ab

ando

ned

plan

ts

Rem

edia

tion

of

cont

amin

ated

site

s

Nat

iona

l/Fed

era

l Sta

tes

- -

- -

Yes

W

eb a

nd

repo

rts

Rad

iatio

n Po

pula

tion Ex

posu

re

to R

adon

in

ho

useh

old

s

Ex

Rad

on

conc

entra

tion

in

dwel

lings

Mon

itorin

g N

atio

nal

Sele

cted

re

gion

s

no

lim

ited

U

V-

Rad

iatio

n Ex

posu

re

War

ning

(U

V-I

ndex

)

Ex

Expe

cted

Le

vel o

f su

nbur

n ef

fect

ive

UV

Lev

el

at n

oon

(inte

rnat

ion

al

defin

ition

)

War

ning

of

Po

pula

tion

Nat

iona

l, R

egio

nal

No,

spec

ial

reco

mm

enda

tion

s for

ch

ildre

n ar

e gi

ven

Fore

cast

Fo

reca

st

UV

-M

easu

rem

ents

fr

om

stat

ions

http

://w

ww

.bfs

.de/

uv/u

v2/u

vi

Dai

ly

(spr

ing,

su

mm

er), W

ebsi

te

Publ

ic

avai

labl

e/In

for

mat

ion

on T

V

Drin

king

w

ater

Q

ualit

y of

dr

inki

ng

wat

er fr

om

cent

ral

supl

iers

Stat

e N

umbe

r of

anal

yses

th

at e

xcee

d th

e lim

it va

lue

(che

mic

al/

mic

robi

olo

gica

l pa

ram

eter

s)

Ass

essm

ent

of d

rinki

ng

wat

er

qual

ity

from

C

entra

l su

pplie

rs

(Trin

kwV

O), C

ompl

ianc

e ch

ecki

ng

Nat

iona

l no

R

esul

ts o

f A

naly

ses a

re

revi

ewed

by

mun

icip

al

heal

th o

ffic

es;

Res

ults

(2

kate

gorie

s)

are

repo

rted

to U

BA

Res

ults

of

anal

ysis

from

C

entra

l wat

er

supp

liers

Y

Web

site

UB

A

http

://w

ww

.env

-it.

de/u

mw

eltd

ate

n/js

p/di

spat

cher

?ev

ent=

WEL

CO

ME

Yes

; bi

annu

all

y; W

eb-

sire

s of

UB

A

and

fede

ral

stat

es

No

cent

ral

asse

ssm

ent

bas

ed

on th

e or

igin

al

mea

sure

s; ag

greg

ate

resu

lts

are

repo

rted

Q

ualit

y of

D

rinki

ng

Stat

e Fr

eque

ncy

of

Ass

essm

ent

of d

rinki

ng

Nat

iona

l; ol

d &

new

Län

der

Gen

der,

adul

t po

pula

tion,

Su

rvey

with

ex

tern

al Q

M

Surv

ey (G

erm

an

Envi

ronm

enta

l Y

lim

ited

Rep

ort

and

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

de

finiti

on

Purp

ose

use

of

indi

cato

r

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-sib

ility

R

epor

ting

C

omm

ent

s

Wat

er

hous

ehol

ds

exce

edan

ce

of li

mit

valu

es o

f ch

emic

al

para

met

ers

wat

er

qual

ity in

ho

useh

olds

preg

nant

w

omen

Su

rvey

) W

eb-s

ite

http

://w

ww

.env

-it.

de/u

mw

eltd

ate

n/js

p/di

spa

tche

r?ev

ent=

WEL

CO

ME

Bat

hing

W

ater

Q

ualit

y of

ba

thin

g w

ater

Stat

e Ex

ceed

ance

of

re

crea

tiona

l w

ater

lim

it va

lues

at

offic

ially

de

sign

ated

ba

thin

g si

tes

(mar

ine/

fre

shw

ater

)

Mon

itorin

g of

bat

hing

w

ater

qu

ality

, C

ompl

ianc

e ch

ecki

ng

Reg

iona

l (L

ände

r); T

he

Res

ults

of t

he

bath

ing

wat

er

repo

rt ar

e av

aila

ble

at

web

site

s ho

sted

by

mun

icip

aliti

es

or re

spon

sibl

e fe

dera

l sta

te

auth

oriti

es

No

Forth

nigh

tly

Ana

lysi

s of

para

met

ers

spec

ified

in

EC D

irect

ive

Ana

lysi

s and

as

sess

men

t of

bath

ing

wat

er

qual

ity b

y re

spon

sibl

e m

unic

ipal

or

stat

e au

thor

ity

Y

Rep

ort a

nd

Web

site

s Y

es,

year

ly,

Rep

ort

and

Web

site

s

Del

ay o

f Pu

blic

ati

on (o

ne

year

la

ter)

, M

onito

ring

of

Off

icia

l de

sign

ate

d si

tes

rest

ricts

us

e

Food

Saf

ety

Surv

eilla

nce

of

infe

ctio

us

dise

ases

S N

umbe

r of

case

s of

acut

e ga

stro

ente

ritis

in

outb

reak

s (>

2 ca

ses)

Surv

eilla

nce

of

infe

ctio

us

dise

ases

(I

fSG

)

Reg

iona

l, lo

cal;

Surv

eilla

nce

of in

fect

ious

di

seas

es b

y R

ober

Koc

h In

stitu

te

Gen

der a

nd

age

are

reco

rded

as

part

of th

e su

rvei

llanc

e pr

ogra

mm

e

Che

mic

al

emer

genc

ies

Inju

ries a

nd

Cas

ualti

es

in

haza

rdou

s in

cide

nts

with

re

porti

ng

oblig

atio

n in

pla

nts

E N

umbe

r of

casu

altie

s an

d In

jurie

s in

su

bgro

ups

(em

ploy

ees

, rel

ief

units

, Po

pula

tion)

Surv

eilla

nce

of

haza

rdou

s in

cide

nts (

Reg

iona

l, lo

cal,

cent

ral

regi

ster

of

haza

rdou

s in

cide

nts i

s an

nual

ly

repo

rting

No

Y

Que

stio

nnai

res

subm

itted

by

the

oper

atin

g co

mpa

ny

Y

Y

Yea

rly,

repo

rt an

d w

eb

Traf

fic

acci

dent

s M

orta

lity

and

Effe

ct

(cas

ualti

es

Num

ber o

f ca

sual

ties

Mon

itorin

g of

traf

fic

Nat

iona

l, R

egio

nal a

nd

Gen

der a

nd

age

? R

egis

tratio

n of

ac

cide

nts b

y th

e ?

Y

Y;

mon

thly

H

arm

oni

satio

n of

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

de

finiti

on

Purp

ose

use

of

indi

cato

r

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-sib

ility

R

epor

ting

C

omm

ent

s

mor

bidi

ty

due

to ro

ad

traff

ic

acci

dent

s

and

inju

ries)

an

d in

jurie

s du

e to

road

tra

ffic

ac

cide

nts

(als

o ra

il/ai

r/nav

iga

tion)

acci

dent

s an

d ro

ad

safe

ty

loca

l po

lice,

as

sess

men

t of

seve

rity

of

inju

ry b

y po

lice

offic

er, c

urre

ntly

no

cro

ss c

heck

w

ith M

orta

lity-

Reg

iste

r

to y

early

, re

port

and

web

inju

ry

regi

stra

tion

on

a eu

rope

an

scal

e

Hou

sing

Li

ving

are

a pe

r per

son

- A

vera

ge

livin

g ar

ea

per p

erso

n

Mon

itorin

g of

de

velo

pme

nt o

f soc

ial

cond

ition

s

Nat

iona

l (o

ld/n

ew

Länd

er)

No

Cal

cula

ted

from

po

pula

tion

stat

istic

s and

re

side

ntia

l bu

ildin

g st

atis

tics

Surv

ey

(Mik

roze

nsus

)

Add

ition

al

Hou

sing

In

dica

tors

Syst

em o

f So

cial

In

dica

tors

No

desc

riptiv

e fr

amew

ork

of in

dica

tor

inte

rlink

age

A

sses

sme

nt o

f Li

ving

co

nditi

ons

, perc

eive

d Q

ualit

y of

lif

e;

Cha

nges

of

the

Soci

al

stru

ctur

e

Nat

iona

l, pe

rtly

regi

onal

Gen

der,

adul

t po

pula

tion

V

ario

us S

urve

ys;

Soci

o-Ec

onom

ic

Pane

l (SO

EP;

carr

ied

out

annu

ally

), M

ikro

cens

us

(1%

Ran

dom

Po

pula

tion

Sam

ple,

car

ried

out a

nnua

lly),

ALL

BU

S (c

arrie

d ou

t bi

annu

ally

)

Y

Oth

er:

Hum

an

Bio

mon

itorin

g

POP

in

Hum

an

milk

Expo

sure

(in

tern

al)

Con

cent

rati

on o

f PC

DD

and

PC

DF

in

brea

st m

ilk

Mon

itorin

g of

tren

d of

ha

zard

ous

subs

tanc

es

in b

reas

t m

ilk,

asse

ssm

ent

of d

ieta

ry

upta

ke

thro

ugh

brea

st

Nat

iona

l, R

egio

nal

“Län

der”

Bre

ast

feed

ing

mot

hers

; no

age

grou

ps

Y

Sam

ple

of 2

400

brea

st fe

edin

g w

omen

, not

re

pres

enta

tive

Y

limite

d R

epor

t of

Fe

dera

l En

viro

nm

enta

l A

genc

y an

d Fe

dera

l In

stitu

te

for R

isk

Ass

essm

Ass

ocia

tion

to

spec

ific

heal

th

effe

cts

deba

tabl

e

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

de

finiti

on

Purp

ose

use

of

indi

cato

r

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-sib

ility

R

epor

ting

C

omm

ent

s

feed

ing

ent

PO

P in

B

lood

Ex

posu

re

(inte

rnal

) C

once

ntra

tion

of

chlo

rinat

ed

orga

nic

com

poun

ds

in h

uman

bl

ood

Mon

itorin

g of

tren

d of

ch

lorin

ated

or

gani

c co

mpo

unds

in

hum

an

bloo

d

Nat

iona

l, ne

w/o

ld

Länd

er

Adu

lt po

pula

tion

(18-

69),

age

Y

Rep

rese

ntat

ive

Popu

latio

n sa

mpl

e G

erm

an

Envi

ronm

enta

l Su

rvey

199

8

(add

ition

al :

Envi

ronm

enta

l Sp

ecim

en B

ank,

U

nive

rsity

st

uden

ts

Y

limite

d R

epor

ts

and

web

si

te

Ass

ocia

tion

to

spec

ific

heal

th

effe

cts

deba

tabl

e

Le

ad in

B

lood

Ex

posu

re

(inte

rnal

) C

once

ntra

tion

of L

ead

in h

uman

B

lood

Mon

itorin

g of

HM

in

Blo

od

(tren

d)

Nat

iona

l (n

ew/o

ld

Länd

er)

Gen

der,

Adu

lt po

pula

tion;

Y

R

epre

sent

ativ

e Po

pula

tion

sam

ple

Ger

man

En

viro

nmen

tal

Surv

ey 1

998,

ad

ditio

nal:

Envi

ronm

enta

l Sp

ecim

en B

ank,

U

nive

rsity

st

uden

ts

Y

limite

d R

epor

t of

UB

A;

web

site

se

e ab

ove

Indo

or a

ir Ex

posu

re

to S

HS

Expo

sure

Pe

rcen

tage

of

ho

useh

olds

w

ith

child

ren

whe

re o

ne

pers

on

smok

es

insi

de th

e dw

ellin

g

Ass

esm

ent

of c

hild

rens

ex

posu

re to

SH

S at

ho

me

Nat

iona

l Fo

r chi

ldre

n un

der u

nder

18

livi

ng a

t ho

me

Y

Surv

ey, C

API

or

Tele

phon

e Su

rvey

; Ger

man

En

viro

nmen

tal

Surv

ey;

Chi

ldre

n an

d A

dole

scen

t H

ealth

Sur

vey

Y

Y (R

epor

t) Y

Web

an

repo

rt

1)

eg

air o

r wat

er p

ollu

tion

surv

eilla

nce,

com

mun

ity n

oise

surv

eys,

traff

ic a

ccid

ent r

egis

tratio

n, m

orta

lity

stat

istic

s, m

edic

al re

gist

ries s

uch

as h

ospi

tal d

isch

arge

regi

strie

s etc

2)

if th

ere

is n

o in

dica

tor a

vaila

ble

for t

he is

sue

men

tione

d, a

dd in

last

col

umn

(com

men

ts) w

heth

er th

ere

is in

tere

st in

such

an

indi

cato

r R

epre

sent

ativ

e Po

pula

tion

sam

ple

Ger

man

Env

ironm

enta

l Sur

vey

1998

,

Ital

y N

ame:

Dot

t.ssa

Luc

iana

Sin

isi

E-m

ail:

sini

si@

apat

.it

Tel:

+390

6 50

07 2

566

Add

ress

: V. B

ranc

ati 4

8, 0

0144

Rom

a, It

aly

T

ype

DPS

EE

A

(DPS

IR)

Geo

grap

hica

l sca

le

The

me

Indi

cato

r n

ame

Ref

erri

ng in

stitu

tions

L

evel

of

info

rmat

ion

BG

Lev

el o

f ag

greg

atio

n

Age

cat

egor

y V

alid

atio

n da

ta q

ualit

y

Qua

lity

&

type

dat

a co

llect

ion

Dat

a co

ntro

l A

cces

sibi

lity

Rep

ortin

g co

mm

ents

D=D

rivin

g Fo

rce

P=Pr

essu

re

S=St

ate

Ex=E

xpos

ure

E=Ef

fect

A

=Act

ion

D

=Driv

ing

Forc

e P=

Pres

sure

S=

Stat

e I=

Impa

ct

R=R

espo

nse

Dis

tinct

ion

diff

eren

t age

ca

tego

ries

poss

ible

: Y

/N

Y/N

(eg

inte

rnat

iona

l st

anda

rds s

uch

as IC

D u

sed

or

not

R=m

edic

al

regi

stry

, S=

surv

ey,

Mo=

mod

ellin

g,

O=o

utdo

or

mea

sure

men

ts

Mss

: mul

ti sc

ope

stat

istic

s

Y/N

(eg

diag

nosi

s, co

ding

of

dise

ase

chec

ked

Ava

ilabl

e fo

r ot

hers

: Y/N

, re

port

or

data

base

Freq

uenc

y ho

w e

g ye

arly

, web

Ben

efits

pro

blem

s de

ficits

rele

vanc

e fo

r prio

rity

area

s

Air

pollu

tion

Air

conc

entra

tions

of

nitro

gen

oxyd

e Ex

(S)

EPA

R

N

Y

O

N

Y, E

DY

A

Yea

rly,

web

A

ir co

ncen

tratio

ns o

f sul

phur

di

oxyd

e Ex

(S)

EPA

R

N

Y

O

N

Y, E

DY

A

Yea

rly,

web

A

ir co

ncen

tratio

ns o

f oz

one

to le

vel o

f the

gro

und

Ex (S

) EP

A

R

N

Y

O

N

Y

, ED

YA

Y

early

, w

eb

A

ir co

ncen

tratio

ns o

f be

nzen

e Ex

(S)

EPA

R

N

Y

O

N

Y, E

DY

A

Yea

rly,

web

A

ir co

ncen

tratio

ns o

f ca

rbon

m

onox

ide

Ex (S

) EP

A

R

N

Y

O

N

Y

, ED

YA

Y

early

, w

eb

A

ir co

ncen

tratio

ns o

f PM

10

Ex

(S)

EPA

R

N

Y

O

N

Y, E

DY

A

Yea

rly,w

eb

Typ

e D

PSE

EA

(D

PSIR

) G

eogr

aphi

cal s

cale

The

me

Indi

cato

r n

ame

Ref

erri

ng in

stitu

tions

L

evel

of

info

rmat

ion

BG

Lev

el o

f ag

greg

atio

n

Age

cat

egor

y V

alid

atio

n da

ta q

ualit

y

Qua

lity

&

type

dat

a co

llect

ion

Dat

a co

ntro

l A

cces

sibi

lity

Rep

ortin

g co

mm

ents

D=D

rivin

g Fo

rce

P=Pr

essu

re

S=St

ate

Ex=E

xpos

ure

E=Ef

fect

A

=Act

ion

D

=Driv

ing

Forc

e P=

Pres

sure

S=

Stat

e I=

Impa

ct

R=R

espo

nse

Dis

tinct

ion

diff

eren

t age

ca

tego

ries

poss

ible

: Y

/N

Y/N

(eg

inte

rnat

iona

l st

anda

rds s

uch

as IC

D u

sed

or

not

R=m

edic

al

regi

stry

, S=

surv

ey,

Mo=

mod

ellin

g,

O=o

utdo

or

mea

sure

men

ts

Mss

: mul

ti sc

ope

stat

istic

s

Y/N

(eg

diag

nosi

s, co

ding

of

dise

ase

chec

ked

Ava

ilabl

e fo

r ot

hers

: Y/N

, re

port

or

data

base

Freq

uenc

y ho

w e

g ye

arly

, web

Ben

efits

pro

blem

s de

ficits

rele

vanc

e fo

r prio

rity

area

s

In

fant

mor

tality

due

to

resp

irato

ry d

iseas

es

E M

in H

ealth

L

N,R

Y

Y

R

Y

Y

, Rep

MH

/ I

Yea

rly, w

eb

M

ortal

ity d

ue to

resp

irato

ry

dise

ases

E

Min

Hea

lth

L N

,R

Y

Y

R

Y

Y, R

ep M

in./

I Y

early

, web

Ca

ncer

Res

pira

tory

A

ppar

atus

E M

in H

ealth

L

R,N

Y

Y

R

Y

Y

, Rep

MH

/ I/

ISS

Yea

rly, w

eb

Loca

l Can

cer

regi

stries

, NO

T at

all

natio

nal l

evel

Po

licies

to re

duce

en

viro

nmen

tal to

bacc

o sm

oke e

xpos

ure

A

Min

Hea

lth

N

N

N

Y

Mo

N

Y, M

H

Po

pulat

ion

anno

yanc

e by

air

pollu

tion

E IS

TAT

N

N

N

Y

O M

ss*

N

Y, R

ep.I

Yea

rly, w

eb

Ra

te of

resp

irato

ry d

iseas

e (c

hron

ic br

onch

itis,

bron

chial

as

thm

a)

E M

in H

ealth

R

N

Y

Y

R

Y

Y

, Rep

MH

./ I

Yea

rly, w

eb

M

ortal

ity d

ue to

isch

emic

hear

th d

iseas

es

E M

in H

ealth

, ISS

, L

R,N

Y

Y

R

Y

Y

, Rep

.I Y

early

, web

Popu

latio

n an

noya

nce b

y ce

rtain

sour

ces o

f noi

se

E IS

TAT

, Env

Age

ncie

s

N

N

O

Mss

* N

Y

, Rep

.I ED

YA

Slee

p di

sturb

ance

by

noise

E

IS

TAT

L N

,R

N

O

Mss

* N

Y

, Rep

.I

Noi

se

Insp

ected

sour

ces a

nd th

eir

perc

entag

e of t

hese

with

at

least

one l

imit

exce

eded

Ex

En

v A

genc

ies

R

N

Y

O

N

Y

, ED

YA

Y

early

, web

O

utdo

or/in

door

hom

e en

viro

nmen

t

Typ

e D

PSE

EA

(D

PSIR

) G

eogr

aphi

cal s

cale

The

me

Indi

cato

r n

ame

Ref

erri

ng in

stitu

tions

L

evel

of

info

rmat

ion

BG

Lev

el o

f ag

greg

atio

n

Age

cat

egor

y V

alid

atio

n da

ta q

ualit

y

Qua

lity

&

type

dat

a co

llect

ion

Dat

a co

ntro

l A

cces

sibi

lity

Rep

ortin

g co

mm

ents

D=D

rivin

g Fo

rce

P=Pr

essu

re

S=St

ate

Ex=E

xpos

ure

E=Ef

fect

A

=Act

ion

D

=Driv

ing

Forc

e P=

Pres

sure

S=

Stat

e I=

Impa

ct

R=R

espo

nse

Dis

tinct

ion

diff

eren

t age

ca

tego

ries

poss

ible

: Y

/N

Y/N

(eg

inte

rnat

iona

l st

anda

rds s

uch

as IC

D u

sed

or

not

R=m

edic

al

regi

stry

, S=

surv

ey,

Mo=

mod

ellin

g,

O=o

utdo

or

mea

sure

men

ts

Mss

: mul

ti sc

ope

stat

istic

s

Y/N

(eg

diag

nosi

s, co

ding

of

dise

ase

chec

ked

Ava

ilabl

e fo

r ot

hers

: Y/N

, re

port

or

data

base

Freq

uenc

y ho

w e

g ye

arly

, web

Ben

efits

pro

blem

s de

ficits

rele

vanc

e fo

r prio

rity

area

s

State

of i

mpl

emen

tatio

n of

m

unici

pal n

oise

clas

sifica

tion

plan

s S

Env

Age

ncie

s L

N

Y

O

Y

Y

Y

early

, web

Airp

ort t

raffi

c Ex

M

in T

rans

. L

N

N

S

N

Y, E

DY

A

Yea

rly, w

eb

Ra

ilway

traf

fic

Ex

Min

Tra

ns.

R

N

N

S

N

Y, E

DY

A

Yea

rly, w

eb

Hig

hway

traf

fic

Ex

Min

Tra

ns.

N

N

N

S

N

Y, E

DY

A

Yea

rly, w

eb

G

ener

ation

of m

unici

pal

was

te Ex

(P)

EPA

L

N

Y

O

Y

Am

ount

of m

unici

pal w

aste

incin

erate

d Ex

(P,R

) EP

A

L N

, R

N

N

S N

Y

, ED

YA

Y

early

, web

Indu

strial

was

te re

cove

ry

Ex (P

,R)

EPA

L

R,N

N

N

S

N

Y, E

DY

A

Yea

rly, w

eb

Am

ount

of s

pecia

l w

aste

reco

vere

d

Ex

EPA

L

R,N

N

N

S

N

Y, E

DY

A

Yea

rly, w

eb

Inco

mpl

ete re

liabi

lity

for l

ack

of a

com

paris

on w

ith

auth

oriza

tions

A

mou

nt o

f mun

icipa

l was

te w

ith d

ispos

al in

land

fills

Ex (P

,R)

Env

Age

ncie

s L

N

Y

O

Y

Y

, ED

YA

Y

early

web

Num

ber o

f lan

dfill

s Ex

(P)

Haz

ardo

us w

aste

gene

ratio

n Ex

EP

A M

in. E

nv.

R

N

N

N

S N

Y

, ED

YA

Y

early

, web

Haz

ardo

us w

aste

polic

ies

A

EPA

Min

. Env

. L,

R

N

N

Y

Mo

N

Was

te

Popu

latio

n an

noya

nce b

y

stree

t soi

l E

ISTA

T

N

N

N

O m

ss

N

Y,

Rep.

ISTA

T Y

early

, web

Con

tam

inat

ed

land

s To

tal n

umbe

r of

cont

amin

ated

land

sites

Ex

En

v A

genc

ies

R

N

N

N

O m

ss,S

N

Y

, ED

YA

Re

p. I

Yea

rly, w

eb

Typ

e D

PSE

EA

(D

PSIR

) G

eogr

aphi

cal s

cale

The

me

Indi

cato

r n

ame

Ref

erri

ng in

stitu

tions

L

evel

of

info

rmat

ion

BG

Lev

el o

f ag

greg

atio

n

Age

cat

egor

y V

alid

atio

n da

ta q

ualit

y

Qua

lity

&

type

dat

a co

llect

ion

Dat

a co

ntro

l A

cces

sibi

lity

Rep

ortin

g co

mm

ents

D=D

rivin

g Fo

rce

P=Pr

essu

re

S=St

ate

Ex=E

xpos

ure

E=Ef

fect

A

=Act

ion

D

=Driv

ing

Forc

e P=

Pres

sure

S=

Stat

e I=

Impa

ct

R=R

espo

nse

Dis

tinct

ion

diff

eren

t age

ca

tego

ries

poss

ible

: Y

/N

Y/N

(eg

inte

rnat

iona

l st

anda

rds s

uch

as IC

D u

sed

or

not

R=m

edic

al

regi

stry

, S=

surv

ey,

Mo=

mod

ellin

g,

O=o

utdo

or

mea

sure

men

ts

Mss

: mul

ti sc

ope

stat

istic

s

Y/N

(eg

diag

nosi

s, co

ding

of

dise

ase

chec

ked

Ava

ilabl

e fo

r ot

hers

: Y/N

, re

port

or

data

base

Freq

uenc

y ho

w e

g ye

arly

, web

Ben

efits

pro

blem

s de

ficits

rele

vanc

e fo

r prio

rity

area

s

Co

ntam

inate

d lan

d sit

es o

f na

tiona

l int

eres

t Ex

EP

A M

in. E

nv.

L N

, R

N

N

O, S

N

Y

, ED

YA

Yea

rly, w

eb

A

reas

use

d fo

r int

ensiv

e ag

ricul

ture

Ex

EP

A M

in. E

nv.

R

N

N

N

O, S

N

Y

, ED

YA

Y

early

, web

A

mou

nt o

f he

avy

meta

ls in

ag

ricul

tura

l gro

unds

Ex

EP

A

L N

, R

N

Y

O

Y

Y, E

DY

A

Yea

rly, w

eb

Def

icien

cy in

the n

et of

mon

itorin

g of

gr

ound

s

Clea

ned-

up si

tes

A

EPA

R

N

N

N

O

, S

N

Y, E

DY

A

Yea

rly, w

eb

D

rinki

ng

wat

er

Popu

latio

n an

noya

nce b

y

irreg

ular

dist

ribut

ion

of th

e w

ater

E IS

TAT

R

N

N

N

O m

ss

N

Y, R

ep. I

Y

early

, web

Pe

rcen

tage o

f fam

ilies

that

does

not

drin

k (u

ntru

st) ta

p w

ater

E IS

TAT

R

N

N

N

O m

ss

N

Y, R

ep. I

Y

early

, web

*inf

orm

ation

on

use

of b

ottle

d dr

inki

ng

wate

r whi

ch ar

e not

re

gulat

ed b

y m

ain

drin

king

wate

r law

Acc

ess t

o ad

equa

te sa

nitat

ion

Ex

Min

Hea

lth

R

N

N

Y

R

N

Y, R

ep I

Yea

rly, w

eb

Rate

of re

nal c

alcul

osis

E IS

TAT

R

N

N

Y

R

Y

Y, R

ep.I

Yea

rly, w

eb

Rate

of in

fecti

ous d

iarrh

oea

E IS

TAT

R

N

Y

Y

R

Y

Y, R

ep.I

Yea

rly, w

eb

W

ater a

bstra

ction

for

dr

inka

ble u

se (s

uper

ficial

and

grou

nd w

aters)

S

EPA

R

N

N

Y

O

Y, E

DY

A

*

Sea-

bath

ing

wat

er

Bacte

riolo

gica

l Qua

lity

Inde

x (B

QI)

Ex (S

) EP

A

L R,

N

N

Y

O

Y

Y, E

DY

A

Yea

rly, w

eb

Typ

e D

PSE

EA

(D

PSIR

) G

eogr

aphi

cal s

cale

The

me

Indi

cato

r n

ame

Ref

erri

ng in

stitu

tions

L

evel

of

info

rmat

ion

BG

Lev

el o

f ag

greg

atio

n

Age

cat

egor

y V

alid

atio

n da

ta q

ualit

y

Qua

lity

&

type

dat

a co

llect

ion

Dat

a co

ntro

l A

cces

sibi

lity

Rep

ortin

g co

mm

ents

D=D

rivin

g Fo

rce

P=Pr

essu

re

S=St

ate

Ex=E

xpos

ure

E=Ef

fect

A

=Act

ion

D

=Driv

ing

Forc

e P=

Pres

sure

S=

Stat

e I=

Impa

ct

R=R

espo

nse

Dis

tinct

ion

diff

eren

t age

ca

tego

ries

poss

ible

: Y

/N

Y/N

(eg

inte

rnat

iona

l st

anda

rds s

uch

as IC

D u

sed

or

not

R=m

edic

al

regi

stry

, S=

surv

ey,

Mo=

mod

ellin

g,

O=o

utdo

or

mea

sure

men

ts

Mss

: mul

ti sc

ope

stat

istic

s

Y/N

(eg

diag

nosi

s, co

ding

of

dise

ase

chec

ked

Ava

ilabl

e fo

r ot

hers

: Y/N

, re

port

or

data

base

Freq

uenc

y ho

w e

g ye

arly

, web

Ben

efits

pro

blem

s de

ficits

rele

vanc

e fo

r prio

rity

area

s

Ba

thin

g w

ater q

ualit

y Ex

M

in H

ealth

EPA

L

R,N

N

Y

O

Y

Y

, Rep

. MH

, ED

YA

Y

early

, web

Nuc

lear p

lants:

activ

ity o

f ra

dioi

soto

pes d

ischa

rged

in

the a

ir an

d w

ater

Ex (P

) EP

A

L N

N

Y

S

Y

, ED

YA

Y

early

, web

Wor

k ac

tiviti

es w

ith N

atura

l O

ccur

ring

Radi

oacti

ve

Mate

rials

(NO

RM)

Ex (D

) EP

A

N

N

N

Y

S

Y, E

DY

A

Conc

entra

tion

of ra

don

indo

or

Ex (S

) EP

A

R

N

N

Y

O

Y

, ED

YA

Y

early

, web

Radi

oacti

vity

conc

entra

tions

of

artif

icial

radi

onuc

lides

in

the

envi

ronm

ental

and

food

m

atrice

s

Ex (S

) EP

A

N

N

Y

S

Y

, ED

YA

Ave

rage

indi

vidu

al ef

fecti

ve

dose

in o

ne y

ear

Ex (I

) EP

A

N

N

Y

S

Y

, ED

YA

Rad

iatio

n

Incid

ence

of s

kin

canc

er

E IS

TAT/

ISS

N

N

Y

Y

R

Y

Y, R

ep I

Ca

ncer

regi

stries

N

OT

at all

nati

onal

level

Broa

dcas

ting

and

telec

omm

unica

tion

sites

fo

und

to ex

ceed

lim

its an

d re

med

iatio

n sta

te (m

onito

red

sites

)

Ex (P

) EP

A

N

N

Y

O

Y, E

DY

A

Yea

rly, w

eb

Agr

icul

ture

D

istrib

utio

n of

ferti

lizer

s fo

r ag

ricul

tura

l use

Ex

(P)

EPA

/ IST

AT

R

N

Y

S

Y

, ED

YA

Y

early

, web

Typ

e D

PSE

EA

(D

PSIR

) G

eogr

aphi

cal s

cale

The

me

Indi

cato

r n

ame

Ref

erri

ng in

stitu

tions

L

evel

of

info

rmat

ion

BG

Lev

el o

f ag

greg

atio

n

Age

cat

egor

y V

alid

atio

n da

ta q

ualit

y

Qua

lity

&

type

dat

a co

llect

ion

Dat

a co

ntro

l A

cces

sibi

lity

Rep

ortin

g co

mm

ents

D=D

rivin

g Fo

rce

P=Pr

essu

re

S=St

ate

Ex=E

xpos

ure

E=Ef

fect

A

=Act

ion

D

=Driv

ing

Forc

e P=

Pres

sure

S=

Stat

e I=

Impa

ct

R=R

espo

nse

Dis

tinct

ion

diff

eren

t age

ca

tego

ries

poss

ible

: Y

/N

Y/N

(eg

inte

rnat

iona

l st

anda

rds s

uch

as IC

D u

sed

or

not

R=m

edic

al

regi

stry

, S=

surv

ey,

Mo=

mod

ellin

g,

O=o

utdo

or

mea

sure

men

ts

Mss

: mul

ti sc

ope

stat

istic

s

Y/N

(eg

diag

nosi

s, co

ding

of

dise

ase

chec

ked

Ava

ilabl

e fo

r ot

hers

: Y/N

, re

port

or

data

base

Freq

uenc

y ho

w e

g ye

arly

, web

Ben

efits

pro

blem

s de

ficits

rele

vanc

e fo

r prio

rity

area

s

D

istrib

utio

n of

pes

ticid

es fo

r ag

ricul

tura

l use

. Ex

(P)

ISTA

T R

N

Y

S

Y, E

DY

A

Yea

rly, w

eb

Indu

strial

sites

Sev

eso

dire

ctory

. Ex

(P)

Env.

Min

R

N

Y

S

Y, E

DY

A

Num

ber o

f mun

icipa

lities

w

ith 4

or m

ore i

ndus

trial

sites

Se

vero

dire

ctory

. Ex

(P)

Env.

Min

L

R, N

Y

S

Y, R

ep. E

nv.

Min

, ED

YA

Typo

logy

of i

ndus

trial

sites

Se

veso

dire

ctory

. Ex

(P)

Env.

Min

L

R, N

Y

S

Y, R

ep. E

nv.

Min

, ED

YA

Che

mic

al

safe

ty

Am

ount

of h

azar

d su

bstan

ces

in th

e ind

ustri

al sit

es S

eves

o di

recto

ry.

Ex (P

) En

v. M

in

N

N

Y

S

Y

, Rep

. Env

. M

in, E

DY

A

Popu

latio

n liv

ing

in

subs

tand

ard

hous

ing

Ex

ISTA

T L

R, N

Y

S m

ss

Y

, Rep

I Y

early

, web

Mor

talit

y du

e to

ext

erna

l ca

uses

in c

hild

ren

unde

r 5

year

s of a

ge

E IS

S

R

N

Y

Y

R

Y

Y, R

ep IS

S Y

early

, web

Scop

e an

d ap

plic

atio

n of

bu

ildin

g re

gula

tions

for

hous

ing

A

Inst

itutio

ns in

volv

ed

Mo

Y

Hou

sing

Land

use

and

urb

an

plan

ning

regu

latio

ns

A

Inst

itutio

ns in

volv

ed

Mo,

O

Y

Traf

fic

acci

dent

s M

orta

lity

from

roa

d ac

cide

nts

E IS

TAT,

Reg

iona

l ag

enci

es P

ublic

hea

lth

Min

.Tra

ns.,M

in.In

terio

rN

N

Y

Y

S

Y

, Rep

. I

Age

ncy

of p

ublic

he

alth

they

are

not

on

all

natio

nal

terr

itory

Typ

e D

PSE

EA

(D

PSIR

) G

eogr

aphi

cal s

cale

The

me

Indi

cato

r n

ame

Ref

erri

ng in

stitu

tions

L

evel

of

info

rmat

ion

BG

Lev

el o

f ag

greg

atio

n

Age

cat

egor

y V

alid

atio

n da

ta q

ualit

y

Qua

lity

&

type

dat

a co

llect

ion

Dat

a co

ntro

l A

cces

sibi

lity

Rep

ortin

g co

mm

ents

D=D

rivin

g Fo

rce

P=Pr

essu

re

S=St

ate

Ex=E

xpos

ure

E=Ef

fect

A

=Act

ion

D

=Driv

ing

Forc

e P=

Pres

sure

S=

Stat

e I=

Impa

ct

R=R

espo

nse

Dis

tinct

ion

diff

eren

t age

ca

tego

ries

poss

ible

: Y

/N

Y/N

(eg

inte

rnat

iona

l st

anda

rds s

uch

as IC

D u

sed

or

not

R=m

edic

al

regi

stry

, S=

surv

ey,

Mo=

mod

ellin

g,

O=o

utdo

or

mea

sure

men

ts

Mss

: mul

ti sc

ope

stat

istic

s

Y/N

(eg

diag

nosi

s, co

ding

of

dise

ase

chec

ked

Ava

ilabl

e fo

r ot

hers

: Y/N

, re

port

or

data

base

Freq

uenc

y ho

w e

g ye

arly

, web

Ben

efits

pro

blem

s de

ficits

rele

vanc

e fo

r prio

rity

area

s

R

ate

of in

jure

s by

road

ac

cide

nts

E IS

TAT

L R

,N

Y

Y

S

Y, R

ep I

Mon

itorin

g ch

emic

al

haza

rds i

n fo

od: p

oten

tial

expo

sure

Ex

M

in H

ealth

, ISS

N

N

N

Y

O

,S

Y

, Rep

.MH

Out

brea

ks o

f foo

d-bo

rne

illne

ss

E M

in H

ealth

L

R,N

Y

R,S

Y

Y

, Rep

.MH

Y

early

,web

Inci

denc

e of

food

-bor

ne

illne

ss

E M

in H

ealth

L

R,N

Y

R,S

Y

Y

, Rep

.MH

Y

early

,web

Food

safe

ty

Gen

eral

food

safe

ty p

olic

y A

M

in H

ealth

, ISS

N

N

N

Y

S

Typ

e D

PSE

EA

(D

PSIR

) G

eogr

aphi

cal s

cale

The

me

Indi

cato

r n

ame

Ref

erri

ng in

stitu

tions

L

evel

of

info

rmat

ion

BG

Lev

el o

f ag

greg

atio

n

Age

cat

egor

y V

alid

atio

n da

ta q

ualit

y

Qua

lity

&

type

dat

a co

llect

ion

Dat

a co

ntro

l A

cces

sibi

lity

Rep

ortin

g co

mm

ents

D=D

rivin

g Fo

rce

P=Pr

essu

re

S=St

ate

Ex=E

xpos

ure

E=Ef

fect

A

=Act

ion

D

=Driv

ing

Forc

e P=

Pres

sure

S=

Stat

e I=

Impa

ct

R=R

espo

nse

Dis

tinct

ion

diff

eren

t age

ca

tego

ries

poss

ible

: Y

/N

Y/N

(eg

inte

rnat

iona

l st

anda

rds s

uch

as IC

D u

sed

or

not

R=m

edic

al

regi

stry

, S=

surv

ey,

Mo=

mod

ellin

g,

O=o

utdo

or

mea

sure

men

ts

Mss

: mul

ti sc

ope

stat

istic

s

Y/N

(eg

diag

nosi

s, co

ding

of

dise

ase

chec

ked

Ava

ilabl

e fo

r ot

hers

: Y/N

, re

port

or

data

base

Freq

uenc

y ho

w e

g ye

arly

, web

Ben

efits

pro

blem

s de

ficits

rele

vanc

e fo

r prio

rity

area

s

MO

RTA

LITY

D

UE

TO

SEV

ERA

L C

AU

SES

- IN

FEC

TOU

S D

ISEA

SES

- - E

ndoc

rine

diso

rder

s -

- neo

plas

tic

dise

ases

-

psyc

hiat

ric

diso

rder

s -

nerv

ous s

yste

m

diso

rder

s -

isch

emic

hea

rth

dise

ases

-

cere

brov

ascu

lar

diso

rder

s -

obst

ruct

ive

pulm

onar

y di

sord

ers

- ep

athi

c di

sord

ers

-

E IS

TAT

L R

,N

Y

Y

R

Y

Y, R

ep I

Not

ye

arly

,web

The

syst

em u

tiliz

e W

HO

Hea

lh fo

r All

Dat

a ba

se

LIFE

STY

LE

Sm

okin

g, d

iet a

nd a

lcho

ol

drin

king

Ex

IS

TAT

R

N

Y

Y

S Y

Y

, Rep

I ib

idem

ib

idem

Typ

e D

PSE

EA

(D

PSIR

) G

eogr

aphi

cal s

cale

The

me

Indi

cato

r n

ame

Ref

erri

ng in

stitu

tions

L

evel

of

info

rmat

ion

BG

Lev

el o

f ag

greg

atio

n

Age

cat

egor

y V

alid

atio

n da

ta q

ualit

y

Qua

lity

&

type

dat

a co

llect

ion

Dat

a co

ntro

l A

cces

sibi

lity

Rep

ortin

g co

mm

ents

D=D

rivin

g Fo

rce

P=Pr

essu

re

S=St

ate

Ex=E

xpos

ure

E=Ef

fect

A

=Act

ion

D

=Driv

ing

Forc

e P=

Pres

sure

S=

Stat

e I=

Impa

ct

R=R

espo

nse

Dis

tinct

ion

diff

eren

t age

ca

tego

ries

poss

ible

: Y

/N

Y/N

(eg

inte

rnat

iona

l st

anda

rds s

uch

as IC

D u

sed

or

not

R=m

edic

al

regi

stry

, S=

surv

ey,

Mo=

mod

ellin

g,

O=o

utdo

or

mea

sure

men

ts

Mss

: mul

ti sc

ope

stat

istic

s

Y/N

(eg

diag

nosi

s, co

ding

of

dise

ase

chec

ked

Ava

ilabl

e fo

r ot

hers

: Y/N

, re

port

or

data

base

Freq

uenc

y ho

w e

g ye

arly

, web

Ben

efits

pro

blem

s de

ficits

rele

vanc

e fo

r prio

rity

area

s

CH

RO

NIC

A

ND

IN

FEC

TIO

US

DIS

EASE

S

E

ISTA

T

N

Y m

ainl

y fo

r in

fect

ious

di

sord

ers

Y

S Y

Y

, Rep

I ib

idem

ib

idem

EPA

: Nat

iona

l Env

ironm

enta

l Pro

tect

ion

Age

ncy

– A

PAT

Env.

Age

ncie

s: R

egio

nal &

Loc

al E

nviro

nmen

tal P

rote

ctio

n A

genc

ies

EDY

A:

Envi

ronm

enta

l Dat

a Y

earb

ook

APA

T R

ep. I

: rep

ort I

STA

T –

Nat

iona

l Sta

tistic

s Ins

titut

e

Rep

. MH

: rep

ort M

in. H

ealth

M

in. E

nv.:

Min

istry

for t

he E

nviro

nmen

t and

Ter

ritor

y IS

S: N

atio

nal I

nstit

ute

of H

ealth

IS

PEL:

Nat

iona

l Ins

titut

e fo

r Saf

ety

Wor

k Pl

aces

Lith

uani

a N

ame:

Ingr

ida

Zurly

te, A

ida

Lauk

aitie

ne

E-m

ail:

ingr

ida@

post

.om

nite

l.net

, aid

a.l@

taka

s.lt

Tel:

+370

5 2

3604

81

Add

ress

: Sta

te E

nviro

nmen

tal H

ealth

Cen

tre, E

nviro

nmen

t and

Hea

lth D

ivis

ion

K

alva

riju

stre

et 1

53, L

T-20

42 V

ilniu

s, Li

thua

nia

T

hem

e In

dica

tor

nam

e

Typ

e O

pera

tiona

l de

finiti

on

Purp

ose

use

of

indi

cato

r

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

Air

qual

ity

Infa

nt

mor

talit

y du

e to

resp

irato

ry

dise

ases

E A

nnua

l m

orta

lity

rate

du

e to

re

spira

tory

di

seas

es in

ch

ildre

n ol

der

than

one

m

onth

and

un

der o

ne

year

of a

ge

Hea

lth

mon

itori

ng, a

ir co

ntro

l po

licy

eval

uatio

n

Loca

l –

mun

icip

ality

Y

Y

M

orta

lity

stat

istic

s, us

er

acce

ssib

le d

ata

base

upd

ated

an

nual

y

Y

Y

Stat

istic

al

anna

ls;

ww

w.ls

ic.lt

H

ealth

in

dica

tors

sy

stem

Y

Yea

rly,

web

, rep

ort

Air

qual

ity

Mor

talit

y du

e to

resp

irato

ry

dise

ases

E A

nnua

l m

orta

lity

rate

du

e to

re

spira

tory

di

seas

es

Mon

itori

ng, a

ir co

ntro

l po

licy

eval

uatio

n

Loca

l –

mun

icip

ality

, ci

ty

Y

Y

Mor

talit

y st

atis

tics,

user

ac

cess

ible

dat

a ba

ses a

re

upda

ted

year

ly

Y

Y

Stat

istic

al

anna

ls;

ww

w.ls

ic.lt

H

ealth

in

dica

tors

sy

stem

Y

Yea

rly,

web

, rep

ort

Air

qual

ity

Mor

talit

y du

e to

dis

ease

s of

the

circ

ulat

ory

syst

em

E A

nnua

l m

orta

lity

rate

du

e to

car

dio-

or

cer

ebro

-va

scul

ar

dise

ases

all

ages

Mon

itori

ng, a

ir co

ntro

l po

licy

eval

uatio

n

Loca

l –

mun

icip

ality

, ci

ty

Y

Y

Mor

talit

y st

atis

tics,

user

ac

cess

ible

dat

a ba

ses a

re

upda

ted

year

ly

Y

Y

Stat

istic

al

anna

ls;

ww

w.ls

ic.lt

H

ealth

in

dica

tors

sy

stem

Y

Yea

rly,

web

, rep

ort

Air

qual

ity

Polic

ies t

o re

duce

en

viro

nmen

tal

A

Com

posi

te

inde

x of

ca

pabi

lity

for

Envi

ron

men

tal

toba

cco

Nat

iona

l N

N

Q

uest

ionn

aire

fo

r pilo

t pro

ject

of

N

Proj

ect

repo

rt N

o re

gula

r re

porti

ng

yet

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

in

dica

tor

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

toba

cco

smok

e ex

posu

re

impl

emen

ting

polic

ies t

o re

duce

en

viro

nmen

tal

toba

cco

smok

e ex

posu

re a

nd

prom

otin

g sm

oke

free

ar

eas

smok

e co

ntro

l po

licy

eval

uatio

n

Envi

ronm

enta

l H

ealth

In

dica

tors

, onc

e co

llect

ed fo

r the

ye

ar 1

996

-20

00.

Noi

se

Popu

latio

n an

noya

nce

by

certa

in

sour

ces o

f no

ise

E Pe

rcen

tage

of

the

popu

latio

n an

noye

d by

ce

rtain

so

urce

s of

envi

ronm

enta

l no

ise

Mon

itori

ng, n

oise

po

licy

eval

uatio

n

Pl

ans i

n th

e fu

ture

, in

clud

ed

into

the

Nat

iona

l lis

t of E

H

indi

cato

rs

Noi

se

Slee

p di

stur

banc

e by

noi

se

E Pe

rcen

tage

of

the

popu

latio

n w

ith se

lf-re

porte

d sl

eep

dist

urba

nce

by

envi

ronm

enta

l no

ise

Mon

itori

ng, n

oise

po

licy

eval

uatio

n

Pl

ans i

n th

e fu

ture

, in

clud

ed

into

the

Nat

iona

l lis

t of E

H

indi

cato

rs

Noi

se

App

licat

ion

of re

gula

tions

, re

stric

tions

an

d no

ise

abat

emen

t m

easu

res

A

Com

posi

te

inde

x of

ca

pabi

lity

to

impl

emen

t re

gula

tions

, re

stric

tions

an

d no

ise

abat

emen

t m

easu

res

Noi

se

polic

y ev

alua

tion

Nat

iona

l N

N

Q

uest

ionn

aire

fo

r pilo

t pro

ject

of

En

viro

nmen

tal

Hea

lth

Indi

cato

rs, o

nce

colle

cted

for t

he

year

199

6 -

2000

.

N

Y

Proj

ect

repo

rt

No

regu

lar

repo

rting

ye

t

Was

te a

nd

cont

ami-

nate

d la

nds

Haz

ardo

us

was

te p

olic

ies

A

Com

posi

te

inde

x on

the

leve

ls o

f ha

zard

ous

was

te p

olic

ies

Haz

ardo

us w

aste

po

licy

eval

uatio

n

Nat

iona

l N

N

Q

uest

ionn

aire

fo

r pilo

t pro

ject

of

En

viro

nmen

tal

Hea

lth

N

Y

Proj

ect

repo

rt

No

regu

lar

repo

rting

ye

t

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

in

dica

tor

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

and

regu

latio

ns

Indi

cato

rs o

nce

colle

cted

for t

he

year

199

6 -

2000

. R

adia

tion

Inci

denc

e of

sk

in c

ance

r E

Ann

ual

inci

denc

e ra

te

of sk

in c

ance

r

Mon

itori

ng

Indi

vidu

al

data

Y

Y

Sp

ecia

lized

ca

ncer

regi

stry

, da

ta a

re

colle

cted

dai

ly,

but u

ser

acce

ssib

le d

ata

upda

ted

year

ly.

Y

Y

ww

w.ls

ic.lt

H

ealth

in

dica

tors

sy

stem

Web

, re

ports

Rad

iatio

n C

umul

ativ

e ra

diat

ion

doze

Ex

Pe

rcen

tage

of

popu

latio

n re

ceiv

ing

a cu

mul

ativ

e ra

diat

ion

dose

in

exc

ess o

f 5

mS/

year

Mon

itori

ng,

radi

atio

n po

licy

eval

uatio

n

Ave

rage

st

atis

tical

in

habi

tant

? Y

Sa

mpl

ing,

ca

lcul

atio

ns,

regi

stry

, m

onito

ring

of

radi

atio

n ex

posu

re,

daily

.

Y

Y

Dat

a ba

se

in

Rad

iatio

n Pr

otec

tion

Cen

tre,

repo

rt

Rep

ort

Rad

iatio

n U

V li

ght

inde

x Ex

U

V li

ght

inde

x M

onito

ring

N

N

Y

St

atis

tical

dat

a,

calc

ulat

ions

, da

ily, b

ut u

ser

acce

ssib

le d

ata

base

s are

up

date

d m

onth

ly

Y

Y,

Dat

a ba

se

in

Lith

uani

anH

ydro

met

eor

olog

ical

se

rvic

e

Y, y

early

to

Envi

ronm

ent

al

Prot

ectio

n A

genc

y

Rad

iatio

n N

umbe

r of

wor

kers

w

orki

ng w

ith

ioni

zing

ra

diat

ion

sour

ces

Ex

Num

ber o

f w

orke

rs

wor

king

with

io

nizi

ng

radi

atio

n so

urce

s

Mon

itori

ng,

radi

atio

n po

licy

eval

uatio

n

Pl

ans i

n th

e fu

ture

in

clud

ed

into

the

Nat

iona

l lis

t of E

H

indi

cato

rs.

Dat

a av

aila

ble

in

Rad

iatio

n Pr

otec

tion

cent

re

Rad

iatio

n Ef

fect

ive

A

Exis

tenc

e of

R

adia

tioN

atio

nal

N

Y

Que

stio

nnai

re

N

Y

No

regu

lar

Envi

ronm

e

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

in

dica

tor

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

envi

ronm

enta

l m

onito

ring

of

radi

atio

n ac

tivity

effe

ctiv

e en

viro

nmen

tal

mon

itorin

g of

ra

diat

ion

activ

ity in

co

mpl

ianc

e w

ith n

atio

nal

and

inte

rnat

iona

l qu

ality

as

sura

nce

prog

ram

s

n po

licy

eval

uatio

n

for p

ilot p

roje

ct

of

Envi

ronm

enta

l H

ealth

In

dica

tors

, onc

e co

llect

ed fo

r the

ye

ar 1

996

-20

00.

Proj

ect

repo

rt re

porti

ng

on su

ch

indi

cato

r ye

t

ntal

ra

diat

ion

mon

itorin

g sy

stem

is

prop

erly

w

orki

ng in

Li

thua

nia.

D

ata

avai

labl

e in

En

viro

nme

ntal

Pr

otec

tion

agen

cy a

nd

Rad

iatio

n Pr

otec

tion

Cen

tre

Rad

iatio

n To

pica

lity

of

perm

its o

n th

e us

e of

ra

dioa

ctiv

e su

bsta

nces

A

Frac

tion

of

com

pani

es,

acco

rdin

g to

di

ffer

ent

cate

gorie

s, ha

ving

an

actu

al p

erm

it fo

r han

dlin

g pr

oces

sing

, em

issi

on e

ct.

of ra

dioa

ctiv

e su

bsta

nces

Rad

iatio

n po

licy

eval

uatio

n

Nat

iona

l N

Y

Q

uest

ionn

aire

fo

r pilo

t pro

ject

of

En

viro

nmen

tal

Hea

lth

Indi

cato

rs, o

nce

colle

cted

for t

he

year

199

6 -

2000

.

N

Y

Proj

ect

repo

rt

No

regu

lar

repo

rting

on

such

in

dica

tor

yet

Dat

a av

aila

ble

in

Rad

iatio

n Pr

otec

tion

Cen

tre

Drin

king

/S

wim

min

g w

ater

and

sa

nita

tion

Acc

ess t

o sa

fe

drin

king

w

ater

Ex

Perc

enta

ge o

f th

e po

pula

tion

with

co

ntin

uous

ac

cess

to

adeq

uate

am

ount

of

safe

drin

king

w

ater

in th

e ho

me

Mon

itori

ng,

drin

king

w

ater

po

licy

eval

uatio

n

Pl

ans i

n th

e fu

ture

, in

clud

ed

into

the

Nat

iona

l lis

t of E

H

indi

cato

rs

Drin

king

Su

pply

from

Ex

Pe

rcen

tage

of

Mon

itori

Loca

l, N

Y

R

outin

e Y

Y

, Y

,

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

in

dica

tor

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

/Sw

imm

ing

wat

er a

nd

sani

tatio

n

publ

ic w

ater

su

pplie

s th

e po

pula

tion

supp

lied

from

pu

blic

wat

er

supp

ly to

the

hom

e

ng,

drin

king

w

ater

po

licy

eval

uatio

n

mun

icip

aliti

es

stat

istic

al d

ata

colle

ctio

n fr

om

ente

rpris

es,

year

ly

Stat

istic

al

anna

ls

year

ly,

repo

rt

Drin

king

/S

wim

min

g w

ater

and

sa

nita

tion

Effe

ctiv

e m

onito

ring

of

recr

eatio

nal

wat

er

A

Prop

ortio

n of

th

e ba

thin

g w

ater

s th

at

are

mon

itore

d an

d su

bjec

t to

syst

emat

ic

cont

rol

(des

igna

ted

bath

ing

wat

ers)

R

epor

ted

sepa

rate

ly f

or

(a)

fres

hwat

er

and

(b)

mar

ine

wat

er

Rec

reat

ion

al

wat

er

polic

y ev

alua

tion

Loca

l, m

unic

ipal

ities

N

Y

R

ecre

atio

nal

wat

er p

ollu

tion

surv

eilla

nce,

ye

arly

Y

Y,

Rec

reat

iona

l wat

er

mon

itorin

g da

ta b

ase

at

the

Inst

itute

of

Hyg

iene

, Pi

lot

proj

ect

repo

rt in

St

ate

Envi

ronm

ent

al H

ealth

C

entre

Y,

EH

indi

cato

rs

pilo

t pr

ojec

t re

port

Food

Saf

ety

Out

brea

ks o

f fo

od-b

one

illne

ss

E N

umbe

r of

outb

reak

s of

com

mun

icab

le

dise

ases

tra

nsm

itted

by

food

per

yea

r; In

cide

nce

num

ber i

n th

e ou

tbre

aks o

f co

mm

unic

abl

e di

seas

es

trans

mitt

ed b

y fo

od p

er y

ear

Mon

itori

ng, f

ood

safe

ty

polic

y ev

alua

tion

Loca

l, m

unic

ipal

ity

Y- b

y ag

e (a

ge g

roup

s:

0-2,

3-6

, 7-1

4,

15 a

nd m

ore)

N

– b

y ge

nder

Y

Com

mun

icab

le

dise

ase

surv

eilla

nce,

da

ily, b

y us

er

acce

ssib

le d

ata

by m

onth

ly

N

Y,

Dat

a ba

se

at th

e C

omm

unic

able

D

isea

se

Prev

entio

n an

d C

ontro

l C

entre

Y,

Yea

rly,

repo

rt

Food

Saf

ety

Inci

denc

e of

fo

od-b

one

illne

ss

E In

cide

nce

rate

of

acu

te

inte

stin

al

com

mun

icab

le

dise

ases

and

Mon

itori

ng, f

ood

safe

ty

polic

y ev

alua

tio

Loca

l, m

unic

ipal

ity

Y- b

y ag

e (a

ge g

roup

s:

0-2,

3-6

, 7-1

4,

15 a

nd m

ore)

N

– b

y ge

nder

Y

Com

mun

icab

le

dise

ase

surv

eilla

nce,

da

ily, b

y us

er

acce

ssib

le d

ata

N

Y,

Dat

a ba

se

at th

e C

omm

unic

able

Y,

Yea

rly,

repo

rt

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

in

dica

tor

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

bact

eria

l foo

d to

xic

infe

ctio

ns

n by

mon

thly

D

isea

se

Prev

entio

n an

d C

ontro

l C

entre

Fo

od S

afet

y G

ener

al fo

od

safe

ty p

olic

y A

C

ompo

site

in

dex

for

basi

c fo

od

safe

ty

mea

sure

s

Food

sa

fety

po

licy

eval

uatio

n

Nat

iona

l N

Y

Q

uest

ionn

aire

fo

r pilo

t pro

ject

of

En

viro

nmen

tal

Hea

lth

Indi

cato

rs, o

nce

colle

cted

for t

he

year

199

6 -

2001

.

N

Y,

Pilo

t pr

ojec

t re

port

No

regu

lar

repo

rting

on

such

in

dica

tor

yet

For t

he

indi

cato

r da

ta fo

r 20

01 a

re

avai

labl

e

Food

Saf

ety

Effe

ctiv

enes

s of

food

safe

ty

cont

rols

A

Com

posi

te

inde

x fo

r qu

antit

ativ

e ou

tput

pa

ram

eter

s of

food

safe

ty

cont

rol

Food

sa

fety

po

licy

eval

uatio

n

Nat

iona

l N

Y

Q

uest

ionn

aire

fo

r pilo

t pro

ject

of

En

viro

nmen

tal

Hea

lth

Indi

cato

rs, o

nce

colle

cted

for t

he

year

199

6 -

2001

.

N

Y,

Pilo

t pr

ojec

t re

port

No

regu

lar

repo

rting

on

such

in

dica

tor

yet

For t

he

indi

cato

r da

ta fo

r 20

01 a

re

avai

labl

e

Che

mic

al

emer

genc

ies

Reg

ulat

ory

requ

irem

ents

fo

r lan

d-us

e pl

anni

ng

A

Reg

ulat

ory

requ

irem

ent

for l

and-

use

plan

ning

ar

ound

site

s co

ntai

ning

la

rge

quan

titie

s of

chem

ical

s ac

cord

ing

to

the

crite

ria fo

r up

per t

ier o

f th

e EU

‘S

eves

o II

’ di

rect

ive

Che

mic

al em

erge

nci

es

polic

y ev

alua

tion

Nat

iona

l N

Y

Q

uest

ionn

aire

fo

r pilo

t pro

ject

of

En

viro

nmen

tal

Hea

lth

Indi

cato

rs, o

nce

colle

cted

for t

he

year

199

6 -

2000

.

N

Y,

Pilo

t pr

ojec

t re

port

No

regu

lar

repo

rting

on

such

in

dica

tor

yet

Che

mic

al

emer

genc

ies

Che

mic

al

inci

dent

s A

Pr

esen

ce o

f an

act

ive,

C

hem

ica

l N

atio

nal

N

Y

Que

stio

nnai

re

for p

ilot p

roje

ct

N

Y,

Pilo

t N

o re

gula

r re

porti

ng

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

in

dica

tor

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

regi

ster

cu

mul

ativ

e re

gist

er o

f ch

emic

al

inci

dent

s with

na

tiona

l co

vera

ge

emer

gen

cies

po

licy

eval

uatio

n

of

Envi

ronm

enta

l H

ealth

In

dica

tors

, onc

e co

llect

ed fo

r the

ye

ar 1

996

-20

00.

proj

ect

repo

rt on

such

in

dica

tor

yet

Che

mic

al

emer

genc

ies

Pois

on c

ente

r se

rvic

e A

Po

ison

cen

tre

serv

ice

staf

f pe

r hea

d of

po

pula

tion

Che

mic

al em

erge

nci

es

polic

y ev

alua

tion

Nat

iona

l N

Y

Q

uest

ionn

aire

fo

r pilo

t pro

ject

of

En

viro

nmen

tal

Hea

lth

Indi

cato

rs, o

nce

colle

cted

for t

he

year

199

6 -

2000

.

N

Y,

Pilo

t pr

ojec

t re

port

No

regu

lar

repo

rting

on

such

in

dica

tor

yet

Che

mic

al

emer

genc

ies

Gov

ernm

ent

prep

ared

ness

fo

r che

mic

al

inci

dent

s

A

Gov

ernm

ent

prep

ared

ness

fo

r che

mic

al

inci

dent

s

Che

mic

al em

erge

nci

es

polic

y ev

alua

tion

Nat

iona

l N

Y

Q

uest

ionn

aire

fo

r pilo

t pro

ject

of

En

viro

nmen

tal

Hea

lth

Indi

cato

rs, o

nce

colle

cted

for t

he

year

199

6 -

2000

.

N

Y,

Pilo

t pr

ojec

t re

port

No

regu

lar

repo

rting

on

such

in

dica

tor

yet

Traf

fic

acci

dent

s M

orta

lity

from

traf

fic

acci

dent

s

E D

eath

rate

du

e to

tra

nspo

rt ac

cide

nts

Mon

itori

ng,

traff

ic

safe

ty

polic

y ev

alua

tion

Loca

l –

mun

icip

ality

, ci

ty

Y

Y

Mor

talit

y st

atis

tics,

user

ac

cess

ible

dat

a ba

ses a

re

upda

ted

year

ly

Y

Y

Stat

istic

al

anna

ls;

ww

w.ls

ic.lt

H

ealth

in

dica

tors

sy

stem

Y

Yea

rly,

web

, rep

ort

Traf

fic

acci

dent

s R

ate

of

inju

ries b

y tra

ffic

ac

cide

nts

E In

jury

rate

du

e to

traf

fic

acci

dent

s

Mon

itori

ng,

traff

ic

safe

ty

polic

y ev

alua

tion

Loca

l, m

unic

ipal

ity,

city

, stre

et

addr

ess

Y

N

Traf

fic

acci

denc

e su

rvei

llanc

e,

daily

N

Y,

Stat

istic

al

anna

ls;

ww

w.p

olic

ija.

lt/ke

liu/

Y,

Yea

rly –

St

atis

tical

de

partm

ent,

Dai

ly –

R

oad

polic

e,

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

in

dica

tor

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

repo

rt, w

eb

Hou

sing

Po

pula

tion

livin

g in

su

bsta

ndar

d ho

usin

g

Ex

Perc

enta

ge o

f th

e po

pula

tion

livin

g in

su

bsta

ndar

d ho

usin

g, th

at

is w

ithou

t the

ex

clus

ive

use

of a

toile

t, sh

ower

or

bath

and

pr

ivat

e co

okin

g fa

cilit

ies.

Mon

itori

ng,

hous

ing

polic

y ev

alua

tion

Pl

ans i

n th

e fu

ture

, in

clud

ed

into

the

Nat

iona

l lis

t of E

H

indi

cato

rs

Hou

sing

M

orta

lity

due

to e

xter

nal

caus

es in

ch

ildre

n un

der 5

yea

rs

of a

ge

E A

nnua

l m

orta

lity

rate

du

e to

the

exte

rnal

ca

uses

: do

mes

tic

acci

dent

s, po

ison

ing

in

child

ren

unde

r fiv

e ye

ars o

f age

Mon

itori

ng,

hous

ing

safe

ty

polic

y ev

alua

tion

Loca

l –

mun

icip

ality

, ci

ty

Y

Y

Mor

talit

y st

atis

tics,

user

ac

cess

ible

dat

a ba

ses a

re

upda

ted

year

ly

Y

Y

Stat

istic

al

anna

ls;

ww

w.ls

ic.lt

H

ealth

in

dica

tors

sy

stem

Y

Yea

rly,

web

, rep

ort

Hou

sing

Sc

ope

and

appl

icat

ion

of

build

ing

regu

latio

ns

for h

ousi

ng

A

Com

posi

te

inde

x fo

r the

sc

ope

and

appl

icat

ion

of

build

ing

regu

latio

ns

for h

ousi

ng

Hou

sing

po

licy

eval

uatio

n

Nat

iona

l N

Y

Q

uest

ionn

aire

fo

r pilo

t pro

ject

of

En

viro

nmen

tal

Hea

lth

Indi

cato

rs, o

nce

colle

cted

for t

he

year

199

6 -

2000

.

N

Y,

Pilo

t pr

ojec

t re

port

No

regu

lar

repo

rting

on

such

in

dica

tor

yet

Hou

sing

La

nd u

se a

nd

urba

n pl

anni

ng

regu

latio

ns

A

Com

posi

te

inde

x fo

r the

sc

ope

and

appl

icat

ion

of

regu

latio

ns

Hou

sing

po

licy

eval

uatio

n

Nat

iona

l N

Y

Q

uest

ionn

aire

fo

r pilo

t pro

ject

of

En

viro

nmen

tal

Hea

lth

N

Y,

Pilo

t pr

ojec

t re

port

No

regu

lar

repo

rting

on

such

in

dica

tor

yet

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

in

dica

tor

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

for l

and

use

and

urba

n pl

anni

ng in

hu

man

se

ttlem

ents

Indi

cato

rs, o

nce

colle

cted

for t

he

year

199

6 -

2000

.

Wor

kpla

ce

Occ

upat

iona

l fa

talit

y ra

te

E O

ccup

atio

nal

fata

lity

rate

in

the

wor

king

po

pula

tion

Mon

itori

ng,

occu

pati

onal

he

alth

po

licy

eval

uatio

n

Nat

iona

l N

Y

Q

uest

ionn

aire

fo

r pilo

t pro

ject

of

En

viro

nmen

tal

Hea

lth

Indi

cato

rs, o

nce

colle

cted

for t

he

year

199

6 -

2000

.

N

Y,

Pilo

t pr

ojec

t re

port

No

regu

lar

repo

rting

on

such

in

dica

tor

yet

Wor

kpla

ce

Rat

es o

f in

jurie

s E

Rat

es o

f in

jurie

s in

the

wor

king

po

pula

tion

Mon

itori

ng,

occu

pati

onal

he

alth

po

licy

eval

uatio

n

Reg

ions

Y

, age

gr

oups

: 20-

29, 3

0-39

, 40-

49, 5

0-59

, 60

and

mor

e

Y

Occ

upat

iona

l ac

cide

nts

surv

eilla

nce,

w

eekl

y

Y

Y,

Stat

e O

ccup

atio

nal

In

spec

tion

data

bas

e

Y,

Ann

ual

repo

rt

Wor

kpla

ce

Stat

utor

y re

ports

of

occu

patio

nal

dise

ases

A

Exis

tenc

e of

a

natio

nal

form

al sy

stem

fo

r rep

ortin

g ca

ses o

f di

seas

es

diag

nose

d an

d co

nfirm

ed a

s du

e to

wor

k in

spec

ific

occu

patio

n at

ris

k (r

egis

ter

of

occu

patio

nal

dise

ases

)

Occ

upat

ion

al

heal

th

polic

y ev

alua

tion

Nat

iona

l N

Y

Q

uest

ionn

aire

fo

r pilo

t pro

ject

of

En

viro

nmen

tal

Hea

lth

Indi

cato

rs, o

nce

colle

cted

for t

he

year

199

6 -

2000

.

N

Y,

Pilo

t pr

ojec

t re

port

No

regu

lar

repo

rting

on

such

in

dica

tor

yet

1) e

g ai

r or w

ater

pol

lutio

n su

rvei

llanc

e, c

omm

unity

noi

se su

rvey

s, tra

ffic

acc

iden

t reg

istra

tion,

mor

talit

y st

atis

tics,

med

ical

regi

strie

s suc

h as

hos

pita

l dis

char

ge re

gist

ries e

tc

2) if

ther

e is

no

indi

cato

r ava

ilabl

e fo

r the

issu

e m

entio

ned,

add

in la

st c

olum

n (c

omm

ents

) whe

ther

ther

e is

inte

rest

in su

ch a

n in

dica

tor

Pola

nd

Nam

e: D

orot

a Ja

rosińs

ka

E-m

ail:

d.ja

rosi

nska

@im

p.so

snow

iec.

pl

Tel:

48 3

2 26

6088

5 A

ddre

ss: 1

3 K

osci

elna

, 41-

200

Sosn

owie

c,

This

Tab

le is

bas

ed o

n th

e in

dica

tors

pro

pose

d in

the

WH

O E

HI (

envi

ronm

enta

l hea

lth in

dica

tors

) pro

ject

, whi

ch a

re c

urre

ntly

pilo

t tes

ted

in

Pola

nd. T

he T

able

is n

ot e

xhau

stiv

e –

it co

ntai

ns e

xam

ples

of t

he E

xpos

ure,

Eff

ect a

nd A

ctio

n in

dica

tors

. T

hem

e In

dica

tor

nam

e

Typ

e O

pera

tiona

l de

finiti

on

Purp

ose

use

of

indi

cato

r

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

Air

qual

ity

In

fant

m

orta

lity

due

to

resp

irato

ry

dise

ases

E A

nnua

l nu

mbe

r of

deat

hs in

ch

ildre

n un

der 1

yea

r of

age

due

to

resp

irato

ry

dise

ases

Mon

itorin

g, e

valu

atio

n N

atio

nal,

regi

onal

. C

hild

ren

unde

r 1

year

of a

ge

ICD

cod

e J0

0-J9

9 ac

cord

ing

to

ICD

–10

Dat

a on

num

ber o

f de

aths

and

live

birt

hs is

co

llect

ed o

n th

e re

gula

r ba

sis a

s a p

art o

f the

ro

utin

e st

atis

tics.

Full

natio

nal r

egis

ter o

f de

aths

/live

birt

hs is

ba

sed

on th

e in

form

atio

n re

porte

d by

re

gion

al st

atis

tical

of

fices

. IC

D 1

0-co

ding

si

nce

1997

.

Y

Dat

a qu

ality

go

od.

QA

/QC

us

ed fo

r the

da

ta e

ntry

, co

ding

, di

agno

ses.

A

popu

latio

n co

vera

ge is

ov

er 9

0%.

Fee

for

full

data

ac

cess

Mai

n St

atis

tical

O

ffic

e.

ww

w.st

at.g

ov.p

l Pu

blis

hed

annu

ally

.

A tw

o ye

ars g

ap

in

colle

ctin

g in

form

atio

n ex

ists

(1

997-

1998

)

M

orta

lity

due

to

resp

irato

ry

dise

ases

E A

nnua

l nu

mbe

r of

deat

hs d

ue to

re

spira

tory

di

seas

es.

Mon

itorin

g, e

valu

atio

n N

atio

nal,

regi

onal

ICD

cod

e J0

0-J9

9 ac

cord

ing

to

ICD

–10

Dat

a on

num

ber o

f de

aths

is c

olle

cted

re

gula

rly a

s a p

art o

f the

ro

utin

e st

atis

tics.

Full

natio

nal r

egis

ter o

f de

aths

bas

ed o

n th

e in

form

atio

n re

porte

d by

re

gion

al st

atis

tical

of

fices

. IC

D

10-c

odin

g us

ed

sinc

e 19

97.

Dea

ths s

tand

ardi

zed

acco

rdin

g to

gen

der,

age,

cau

se o

f dea

th.

Y

Dat

a qu

ality

is

good

. Q

ualit

y as

sura

nce

and

qual

ity

cont

rol i

s us

ed fo

r the

da

ta e

ntry

, co

ding

and

di

agno

ses.

A

popu

latio

n

M

ain

Stat

istic

al

Off

ice.

w

ww

.stat

.gov

.pl

Publ

ishe

d an

nual

ly.

Info

rmat

ion

abou

t de

aths

ac

cess

ible

ac

cord

ing

to th

e pl

ace

of d

eath

an

d pl

ace

of

resi

denc

e.

A tw

o ye

ars g

ap

in

colle

ctin

g

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

in

dica

tor

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

cove

rage

is

over

90%

. in

form

atio

n ex

ists

(1

997-

1998

)

M

orta

lity

due

to

dise

ases

of

the

circ

ulat

ory

sy

stem

E A

nnua

l nu

mbe

r of

deat

hs d

ue to

ca

rdio

-va

scul

ar

dise

ases

.

Mon

itorin

g, e

valu

atio

n N

atio

nal,

regi

onal

To

tal

popu

latio

n/ye

ar.

ICD

cod

e I0

0-I9

9 ac

cord

ing

to IC

D –

10

Dat

a on

num

ber o

f de

aths

col

lect

ed o

n th

e re

gula

r bas

is a

s a p

art o

f th

e ro

utin

e st

atis

tics.

Full

natio

nal r

egis

ter o

f de

aths

bas

ed o

n th

e in

form

atio

n re

porte

d by

re

gion

al st

atis

tical

of

fices

. IC

D 1

0-co

ding

si

nce

1997

. D

eath

s are

stan

dard

ized

ac

cord

ing

to g

ende

r, ag

e an

d ca

use

of d

eath

.

Y

Dat

a qu

ality

is

good

. Q

ualit

y as

sura

nce

and

qual

ity

cont

rol i

s us

ed fo

r the

da

ta e

ntry

, co

ding

and

di

agno

ses.

A

popu

latio

n co

vera

ge is

ov

er 9

0%.

M

ain

Stat

istic

al

Off

ice.

w

ww

.stat

.gov

.pl

Publ

ishe

d an

nual

ly

Info

rmat

ion

abou

t de

aths

is

acce

ssib

le

acco

rdin

g to

the

plac

e of

dea

th

and

plac

e of

re

side

nce

of a

per

son

who

die

d.

A

two

year

s ga

p in

co

llect

ing

info

rmat

ion

abou

t de

aths

ex

ists

(1

997-

1998

)

Polic

ies

to re

duce

ex

posu

re

to E

TS

A

Fo

r pol

icy

eval

uatio

n

Nat

iona

l -

- -

- Su

bjec

tive

asse

ssm

ent;

need

for

obje

ctiv

e m

easu

res t

o ev

alua

te

effic

ienc

y of

the

polic

ies

Noi

se

App

licat

ion

of

regu

latio

ns,

A

Fo

r pol

icy

eval

uatio

n

Nat

iona

l -

- -

- A

sses

smen

t bi

as

poss

ible

.

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

in

dica

tor

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

rest

rictio

ns a

nd

nois

e ab

atem

ent

m

easu

res

Drin

king

/S

wim

min

g w

ater

and

sa

nita

tion

Dia

rrho

ea m

orbi

dit

y in

ch

ildre

n

E N

umbe

r of

case

s of

diar

rhea

and

in

cide

nce

rate

pe

r 100

000

po

pula

tion

of

child

ren

less

th

en 2

yea

rs

old.

Mon

itorin

g N

atio

nal,

regi

onal

(v

oivo

dshi

p).

Dat

a on

the

loca

l (di

stric

t) le

vel n

ot

publ

ishe

d ro

utin

ely,

but

av

aila

ble

for

the

requ

est

IC

D-1

0 co

ding

use

d (A

04, A

08,

A09

).

Dia

rrhe

a in

chi

ldre

n le

ss th

en 2

yea

rs o

ld is

am

ong

the

infe

ctio

us

dise

ases

for w

hich

no

tific

atio

n an

d re

gist

ratio

n is

ob

ligat

ory.

Dat

a ar

e co

llect

ed, v

erifi

ed a

nd

anal

yzed

by

the

NIH

, as

repo

rted

by th

e re

gion

al

Sani

tary

-Ep

idem

iolo

gica

l St

atio

ns.

Dat

a ba

sed

on a

co

mpl

ete

inve

ntor

y,

coun

t the

da

ta q

ualit

y is

ver

y go

od

Fee

for

data

ac

cess

Publ

ishe

d by

the

Nat

iona

l In

stitu

te o

f H

ygie

ne

(NIH

), an

nual

, se

mi-

annu

al a

nd

biw

eekl

y “R

epor

ts

on c

ases

of

infe

ctio

us

dise

ases

an

d to

xic

effe

cts o

f ch

emic

al

subs

tanc

es

in P

olan

d”

O

utbr

eak

s of

wat

erbo

rne

di

seas

es

E

Und

erre

por

ting

poss

ible

Food

Saf

ety

Che

mic

al

emer

genc

ies

Traf

fic

acci

dent

s M

orta

lity

from

tra

ffic

ac

cide

nts

E N

umbe

r of

deat

h do

e to

tra

ffic

ac

cide

nts

IC

D-1

0 co

ding

use

d

Polic

e st

atis

tics

In

jurie

s du

e to

tra

ffic

E

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

in

dica

tor

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

acci

dent

s H

ousi

ng

Mor

talit

y du

e to

ex

tern

al

caus

es in

ch

ildre

n un

der 5

ye

ars o

f ag

e

E A

nnua

l nu

mbe

r of

deat

hs in

ch

ildre

n un

der 5

yea

r of

age

due

to

exte

rnal

ca

uses

. *)

N

atio

nal,

regi

onal

ICD

cod

e W

00.0

or

W.0

0-Y

34.0

or

Y.3

4.1

acco

rdin

g to

IC

D –

10

Dat

a on

num

ber o

f de

aths

col

lect

ed o

n th

e re

gula

r bas

is a

s a p

art o

f th

e ro

utin

e st

atis

tics.

Full

natio

nal r

egis

ter o

f de

aths

/live

birt

hs is

ba

sed

on th

e in

form

atio

n re

porte

d by

re

gion

al st

atis

tical

of

fices

. IC

D 1

0-co

ding

si

nce

1997

.

Dat

a qu

ality

go

od.

QA

/QC

us

ed fo

r the

da

ta e

ntry

, co

ding

and

di

agno

ses.

Popu

latio

n co

vera

ge is

ov

er 9

0%..

Fee

for

data

ac

cess

Mai

n st

atis

tical

O

ffic

e w

ww

.stat

.gov

.pl

Publ

ishe

d an

nual

ly

A tw

o ye

ars g

ap

in

colle

ctin

g in

form

atio

n ex

ists

(1

997-

1998

). D

ata

on

deat

hs is

co

llect

ed

acco

rdin

g to

the

plac

e of

/dea

th

and

plac

e of

a

resi

denc

e of

a

mot

her/p

ers

on w

ho

died

.

Scop

e an

d ap

plic

ati

on o

f bu

ildin

g re

gula

tions

for

hous

ing

A

Ev

alua

tion;

pl

anni

ng

Nat

iona

l

O

bjec

tive

tool

s to

eval

uate

ef

fect

iven

ess

nee

ded

La

nd u

se

and

urba

n pl

anni

ng

A

Ev

alua

tion,

pl

anni

ng

Nat

iona

l

O

bjec

tive

tool

s to

eval

uate

ef

fect

iven

ess

nee

ded

*) P

opul

atio

n da

ta c

once

rnin

g ch

ildre

n u

nder

6 y

ears

of a

ge is

acc

essi

ble

for f

ree

from

the

repo

rts w

hich

are

pub

lishe

d an

nual

ly fo

r yea

rs 1

998

and

1999

. Dat

a on

chi

ldre

n un

der 5

yea

rs o

f age

not

acc

essi

ble

from

the

rout

ine

stat

istic

al re

ports

Port

ugal

N

ame:

Ces

altin

a R

amos

E-

mai

l:cra

mos

@dg

saud

e.m

in-s

aude

.pt

Tel:2

1843

0500

A

ddre

ss:A

lam

eda

D. A

fons

o H

enriq

ues,

45 -

1059

-005

LIS

BO

A

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

indi

cato

r G

eogr

aphi

cal

Scal

e G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

Drin

king

/S

wim

min

g w

ater

and

sa

nita

tion

Wat

San_

P1 W

atSa

n_S1

Wat

San_

S2 W

atSa

n_S3

Wat

San_

Ex1 W

atSa

n_Ex

2 Wat

San_

E1 W

atSa

n_E2

A

A

A

A

Ex

Ex

E E

% c

over

age

Exce

edan

ce

VM

A/ri

sk

Exce

edan

ce

VM

A/ri

sk

Exce

edan

ce

VM

A/ri

sk

% c

over

age

% c

over

age

Out

brea

ks o

f w

ater

-bor

ne

dise

ases

D

iarr

hoea

m

orbi

dity

in

Mon

itorin

g ev

alua

tion

wat

er

qual

ity

Mon

itorin

g ev

alua

tion

wat

er

qual

ity

Mon

itorin

g ev

alua

tion

wat

er

qual

ity

Acc

ess t

o ad

equa

te

sani

tatio

n

Acc

ess t

o ad

equa

te

sani

tatio

n A

cces

s to

adeq

uate

sa

nita

tion

Rou

tine

pass

ive

case

re

porti

ng

N.º

of c

ases

/

Nat

iona

l N

atio

nal

Nat

iona

l N

atio

nal

Nat

iona

l N

atio

nal

Nat

iona

l N

atio

nal

N

N

N

N

N

N

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Com

mun

ity

surv

eys

Mon

itorin

g/Y

ear

ly u

pdat

e da

ta

Mon

itorin

g/Y

ear

ly u

pdat

e da

ta

Mon

itorin

g/Y

ear

ly u

pdat

e da

ta

Com

mun

ity

surv

eys/

Nat

iona

l ce

nsus

es

Com

mun

ity

surv

eys/

Nat

iona

l ce

nsus

N

otifi

catio

n sy

stem

s M

edic

al

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

inte

rest

in a

n in

dica

tor

inte

rest

in a

n in

dica

tor

inte

rest

in a

n in

dica

tor

inte

rest

in a

n in

dica

tor

inte

rest

in a

n in

dica

tor

inte

rest

in a

n in

dica

tor

inte

rest

in a

n in

dica

tor

inte

rest

in a

n

Wat

San_

A1

A

child

ren

Inte

nsity

of

recr

eatio

nal

wat

er

mon

itorin

g

child

ren/

yea

r N.º

of v

alid

m

easu

rem

ents

per

po

lluta

nt/re

cre

atio

nal

area

/yea

r

Nat

iona

l

N

Rec

reat

iona

l w

ater

su

rvei

llanc

e

regi

strie

s/no

tific

atio

n sy

stem

s M

onito

ring

Y

Y

Y

indi

cato

r in

tere

st in

an

indi

cato

r

Hou

sing

and

Se

ttlem

ents

H

ous_

S1

Hou

s_Ex

1 H

ous_

E1

Hou

s_A

1 H

ous_

A2

A

Ex

E A

A

Mor

talit

y du

e to

ex

tern

al

caus

es

Dom

estic

ac

cide

nts

and

pois

onin

g

Nat

iona

l N

atio

nal

Nat

iona

l N

atio

nal

Reg

iona

l/Loc

al

N

N

Y

Y

Y

Y

Com

mun

ity

surv

eys/

Nat

iona

l ce

nsus

es

Com

mun

ity

surv

eys/

Nat

iona

l ce

nsus

es

Med

ical

re

gist

ries

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Air

qual

ity

Air_

P1

Air_

Ex1

Air_

E1

Air_

E2

Air_

E3

Air_

A1

Ex

Ex

E E E A

Mon

itorin

g ev

alua

tion

Mon

itorin

g ev

alua

tion

Reg

iona

l Lo

cal

Nat

iona

l N

atio

nal

Nat

iona

l N

atio

nal

Y

N

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Com

mun

ity

surv

eys

Traf

fic a

ccid

ent

regi

stra

tion

Med

ical

re

gist

ries

Med

ical

re

gist

ries

Med

ical

re

gist

ries

Com

mun

ity

surv

eys

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Was

te a

nd

cont

amin

ated

la

nds

Was

te_P

1 W

aste

_A1

A

A

Reg

iona

l N

atio

nal

N

N

Y

Y

Com

mun

ity

surv

eys

Y

Y

Y

Y

Y

Che

mic

al

emer

genc

ies

Che

m_E

1 C

hem

_A1

Che

m_A

2 C

hem

_A3

A

E A

A

Reg

iona

l N

atio

nal

Nat

iona

l N

atio

nal

N

Y

N

Y

Y

Y

Y

Com

mun

ity

surv

eys

Med

ical

re

gist

ries

Acc

iden

t re

gist

ratio

n

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Che

m_A

4 C

hem

_A5

A

A

Nat

iona

l N

atio

nal

Y

Y

Y

Y

Y

Y

Food

Saf

ety

Food

_Ex1

Food

_E1

Food

_E2

Food

_A1

A

A

E A

Reg

iona

l N

atio

nal

Nat

iona

l R

egio

nal

N

Y

Y

N

Y

Y

Y

Y

Mon

itorin

g M

edic

al

regi

strie

s M

edic

al

regi

strie

s C

omm

unity

su

rvey

s

Y

Y

Y

N

Y

Y

Y

Y

Y

Y

Y

Y

Noi

se

Noi

se_A

1 A

N

atio

nal

N

Y

Com

mun

ity

surv

eys

Y

Y

Y

Rad

iatio

n R

ad_E

1 E

Nat

iona

l Y

Y

M

edic

al

regi

strie

s Y

Y

Y

Traf

fic

acci

dent

s Tr

af_E

1 Tr

af_E

2

E E

Nat

iona

l N

atio

nal

Y

Y

Y

Y

Med

ical

re

gist

ries

Acc

iden

t re

gist

ratio

n

Y

Y

Y

Y

Y

Y

Oth

er:

Wor

kpla

ce

Wor

k_E1

W

ork_

E2

Wor

k_E3

W

ork_

A1

Stat

istic

s St

atis

tics

Stat

istic

s E

Nat

iona

l N

atio

nal

Nat

iona

l N

atio

nal

Y

Y

Y

Y

Y

Y

Y

Y

Acc

iden

t re

gist

ratio

n A

ccid

ent

regi

stra

tion

Med

ical

re

gist

ries

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Rom

ania

N

ame:

Ale

xand

ra C

ucu

Add

ress

: Min

istry

of H

ealth

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

indi

cato

r G

eogr

aphi

cal

Scal

e G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

Air

qual

ity

1. E

xpos

ure

to a

mbi

ent

air

pollu

tant

s (u

rban

) 2.

In

fant

m

orta

lity

due

to

resp

irato

ry

dise

ases

3.

Po

licie

s to

redu

ce

envi

ronm

ent

al to

bacc

o sm

oke

expo

sure

Ex

E A

1.

popu

latio

n-w

eigh

ted

mea

n ex

ceed

ance

of

the

refe

renc

e co

ncen

tratio

ns

for a

ir po

llutio

n in

ur

ban

setti

ngs

2.

Ann

ual

mor

talit

y ra

te

due

to

resp

irato

ry

dise

ases

in

child

ren

olde

r th

an o

ne m

onth

an

d un

der o

ne

year

of a

ge

3.

Com

posi

te

inde

x of

ca

pabi

lity

for

impl

emen

ting

polic

ies t

o re

duce

en

viro

nmen

tal

toba

cco

smok

e ex

posu

re a

nd

prom

otin

g sm

oke

free

ar

eas

1.

Mon

itorin

g,

impa

ct

eval

uatio

n 2.

M

onito

ring,

es

timat

ion

of th

e bu

rden

of

dise

ase

attri

buta

ble

to in

door

air

pollu

tion.

3.

Ev

alua

tion

of c

apab

ility

to

im

plem

ent

polic

ies f

or

redu

cing

en

viro

nmen

tal

toba

cco

smok

e ex

posu

re

1.

Loca

l (ur

ban

setti

ngs)

2.

N

atio

nal

Reg

iona

l 3.

N

atio

nal

N

Y

N

Y

Yea

rly

Rou

tine

data

co

llect

ion

(mon

thly

, qu

arte

rly,

year

ly)

N

Y

(reg

iona

l an

alys

is

com

mis

sio

n)

on re

ques

t Y

Y

Yea

rly

publ

ishe

d re

port

Y

Qua

rterly

, ye

arly

pu

blis

hed

repo

rts

Poor

ge

ogra

phic

al

cove

rage

Noi

se

1.

1.

1.

1.

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

indi

cato

r G

eogr

aphi

cal

Scal

e G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

Pop

ulat

ion

anno

yanc

e by

ce

rtain

so

urce

s of

no

ise

2.

Slee

p di

stur

banc

e by

noi

se

E E

%

of

the

popu

latio

n an

noye

d by

ce

rtain

sou

rces

of

en

viro

nmen

tal

nois

e 2.

%

of t

he

popu

latio

n w

ith se

lf-re

porte

d sl

eep

dist

urba

nce

by

envi

ronm

enta

l no

ise

long

-term

he

alth

ef

fect

s ev

alua

tion,

po

licy-

mak

ing,

new

re

gula

tions

2.

lo

ng-te

rm

heal

th

effe

cts

eval

uatio

n,

polic

y-m

akin

g, n

ew

regu

latio

ns

Loca

l (ur

ban

setti

ngs)

2.

Lo

cal (

urba

n se

tting

s)

N

N

N

N

Ever

y 2

year

s Ev

ery

2 ye

ars

N

N

N

N

Rep

orts

ev

ery

2 ye

ars

Rep

orts

ev

ery

2 ye

ars

Nee

d fu

rther

m

etho

dolo

gica

l st

anda

rdis

ati

on

Was

te a

nd

cont

amin

ated

la

nds

Rad

iatio

n In

cide

nce

of

skin

can

cer

E A

nnua

l in

cide

nce

rate

of

skin

can

cer

Mon

itorin

g,

risk

com

mun

ica-

tion

Reg

iona

l, N

atio

nal

Y

Y

R

outin

e co

llect

ion

(yer

aly)

Y

(reg

iona

l an

alys

is

com

mis

sio

n)

Y

Yea

rly

repo

rt Fr

om th

e N

atio

nal

Can

cer

Reg

istry

Drin

king

/S

wim

min

g w

ater

and

sa

nita

tion

1.

Exce

edan

ce

of W

HO

dr

inki

ng

wat

er

guid

elin

es

for

mic

robi

olo-

gica

l pa

ram

eter

s 2.

O

utbr

eaks

of

wat

er-b

orne

di

seas

es

Ex

E

1.

% o

f drin

king

w

ater

sam

ples

w

ith E

col

i or

faec

al

stre

ptoc

occi

ex

ceed

ing

the

guid

elin

e va

lue

of 0

/ 100

ml

wat

er ov

er a

gi

ven

time

perio

d 2.

N

umbe

r of

outb

reak

s of

wat

er-b

orne

di

seas

es a

nd

tota

l num

ber o

f

1.

Mon

itorin

g,

eval

uatio

n of

drin

king

w

ater

m

icro

biol

o-gi

cal s

afet

y 2.

M

onito

ring,

aw

arne

ss

rais

ing,

risk

co

mm

unic

a-tio

n,

Loca

l Lo

cal

N

Y

No

qual

ity

assu

ranc

e sy

stem

in p

lace

Y

Yea

rly

Qua

rterly

, yea

rly

N

N

On

requ

est

Y

Yea

rly

publ

ishe

d re

ports

Y

early

pu

blis

hed

repo

rts

Prob

lem

s of

info

rmat

ion

flow

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

indi

cato

r G

eogr

aphi

cal

Scal

e G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

case

s rep

orte

d se

para

tely

for

drin

king

wat

er

and

recr

eatio

nal

wat

ers

inte

rven

tion

plan

s

Food

Saf

ety

1.

Mon

itorin

g ch

emic

al

haza

rds

in

food

: po

tent

ial

expo

sure

2.

O

utbr

eaks

of

food

-bor

ne

illne

ss

Ex

E

1.

Die

tary

ex

posu

re

asse

ssm

ent t

o po

tent

ially

ha

zard

ous

chem

ical

s m

onito

red

in

food

acc

ordi

ng

to th

e GEM

S /

Food

Pr

ogra

mm

e 2.

N

umbe

r of

outb

reak

s of

food

-bor

ne

illne

ss a

nd

tota

l num

ber o

f ca

ses i

n th

e ou

tbre

aks

Mon

itorin

g M

onito

ring,

in

terv

entio

n pl

ans

Loca

l, R

egio

nal

Loca

l

N

Y

N

Y

Yea

rly

year

ly

N

N

On

requ

est

On

requ

est

Yea

rly

publ

ishe

d re

ports

Y

early

pu

blis

hed

repo

rts

Prob

lem

s of

info

rmat

ion

flow

Che

mic

al

emer

genc

ies

Traf

fic

acci

dent

s M

orta

lity

from

tra

ffic

acci

dent

s

E D

eath

rate

due

to

tran

spor

t ac

cide

nts

Mon

itorin

g,

traff

ic p

olic

y ev

alua

tion

Reg

iona

l, N

atio

nal

Y

Y

Rou

tine

colle

ctio

n (q

uarte

rly,

year

ly)

N

Y

Yea

rly

publ

ishe

d re

ports

2 da

ta

sour

ces:

M

inis

try o

f H

ealth

M

inis

try o

f In

tern

al

Aff

airs

H

ousi

ng

Livi

ng fl

oor

area

per

pe

rson

Ex

Mea

n ha

bita

ble

floor

are

a pe

r pe

rson

Ris

k as

sess

men

t R

egio

nal,

Nat

iona

l

Spai

n N

ame:

Fra

ncis

co M

arqu

es

Add

ress

: San

idad

Am

bien

tal y

Sal

ud L

abor

al, M

inis

terio

de

Sani

dad

y C

onsu

mo

The

me

IND

ICA

TO

R ID

/NA

ME

T

ype

Geo

gra-

phic

al S

cale

A

ge

cate

gory

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion

Dat

a co

ntro

l D

ata

proc

ess-

ing

Acc

essi

bilit

y R

epor

ting

Com

men

ts

A

ir D

2 C

onsu

mpt

ion

of fu

el b

y ty

pe fr

om ro

ad tr

ansp

ort

Driv

ing

forc

e N

atio

nal

N/A

In

tern

atio

nal

Ener

gy

Age

ncy

N

/A

Y

es,

ww

w.ie

a.or

g

Yea

rly

(inte

rnat

ion

al e

nerg

y ag

ency

)

A

ir P2

Em

issi

ons o

f air

pollu

tant

s Pr

essu

re

Nat

iona

l R

egio

nal

N/A

EU

agr

eed

met

hodo

logy

O

utdo

or

Mea

sure

men

ts

N/A

Yes

, acc

essi

ble

in re

ports

A

s req

uire

d by

EU

di

rect

ives

A

ir_Ex

1 A

mbi

ent C

once

ntra

tions

of

air

pollu

tant

s (ur

ban

popu

latio

n-ba

sed

expo

sure

).

Expo

sure

R

egio

nal,

urba

n (lo

cal)

N/A

EU

agr

eed

met

hodo

logy

O

utdo

or

Mea

sure

men

ts

N/A

Yes

, acc

essi

ble

in re

ports

A

s req

uire

d by

EU

di

rect

ives

A

ir_E1

In

fant

mor

talit

y du

e to

re

spira

tory

dis

ease

s.

Effe

ct

Nat

iona

l Y

es

ICD

-10

Nat

iona

l st

atis

tics

Yes

Yes

w

ww

.ine.

es

Yea

rly

A

ir_E2

M

orta

lity

due

to

resp

irato

ry d

isea

ses a

ll ag

es

Effe

ct

Nat

iona

l Y

es

ICD

-10

Nat

iona

l st

atis

tics

Yes

Yes

w

ww

.ine.

es

Yea

rly

A

ir_E3

M

orta

lity

due

to d

isea

ses

of th

e ci

rcul

ator

y sy

stem

, al

l age

s

Effe

ct

Nat

iona

l Y

es

ICD

-10

Nat

iona

l st

atis

tics

Yes

Yes

w

ww

.ine.

es

year

ly

HO

USI

NG

H

ous_

S1

Livi

ng fl

oow

per

are

a pe

r pe

rson

Stat

e N

atio

nal

N/A

N

/A

Nat

iona

l St

atis

tics

N/A

Yes

w

ww

.ine.

es

Yea

rly

H

ouse

_Ex1

Po

pula

tion

livin

g is

Su

bsta

ndar

d H

ousi

ng

Expo

sure

N

atio

nal

N/A

N

/A

Surv

ey

N/A

Yes

, w

ww

.ine.

es

Yea

rly

H

ous_

E1

Effe

ct

Nat

iona

l Y

es

ICD

-10

Nat

iona

l Y

es

Y

es

Yea

rly

The

me

IND

ICA

TO

R ID

/NA

ME

T

ype

Geo

gra-

phic

al S

cale

A

ge

cate

gory

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion

Dat

a co

ntro

l D

ata

proc

ess-

ing

Acc

essi

bilit

y R

epor

ting

Com

men

ts

Mor

talit

y du

e to

ext

erna

l ca

uses

in c

hild

ren

And

er 5

ye

ars o

f age

stat

istic

s w

ww

.ine.

es

H

ous_

A1

Scop

e an

d ap

plic

atio

n of

bu

ildin

g re

gula

tions

for

hous

ing

Act

ion

Nat

iona

l N

/A

N/A

N

/A

N/A

Yes

, in

Bol

etín

O

ficia

l del

Es

tado

w

ww

.boe

.es

N/A

H

ous_

A2

Land

use

and

urb

an

plan

ning

regu

latio

n

Act

ion

N

/A

N/A

N

/A

N/A

Yes

, in

Bol

etín

O

ficia

l del

Es

tado

w

ww

.boe

.es

N/A

TR

AFF

IC

Traf

_E1

Mor

talit

y fr

om tr

affic

ac

cide

nts

Effe

ct

Nat

iona

l Y

es

Yes

N

atio

nal

Stat

istic

s Y

es

Y

es.

ww

w.in

e.es

Yea

rly,

Tr

af_E

2 R

ate

of in

jurie

s by

traff

ic

acci

dent

s

Effe

ct

Nat

iona

l Y

Es

YEs

Su

rvey

Y

es, u

pon

requ

est t

o w

ww

.dgt

.es

Yea

rly,

NO

ISE

N

oise

_E1

Popu

latio

n an

noya

nce

by

certa

in so

urce

s of n

oise

Effe

ct

Nat

iona

l N

o N

o Su

rvey

N

o

Yes

, ww

w.in

e.es

Yea

rly

sinc

e 19

98

N

oise

_A1

App

licat

ion

of re

gula

tion,

re

stric

tions

and

noi

se

abat

emen

t mea

sure

s

Act

ion

Nat

iona

l Lo

cal

N/A

N

/A

N/A

N

/A

Y

es, i

n B

olet

ín

Ofic

ial d

el

Esta

do

ww

w.b

oe.e

s

N/A

Con

tam

inat

ed L

and

Che

m_P

1

Site

s con

tain

ing

larg

qu

antit

ies o

f che

mic

als

Pres

sure

N

atio

nal

N/A

N

o R

egis

try

N/A

Onl

y th

e nu

mbe

r of

site

s, no

t the

lo

catio

n

C

hem

_E1

Mor

talit

y fr

om C

hem

ical

A

ccid

ents

Effe

ct

Nat

iona

l Y

es

ICD

-10

Nat

iona

l St

atis

tics

N/A

Yes

, w

ww

.ine.

es

year

ly

C

hem

_A1

egul

ator

y re

quire

men

ts fo

r la

nd-u

se p

lann

ing

Act

ion

Nat

iona

l N

/A

N/A

N

/A

N/A

Yes

, in

Bol

etín

O

ficia

l del

Es

tado

w

ww

.boe

.es

N/A

C

hem

_A2

Act

ion

Reg

iona

l N

/A

N/A

R

egis

tries

N

/A

N/A

The

me

IND

ICA

TO

R ID

/NA

ME

T

ype

Geo

gra-

phic

al S

cale

A

ge

cate

gory

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion

Dat

a co

ntro

l D

ata

proc

ess-

ing

Acc

essi

bilit

y R

epor

ting

Com

men

ts

Che

mic

al in

cide

nts

regi

ster

Che

m_A

5 G

over

nmen

t pre

pare

dnes

s A

ctio

n N

atio

nal

N/A

N

/A

N/A

N

/A

Y

es

N/A

Rad

iatio

n R

ad_E

1 In

cide

nce

of sk

in c

ance

r Ef

fect

R

egio

nal

Reg

iona

l, on

ly fo

r so

me

regi

ons

Yes

M

edic

al

regi

stry

Y

es,

publ

icat

ions

R

ad_A

1 Ef

fect

ive

envi

ronm

enta

l m

onito

ring

of ra

diat

ion

activ

ity

Act

ion

Nat

iona

l N

/A

N/A

N

/A

N/A

Yes

, in

Bol

etín

O

ficia

l del

Es

tado

w

ww

.boe

.es

Was

te

Was

t_A

1 H

azar

dous

was

te p

olic

ies

Act

ion

Nat

iona

l N

/A

N/A

N

/A

Yes

, in

Bol

etín

O

ficia

l del

Es

tado

w

ww

.boe

.es

N/A

Wat

er

Wat

San_

P1

Was

te W

ater

trea

tem

ent

cove

rage

Pres

sure

N

atoi

nal

N/A

N

/A

Surv

ey

N/A

Yes

, w

ww

.ine.

es

Yea

rly

W

atSa

n_S1

Ex

ceed

ance

of

recr

eatio

nal w

ater

lim

it va

lues

for m

icro

biol

ogic

al

para

met

ers

Stat

e N

atio

nal

N/A

Y

es

Mea

sure

men

ts

N/A

Yes

, w

ww

.msc

.es

Yea

rly

W

atSa

n_S2

Ex

ceed

ance

of W

HO

dr

inki

ng w

ater

gui

delin

es

for m

icro

biol

ogic

al

para

met

ers

Stat

e N

atio

nal

N/A

Y

es

Mea

sure

men

ts

N/A

Yes

, w

ww

.msc

.es

Yea

rly

W

atSa

n_S3

Ex

ceed

ance

of W

HO

dr

inki

ng w

ater

gui

delin

es

for c

hem

ical

par

amen

ters

Stat

e N

atio

nal

N/A

Y

es

Mea

sure

men

ts

N/A

Yes

, w

ww

.msc

.es

Yea

rly

W

atSa

n_Ex

1 A

cces

s to

drin

king

wat

er

com

plyi

ng w

ith W

HO

gu

idel

ine

valu

es

Expo

sure

N

atio

nal

N/A

N

/A

Surv

ey

Yes

, w

ww

.ine.

es

Yea

rly

The

me

IND

ICA

TO

R ID

/NA

ME

T

ype

Geo

gra-

phic

al S

cale

A

ge

cate

gory

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion

Dat

a co

ntro

l D

ata

proc

ess-

ing

Acc

essi

bilit

y R

epor

ting

Com

men

ts

W

atSa

n_Ex

2 A

cces

s to

adeq

uate

sa

nita

tion

Expo

sure

N

atio

nal

N/A

N

/A

Surv

ey

Yes

, w

ww

.ine.

es

Yea

rly

W

atSa

n_E1

O

utbr

eaks

of

w

ater

born

e di

seas

es

Effe

ct

Nat

iona

l Y

es

Yes

M

edic

al

regi

stry

Y

es, u

pon

requ

est t

o In

stitu

to d

e Sa

lud

Car

los I

II

ww

w.is

ciii.

es

Yea

rly

W

atSa

n_A

1 Ef

fect

ive

mon

itorin

g of

re

crea

tiona

l wat

er

Act

ion

Nat

iona

l N

/A

N/A

N

/A

N/A

Yes

, w

ww

.msc

.es

Yea

rly

Food

Fo

od_E

1 N

umbe

r of o

utbr

eaks

of

food

born

e ill

ness

Effe

ct

Nat

iona

l,

Yes

Y

es

Med

ical

re

gist

ry

Yes

, upo

n re

ques

to to

In

stitu

to d

e Sa

lud

Car

los I

II

ww

w.is

ciii.

es

Yea

rly

Fo

od_E

2 In

cide

nce

rate

of

food

born

e ill

ness

es

Effe

ct

Nat

iona

l Y

es

Yes

M

edic

al

regi

stry

Y

es, u

pon

requ

est t

o In

stitu

to d

e Sa

lud

Car

los I

II

ww

w.is

ciii.

es

Yea

rly

Fo

od _

A1

Act

ion

Nat

iona

l N

/A

N/A

N

/A

N/A

Yes

, in

Bol

etín

O

ficia

l del

Es

tado

w

ww

.boe

.es

Wor

k W

ork_

E1

Occ

upat

iona

l fat

ality

rate

Ef

fect

N

atio

nal

Yes

IC

D-1

0 N

atio

nal

Stat

istic

s

Y

es, u

pon

requ

est t

o M

inis

try o

f W

ork

and

Soci

al

Aff

airs

Yea

rly

W

ork_

E2

Occ

upat

iona

l inj

ury

rate

Ef

fect

N

atio

nal

IC

D-1

0 re

gist

ry

Yes

, upo

n re

ques

t to

Min

istry

of

Yea

rly

The

me

IND

ICA

TO

R ID

/NA

ME

T

ype

Geo

gra-

phic

al S

cale

A

ge

cate

gory

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion

Dat

a co

ntro

l D

ata

proc

ess-

ing

Acc

essi

bilit

y R

epor

ting

Com

men

ts

Wor

k an

d So

cial

A

ffai

rs

W

ork_

A1

Stat

utor

y re

ports

of

occu

patio

nal d

isea

ses

Act

ion

Nat

iona

l N

/A

N/A

N

/A

N/A

NB

1 F

ocus

on

EH in

dica

tors

eg

num

ber o

f cas

es a

ttrib

uted

to a

ir po

llutio

n, n

oise

exp

osur

e et

c; n

umbe

r of p

eopl

e ex

pose

d to

cer

tain

pol

lutio

n le

vels

or e

xced

ance

of l

imits

N

B 2

if th

e in

dica

tor i

s not

ava

ilabl

e, a

dd in

last

col

umn

(com

men

ts) w

heth

er th

ere

is in

tere

st in

such

an

indi

cato

r N

B 1

Foc

us o

n EH

indi

cato

rs e

g nu

mbe

r of c

ases

attr

ibut

ed to

air

pollu

tion,

noi

se e

xpos

ure

etc;

num

ber o

f peo

ple

expo

sed

to c

erta

in p

ollu

tion

leve

ls o

r exc

edan

ce o

f lim

its

NB

2 if

the

indi

cato

r is n

ot a

vaila

ble,

add

in la

st c

olum

n (c

omm

ents

) whe

ther

ther

e is

inte

rest

in su

ch a

n in

dica

tor

Slov

enia

N

ame:

Ves

na S

mak

a K

incl

E-

mai

l: ve

sna.

smak

a@m

arib

or.si

Te

l: +

+ 3

86 2

220

1 44

5 A

ddre

ss: M

unic

ipal

ity o

f Mar

ibor

, Slo

vens

ka 4

0, 2

000

Mar

ibor

, Slo

veni

a C

ount

ry o

r pro

ject

: Eur

opea

n co

mm

on in

dica

tors

- To

war

ds a

loca

l sus

tain

abili

ty p

rofil

e Y

= ye

s, N

= N

o T

hem

e In

dica

tor

nam

e

Typ

e O

pera

tion

al

defin

ition

Purp

ose

use

of

indi

cato

r

Geo

gra-

phic

al S

cale

G

ende

r

Age

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion;

m

etho

d an

d fr

eque

ncy

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

Air

qual

ity

Loca

l co

ntrib

utio

n to

cl

imat

ic

chan

ges

Ex

CO

2 em

issi

on

per c

apita

Mon

itorin

g Lo

cal

N

N

Ever

y 2

year

s N

w

ww

.sust

aina

ble-

citie

s.org

/indi

cato

rs

ww

w.m

arib

or.si

Ever

y 2

year

s

Air

qual

ity

Loca

l m

obili

ty

and

publ

ic

trans

port

A

% o

f trip

s by

m

otor

ised

pr

ivat

e tra

nspo

rt

Cal

cula

tion

Loca

l N

N

Ev

ery

2 ye

ars

N

ww

w.su

stai

nabl

e-ci

ties.o

rg/in

dica

tors

w

ww

.mar

ibor

.si

Ever

y 2

year

s

Hou

sing

A

vaila

bilit

y of

loca

l pu

blic

ope

n ar

eas

and

serv

ices

A

% o

f ci

tizen

s liv

ing

with

in 3

00

m fr

om

publ

ic o

pen

area

s >

5000

m2

Cal

cula

tion

Loca

l N

N

Ev

ery

2 ye

ars

N

ww

w.su

stai

nabl

e-ci

ties.o

rg/in

dica

tors

w

ww

.mar

ibor

.si

Ever

y 2

year

s

Air

qual

ity

Qua

lity

of

the

air

Ex

the

num

ber

of ti

mes

th

e lim

it

Mon

itorin

g lo

cal

N

Y

Dai

ly

w

ww

.sust

aina

ble-

citie

s.org

/in

Y w

eb a

nd

repo

rt

valu

e is

ex

ceed

ed

fo

r SO

2, N

O2,

PM10

, C

O, O

3

dica

tors

w

ww

.mar

ibor

.si

Air

qual

ity

Chi

ldre

n's

jour

neys

to

and

from

sc

hool

A

% o

f ch

ildre

n go

ing

to

scho

ol b

y ca

r

Mea

sure

me

nts,

Lo

cal

6-

18

N

Ever

y 2

year

s N

w

ww

.sust

aina

ble-

citie

s.org

/indi

cato

rs

ww

w.m

arib

or.si

Ever

y 2

year

s

Noi

se

Noi

se

pollu

tion

E %

po

pula

tion

expo

sed

to

Ligh

t > 5

5 dB

(A)

Mea

sure

me

nts,

calc

ulat

ions

Loca

l N

Y

Ev

ery

2 ye

ars

N

ww

w.su

stai

nabl

e-ci

ties.o

rg/in

dica

tors

w

ww

.mar

ibor

.si

Ever

y 2

year

s

Hou

sing

Su

stai

nabl

e la

nd u

se

A

% o

f pr

otec

ted

area

Mea

sure

me

nts

Loca

l N

N

Ev

ery

2 ye

ars

N

ww

w.su

stai

nabl

e-ci

ties.o

rg/in

dica

tors

w

ww

.mar

ibor

.si

Ever

y 2

year

s

Food

sa

fety

Pr

oduc

t pr

omot

ing

sust

aina

bili

ty

A

% o

f pe

ople

bu

ying

su

stai

nabl

e pr

oduc

t

Mea

sure

me

nts ,

ca

lcul

atio

ns

loca

l N

N

Ev

ery

2 ye

ars

N

ww

w.su

stai

nabl

e-ci

ties.o

rg/in

dica

tors

w

ww

.mar

ibor

.si

Ever

y 2

year

s

Oth

er –

su

stai

nabl

e man

agem

ent

Citi

zens

’ sa

tisfa

ctio

n w

ith

the

loca

l co

mm

unity

A

aver

age

satis

fact

ion

with

loca

l co

mm

unity

Que

stio

ner

– calc

ulat

ion

Loca

l N

N

Ev

ery

2 ye

ars

N

ww

w.su

stai

nabl

e-ci

ties.o

rg/in

dica

tors

w

ww

.mar

ibor

.si

Ever

y 2

year

s

Oth

er -

Sust

aina

ble m

anag

eme

nt

Sust

aina

ble

man

agem

ent

of l

ocal

au

thor

ity

and

loca

l en

terp

rises

A

% o

f en

viro

nmen

tal

Cer

tific

atio

ns o

n to

tal

ente

rpris

es

mea

sure

me

nts

Loca

l N

N

Ev

ery

2 ye

ars

N

ww

w.su

stai

nabl

e-ci

ties.o

rg/in

dica

tors

w

ww

.mar

ibor

.si

Ever

y 2

year

s

Slov

enia

N

ame:

Pet

er O

tore

pec

E-m

ail:

pete

r.oto

repe

c@iv

z-rs

.si

Add

ress

: Tru

barje

va 2

, 100

0 Lj

ublja

na

The

me

Indi

cato

r na

me

T

ype

Ope

ratio

nal

defin

ition

Pu

rpos

e us

e of

indi

cato

r G

eogr

a-ph

ical

Sc

ale

Gen

der

A

ge

Val

idat

ion

Dat

a qu

ality

D

ata

colle

ctio

n;

met

hod

and

freq

uenc

y

Dat

a co

ntro

l A

cces

-si

bilit

y R

epor

ting

Com

men

ts

Air

qual

ity

Noi

se

Was

te a

nd

cont

ami-n

ated

la

nds

Rad

iatio

n

D

rinki

ng

/Sw

imm

ing

wat

er a

nd

sani

tatio

n

wat

erbo

rne

dise

ases

Ex

E

%

popu

latio

n ex

pose

d to

ce

rtain

ha

rmfu

l m

icro

biol

ogi

cal o

r ch

emic

al

pollu

tant

s,

% o

f op

ulat

ion

with

co

nnec

tion

to p

ublic

w

ater

supp

ly

syst

ems,

w

ater

born

e ou

tbre

aks

na

tiona

l, re

gion

al

N

Y

N

wat

er q

ualit

y su

rvei

llanc

e,

wat

erbo

rne

outb

reak

s (n

otify

ing

syst

em)

N

Y

early

Food

Saf

ety

Mic

robi

olog

ical

fo

odbo

rne di

seas

es

(HFA

W

HO

)

E M

icro

biol

ogic

al

food

born

e di

seas

es

No

of

outb

reak

s,

mic

robi

olog

ica

l

food

born

e di

seas

es/1

00

000,

m

icro

biol

ogi

cal

food

born

e di

seas

es N

o of

cas

es

Che

mic

al

emer

genc

ies

Traf

fic

acci

dent

s M

orta

lity

due

to t.

a.

rate

H

ospi

talis

atio

n du

e to

t.a.

rate

A

ttend

anc

es d

ue to

t.a

. in

out-

patie

nt

heal

th

care

se

rvic

es

Atte

ndan

ces

due

to

t.a. i

n ou

t-pa

tient

sp

ecia

list

clin

ics

E Ex

E

Num

ber o

f ca

ses p

er

100.

000

inha

bita

nts

Num

ber o

f ac

cide

nts

Inju

ry

surv

eilla

nce,

plan

ning

pr

even

tive

stra

tegi

es,

polic

y ev

alua

tion

Nat

iona

l/reg

iona

l, in

divi

dual

N

atio

nal/r

egio

nal,

indi

vidu

al

Nat

iona

l/reg

iona

l N

atio

nal/r

egio

nal

Nat

iona

l/reg

iona

l/ind

ivid

ual

Y/Y

Y

/Y (1

-3, 4

-6,

7-9,

10-

14, 1

5-19

, 20-

29, 3

0-39

, 40-

49, 5

0-59

, 60-

64,

65+)

Y (I

CD

-9,

from

199

7 IC

D-1

0 us

ed)

Ever

y ye

ar

(mor

talit

y st

atis

tics,

hosp

ital

disc

harg

e re

gist

ries,

out-

patie

nt

atte

ndan

ces

data

base

)

Y

Y

Stat

istic

al

year

book

, N

atio

nal

heal

th

stat

istic

s da

taba

ses

Ever

y ye

ar

Hou

sing

O

ther

:

Y

= ye

s, N

= N

o

Swed

en

Nam

e: M

onic

a N

ordb

erg,

Ass

ocia

te P

rofe

ssor

E-

mai

l: m

onic

a.no

rdbe

rg@

imm

.ki.s

e Te

l: +4

6-8-

7287

-400

A

ddre

ss: I

nstit

ute

for E

nviro

nmen

tal M

edic

ine,

Kar

olin

ska

Inst

itute

t; B

ox 2

10, S

E-17

1 77

Sto

ckho

lm

The

me

Indi

cato

r na

me

T

ype

Geo

gra-

phic

al S

cale

A

ge

cate

gory

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion

Dat

a co

ntro

l D

ata

proc

ess-

sing

Acc

es-

sibi

lity

Rep

ortin

g C

omm

ent

s

Air

Ex

=

expo

sure

E

= ef

fect

A

=

actio

n

Nat

iona

l, R

egio

nal,

Loca

l, eg

ci

ty o

r pos

tal

code

PM

this

is

the

leve

l at

whi

ch d

ata

are

avai

labl

e.

Leve

l of d

ata

colle

ctio

n m

ay b

e lo

wer

(in

divi

dual

)

Dis

tinc-

tion

diff

eren

t ag

e ca

tego

ries

poss

ible

: Y

/N

Y

Y/N

(eg

inte

rnat

iona

l st

anda

rds s

uch

as IC

D u

sed

or

not)

R=

med

ical

re

gist

ry

S= su

rvey

M

o =

mod

ellin

g O

= o

utdo

or

mea

sure

men

ts

??

Y/N

(eg

diag

nosi

s, co

ding

of

dise

ases

ch

ecke

d)

EG m

etho

d.

for i

ndic

ator

ca

lcul

atio

n Th

is c

olum

n m

ay b

e de

lete

d?

Ava

ilabl

e fo

r oth

ers:

Y

/N,

nam

e w

ebsi

te o

r da

taba

se

Freq

uenc

y H

ow

Eg y

early

, w

eb

Ben

efits

Pr

oble

ms

Def

icits

R

elev

ance

fo

r pr

iorit

y ar

eas

vo

latil

e or

gani

c su

bsta

nces

NO

x, S

Ox,

03

, par

ticle

s, PA

H,

benz

opyr

en,

benz

ene,

ete

n

nu

mbe

r of

pers

ons

expo

sed

to

high

leve

ls o

f N

O2.

Ex

N

atio

nal,

Reg

iona

l, Lo

cal,

http

://w

ww

.inte

rna

t.nat

urva

rdsv

erke

t.se/

inde

x.ph

p3?

mai

n=/d

ocum

ent

s/is

sues

/mon

itor/m

onito

r.htm

so

s.se

The

me

Indi

cato

r na

me

T

ype

Geo

gra-

phic

al S

cale

A

ge

cate

gory

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion

Dat

a co

ntro

l D

ata

proc

ess-

sing

Acc

es-

sibi

lity

Rep

ortin

g C

omm

ent

s

nu

mbe

r of

pers

ons

expo

sed

to

high

noi

se

R

adon

Noi

se

num

ber o

f pe

rson

s ex

pose

d to

hi

gh n

oise

Ex

Th

resh

old

limit

valu

es

Was

te

Loca

l pr

ogra

ms,

Inve

ntor

y pr

ogra

ms

Per

mis

sion

Con

tam

inat

ed

land

Loca

l pr

ogra

mm

es ,

inve

ntor

y pr

ogra

ms

Per

mis

sion

Drin

king

w

ater

Reg

ulat

ed b

y ag

enci

es,

Swim

min

g w

ater

Reg

ulat

ed b

y ag

enci

es,

Rad

iati

on

Rad

on

Mon

itorin

g vi

cini

ty o

f nu

clea

r pow

er

plan

ts

Food

or

gani

c po

lluta

nts i

n m

othe

rs m

ilk

http

://w

ww

.inte

rna

t.nat

urva

rdsv

erke

t.se/

inde

x.ph

p3?

mai

n=/d

ocum

ent

s/is

sues

/mon

itor/m

onito

r.htm

so

s.se

The

me

Indi

cato

r na

me

T

ype

Geo

gra-

phic

al S

cale

A

ge

cate

gory

V

alid

atio

n D

ata

qual

ity

Dat

a co

llect

ion

Dat

a co

ntro

l D

ata

proc

ess-

sing

Acc

es-

sibi

lity

Rep

ortin

g C

omm

ent

s

H

uman

ex

posu

re to

m

etal

s and

or

gani

c po

lluta

nts

Food

m

easu

rem

ents

of

met

als i

n th

e bl

ood

of

preg

nant

w

omen

expo

sure

to

mer

cury

expo

sure

to

cadm

ium

Food

expo

sure

to

orga

nic

pollu

tant

s R

esid

ues

pest

icid

es,

PCB

, MeH

g

Hou

sin

g

Oth

er:

…

Hum

an

biol

ogy

spec

imen

ban

k to

be

used

for

stor

ing

hum

an

sam

ples

http

://w

ww

.inte

rna

t.nat

urva

rdsv

erke

t.se/

inde

x.ph

p3?

mai

n=/d

ocum

ent

s/is

sues

/mon

itor/m

onito

r.htm

so

s.se

NB

1 F

ocus

on

EH in

dica

tors

eg

num

ber o

f cas

es a

ttrib

uted

to a

ir po

llutio

n, n

oise

exp

osur

e et

c; n

umbe

r of p

eopl

e ex

pose

d to

cer

tain

pol

lutio

n le

vels

or e

xced

ance

of l

imits

N

B 2

if th

e in

dica

tor i

s not

ava

ilabl

e, a

dd in

last

col

umn

(com

men

ts) w

heth

er th

ere

is in

tere

st in

such

an

indi

cato

r

Annex III: Exemplary International and National Indicator sets

Title Project management

Funded by Information

1 Environmental Health Indicator System; WHO

WHO-ECEH, Bonn Office M. Krzyzanowski, D. Dalbokova

WHO and resources in the participating Member States

www.who.dk/EHindicators

2 ECOEHIS WHO-ECEH, Bonn Office,

EC, DG SANCO http://www.who.dk/eprise/main/WHO/Progs/EHI/Methodology/20030527_5

3 Children’s health and environment indicators

WHO-ECEH, Rome Division

WHO and resources in the participating Member States

www.who.dk/childhealthenv/Monitoring/20020802_1

4 Environmental indicators with focus on health issues

EEA D. Stanners, R. Uhel

EEA www.eea.eu.int

5 CHILD M. Rigby, L. Köhler EC, DG SANCO

EC, DG SANCO http://europa.eu.int/comm/health/ph_projects/2000/monitoring/fp_monitoring_2000_exs_08_en.pdf

6 European Community Health Indicators ECHI (I & II)

P. Kramers RIVM (NL) EC, DG SANCO

EC, DG SANCO http://europa.eu.int/comm/health/ph_information/indicators/project_indicators_en.htm http://europa.eu.int/comm/health/ph_information/documents/monitoring_projlead_en.pdf

7 Sustainable Development Project

EC, DG Environment

www.sustainable -cities.org/indicators

8 Healthy Cities Project Expert Group on the Urban Environment

EC, DG Environment

www.sustainable-cities.org/indicators

9 EEA Indicators Slovenia

10 Sustainable Development Indicators Malta

http:// home.um.edu.mt/islands

11 Sweden

http://www.miljomal.nu/english/english.php

Description of projects: 1 Project Environmental Health Indicator System WHO-ECEH, Bonn Office and participating Member States The indicator set and the methodology is published (http://www.who.dk/document/e76979.pdf) WHO List of indicators: Issue Ind. Code Ind. Title Air Quality Air_D1 Passenger transport demand by mode of transport Air_D2 Road transport fuel consumption Air_P1 Emissions of air pollutants Air_Ex1 Exposure to ambient air pollutants (urban) Air_E1 Infant mortality due to respiratory diseases Air_E2 Mortality due to respiratory diseases Air_E3 Mortality due to diseases of the circulatory system Air_A1 Policies to reduce environmental tobacco smoke exposure Housing and Settlements Hous_S1 Living floor area per person Hous_Ex1 Population living in substandard housing Hous_E1 Mortality due to external causes in children under 5 years of age Hous_A1 Scope and application of building regulations for housing Hous_A2 Land use and urban planning regulations Traffic Accidents Traf_E1 Mortality from traffic accidents Traf_E2 Rate of injuries by traffic accidents Noise Noise_E1 Population annoyance by certain sources of noise Noise_E2 Sleep disturbance by noise Noise_A1 Application of regulations, restrictions and noise abatement measures Waste and Contaminated Lands Waste_P1 Hazardous waste generation Waste_S1 Contaminated land sites Waste_A1 Hazardous waste policies Radiation Rad_E1 Incidence of skin cancer Rad_A1 Effective environmental monitoring of radiation activity Water and Sanitation WatSan_P1 Waste water treatment coverage

WatSan_S1 Exceedance of recreational water limit values for microbiological parameters

WatSan_S2 Exceedance of WHO drinking water guidelines for microbiological parameters

WatSan_S3 Exceedance of WHO drinking water guidelines for chemical parameters WatSan_Ex1 Access to safe drinking water WatSan_Ex2 Access to adequate sanitation WatSan_E1 Outbreaks of water-borne diseases WatSan_E2 Diarrhoea morbidity in children

WatSan_A1 Effective monitoring of recreational water Food Safety Food_Ex1 Monitoring chemical hazards in food: potential exposure Food_E1 Outbreaks of food-borne illness Food_E2 Incidence of food-borne illness Food_A1 General food safety policy Food_A2 Effectiveness of food safety controls Chemical Emergencies Chem_P1 Sites containing large quantities of chemicals Chem_E1 Mortality from chemical incidents Chem_A1 Regulatory requirements for land-use planning Chem_A2 Chemical incidents register Chem_A3 Poison centre service Chem_A4 Medical treatment guidelines Chem_A5 Government preparedness Workplace Work_E1 Occupational fatality rate Work_E2 Rates of injuries Work_E3 Sickness absence rate Work_A1 Statutory reports of occupational diseases 3 Children’s health and environment indicators WHO-ECEH, Rome Division and participating Member States www.who.dk/childhealthenv/Monitoring/20020802_1 Operational Definitions so far not available Core set of Indicators (last revised: December 2002) Health status indicators Mortality indicators Infant mortality rate (MR) Infant mortality under 5 (MR) RI under 5 (MR) Mortality from diarrhoeal disease under 5 (MR) External causes (under 5, 5-18) (MR) Mortality from violence and suicide (under 5, 5-18) (MR) Morbidity indicators Low birth weigth (percentage) Underweight (percentage) Stunted (percentage) Obesity Hospital admission for home accidents (0-18 years) Incidence of congenital anomalies Incidence of childhood cancer Hospital admissions for road accidents (0 -18 yrs) Exposure indicators Indoor air pollution Children exposed to biomass fuel burning

Children exposed to ETS at home Outdoor air pollution Children exposed to average yearly concentration of particulate matter (PM10) over 40 µg/m3 Poor water supply & inadequate sanitation Children living without basic infrastructure for water supply, sanitation and hygiene in day care centres, schools, and homes Inadequate dietary intake Children with adequate dietary intakes Inadequate building standards and materials Homes and schools which do not comply to safety standards for children Occupational hazards Working children under 14 Specific adverse social environments Abandoned children Institutionalized children Policy indicators (LPP = legislation, policies and programmes) Indoor air pollution LPP to make safer heating and cooking devices available to households LPP to reduce exposure of children to ETS Outdoor air pollution LPP to raise awareness about the hazards to children’s health from outdoor air pollution Poor water supply & inadequate sanitation LPP to ensure proper water supply, sanitation and hygiene in day care centres, schools, and homes LPP to improve hygienic practices among children, parents, school teachers and administrators Inadequate dietary intake LPP to improve dietary intakes Food contamination LPP to improve infant food safety Inadequate building standards and materials Ensure minimum safety standards for children in homes and schools Provision of information to parents and children to prevent home accidents Hazardous chemicals LPP to ban lead from building materials and industrial production LPP to protect pregnant women from occupational exposures Mobility and transport LPP to increase road safety LPP to promote safe mobility and physical activity Environmental emergencies LPP to increase emergency preparedness among caretakers, teachers and children Occupational hazards LPP to protect children and adolescents from hazardous working conditions Specific adverse social environments LPP to prevent abandonment and reduce institutionalisation

4 Environmental indicators with focus on health issues EEA; www.eea.eu.int

4a) Indicators related to environment and health in the EEA core set.

ST= short term, MT= medium term, LT= long term

4b) Indicators related to chemicals and hazardous substances in the EEA core set

5 Children Health Indicators of Life & Development (CHILD project) M. Rigby, L. Köhler; EC, DG SANCO; http://europa.eu.int/comm/health/ph_projects/2000/monitoring/fp_monitoring_2000_exs_08_en.pdf Class 1: Demography &Socio-economic situation (Upstream health determinants)

• Economic Circumstances

• Poverty • Parental

Education Attainment

• Single Parent Household

• Asylum Seeking

• Total Mortality • Mortality • Selected Cause-

specific Child Mortality Rates

• Infectious diseases

• Congenital Malformations

• Malignant Neoplasm (Cancer)

• Unintentional Injuries

• (Burns, Poisoning, Transport, Drowning, Suicide, Assault & Homicide, Perinatal)

• Morbidity • Incidence of Childhood Cancer

• Incidence of Childhood Diabetes

• Prevalence of Asthma

• Incidence of Specific Childhood Infectional Diseases

• Child Dental Morbidity

• Injuries • Burns • Poisoning • Fractures

Class 2: Health Status and Well-being

• Mental Health • Attempted Suicide

• Mental Health (Indicators to be developed)

• Child Abuse

• Mental Health (Indicators to be developed)

• Behavioural Disorders

• Hyperactivity • Conduct

disorders • Adolescence

depression • Adolescence

anxiety • Learning

disorders • Educational

development • Perceived well-

being • Permanent or

Severe Disability

• Parental Determinants

• Breastfeeding • Exposure to

Household Environmental Tobacco Smoke

• Parental support

• Lifestyle Determinants

• Physical Activity • Tobacco smoking • Alcohol Abuse • Substance Misuse

Class 3: Determinants of health, Risk & Protective Factors

• Other Health Determinant Factors

• Overweight/Obesity • Children in Care • Early School leavers • Pre-primary

Education Enrolment • Air pollution

Exposure of Children

• Health Systems Policy

• Health Systems Quality

Class 4: Health

systems and Policy • Social Policy

Indicators

• Transportation safety • Protection from

Exposure to Lead • Protection from

Exposure to potentially Hazardous Noise

• Reduction of Exposure to Environmental Tobacco smoke

• Play & Leisure • (to be developed)

• Access to safe facilities

• Physical Protection Policy

• Healthy Parenting • (to be developed)

• % of children whose parents have attended educational programmes

6 European Community Health Indicators ECHI project P. Kramers, RIVM (NL); EC, DG SANCO http://europa.eu.int/comm/health/ph_information/indicators/project_indicators_en.htm http://europa.eu.int/comm/health/ph_information/documents/monitoring_projlead_en.pdf The proposed set of European Community Health Indicators Class 1: Demography &Socio-economic situation

• Population • Socio-economic

factors

• Mortality • Life expectancy and related indicators

• General mortality • Cause-specific

mortality

• Morbidity • Morbidity, disease-specific

• Diseases/disorders of large impact

• Diseases selected for other reasons

• Generic health status

Class 2: Health Status

• Composite measures of health status

• Personal and biological factors

• Biological risk factors • Personal conditions

• Health behaviours • Substance use • Nutrition • Other health related

behaviours

• Physical environment • Outdoor air • Housing • Drinking water

supply • Sewage system • Ionising radiation • Noise

Class 3: Determinants of health

• Living and working conditions

• Working conditions • Physical workplace exposure

• Mental work place exposure

• Accidents related to work

• Occupational diseases

• Social & cultural environment

• Social support • Social

isolation/networks• Life events

• Prevention, health protection and promotion

• Disease prevention • Health promotion • Health protection

• Class 4: • Health

systems • Health care resources • Facilities

• Manpower • Education • Technology

• Health care utilisation • In-patient care utilisation

• Pu-patient care utilisation

• Surgical operations • Medicine use/medical

aids

• Health expenditures • /financing

• Health are system • National expenditures

on health • Expenditures • on medical services • Medical goods

dispended to out-patients

• Total health expenditure by age group

• Health expenditure by fund source

• Class 4: • Health

systems

• Health care • Subjective indicators • Health acre process

indicators • Health outcomes

7 Selected Sustainable Development Indicators

Chapter of Agenda 21

Driving Force Indicators

State Indicators

Response Indicators

Category: Environmental Chapter 18: Protection of the quality and supply of freshwater resources

Annual withdrawals of ground and surface water Domestic consumption of water per capita

Groundwater reserves Concentration of faecal coliforms in freshwater Biochemical oxygen demand in water bodies

Waste-water treatment coverage Density of hydrological networks

Chapter 9: Protection of the atmosphere

Emissions of greenhouse gases Emissions of sulphur oxides Emission of nitrogen oxides Consumption of ozone depleting substances

Ambient concentrations of pollutants in urban areas

Expenditure on air pollution abatement

Chapter 21: Environmentally sound management of solid wastes and sewage-related issues

Generation of industrial and municipal solid waste Household waste disposed per capita

Expenditure on waste management Waste recycling and reuse Municipal waste disposal

Chapter 19: Environmentally sound management of toxic chemicals

Chemically induced acute poisonings

Number of chemicals banned or severely restricted

Chapter 20: Environmentally sound management of hazardous wastes

Generation of hazardous wastes Imports and exports of hazardous wastes

Area of land contaminated by hazardous wastes

Expenditure on hazardous waste treatment

Chapter 22: Safe and environmentally sound management of radioactive waste

Generation of radioactive waste

8 Sustainable Cities Indicator set

Indicators of Healthy Cities (European Region) Health Indicators Mortality: all causes

• Cause of death • Low birth weight

Health Service Indicators

Existence within city of inventory of self-help organisations • Existence within the city of a support

programme for self-help organisations • Existence of a city health education

programme • Percentage of six-year old children fully

immunised (having received all compulsory vaccinations)

• Number of inhabitants per practising general practitioner

• Number of inhabitants per nurse • Percentage of population covered by health

insurance • Percentage of population having access to

an emergency medical service which is less than 30 minutes away by car

• Availability of primary health care services in foreign languages

• Health information communication • Number of health questions examined by

the city council every year Environmental Indicators Atmospheric pollution

• Microbiological quality of the water supply• Chemical quality of the water supply • Percentage of water pollutants removed

from total sewage produced • Household waste collection quality index • Household waste treatment quality index • Pollution level indicator as perceived by

the population • Quantity of drinking-water used per

inhabitant per day • Relative surface area of green spaces in the

city • Public access to green spaces • Derelict industrial sites • Sport and leisure • Pedestrian streets • Cycling in city • Public transport • Public transport network cover • Living space

• Comfort and hygiene • Emergency services

Socioeconomic Indicators Number of square metres of living space per inhabitant • Percentage of population living in

substandard dwellings • Estimated number of homeless people • Unemployment rate • Work absenteeism rate • Percentage of families below the national

poverty level • Percentage of total employment provided

by the 10 most important economic activities

• Percentage of one-person households • Percentage of single-parent families • Percentage of children leaving school after

compulsory education • Illiteracy rate • Percentage of city’s budget allocated to

health and social actions • Crime rate • Percentage of dwellings for elderly people

who have emergency call facilities • Main causes for emergency calls • Percentage of young children on waiting

lists for child-care facilities • Median age of women giving birth for the

first time • Abortion rate in relation to total number of

births • Percentage of people under 18 “under

police surveillance” • Percentage of disabled people in

employment compared to total number of disabled people of working age (between 18 and 65).

Source: WHO

9 Environmental Indicators from Slovenia Following EEA indicators are executed in Slovenia

State and changes in the environment Water Water use Urban waste water treatment River water quality index Nitrates in groundwater Pesticides in groundwater Air Sulphur dioxide emissions ☺ Nitrogen oxide emissions Exceedance days of sulphur dioxide threshold values ☺ Exceedance days of ozone threshold values Ozone and climate change Consumption of ozone depleting substances ☺ Greenhouse gas emissions Soil Land use and land cover change Nitrate directive implementation Nature and biodiversity Protected areas Forest decline and tree defoliation Waste Generation of municipal waste Generation of hazardous waste Transboundary movements of hazardous waste ☺ Integration of environmental considerations into sectoral policies Agriculture, forestry, hunting and fishing Agri-environmental measures ☺ Pesticide consumption Fertiliser consumption Energy Final energy consumption ☺ Renewable electricity ☺ Transport Average age of vehicle fleet ☺ Vehicles meeting emission standards ☺ Freight transport – modal split Health Drinking water quality ☺ Bathing water quality Financing and economic instruments of environmental protection Environmental expenditure ☺

10 Malta (Blue Plan Indicators for Sustainable Development) P = Pressure, S = State, R = Response.

Theme N° Type Indicator Name 1 P Population growth rate

Demography and population 2 R Total fertility rate 3 S Women per hundred men in the labour force 4 S Human poverty index (HPI)

Standard of living, employment, social inequities, poverty,

unemployment 5 R Employment rate 6 P School enrolment gross ratio

7 S Difference between male and female school enrolment ratios

8 S Production of cultural goods

9 R Share of private and public finances allocated to the professional training

Culture, education, training, awareness improvement

10 R Public expenditure for the conservation and value enhancement of natural, cultural and historical patrimony

11 S Life expectancy at birth 12 S Infant mortality rate Health, public health 13 R Access to safe drinking water 14 P Annual energy consumption per inhabitant 15 P Number of passenger cars per 100 inhabitants 16 S Main telephone lines per 100 inhabitants

Consumption and production patterns

17 S Distribution of food consumption per income decile 18 P Urban population growth rate 19 P Loss of agricultural land due to the urbanisation 20 S Urbanisation rate

Habitat and urban systems

21 S Floor area per person 22 P Population change in mountain areas

Rural and dry areas, mountains and hinterland 23 R Existence of program(s) concerning the less

favoured rural zones 24 P Exploitation index of forest resources 25 S Forest area Forests 26 R Forest protection rate 27 P Artificialized coastline / total coastline 28 P Number of tourists per km of coastline 29 P Number of moorings in yachting harbours 30 S Population growth in Mediterranean coastal regions 31 S Population density in coastal regions 32 S Coastline erosion

Littoral and "littoralisation"

33 R Protected coastal area 34 P Oil tanker traffic 35 S Global quality of coastal waters 36 S Density of the solid waste disposed in the sea 37 S Coastal waters quality in some main “hot spots” 38 S Quality of biophysical milieu 39 R Protection of specific ecosystems

Sea

40 R Existence of monitoring programs concerning pollutant inputs

Theme N° Type Indicator Name

41 R Wastewater treatment rate before sea release for coastal agglomerations over 100 000 inhabitants

42 R Harbour equipment ratio in unballasting facilities 43 P Distribution of GDP (Agriculture, Industry, Services) 44 P Foreign Direct Investment 45 S External debt / GDP 46 S Saving / investment 47 S Public deficit / GDP 48 S Current payments / GDP

Global economy

49 S Employment distribution (Agriculture, Industry, Services)

50 P Use of agricultural pesticides 51 P Use of fertilisers per hectare of agricultural land 52 P Share of irrigated agricultural land 53 P Agriculture water demand per irrigated area 54 S "Arable land" per capita 55 S Rate of food dependence 56 S Annual average of wheat yield

Agriculture

57 R Water use efficiency for irrigation 58 P Value of halieutic catches at constant prices 59 P Number and average power of fishing boats 60 S Fishing production per broad species groups 61 S Production of aquaculture

Fisheries, aquaculture

62 R Public expenditures on fish stocks monitoring 63 P Industrial Releases into water 64 S Intensity of material use Mines, industry 65 R Number of mines and carries rehabilitated after

exploitation 66 S Turnover distribution of commerce according to the

number of employees 67 S Share of merchant services to the enterprises Services and commerce

68 R Existence of legislations on the hypermarket setting up restriction

69 P Energy intensity 70 P Energy balance Energy 71 R Share of consumption of renewable energy

resources 72 P Average annual distance covered per passenger

car 73 S Structure of transport by mode 74 S Density of the road network

Transports

75 R Share of collective transport 76 P Number of nights per 100 inhabitants

77 P Number of secondary homes over total number of residences

78 P Number of bed-places per 100 inhabitants 79 P Public expenditure on tourism development 80 P Number of international tourists per 100 inhabitants81 S Share of tourism receipts in the exportations

Tourism

82 S Currency balance due to tourism activities

Theme N° Type Indicator Name 83 R Public expenditure on tourism sites conservation

84 P Exploitation index of renewable resources 85 P Non-sustainable water production index

86 S Share of distributed water not conform to quality standards

87 S Water global quality index

88 R Share of collected and treated wastewater by the public sewerage system

89 R Existence of economic tools to recover the water cost in various sector

90 R Drinking water use efficiency

Freshwater and Wastewater

91 R Share of Industrial wastewater treated on site 92 P Ratio of land exploitation 93 S Land use change Soils, vegetation and

desertification 94 S "Arable land" change 95 P Wetland area 96 P Number of turtles catched per year 97 P Share of fishing fleet using barge 98 S Threatened species

Biological diversity, ecosystems

99 R Total expenditure on protected areas management 100 P Generation of municipal solid waste 101 P Generation of hazardous wastes 102 P Imports and exports of hazardous wastes 103 P Generation of industrial solid waste 104 S Area of land contaminated by hazardous wastes 105 S Distribution of municipal wastes 106 R Minimisation of waste production 107 R Cost recovery index of municipal wastes 108 R Destination of household wastes

Solid, industrial and hazardous waste

109 R Collection rate of household wastes 110 P Emissions of greenhouse gasses 111 P Emissions of sulphur oxides 112 P Emissions of nitrogen oxides 113 P Consumption of ozone depleting substances 114 S Frequency of excess over air standard (ozone) 115 R Expenditure on air pollution abatement

116 R Share of clean fuels consumption in total motor fuels consumption

Air quality

117 R Share of agglomerations over 100 000 inhabitants equipped with a air pollution monitoring network

118 P Number of sites with high risk 119 S Economic impact of natural disasters 120 S Burnt area per year

Natural and technological risks

121 R Existence of intervention plans

122 R Number of direct employments linked to the environment

123 R Number of associations involved in environment and/or sustainable development

Actors of the sustainable development

124 R Number of enterprises engaged in “environment management" processes

Theme N° Type Indicator Name

125 R Public expenditure on environmental protection as a percent of GDP

126 R Existence of environment national plans and/or sustainable development strategies Policies and strategies of the

sustainable development

127 R Number of Agendas 21 adopted by local authorities

International trade, Free trade zone and environment 128 P Openness rate of GDP Others Mediterranean

exchanges 129 P Net migration rate Mediterranean cooperation in the fields of environment and

sustainable development 130 R Public development assistance coming from abroad

environment and health indicators · instituto de salud carlos iii/ escuela nacional de sanidad...

Documents