Academic journal article Canadian Journal of Public Health

Challenges and Directions for Environmental Public Health Indicators and Surveillance

Academic journal article Canadian Journal of Public Health

Challenges and Directions for Environmental Public Health Indicators and Surveillance

Article excerpt

Correspondence: Chris Furgal, Public Health Research Unit, CHUQ - Pavillon CHUL, 2400 rue d'Estimauville, Beauport, QC G1E 7G9, Tel: 418-666-7000 ext. 555, Fax: 418-666-2776, E-mail:

The official recognition of the state of many of the earth's modern environmental problems, and their influence on human health was first stated in unity by governments at the 1992 Rio Earth Summit. Issues such as anthropogenic contaminants in the environment, human-induced climate change, growing inequities between rich and poor, and the influence that these factors have on human health were identified and since then have been noted to be getting worse in many areas of the world. It was recognized that a better understanding and identification of these environmental health issues were required in order to begin to address them, and that this action would require collective efforts among communities and countries as many of these issues did not recognize political boundaries but were of a global nature. Here, we refer to "environmental health" in the following sense:

"Environmental health comprises those aspects of human health, including quality of life, that are determined by physical, chemical, biological, social and psychological factors in the environment. It also refers to the theory and practice of assessing, correcting, controlling, and preventing those factors in the environment that can potentially affect adversely the health of present and future generations."(1)

Some recent yet preliminary calculations of the burden of disease relating to these environmental and occupational determinants(2) estimate that these factors are related to approximately 11% of all diseases in Latin American countries. Other World Health Organization (WHO) studies show that the poor, and especially children and women, share a disproportionate burden of disease relating to environmental sources. The contribution of environmental factors to disease among the most vulnerable populations has been roughly estimated by WHO to be between 25% and 33% of the global burden of disease (many more studies are currently underway to further refine these figures).(3) This situation has generated a high level of activity towards the development of environmental public health indicators and surveillance systems, primarily in Europe(4) and the Americas.(5)

The Conference on Environmental Health Surveillance, Quebec City, 2000

In October 2000, a group of researchers, practitioners and health professionals came together in Quebec City to discuss the challenges facing environmental health monitoring and surveillance and to discuss the possibility of developing consensus on many of these issues (see List of Conference Attendees on page 71 of this Supplement). The conference was initiated and supported by the International Joint Commission (IJC), the Pan American Health Organization (PAHO), Health Canada, Environment Canada, and the U.S. Agency for Toxic Substances and Disease Registry (ATSDR). To initiate discussions, a number of papers were commissioned, providing a review of the state of the knowledge in various pertinent areas and proposing a list of potential indicators to monitor the interactions between specific environments and human health. A number of common or cross-cutting themes emerged from the papers and conference discussions and are used in this supplement to propose an approach to developing a set(s) of common environmental health indicators to meet basic needs for environmental public health monitoring and surveillance.

Overview of the Conference

The concept of environmental health is multifaceted and complex in nature, consisting of both biotic and abiotic components of physical environments as well as aspects of social, economic and political processes which influence the health of ecosystems and in turn, the well-being of the world's populations. For example, the demographic changes that are taking place in coastal zones and the dependence of many groups on the sea (e. …

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