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Chapter 11: Prediction and Evaluation of Environmental Effects - Human Health

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Contents

Part 1 - Introduction

• The definition of "health" in the context of SEA

Part 2 - Legislative requirements

• The relevant statutory provisions

Part 3 - Prediction and evaluation of effects on human health

• Establishing a suitable level of detail
• Existing assessment methods
• Health at the screening and scoping stages
• Health assessment for the Environmental Report
• Examples of how PPS can affect human health
• Presenting human health issues in the Environmental Report

Part 4 - Useful information sources

• Data and advice on Health issues

Part 1 - Introduction

The definition of "health" in the context of SEA

11.1.1 The Environmental Assessment (Scotland) Act 2005 ('the Act') identifies human health as an environmental component to be assessed during an environmental assessment of a plan, programme or strategy ( PPS).

11.1.2 During the Act's passage through the Scottish Parliament, the Scottish Ministers made a commitment to include 'human health' within SEA guidance. This was not a reflection that human health issues had greater importance than other environmental issues, but that most Responsible Authorities had little or no experience of assessing human health in an environmental context. In time, as experience of assessing human health grows, the SEA Gateway team would expect to revisit this Chapter and reflect this experience in the subsequent version.

11.1.3 The definition of "health" in the context of environmental assessment generally, and SEA in particular, is evolving and changing with experience. The advice offered by the Scottish Executive is that the definition of health in the context of SEA should:

• be relevant and proportionate to the type of PPS being prepared; and
• be considered in the context of the other issues outlined in Schedule 3(6) of the Act, thereby focusing on environmentally-related health issues such as significant health effects arising from the quality of air, water or soil.

Part 2 - Legislative requirements

The relevant statutory provisions

11.2.1 A PPS subject to screening should include risks to human health as one of the criteria used to determine whether a significant environmental effect is likely to arise.

11.2.2 All qualifying PPS are subject to scoping. This is the stage at which the Responsible Authority sets out the scope and level of detail of information proposed for the Environmental Report. Scoping documentation needs to outline the level of detail proposed for the assessment of likely significant effects on the environment on a number of issues, including human health ( Chapter 5).

11.2.3 Schedule 3 of the Act sets out the information required to be included in Environmental Reports ( Chapter 6).

This information includes the likely significant effects on a number of environmental issues, including human health (Paragraph 6), and the measures envisaged to prevent, reduce and as fully as possible offset any significant adverse effects on the environment, including adverse effects on human health where relevant (Paragraph 7). ( Chapter 6).

11.2.4 The monitoring required by this section of the Act shall include significant effects on human health, where these have been identified in the environmental assessment ( Chapter 14). Accordingly, indicators for monitoring health should be identified as part of the assessment process.

Part 3 - Prediction and evaluation of effects on Human Health

Establishing a suitable level of detail

11.3.1 The level of detail of information about health to be included cannot be prescribed and will depend upon the:

• nature and complexity of the PPS;
• the geographic and temporal coverage of the PPS;
• the existing state of the environment in respect of health; and
• the amount of information that is available.

The level of detail should be proportionate to the nature of the PPS and to the significance and nature of any health effects. The European Commission guidance (paragraph 5.26) suggests that human health should be considered in the context of the other issues mentioned ( i.e. biodiversity, fauna, flora etc.), thus environmentally related health issues such as exposure to traffic noise or air pollutants are obvious aspects to study. The processes described in the following sections may assist in deciding on the appropriate level of detail.

Existing assessment methods

11.3.2 Responsible Authorities are not required to carry out a Health Impact Assessment ( HIA) as part of an SEA. However, the two processes have elements in common i.e. screening, scoping, impact assessment, and mitigation. The World Health Organisation has suggested that the approach developed for an HIA could provide a practical way of considering health issues within SEA: http://www.euro.who.int/healthimpact/MainActs/20030120_1.

11.3.3 HIA is a systematic method to assess the effects of a PPS on health. The most commonly used definition of HIA is taken from the World Health Organisation Gothenburg consensus paper on HIA ( WHO, 1999):

"[ HIA is] a combination of procedures, methods and tools by which a policy, programme or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population. HIA tries to minimise the likelihood of negative health outcomes, maximise positive health impacts … It tries to identify all potential health impacts: intended and unintended, positive and negative."

It may be useful for Responsible Authorities to utilise some of the HIA methods and approaches.

Health at the screening and scoping stages

11.3.4 If the PPS is subject to screening then human health, amongst other issues, must be included in the screening considerations.

11.3.5 At the scoping stage, the Responsible Authority has to determine the scope and level of detail that is appropriate for the assessment of the PPS likely significant effects on human health. The Responsible Authority can include an outline of the assessment methods that it proposes to utilise, including those proposed for assessing the impact on human health.

11.3.6 Key issues to consider are:

• what the PPS entails e.g. policies, locational proposals, etc;
• how these could give rise to significant impacts on health and the types of impact; and
• the key population groups affected.

11.3.7 The NHS Lothian HIA checklist ( NHS Lothian HIA Screening check list) may assist in offering a structure for the assessment of impacts on health. The checklist includes:

• identification of the population groups potentially affected by a PPS;
• identification of a range of potential health effects, both positive and negative, including changes to the physical environment;
• the need to highlight areas of uncertainty and research required; and
• the potential to identify measures to prevent, reduce and offset as fully as possible any significant health effects.

Note that certain aspects of the checklist go beyond the advice offered in Paragraph 11.1.2 on the definition of health. Responsible Authorities should use their own judgement about the application of the checklist to the PPS they are taking forward.

11.3.8 In practical terms scoping preparation may be undertaken as a group exercise, e.g. steering groups, or through discussions with key stakeholders. A Responsible Authority could also contact experts in other organisations who can support this process e.g. local authorities, NHS in Scotland. There are 14 area NHS Boards throughout Scotland and public health departments at each Board which are a good point of contact for advice about health issues relating to the general population.

Health assessment for the Environmental Report

11.3.9 The approach adopted by a Responsible Authority is determined to a certain extent by the nature of the PPS and its potential, among other things, for its effects on human health.

11.3.10 The bullet points below can aid a Responsible Authority with its approach to the assessment of the significant effects on human health:

• seek advice from health professionals and health organisations;
• the key to an effective assessment is the consideration of actions arising from the PPS as well as consideration of the health of potentially affected populations.
• It is important to scope the assessment properly before going out to gather lots of environmental baseline data that will not assist with the assessment.
• ensure that conclusions on effects and measures envisaged to prevent, reduce and offset as fully as possible any significant adverse effects are evidence-based.

Examples of how PPS can affect human health

11.3.11 Transport policy can effect reductions or increases in pollutant emission levels. For human health, pollutants such as particulates and nitrogen dioxide have been demonstrated to have effects on human health (which is reflected in the standards). When assessing this type of PPS the following issues could be considered:

• the result of the policy would be increased or decreased emissions;
• the receptor would be human beings in general and those with respiratory problems in particular. The latter necessitates identifying whether there are any health "hotspots" in the area e.g. ex-miners; and
• the effects would be increased or decreased incidence of health problems ²⁷ and increased or decreased quality of life e.g. increases in numbers of non-fatal asthma attacks.

11.3.12 The assessment of noise effects in terms of health is less straightforward than the assessment of air quality. Noise effects are more often in the realm of "nuisance" or "quality of life" than in that of health. Noise can affect health but this involves high-decibel prolonged exposure. Noise is normally associated with transport and/or industry; the former is currently subject to assessment. Examples of the latter have yet to be assessed.

11.3.13 Other issues which can be assessed as part of "population and human health" include:

• access to services (particularly health and recreation);
• opportunities for recreation; and
• opportunities for cycling/walking ( e.g. as alternatives to car transport).

Presenting human health issues in the Environmental Report

11.3.14 There is a summary of a possible approach along with two tables to help Responsible Authorities to prepare and present an assessment of significant environmental effects in terms of human health issues at the end of this Chapter. Please note that neither the summary nor the tables are mandatory and Responsible Authorities may adopt a different approach or adapt them to meet their own needs.

Part 4 - Useful sources at this stage

Data and advice on health issues

11.4.1 At the screening and scoping stages a Responsible Authority has to consult the Consultation Authorities, who will endeavour to offer advice and opinions in the usual way. Section 14(3) and Schedule 3 place a duty on the Responsible Authority to collect relevant baseline data, although Section 14(3) recognises that there may be a limit to the information in Schedule 3 that can reasonably be collated ( Chapter 8). In terms of human health issues, this could mean liaising with specialist health groups to find the appropriate health data and advice. A number of useful sources are listed in Chapter 8.

Summary Overview of One Possible Approach

Screening

Taking care to avoid making assumptions, gain an understanding of the population groups who may be affected by the PPS, including those groups who may be excluded from the benefits of the PPS.

Consider if there are any likely significant environmental effects, in terms of health issues, of the PPS on the population groups identified and indicate whether negative or positive.

Scoping

Set out the scope and level of detail intended for the Environmental Report regarding the assessment of likely significant effects on health. Key issues to consider are:

• what the PPS entails e.g. policies, location proposals, etc;
• how these could give rise to significant impacts on health and the types of impact; and
• the key population groups affected.

Environmental Report

Carry out and present an assessment of the significant effects on health.

If there are any gaps, uncertainties or unknown factors, note these.

Consider measures to prevent, reduce and offset as fully as possible any significant adverse effects.

Put the assessment of significant effects on health into the context of the other environmental issues that have been assessed for the SEA.

Post Adoption and Monitoring

Ensure that significant effects on health are monitored in accordance with the requirements of the Act.

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