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Developing environmental health indicators [EHIs] for Iran based on the causal effect model

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Abstract

Background

Environmental health monitoring and its effects on health are very important in health systems. Relationship between environment and health can be done by simplifying data in understandable indicators for people and policy-makers. The present study presents the general framework for formulating environmental health quality index for Iran.

Methods

This study was implemented through expert panel at two levels: indicator domain determination and domain specific variables selection. Domain specific variables were selected based on the Driving force-Pressure-State-Exposure-Effect-Action (DPSEEA) framework from the list of national and international variables.

Results

Seven environmental health issues [air quality, drinking water, sewage disposal, food, radiation management and housing and human settlements] were determined, and three variables were selected for air quality, 8 variables for water quality, 5 variables for sanitation, 1 variable for food quality, 3 variables for housing and human settlements, 4 variables for solid waste management and 3 variables for radiation management.

Conclusions

Environmental health indicators determination based on the causal effect model leads to a better understanding of the relationship between the environment and health by simplifying data in an understandable format for public and improves prioritization of policy-making in the environmental health. In this study, environmental health indicators for Iran were proposed.

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References

  1. Briggs D. Environmental health indicators : frameworks and methodologies. WHO/SDE/OEH/99.10. Geneva: World Health Organization; 1999.

    Google Scholar 

  2. Briggs DJ, Field K. Informing Environmental health Policy in urban areas: the HEADLAMP approach. Rev Environ Health. 2000;15(1–2):169–86.

    CAS  Google Scholar 

  3. Corvalan CF, Kjellström T, Smith KR. Health, environment and sustainable development: identify links and indicators to promote action. Epidemiology-Baltimore. 1999;10(5):656–60.

    Article  CAS  Google Scholar 

  4. Samson PR. Developing environmental public health indicators: A view from Canada. Stat J United Nations Econ Comm for Eur. 2002 Jan 1;19(1,2):105–16.

    Google Scholar 

  5. Messer LC, Jagai JS, Rappazzo KM, Lobdell DT. Construction of an environmental quality index for public health research. Environ Heal A Glob Access Sci Source. 2014;13(1).

  6. Coussens CM, Goldman L, others. Environmental Health Indicators: Bridging the Chasm of Public Health and the Environment--Workshop Summary: National Academies Press; 2004.

  7. Tisch CL, Pearson A, Kingham S, Borman B, Briggs D. Environmental health indicators: a review of initiatives worldwide. Manag environ Qual an Int J. 2014 Jun 3;25(4):446–66.

    Article  Google Scholar 

  8. Khan R, Voice T, Phillips D. Developing National Environmental Health Indicators for New Zealand. Christchurch, Wellington: Environmental Science and Research, Ministry of Health. 2005 Jun

  9. Almeida N, das TA, García-Sánchez IM, das Neves Almeida TA, García-Sánchez IM. A comparative analysis between composite indexes of environmental performance: an analysis on the CIEP and EPI. Environ Sci Policy. 2016;64:59–74.

    Article  Google Scholar 

  10. English PB, Sinclair AH, Ross Z, Anderson H, Boothe V, Davis C, et al. Environmental health indicators of climate change for the United States: Findings from the state environmental health indicator collaborative, vol. 117: Environmental Health Perspectives; 2009. p. 1673–81.

  11. Hambling T, Weinstein P, Slaney D. A review of frameworks for developing Environmental health indicators for climate change and health. Int J Environ Res Public Health. 2011 Jul 13;8(7):2854–75.

    Article  Google Scholar 

  12. Environment and Health Information System [ENHIS] data source - European Health Information Gateway [Internet]. [cited 2018 Jul 9]. Available from: https://gateway.euro.who.int/en/datasets/enhis/. Accessed 9 Jul 2018

  13. Lewin S, Strauss N. Planning urban environmental health information systems: a case study of Cape Town, South Africa. Environ Urban. 1999 Oct 1;11(2):247–60.

    Article  Google Scholar 

  14. Bell ML, Cifuentes LA, Davis DL, Cushing E, Gusman Telles A, Gouveia N. Environmental health indicators and a case study of air pollution in Latin American cities. Environ Res 2011 Jan 1;111[1]:57–66.

  15. Eatman S, Strosnider HM. CDC’s National Environmental Public Health Tracking Program in Action: Case Studies From State and Local Health Departments. J public Heal Manag Pract JPHMP. 2017;(23) [Suppl 5 ENVIRONMENTAL PUBLIC HEALTH TRACKING]:S9.

  16. Marchetti A, Pilehvar S, ‘t Hart L, Leyva Pernia D, Voet O, Anaf W, et al. Indoor environmental quality index for conservation environments: The importance of including particulate matter. Build Environ. 2017 Dec 1;126:132–46.

  17. Waheed B, Khan FI, Veitch B. Developing a quantitative tool for sustainability assessment of HEIs. Int J Sustain High Educ. 2011;12(4):355–68.

    Article  Google Scholar 

  18. Waheed B, Khan F, Veitch B. Linkage-based frameworks for sustainability assessment: making a case for driving force-pressure-state-exposure-effect-action [DPSEEA] frameworks. Sustainability. 2009;1(3):441–63.

    Article  Google Scholar 

  19. Mamat L, Basri NEA, Zain SM, Rahmah E. Environmental sustainability indicators as impact tracker: a review. J Sustain Sci Manag. 2016;11(1):29–42.

    Google Scholar 

  20. UNICEF, World Health Organization. Progress on drinking water, Sanitation and Hygiene: Unicef; 2017.

  21. Khan R, Phillips D, Fernando D, Fowles J, Lea R. Environmental health indicators in New Zealand: drinking water - a case study. EcoHealth. 2007;4(1):63–71.

    Article  Google Scholar 

  22. Kit Yok MC, Wah YB, King TS, Hung WM, Lawai E. A system dynamic model for the Environmental Performance Index of Malaysia. Adv Mater Res. 2012;518–523:1062–71.

    Article  Google Scholar 

  23. Sly JL, Moore SE, Gore F, Brune MN, Neira M, Jagals P. Children’s Environmental health indicators in Australia. Ann Glob Heal. 2016 Jan 1;82(1):156–68.

    Article  Google Scholar 

  24. Jung EM, Kim EM, Kang M, Goldizen F, Gore F, Drisse MNB, et al. Children’s Environmental health indicators for low- and middle-income countries in Asia. Ann Glob Heal. 2017 May 1;83(3–4):530–40.

    Article  Google Scholar 

  25. de Moraes FF, de Magalhaes CV, Froes Asmus CIR. Development of Environmental health indicators for the child population: report on a Brazilian experience. Ann Glob Heal. 2017 Mar 1;83(2):227–33.

    Article  Google Scholar 

  26. WHO | Global Initiative on Children’s Environmental Health Indicators. WHO. 2010;

  27. Samson PR. Developing environmental public health indicators: a view from Canada. Stat J UN Econ Comm Eur. 2002;19(1, 2):105–16.

    Google Scholar 

  28. Lobdell D, Murphy P, Calderon R. Environmental Public Health Indicators. Epidemiology. 2007 Sep;18[Suppl]:S155.

  29. Stavanovic-carapina H, Kasanin-grubin M, Zugic-drakulic N, Vasilic R, Mihajlov A. Improved methodology for assessing the environmental health indicators. J Environ Prot Ecol. 2010;11(3):941–8.

    Google Scholar 

  30. McGeehin MA, Qualters JR, Niskar AS. National Environmental Public Health Tracking Program: bridging the information gap. Environ Health Perspect. 2004 Oct 3;112(14):1409–13.

    Article  Google Scholar 

  31. Zhou Y, Jerrett M. Linking exposure and health in Environmental public health tracking. Environ Res. 2014;134:453.

    Article  CAS  Google Scholar 

  32. For Disease Control C, Prevention. othersGuide to Building an Environmental Public Health Tracking Network. Atlanta: Centers Dis Control Prev Dep Heal Hum Serv; 2011.

    Google Scholar 

  33. Yip FY. Environmental public health tracking: from data to action. LWW: Environmental Public Health Tracking; 2017.

  34. Asadi-Lari M, Vaez-Mahdavi MR, Faghihzadeh S, Cherghian B, Esteghamati A, Farshad AA, et al. Response-oriented measuring inequalities in Tehran: second round of urban health equity assessment and response tool [urban HEART-2], concepts and framework. Med J Islam Repub Iran. 2013;27(4):236–48.

    Google Scholar 

  35. Rashidian A, Karimi-Shahanjarini A, Khosravi A, Elahi E, Beheshtian M, Shakibazadeh E, et al. Iran’s multiple indicator demographic and health survey-2010: Study protocol. Int J Prev Med. 2014;5(5):632.

    Google Scholar 

  36. Asadi-Lari M, Vaez-Mahdavi MR, Faghihzadeh S, Montazeri A, Farshad AA, Kalantari N, et al. The application of urban health equity assessment and response tool [Urban HEART] in Tehran concepts and framework. Med J Islam Repub Iran. 2010;24(3).

  37. Moridi A, Kerachian R, Zokaei M. Assessment of Iran’s water resources quality [2004-2014]. Iran Water Resour Res. 2017;12(4):23–35.

    Google Scholar 

  38. Lankarani KB, Alavian SM, Peymani P. Health in the Islamic Republic of Iran, challenges and progresses. Med J Islam Repub Iran. 2013 Feb 10;27(1):42–9.

    Google Scholar 

  39. Anonymous. OECD Environmental Performance Reviews: The Netherlands 2015. OECD Environmental Performance Reviews 2015.

  40. Anonymous. OECD Environmental Performance Reviews: Estonia 2017. OECD Environmental Performance Reviews. 2017.

  41. OECD. Health at a glance 2013: OECD indicators. OECD Publishing 2013. 210 p.

  42. Liu H-Y, Bartonova A, Pascal M, Smolders R, Skjetne E, Dusinska M. Approaches to integrated monitoring for environmental health impact assessment. Environ Heal. 2012;11(1):88.

    Article  Google Scholar 

  43. Hsu A, de Sherbinin A, Shi H. Seeking truth from facts: the challenge of environmental indicator development in China. Environ Dev. 2012;3(1):39–51.

    Article  Google Scholar 

  44. Yale Center for Environmental Law & Policy. Environmental Performance Index [Internet]. 2014 Environmental Performance Index 2014. Available from: http://epi.yale.edu/issue/climate-and-energy. Accessed 9 Jul 2018

  45. Lobdell DT, Jagai JS, Rappazzo K, Messer LC. Data sources for an environmental quality index: availability, quality, and utility. Am J Public Health. 2011;101(S1):S277–85.

    Article  Google Scholar 

  46. Hambling T, Slaney D. Environmental health indicators for New Zealand: Annual report 2007. Inst Environ Sci Res Ltd, Porirua, New Zeal 2007 Jun. http://www.survesrcrinz/ehi/ehi_reports php.

  47. Dalbokova D, Krzyzanowski M. Environmental health indicators: development of a methodology for the WHO European Region. Stat J UN Econ Comm Eur. 2002;19(1, 2):93–103.

    Google Scholar 

  48. WHO European Region. Towards Environmental Health Inequality Reporting. Development of a core set of indicators for reporting and assessing environmental health inequalities in the WHO European Region. In: Report of an expert group meeting; 2010. p. 68.

    Google Scholar 

  49. Gore F. Children’s Environmental health indicators [CEHI]: presenting regional successes learning for the future. WHO/HSE/PHE/EPE.09.1. Geneva: World Health Organization; 2009. 24 p.

    Google Scholar 

  50. WEF. Environment Performance Index [Internet]. World Economic Forum: Annual Meeting, An initiative of the Global Leaders of Tomorrow Environment Task Force. 2006. Available from: www.epi.yale.edu/. Accessed 7 Sept 2018

  51. EPI. Yale Environmental Performance Index, vol. 2016: Yale University; 2016.

  52. Ghozikali MG, Mosaferi M, Naddafi K. Environmental health problems and indicators in Tabriz, Iran. Heal Promot Perspect. 2013;3(1):113–23.

    Google Scholar 

  53. Chandrasekharan I, Sendhil Kumar R, Seena Raghunathan R, Chandrasekaran S. Construction of environmental performance index and ranking of states. Curr Sci. 2013;104(4):435–9.

    Google Scholar 

  54. Zuo X, Hua H, Dong Z, Hao C. Environmental Performance Index at the Provincial Level for China. Ecol Indic. 2006–2011;2017.

  55. Hsu A, Johnson LA, Lloyd A. Measuring progress: a practical guide from the developers of the environmental performance index [EPI]. New Haven: Yale Center for Environmental Law & Policy; 2013. 26 p.

    Google Scholar 

  56. World Health Organization. Ambient Air Pollution: A global assessment of exposure and burden of disease. WHO; 2016.

  57. Washington TWBI for HM and EU of The Cost of Air Pollution: Strengthening the Economic Case for Action. The World Bank and Institute for Health Metrics and Evaluation University of Washington, Seattle. 2016.

  58. Chen H, Goldberg MS, Villeneuve PJ. A systematic review of the relation between long-term exposure to ambient air pollution and chronic diseases. Rev Environ Health. 2008;23(4):243–97.

    CAS  Google Scholar 

  59. United Nations. Water and sanitation - United Nations sustainable development [Internet]. Sustainable Development Goals 2016. Available from: http://www.un.org/sustainabledevelopment/water-and-sanitation/. Accessed 7 Sept 2018

  60. Zebardast L, Salehi E, Afrasiabi H. Application of DPSIR framework for integrated Environmental assessment of urban areas: a case study of Tehran. Int J Environ Res. 2015;9(2):445–56.

    CAS  Google Scholar 

  61. WHO/UNICEF. Progress on Sanitation and Drinking Water, vol. 2015: Update and MDG assessment. World Health Organization; 2015.

  62. Gentry-Shields J, Bartram J. Human health and the water environment: using the DPSEEA framework to identify the driving forces of disease. Sci Total Environ. 2014;468-469:306–14.

    Article  CAS  Google Scholar 

  63. Group FDBER. Foodborne disease burden epidemiology reference group. WHO Estimates of the global burden of foodborne diseases: WHO; 2015.

    Google Scholar 

  64. World Health Organization. Children’s Environmental health indicators [CEHI]: presenting regional successes learning for the future. Geneva: World Health Organization; 2009.

    Google Scholar 

  65. Environmental Health Indicators New Zealand [Internet]. 2017. Available from: http://www.ehinz.ac.nz/indicators/overview/. Accessed 7 Sept 2018

  66. ENHIS database [Internet]. World Health Organization; 2018 [cited 2018 Jul 9]. Available from: http://www.euro.who.int/en/data-and-evidence/environment-and-health-information-system-enhis/enhis-database. Accessed 9 Jul 2018

  67. Khan R, Phillips D. National Environmental Health Indicators in New Zealand. Cambridge: Challenges and Opportunities. Epidemiol; 2004.

    Google Scholar 

  68. Niemeijer D, de Groot RS. A conceptual framework for selecting environmental indicator sets. Ecol Indic. 2008;8(1):14–25.

    Article  Google Scholar 

  69. Pong RW, Pitblado JR, Irvine A. A strategy for developing environmental health indicators for rural Canada. Can J Public Health. 2002 Sep 1;93(1):S52-6.

  70. National B, Stewardship E, Profiles C. Environmental sustainability Index. Environ Law. 2005;2005.

  71. Abdullah L, Ismail WKW. A new ranking of environmental performance index using weighted correlation coefficient in intuitionistic fuzzy sets: a case of ASEAN countries. Mod Appl Sci. 2013;7(6):42–52.

    Article  Google Scholar 

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Acknowledgments

This study was a Ph.D. dissertation supported by the school of public health, Tehran University of medical sciences, Iran.

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Authors and Affiliations

  1. Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Mohammad Maroosi, Alireza Mesdaghinia, Mahmood Alimohammadi, Kazem Naddafi, Amir Hossein Mahvi & Ramin Nabizadeh Nodehi

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  1. Mohammad Maroosi
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  2. Alireza Mesdaghinia
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  3. Mahmood Alimohammadi
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Correspondence to Alireza Mesdaghinia or Mahmood Alimohammadi.

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Maroosi, M., Mesdaghinia, A., Alimohammadi, M. et al. Developing environmental health indicators [EHIs] for Iran based on the causal effect model. J Environ Health Sci Engineer 17, 273–279 (2019). https://doi.org/10.1007/s40201-019-00346-1

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