Biological Monitoring of Cadmium Exposed Workers in a Nickel-Cadmium Battery Factory in China

Abstract: Biological Monitoring of Cadmium Exposed Workers in a Nickel-Cadmium Battery Factory in China: Guicheng ZHANG, et al. School of Public Health, Curtin University of Technology-A cross-sectional study of renal damage in workers from a Chinese Ni-Cd battery factory is reported in this paper. The present exposure of surveyed workers to Cd may be likened to that of factories in developed countries prior to the 1950s. The results show urinary cadmium did not increase significantly with the years of exposure in aged workers exposed to cadmium. In these occupationally exposed workers urinary cadmium levels of 3 to 60 µg/g creatinine relate to between 15% and 20% of the workers having B 2 -MG proteinura, and blood cadmium levels less than 5 µg/l relate to more than 10% of the workers having B 2 -MG proteinura. The results suggest that a urinary cadmium concentration of 5 µg/g cr or a blood cadmium concentration of 5 µg/ l would not be a safe level. (J Occup Health 2002; 44: 15-21

Assessing health impacts within environmental impact assessments: An opportunity for public health globally which must not remain missed

Within the member states of the United Nations 190 of 193 have regulated Environmental Impact Assessments (EIA) which is a systematic process to prevent and mitigate the potential environmental impacts of industry development projects before these occur. However, the routine and comprehensive assessment of health impacts within EIAs remains underdeveloped. Focusing, as an example, on the risks to global health from the global shift in the mining industry towards Low and Middle Income Countries LMIC), this viewpoint details why connecting with EIA is an essential task for the health system. Although existing knowledge is out of date in relation to global practice we identify how health has been included, to some extent, in High Income Country EIAs and the institutional requirements for doing so. Using arguments identified by industry themselves about requiring a ‘social license to operate’, we conclude that EIA regulations provide the best current mechanism to ensure health protection is a core aspect in the decision making process to approve projects

What makes health impact assessments successful? Factors contributing to effectiveness in Australia and New Zealand

Background: While many guidelines explain how to conduct Health Impact Assessments (HIAs), less is known about the factors that determine the extent to which HIAs affect health considerations in the decision making process. We investigated which factors are associated with increased or reduced effectiveness of HIAs in changing decisions and in the implementation of policies, programs or projects. This study builds on and tests the Harris and Harris-Roxas' conceptual framework for evaluating HIA effectiveness, which emphasises context, process and output as key domains. Methods: We reviewed 55 HIA reports in Australia and New Zealand from 2005 to 2009 and conducted surveys and interviews for 48 of these HIAs. Eleven detailed case studies were undertaken using document review and stakeholder interviews. Case study participants were selected through purposeful and snowball sampling. The data were analysed by thematic content analysis. Findings were synthesised and mapped against the conceptual framework. A stakeholder forum was utilised to test face validity and practical adequacy of the findings. Results: We found that some features of HIA are essential, such as the stepwise but flexible process, and evidence based approach. Non-essential features that can enhance the impact of HIAs include capacity and experience; 'right person right level'; involvement of decision-makers and communities; and relationships and partnerships. There are contextual factors outside of HIA such as fit with planning and decision making context, broader global context and unanticipated events, and shared values and goals that may influence a HIA. Crosscutting factors include proactive positioning, and time and timeliness. These all operate within complex open systems, involving multiple decision-makers, levels of decision-making, and points of influence. The Harris and Harris-Roxas framework was generally supported. Conclusion: We have confirmed previously identified factors influencing effectiveness of HIA and identified new factors such as proactive positioning. Our findings challenge some presumptions about 'right' timing for HIA and the rationality and linearity of decision-making processes. The influence of right timing on decision making needs to be seen within the context of other factors such as proactive positioning. This research can help HIA practitioners and researchers understand and identify what can be enhanced within the HIA process. Practitioners can adapt the flexible HIA process to accommodate the external contextual factors identified in this report

Health impacts of climate change: Adaptation strategies for Western Australia

It has been demonstrated that the Earth is warming and climatic parameters are changing. In western Australia, the south west has been experiencing rainfall reductions for several decades and other areas across the State have experienced droughts and atypical events. It is now generally accepted that western Australia will experience a climate in the near future that is drier, hotter and has more extreme weather events than it had in the past. The trends in climatic change will impact human populations through their effects on the physical and biological components of the environment. Global efforts are being made to mitigate climate change and reduce greenhouse gas emissions. However it has been accepted that some change will occur and that individuals and communities will need to adapt to these changed environmental circumstances to avoid adverse consequences. Of significance are the potential health impacts on people in western Australia. The severity of possible impacts on communities will be dependent on our ability to adapt to situations and environments that may be quite different from those we have now. The Department of Health and the world Health Organisation Collaborating Centre for Environmental Health Impact Assessment at Curtin University recognised that the Health Impact Assessment process provides an appropriate means by which the potential impacts of climate change in WA can be initially assessed. A Health Impact Assessment of Climate Change Project was undertaken in collaboration with Government and other stakeholders to consider the implications of climate change on the health of the people of western Australia and to develop a range of adaptive responses to provide Government with the basis for future decision making. The Project was undertaken in two phases. Phase One was the identification of the potential health impacts that could arise given a particular set of climatic situations in the future, consideration of our current coping capacity and identification of health related vulnerabilities of people, regions, infrastructure and the economy to specific climatic and environmental events. The second phase entailed a risk assessment of the health impacts on communities including specific reference to vulnerability, and the development of adaptations which could be used to mitigate the identified impacts. It was recognised that the lack of detailed knowledge of future climatic conditions in western Australia, the future distribution and densities of populations and the development of associated infrastructure did not allow for a comprehensive and quantitative assessment of health impacts. what emerged from this project, however, was a good understanding of current activities, their adequacy with respect to health and a range of adaptations and required supporting research. The outcomes have been designed to provide a proactive approach to the protection of the health of communities in Western Australia from any adverse environmental impacts associated with climate change. They form the basis for future planning and decision making by Governments and other relevant sectors and adaptive responses that can be taken up by society in Western Australia

Additional file 1: of What makes health impact assessments successful? Factors contributing to effectiveness in Australia and New Zealand

Effectiveness of HIA studies (DOCX 21 kb

The effectiveness of health impact assessment in influencing decision-making in Australia and New Zealand 2005-2009

Background: Health Impact Assessment (HIA) involves assessing how proposals may alter the determinants of health prior to implementation and recommends changes to enhance positive and mitigate negative impacts. HIAs growing use needs to be supported by a strong evidence base, both to validate the value of its application and to make its application more robust. We have carried out the first systematic empirical study of the influence of HIA on decision-making and implementation of proposals in Australia and New Zealand. This paper focuses on identifying whether and how HIAs changed decision-making and implementation and impacts that participants report following involvement in HIAs. Methods: We used a two-step process first surveying 55 HIAs followed by 11 in-depth case studies. Data gathering methods included questionnaires with follow-up interview, semi-structured interviews and document collation. We carried out deductive and inductive qualitative content analyses of interview transcripts and documents as well as simple descriptive statistics. Results: We found that most HIAs are effective in some way. HIAs are often directly effective in changing, influencing, broadening areas considered and in some cases having immediate impact on decisions. Even when HIAs are reported to have no direct effect on a decision they are often still effective in influencing decision-making processes and the stakeholders involved in them. HIA participants identify changes in relationships, improved understanding of the determinants of health and positive working relationships as major and sustainable impacts of their involvement.Conclusions: This study clearly demonstrates direct and indirect effectiveness of HIA influencing decision making in Australia and New Zealand. We recommend that public health leaders and policy makers should be confident in promoting the use of HIA and investing in building capacity to undertake high quality HIAs. New findings about the value HIA stakeholders put on indirect impacts such as learning and relationship building suggest HIA has a role both as a technical tool that makes predictions of potential impacts of a policy, program or project and as a mechanism for developing relationships with and influencing other sectors. Accordingly when evaluating the effectiveness of HIAs we need to look beyond the direct impacts on decisions