1 April 2015

Opportunity: Recruitment for Health Impact Assessment Consultant

Go to ADB site by clicking here.

If you have any questions, Dr Susann Roth is the contact (sroth@adb.org)

Scope of Work
The consultant will have three main tasks: 
1. Strengthen ADB’s HIA tools, applications, and project screening, 
2. Strengthen and support the policy dialogue on HIA in the Greater Mekong Sub-region (GMS), 
3. Work with infrastructure projects (ADB and private sector) to develop 
in collaboration with Civil Society Organizations (CSOs) malaria screening and treatment activities linked to workers and communities 
involved in infrastructure projects.

Detailed Tasks and/or Expected Output
The consultant will develop and implement an HIA tool for ADB’s infrastructure projects and for developing member countries to apply for non-ADB-financed infrastructure projects. The consultant’s tasks will include the following:
• Finalizing ADB working paper on HIA and developing HIA assessment tools for ADB;
• Working closely with Operational Departments specifically in the transport and energy sector groups.
• Developing screening method for projects which need HIA and developing database for ADB projects;
• Developing training material for ADB staff on HIA;
• Discussing possible projects which benefit from HIA with ADB team leaders and propose actions;
• Conducting desk review and stakeholder consultations, including with private sector, on existing HIA tools in GMS countries;
• Conducting in-country consultation workshops with stakeholders on HIA policies and implementations and need to strengthen those;
• Identifying collaboration partners in each country;
• Determining feasibility and develop an HIA tool for use by local governments and private companies to reduce transmission risks for 
communicable diseases;
• Working with local governments to apply the HIA tool in at least four ADB/and or private sector infrastructure projects in areas with 
high risks of malaria; 
• Sharing lessons from implementing the HIA tool with stakeholders;
• Collaborating closely with national malaria programs and Mahidol Oxford Research Unit on identifying geographic malaria hot spots;
• Collaborating with various regional stakeholders such as PSI, WHO, Myanmar Business Coalition on Aid; and
• Leading the preparation and conduct of GMS regional workshop on HIA with government, development partners and private sector.

• A finalized working paper on HIA at ADB
• Finalized guidelines for HIA for ADB projects
• Regular discussions with team leaders including commenting on ADB projects which need HIA
• Conduct of regional workshop on HIA with government, development partners, private sector (material, agenda etc.)
• Presentation material on HIA
• HIA assessment of 4 ADB projects
• Action Plan on HIA recommendation for 4 projects
• Identification of suitable CSOs to implement action plan (related to malaria prevention and treatment of workers)

Minimum Qualification Requirements
Educational Background
Degree in public health, medical science, medicine, occupational health or related fields. Additional training in health impact assessment is a must.

Professional Background
10 years of experience in public health and health impact assessment. Experience working in Southeast Asia (Cambodia, Lao PDR, Myanmar, Viet Nam, Thailand). Experience working with private sector on hIA of infrastructure projects. Experience in policy dialogue with  Governments on HIA.

Minimum General Experience 15 Years
Minimum Specific Experience  (relevant to assignment) 10 Years
Regional/Country Experience Desired

31 March 2015

Mercury puts Arctic kids at risk

There is a long standing debate about the benefits of eating fish particularly for pregnant women and unborn children because of high levels of mercury in fish.
A recently published study shows how high intake of mercury is damaging brain development Inuit children in the Arctic Quebec, Canada. Children’s IQ level was found to be low and linked to the intake of contaminated marine animals e.g. beluga whale, seal, walrus and fish.
Pregnant women in the Arctic have been urged to eat a lot more Arctic Char then eating the beluga whale as the Arctic char is currently considered to be less contaminated.
The high exposure of mercury not only affects children’s IQ it can also have other health problems such as attention disorders, motor skills, heart rate, respiratory problem and ear infections.

Jacobson JL, Muckle G, Ayotte P, Dewailly É, Jacobson SW. Relation of Prenatal Methylmercury Exposure from Environmental Sources to Childhood IQ. Environ Health Perspect; http://dx.doi.org/10.1289/ehp.1408554. Advance Publication: 10 March 2015
Although prenatal methylmercury exposure has been linked to poorer intellectual function in several studies, data from two major prospective, longitudinal studies yielded contradictory results. Associations with cognitive deficits were reported in a Faroe Islands cohort, but few were found in a study in the Seychelles Islands. It has been suggested that co-exposure to another contaminant, polychlorinated biphenyls (PCBs), may be responsible for the positive findings in the former study and that co-exposure to nutrients in methylmercury-contaminated fish may have obscured and/or protected against adverse effects in the latter.
To determine the degree to which co-exposure to PCBs may account for the adverse effects of methylmercury and the degree to which co-exposure to docosahexaenoic acid (DHA) may obscure these effects in a sample of Inuit children in Arctic Québec.
IQ was estimated in 282 school-age children from whom umbilical cord blood samples had been obtained and analyzed for mercury and other environmental exposures.
Prenatal mercury was related to poorer estimated IQ after adjustment for potential confounding variables. The entry of DHA into the model significantly strengthened the association with mercury, supporting the hypothesis that beneficial effects from DHA intake can obscure adverse effects of mercury exposure. Children with cord mercury ≥ 7.5 μg/L were four times as likely to have an IQ score below 80, the clinical cut-off for borderline intellectual disability. Co-exposure to PCBs did not alter the association of mercury with IQ.
To our knowledge, this is the first study to document an association of prenatal mercury exposure with poorer performance on a school-age assessment of IQ, a measure whose relevance for occupational success in adulthood is well established. This association was seen at levels in the range within which many U.S. children of Asian American background are exposed.

Full Article:  click here

5 March 2015

Trading away Health: Reflections on an HIA of a trade agreement”

Guest post by Fiona Haigh:
The HIA team at CHETRE has been working with a group of Australian academics and non-government organisations to carry out a health impact assessment (HIA) on the Trans Pacific Partnership Agreement (TPP) negotiations. The report has attracted a lot of attention and in general has been a different experience from the typical HIAs that we are involved in. We thought it would be interesting to share with the HIA community a few reflections on our experience.
We weren’t commissioned to do this HIA- a small group of us thought it would be a good and interesting thing to do and we somehow managed with some support from CHETRE and the Public Health Association of Australia keep it going. The support from CHETRE enabled us to bring in Katie Hirono to do a lot of the work on it and we were supported by a group of experts and advocacy groups who contributed their expertise and advice. There were some technical challenges to do with trying to do an HIA on something that is being kept secret. We had to base our assessment on leaked documents on wikileaks and advice from academics working in the area and policy experts. We also faced the challenge of trying to predict likely future public health policies that could be impacted on by the trade agreement (since it won’t affect current policies). We approached this by working with policy experts to identify likely future public health policies in our scoped areas of focus that would be impacted on by the TPP.
We also walked the talk of taking a participatory approach, which meant sharing power with the technical advisory group and the advocacy groups that we worked with throughout the process. We feel that this has worked really well- it meant that we focused on issues they identified as important and we have produced a report that they have been able to immediately use for their advocacy. Without them I’m pretty sure this report would not be having the impact it has had so far. The report is being talked about on the front pages of major newspapers, there have been multiple radio interviews, a social media campaign led by CHOICE (the main consumer advocacy group in Australia), lots of tweets and perhaps most satisfying of all we’ve been labeled scaremongers in a press release from the minister for trade and investment - we must be doing something right!

3 March 2015

Health Impact Assessment of the Proposed Trans-Pacific Partnership Agreement

An HIA of the Trans-Pacific Partnership Agreement (TPP) has just been released, authored by Katie Hirono, Fiona Haigh, Deborah Gleeson, Patrick Harris and Anne Marie Thow.

From the media release:

Report finds medicine affordability, public health policies at risk in Trans Pacific Partnership
A report released today by a large team of academics and non-government health organisations reveals that the Trans-Pacific Partnership Agreement (TPP) poses risks to the health of Australians in areas such as provision of affordable medicines, tobacco and alcohol policies and nutrition labelling. Many public health organisations have been tracking the progress of the TPP negotiations over the past several years and have expressed concerns about the potential impacts and lack of transparency. 
“The TPP includes provisions that don’t just affect trade. They affect the way the Government regulates public health,” said Michael Moore, Chief Executive Officer (CEO) of the Public Health Association of Australia (PHAA). “In many areas – such as nutrition labelling - it’s already a struggle to implement effective policies that promote health. If certain provisions are adopted in the TPP, this will be another hurdle for organisations seeking positive public health outcomes.”
The report also argues that: “The TPP risks increasing the cost of the Pharmaceutical Benefits Scheme (PBS), which is likely to flow on to the Australian public in terms of increased co-payments (out-of-pocket expenses) for medicines”. An increase in co-payments risks declining public health and increasing hospitalisations, particularly for people who are already disadvantaged.
A team of researchers from UNSW Australia, Sydney University and La Trobe University conducted the health impact assessment based on leaked documents from the trade negotiations.
“In the absence of publicly available current drafts of the trade agreement, it is difficult to predict what the impacts of the TPP will be,” said Dr Deborah Gleeson, one of the report’s authors. “In the study, we traced the potential impacts based on proposals that have been - or are being - discussed in the negotiations. But the only way to properly assess the risks is to allow a comprehensive health impact assessment to be conducted on the final agreement before it gets signed by Cabinet.”
The report offers a set of recommendations to the Department of Foreign Affairs and Trade to reduce the likelihood that the TPP will negatively impact health in Australia. Such recommendations include excluding an investor-state dispute settlement (ISDS) mechanism, and including strong wording to ensure that public health takes priority where there is a conflict with trade concerns. The report also recommends that Government change its approach to conducting trade agreements, for example by publishing draft texts and negotiating positions on issues of public interest.
Trade negotiators are meeting next week in Hawaii. The Minister for Trade and Investment, Andrew Robb, has said he anticipates the negotiations will wrap up within the next few months.
“It’s vitally important that health is given high priority in the final stages of the negotiations,” said Lynn Kemp, Director, Centre for Health Equity Training, Research and Evaluation. “We urge the Australian Government to consider these issues seriously.”
The HIA report can be accessed here.

11 February 2015

Health impact assessment of a roundabout?

I've done health impact assessments on all types of proposals. The smallest was of a specific health facility. The biggest was of a population plan for several hundred thousand people. 

This is the first time I've seen an HIA of a roundabout though. The process scales to any size!

27 January 2015

UK Committee calls for halt on fracking in the UK

The Environmental Audit Committee of the UK Parliament published a report today in which it called for a moratorium on fracking until the climate and environmental health impacts had been investigated further.
The report is a summary of the statements made, and responses to questions, by a range of stakeholders and the conclusions that the Committee reached on the basis of those statements and answers. It is a useful summary of the key issues in relation to the environmental and  health impacts and what key stakeholders considered the risks and dangers are; or are not. It is not a scientific review of the evidence.
The committee re-affirms the importance of key mitigation measures that have been identified in a number of other fracking reports and papers. Two key ones are monitoring health impacts across the lifecycle including post closure and being open about the chemicals used.
Despite the assurances from some that environmental risks can be safely accommodated by  existing regulatory systems, an extensive range of uncertainties remains over particular  hazards — to groundwater quality and water supplies,  from waste an d air emissions , to our  health and  to  biodiversity,  to the  geological integrity of the areas involved, and  from  noise  and disruption.  Uncertainty about their significance is in part a reflection of the fact that fracking operations have yet to move beyond the exploratory stage in the UK. It is imperative that the environment is protected from potentially irreversible damage.
Fracking must be prohibited outright in protected and nationally important areas.
Full containment of methane must be mandated.
Fracking should be prohibited in all  water source protection zones.

12 January 2015

UQ - Mining and resettlement research initiative

Mining for the Common Good

As a multi-party, industry-University research collaboration on mining and resettlement, ComRel will build knowledge for practical application. This initiative is the first of its kind.

The aim is to:

  •  improve understanding of how mining and resettlement risks are being managed by the industry.
  • identify strategies for improving outcomes for people affected by mining and resettlement.
  • conduct applied research that informs future policy and practice.
  •  contribute to debates about social due diligence and the development of social safeguards.    
For full article: click here

8 January 2015

Health impact assessment of traffic noise in Madrid, Spain

Environmental Research Volume 137, February 2015, Pages 136–140

  • The results obtained tend to question the WHO health protection threshold values. 
  • This study highlights the importance of traffic noise to the health in large cities. 
  • These results serve to highlight the need to implement noise-abatement measures.


The relationship between environmental noise and health has been examined in depth. In view of the sheer number of persons exposed, attention should be focused on road traffic noise.

The city of Madrid (Spain) is a densely populated metropolitan area in which 80% of all environmental noise exposure is attributed to traffic.

The aim of this study was to quantify avoidable deaths resulting from reducing the impact of equivalent diurnal noise levels (LeqD) on daily cardiovascular and respiratory mortality among people aged ≥65 years in Madrid.

A health impact assessment of (average 24 h) LeqD and PM2.5 levels was conducted by using previously reported risk estimates of mortality rates for the period 2003–2005: 

For cardiovascular causes: LeqD 1.048 (1.005, 1.092) and PM2.5 1.041(1.020, 1.062) 

For respiratory causes: LeqD 1.060 (1.000, 1.123) and PM2.5 1.030 (1.000, 1.062).

The association found between LeqD exposure and mortality for both causes suggests an important health effect. A reduction of 1 dB(A) in LeqD implies an avoidable annual mortality of 284 (31, 523) cardiovascular- and 184 (0, 190) respiratory-related deaths in the study population.

The magnitude of the health impact is similar to reducing average PM2.5levels by 10 µg/m3. Regardless of air pollution, exposure to traffic noise should be considered an important environmental factor having a significant impact on health.

Paywall: For full article click here

7 January 2015

Health Impact Assessment Practice and Potential for Integration within Environmental Impact and Strategic Environmental Assessments in Italy

Int. J. Environ. Res. Public Health 2014, 11

ABSTRACT Avoiding or minimizing potential environmental impact is the driving idea behind protecting a population’s health via Environmental Impact Assessments (EIAs) and Strategic Environmental Assessments (SEAs). However, both are often carried out without any systematic approach. This paper describes the findings of a review of HIA, EIA and SEA experiences carried out by the authors, who act as institutional competent subjects at he national and regional levels in Italy. The analysis of how health is tackled in EIA and SEA procedures could support the definition of a protocol for the integration of HIA with EIA and SEA. Although EIA and SEA approaches include the aim of protecting health, significant technical and methodological gaps are present when assessing health systematically, and their basic principles regarding assessment are unsatisfactory for promoting and addressing healthcare concepts stated by the WHO. HIA is still poorly integrated into the decision-making process, screening and monitoring phases are only occasionally implemented, and operational details are not well-defined. The collaborative approach of institutions involved in environment and health is a core element in a systematic advancement toward supporting effective decisions and effective protection of the environment and health. At the Italian national level, the definition of guidelines and tools for HIA, also in relation with EIA and SEA, is of great interest 


For full article click here