An estimation of the health impact of groundwater pollution caused by dumping of chlorinated solvents

Background

Hazardous waste sites are major environmental concerns, but few studies have quantified their expected utility loss on health.

Objectives

To evaluate the health impact of groundwater pollution by an electronics manufacturing factory, we conducted a health risk assessment based on expected utility loss from liver cancer.

Methods

Based on measurements of major pollutants, we estimated the likelihood of developing liver cancer after exposure to groundwater contamination. All patients with liver cancer between 1990 and 2005 in the Taiwan Cancer Registry were followed through 2007 using the National Mortality Registry to obtain survival function. Quality of life was assessed with two cross-sectional surveys, one employing the standard gamble method, and the other using the EQ-5D instrument. Quality-adjusted life expectancy (QALE) was estimated by multiplying the utility values with survival function under the unit of quality-adjusted life year (QALY). The difference of QALE between the cancer cohort and the age- and gender-matched reference population was calculated to represent the utility loss due to liver cancer.

Results

A total of 94,144 patients with liver cancer were identified. The average utility loss to development of liver cancer was 17.5 QALYs. Based on toxicological approach, we estimated that groundwater pollution caused 1.7 extra cases of liver cancer, with an overall loss of 29.8 QALYs. Based on epidemiological approach, the expected annual excess number of liver cancer would be 3.65, which would have been accumulated through the years, had the pollution not mitigated.

Conclusions

We demonstrated a practical approach for comparative health risk assessment using QALY as the common unit. This approach can be used for policy decisions based on possible health risks.     

Assessment of complex environmental health problems: Framing the structures and structuring the frameworks

Many environmental risks are multi-faceted and their health consequences can be far-ranging in both time and space. It can be a challenging task to develop informed policies for such risks. Integrated environmental health impact assessment aims to support policy by assessing environmental health effects in ways that take into account the complexities and uncertainties involved. For such assessment to be successful, a clear and agreed conceptual framework is needed, which defines the issue under consideration and sets out the principles on which the assessment is based. Conceptual frameworks facilitate involvement of stakeholders, support harmonized discussions, help to make assumptions explicit, and provide a framework for data analysis and interpretation.Various conceptual frameworks have been developed for different purposes, but as yet no clear taxonomy exists. We propose a three-level taxonomy of conceptual frameworks for use in environmental health impact assessment. At the first level of the taxonomy, structural frameworks show the wide context of the issues at hand. At the second level, relational frameworks describe how the assessment variables are causally related. At the third level, this causal structure is translated into an operational model, which serves as a basis for analysis. The different types of frameworks are complementary and all play a role in the assessment process. The taxonomy is illustrated using a hypothetical assessment of urban brownfield development for residential uses.We suggest that a better understanding of types of conceptual frameworks and their potential roles in the different phases of assessment will contribute to more informed assessments and policies.     

Estimated effect of ventilation and filtration on chronic health risks in U.S. offices,schools, and retail stores

We assessed the chronic health risks from inhalation exposure to volatile organic compounds (VOCs) and particulate matter (PM2.5) in U.S. offices, schools, grocery, and other retail stores and evaluated how chronic health risks were affected by changes in ventilation rates and air filtration efficiency. Representative concentrations of VOCs and PM2.5 were obtained from available data. Using a mass balance model, changes in exposure to VOCs and PM2.5 were predicted if ventilation rate were to increase or decrease by a factor of two, and if higher efficiency air filters were used. Indoor concentrations were compared to health guidelines to estimate percentage exceedances. The estimated chronic health risks associated with VOC and PM2.5 exposures in these buildings were low relative to the risks from exposures in homes. Chronic health risks were driven primarily by exposures to PM2.5 that were evaluated using disease incidence of mortality, chronic bronchitis, and non‐fatal stroke. The leading cancer risk factor was exposure to formaldehyde. Using disability‐adjusted life years (DALYs) to account for both cancer and non‐cancer effects, results suggest that increasing ventilation alone is ineffective at reducing chronic health burdens. Other strategies, such as pollutant source control and the use of particle filtration, should also be considered.     

医院中央空调环境污染健康危险度评价方法的研究

以通用的危险度评价方法为基础,结合医院中央空调环境污染物每增高一单位所产生的健康损失,并对环境污染物浓度变化所致的健康影响进行定量评估。提出了医院中央空调环境健康危险度评价流程图,以及估计由医院中央空调环境污染造成的超死亡数或超病例数的计算公式。采用本方法可对我国医院中央空调环境污染改善措施的优先选用和效果作出健康效益的评定。     

Beyond REACH: Roadblocks and shortcuts en route to integrated risk assessment and management of chemicals

This paper addresses obstacles and opportunities for the development and application of novel methods for integrated assessment of cumulative risks from chemicals, exemplified by the REACH legislation of the EU, in the context of multiple stressors and of chemicals policy. We examine the role of such methods in connection with REACH by models of integration and innovation of risk information in multi-actor risk governance; analyses of key documents on REACH; and interviews with EU regulators and stakeholders. We first explain the emergence of REACH as a response to tensions in EU chemicals, environmental and other policies. We then analyze the present configuration of REACH particularly in relation to key dimensions of risk integration: across stressors; exposed organisms; and impacts. Among the policy aspects of integrated risk information, we focus on its interaction with management and the contesting framings and interpretations of assessment. Avenues and barriers are identified for integrated treatment of risks under REACH and with other instruments. We emphasize how bounded, formal and static assessments interact with open and informal approaches that have more flexibility in integrating risks in new ways. We conclude with a generalizing discussion on the role of novel methods of integrated risk assessment in the development of reflexive and participatory governance under REACH and beyond.     

A fuzzy approach to construction project risk assessment

The increasing complexity and dynamism of construction projects have imposed substantial uncertainties and subjectivities in the risk analysis process. Most of the real-world risk analysis problems contain a mixture of quantitative and qualitative data; therefore quantitative risk assessment techniques are inadequate for prioritizing risks. This article presents a risk assessment methodology based on the Fuzzy Sets Theory, which is an effective tool to deal with subjective judgement, and on the Analytic Hierarchy Process (AHP), which is used to structure a large number of risks. The proposed methodology incorporates knowledge and experience acquired from many experts, since they carry out the risks identification and their structuring, and also the subjective judgements of the parameters which are considered to assess the overall risk factor: risk impact, risk probability and risk discrimination. All of these factors are expressed by qualitative scales which are defined by trapezoidal fuzzy numbers to capture the vagueness in the linguistic variables. The most notable differences with other fuzzy risk assessment methods are the use of an algorithm to handle the inconsistencies in the fuzzy preference relation when pair-wise comparison judgements are necessary, and the use of trapezoidal fuzzy numbers until the defuzzification step. An illustrative example on risk assessment of a rehabilitation project of a building is used to demonstrate the proposed methodology.     

Do we all face the same risk when bathing in the estuary?

With the development of coastal areas, microbial water quality is an emerging public health issue though few studies have focused on risks according to age. A survey was undertaken of faecal contamination in relation to recreational activities in the Peel Harvey estuarine system, Western Australia. Levels of exposure to contaminated water were estimated though social surveys. Follow-up was also conducted to estimate the incidence of disease associated with bathing in the estuary. Pathogen levels exceeded the guideline values recommended by the World Health Organisation (WHO) at most locations throughout the year. The social survey provided information about exposure of the population in age groups. Only 31% of the recreational users belonged to the healthy adult group upon which the WHO quantitative microbial risk assessment model is based. A correlation was established between microbial water quality and incidence of respiratory diseases for children as well as for adults. Exposure to recreational water increased the incidence of respiratory illnesses for the whole population almost by a factor 2. Behaviours which resulted in increased exposures were associated with increased incidence of illnesses were observed, particularly among children aged 11-15 yr, who exhibited the highest odd ratio (OR 4.23 [2.44-6.01], CI 95%, p=0.05). There is a need for combining epidemiology studies with risk assessment processes and complementing them with social surveys for understanding the risk of recreational activities to public health.     

Perceptions of drinking water quality and risk and its effect on behaviour: A cross-national study

There is a growing effort to provide drinking water that has the trust of consumers, but the processes underlying the perception of drinking water quality and risks are still not fully understood. This paper intends to explore the factors involved in public perception of the quality and risks of drinking water. This purpose was addressed with a cross-national mixed-method approach, based on quantitative (survey) and qualitative (focus groups) data collected in the UK and Portugal. The data were analysed using several methods, including structural equation models and generalised linear models. Results suggest that perceptions of water quality and risk result from a complex interaction of diverse factors. The estimation of water quality is mostly influenced by satisfaction with organoleptic properties (especially flavour), risk perception, contextual cues, and perceptions of chemicals (lead, chlorine, and hardness). Risk perception is influenced by organoleptics, perceived water chemicals, external information, past health problems, and trust in water suppliers, among other factors. The use of tap and bottled water to drink was relatively well explained by regression analysis. Several cross-national differences were found and the implications are discussed. Suggestions for future research are provided.     

The assessment of human health impact caused by industrial and civil activities in the Pace Valley of Messina

The impact of industrial and civil activities on an agricultural and residential area is presented in a detailed and global analysis. The examined area is the Pace river valley situated in the northern zone of Messina (Italy). The sources of pollution present in the area are: a Municipal Solid Waste Incinerator operating since 1979, a disused urban solid waste landfill which was used for 30 years, an urban solid waste treatment facility with heavy vehicles traffic, and two open pits for the production of bitumen. Large quantities of toxic, carcinogenic substances and criteria pollutants are released into the environment and represent potential hazards to human health. The analysis is performed using the EHHRA-GIS tool which employs an integrated, multimedia, multi-exposure pathways and multi-receptor risk assessment model that is able to manage all the steps which constitute the human health risk analysis in a georeferenced structure. The transport of pollutants in different environmental media is assessed applying models (AERMOD, GMS, CALINE) that take into account the particular three-dimensional morphology of the terrain. The results obtained, combined with a probabilistic risk assessment and a sensitivity analysis of calculation parameters, are a comprehensive assessment of the total human health risk in the area. Finally human health risks caused by toxic and carcinogenic substances are compared with acceptable legal limits in order to support environmental managers' decisions.     

供水管网水质健康风险评价模型及实例

对供水管网系统存在的水质健康风险进行分析,提出了"区域内单化学污染物的健康风险"、"区域叠加风险"和"系统综合风险"这三个评价指标及其计算方法,并在此基础上建立了供水管网水质健康风险评价模型,包括区域划分、数据收集及分析、危害判定、暴露评价、剂量-响应评估、风险表征及风险管理.应用该模型进行实例研究的结果表明,它将供水管网系统的水质与公众的健康风险联系起来,对供水管网系统的健康风险管理有一定的指导意义.     

Infection risk assessment of diarrhea-related pathogens in a tropical canal network

A quantitative microbial risk assessment (QMRA) of Cryptosporidium, Giardia and diarrhegenic Escherichia coli (DEC) infection was performed using Monte Carlo simulations to estimate the human health risks associated with the use of canal water for recreational purposes, unrestricted and restricted irrigation in a tropical peri-urban area. Three canals receiving municipal, agricultural, and, predominantly, industrial wastewater were investigated. Identification of pathogenic protozoans revealed the major presence of Cryptosporidium hominis and both assemblages A and B of Giardia lamblia. The highest individual infection risk estimate was found to be for Giardia in an exposure scenario involving the accidental ingestion of water when swimming during the rainy season, particularly in the most polluted section, downstream of a large wholesale market. The estimated annual risks of diarrheal disease due to infection by the protozoan parasites were up to 120-fold greater than the reported disease incidence in the vicinity of the studied district and the entire Thailand, suggesting a significant host resistance to disease beyond our model's assumptions. In contrast, annual disease risk estimates for DEC were in agreement with actual cases of diarrhea in the study area.     

Are pharmaceuticals potent environmental pollutants? Part I: environmental risk assessments of selected active pharmaceutical ingredients

As part of achieving national environmental goals, the Swedish Government commissioned an official report from the Swedish Medical Products Agency on environmental effects of pharmaceuticals. Considering half-lives/biodegradability, environmental occurrence, and Swedish sales statistics, 27 active pharmaceutical ingredients were selected for environmental hazard and risk assessments. Although there were large data gaps for many of the compounds, nine ingredients were identified as dangerous for the aquatic environment. Only the sex hormones oestradiol and ethinyloestradiol were considered to be associated with possible aquatic environmental risks. We conclude that risk for acute toxic effects in the environment with the current use of active pharmaceutical ingredients is unlikely. Chronic environmental toxic effects, however, cannot be excluded due to lack of chronic ecotoxicity data. Measures to reduce potential environmental impact posed by pharmaceutical products must be based on knowledge on chronic ecotoxic effects of both active pharmaceutical ingredients as well as excipients. We believe that the impact pharmaceuticals have on the environment should be further studied and be given greater attention such that informed assessments of hazards as well as risks can be done.     

Life cycle structural integrity management of offshore structures

An overview of structural integrity management of offshore structures in the oil and gas energy sector is presented in this article. Based on relevant experiences with the hazards, accidents and means to control the associated risks are categorised from a technical and physical as well as human and organisational point of view. Structural risk relates to extreme environmental and accidental events, as well as structural degradation and can be controlled by use of adequate design criteria, inspection, repair and maintenance as well as quality assurance and control of the engineering processes. Such measures are briefly outlined, with an emphasis placed upon a quantitative design approach for dealing with a life cycle approach especially relating to crack degradation phenomena. The current status of risk and reliability methodologies to aid decisions in the safety management of novel and mature offshore structures is briefly reviewed.     

Valuing the subsurface pathogen treatment barrier in water recycling via aquifers for drinking supplies

A quantitative microbial risk assessment (QMRA) was performed at four managed aquifer recharge (MAR) sites (Australia, South Africa, Belgium, Mexico) where reclaimed wastewater and stormwater is recycled via aquifers for drinking water supplies, using the same risk-based approach that is used for public water supplies. For each of the sites, the aquifer treatment barrier was assessed for its log₁₀ removal capacity much like for other water treatment technologies. This information was then integrated into a broader risk assessment to determine the human health burden from the four MAR sites. For the Australian and South African cases, managing the aquifer treatment barrier was found to be critical for the schemes to have low risk. For the Belgian case study, the large treatment trains both in terms of pre- and post-aquifer recharge ensures that the risk is always low. In the Mexico case study, the risk was high due to the lack of pre-treatment and the low residence times of the recharge water in the aquifer. A further sensitivity analysis demonstrated that human health risk can be managed if aquifers are integrated into a treatment train to attenuate pathogens. However, reduction in human health disease burden (as measured in disability adjusted life years, DALYs) varied depending upon the number of pathogens in the recharge source water. The beta-Poisson dose response curve used for translating rotavirus and Cryptosporidium numbers into DALYs coupled with their slow environmental decay rates means poor quality injectant leads to aquifers having reduced value to reduce DALYs. For these systems, like the Mexican case study, longer residence times are required to meet their DALYs guideline for drinking water. Nevertheless the results showed that the risks from pathogens can still be reduced and recharging via an aquifer is safer than discharging directly into surface water bodies.     

公路隧道施工空气污染健康损害评价

为了评估公路隧道施工空气污染对施工人员健康的影响,按照生命周期评价思想和影响路径分析方法,以NO_2、SO_2作为研究对象。结合流行病学和病理学的成果,将NO_2、SO_2的健康损害效应归类,建立公路隧道施工NO_2、SO_2浓度和健康损害定量关系,最后用伤残调整生命年(DALY)表征空气污染对施工人员造成的健康损害。研究发现相同浓度下空气污染物的健康损害能力差别显著,建议优先控制能造成更不利健康损害的空气污染物浓度。将当前关于隧道施工环境的研究范围从单纯的空气质量监测及改善方法拓宽到施工人员健康损害上,对于优化设计和施工方案,推进绿色隧道施工有直接的参考意义。     

Bacterial-based additives for the production of artificial snow: What are the risks to human health?

For around two decades, artificial snow has been used by numerous winter sports resorts to ensure good snow cover at low altitude areas or more generally, to lengthen the skiing season. Biological additives derived from certain bacteria are regularly used to make artificial snow. However, the use of these additives has raised doubts concerning the potential impact on human health and the environment. In this context, the French health authorities have requested the French Agency for Environmental and Occupational Health Safety (Afsset) to assess the health risks resulting from the use of such additives. The health risk assessment was based on a review of the scientific literature, supplemented by professional consultations and expertise. Biological or chemical hazards from additives derived from the ice nucleation active bacterium Pseudomonas syringae were characterised. Potential health hazards to humans were considered in terms of infectious, toxic and allergenic capacities with respect to human populations liable to be exposed and the means of possible exposure. Taking into account these data, a qualitative risk assessment was carried out, according to four exposure scenarios, involving the different populations exposed, and the conditions and routes of exposure. It was concluded that certain health risks can exist for specific categories of professional workers (mainly snowmakers during additive mixing and dilution tank cleaning steps, with risks estimated to be negligible to low if workers comply with safety precautions). P. syringae does not present any pathogenic capacity to humans and that the level of its endotoxins found in artificial snow do not represent a danger beyond that of exposure to P. syringae endotoxins naturally present in snow. However, the risk of possible allergy in some particularly sensitive individuals cannot be excluded. Another important conclusion of this study concerns use of poor microbiological water quality to make artificial snow.     

Nitrates in ground and drinking water: Analysis of policies and regulations

On the societal level, risks are the result of collective processes of definition. Accepted risks are mainly the output and secondarily the (scientific) input of these processes. As a consequence, in this paper the question of risk management of the nitrate burden to ground and drinking water is analysed within the framework of comparative policy analysis. Various actors pursue their respective interests in different policy arenas within the given rules of the policy game. The impacts of the policy outputs on the policy addressees, namely farmers and water companies, (substantially) determine the level of actual risk. Different national regulatory styles and traditions towards nitrate regulation shape the policy outputs. Consequently, the assumption or normative postulate of a ‘rational’ (scientific) risk assessment and risk management appears to be utterly heroic and, in the end, misleading.     

An evaluation of the use of insurance in managing construction risks

One of the major methods of managing construction risks in the Nigerian construction industry is the insurance method. On the basis of data from some selected construction sites in Nigeria, this paper evaluates the effectiveness of the method. Also it identifies, through a questionnaire survey, the various insurable construction risks perceived to be encountered in the Nigerian construction industry and the types of insurance policy employed in managing them. High importance is placed by the construction industry on site security, construction risk, and health and welfare requirements, and the use of an all-risk insurance policy is the most prominent method for managing the identified risks. Finally it is concluded that there is a correlation between insured sum and actual replacement cost when there are losses or damages. However, the insurance claims settled could cater for only 61.1% of the replacement cost of on-going construction works studied.     

In search of determinants for quoted housing rents: Empirical evidence from major German cities

Housing policy made a comeback on the German political agenda. Apartment rental prices increased drastically in most major cities over the last years. Despite wide agreement by policymakers regarding the need for regulation of the housing market, there is close to no empirical evidence on the drivers of rent prices. We follow a comparative, quantitative approach to determine the driving factors of rent prices in German cities, taking economic, societal and political variables into account and using time-series analysis. Our results show that the share of students and the local mean income account for differences in quoted rent prices.     

An LCA-based environmental impact assessment model for construction processes

A quantitative assessment of the environmental impact of construction activities can help decision-makers identify major environmental impact factors and make environmentally friendly construction plans in the early stages of construction. This paper presents an integrated life cycle environmental impact assessment model that is applicable to construction phase studies, where impact factors are examined according to two aspects of a typical construction process: construction equipment and ancillary materials. Environmental impacts are categorized into three safeguard subjects: ecosystems, natural resources and human health. A disability adjusted life year (DALY) model for assessing human health damage due to construction dust is developed. In addition, the environmental impact of earthwork construction is assessed as a case study to demonstrate the application of the proposed model. Results indicate that the proposed model can effectively quantify the environmental impacts of construction processes, and can potentially be used as a tool for contractors to select environmentally friendly construction plans.