Summary
Routine surveillance system collecting information on exposures in the physical environment and comparing, at a temporal and spatial level, with health outcome data to examine potential associations.
Description
Despite wide acceptance of the physical environment as a key determinant of human health, the current trend towards evidence-based public health is less obvious in policy and action on the environment than in other areas. A role for the physical environment is accepted in the causation and exacerbation of many conditions and is hypothesised for many more. Many cancers, much heart disease and aspects of respiratory and mental health are known to have an environmental component within an, often complex causal "cocktail" and, although mechanisms are poorly understood, few doubt the influence of physical environment in conditions such as asthma, adult onset hypersensitivity and some degenerative neurological disorders. The failure of housing (an important component of physical environment) to protect against low outdoor temperature is recognised as an exacerbating factor in excess winter deaths and winter pressures on the health service. Thus both long term (chronic) and short-term (acute) exposures to aspects of the physical environment may have public health significance.
What we propose is the creation of an Environmental Health Surveillance System for Scotland (EHS3). The creation of EHS3 falls conveniently into three stages; Phase 1, an initial "pilot" stage (completed in 1998); Phase 2, an "extended pilot" stage incorporating a detailed evaluation of environmental data, and Phase 3, a final stage during which, subject to fulfilment of appropriate criteria, the project will be rolled out to Scotland as a whole.
EHS3, in its completed form, will be an ongoing multi-agency collaboration involving area NHS boards, NHS Information & Statistics Division, local authorities, the Scottish Environment Protection Agency (SEPA), Water Authorities and other relevant agencies. Its purpose will be to collect, hold and, as appropriate, analyse and interpret environmental and health data throughout Scotland. Much of this data is currently available but is under-utilised. In keeping with the principles of surveillance, data gathering will be ongoing and regular outputs will be agreed which will inform policy and action to promote improved environmental standards and public health. With appropriate development, the system will also have potential as a predictive tool for managing environmentally occasioned (including weather-related) fluctuations in demand for NHS services. A further important characteristic of EHS3 will be its dynamic character with an ability to change emphasis and enhance outputs in response to circumstances as they emerge.
Thus EHS3 will provide information for action.
EHS3 Contacts
Last reviewed: 19 October 2009