Suchergebnisse

Work package 6 (WP6) of the Moniter Project is mainly intended to outline HIA model Guidelines to be applied to the Waste Incinerating Plant or future combustion plant projects. In particular, Action 1, within the framework of WP6, is mainly designed to describe a methodology for the definition of an HIA model1 specifically developed for the implementation of a "Health Impact Assessment of the solid municipal waste incinerating plant on the population living in its surroundings". A retrospective impact assessment (application of a retrospective Rapid HIA) allows to collect the available knowledge through a literature review, focusing on the issue of waste incineration, and the consultation of local key information providers. This first application se is intended to define the guidelines, the main thematic areas and the objectives to be pursued. Then the rapid simultaneous (or cross-cutting) application, involving Moniter WP collaborators, the institutional individuals and groups, benefits from the monitoring experience made in the Emilia-Romagna region and analyses the social and political context. In this case the concrete health improvement opportunities in the area under study and the guidelines for the description of HIA procedure in the area are taken into account. The general knowledge that has been gathered is at the basis of recommendations and guidelines for the prospective application to be developed in the future.

Il presente rapporto descrivere la metodologia seguita e i risultati ottenuti dall'Azione 1 della linea Progettuale 6 del Progetto Moniter nell'intento di definire un modello di VIS1 per la "Valutazione degli impatti sanitari di un impianto di incenerimento di rifiuti solidi urbani sulla popolazione che risiede in un'area circostante". Lo stato attuale delle conoscenze sulla procedura di VIS e sul suo uso, evidenzia da una parte una carenza di Linee Guida per la selezione del metodo di VIS pi? adatto (per vari settori tematici e per applicazioni sia a progetti che a politiche) e dall'altra la necessit? di revisioni sistematiche delle evidenze prodotte in valutazioni concluse (Dannenberg, et al., 2006). L'Azione 1 ha una connotazione di ricerca innovativa volta alla selezione di un metodo di VIS migliore per lo specifico oggetto del progetto Moniter, e allo stesso tempo si basa su una revisione di evidenze gi? disponibili (provenienti da studi epidemiologici o da rassegne di studi) e su conoscenze specifiche in merito a sorveglianza e monitoraggio prodotte dalle Linee Progettuali (LP) di Moniter. Alla luce dell'esperienza maturata durante la realizzazione delle attivit? dell'Azione 1 e degli utili confronti con i vari collaboratori del progetto ? utile esplicitare la seguente considerazione sulle applicazioni di VIS realizzate dalla Azione 1.

, ; Una certa permeabilit? ai concetti di base della VIS si osserva, di recente, negli ambiti che si occupano di salute pubblica. Il diffondersi di conoscenze di base su principi e fondamenti della VIS ? di fatto legato ad una proposta in atto di istituzionalizzare atteggiamenti, finora autonomi e volontari, volti a tutelare e promuovere la salute pubblica e delle comunit?. In tema di valutazione di impatti ambientali e sanitari le norme europee e nazionali indirizzano, con crescente enfasi, alla inclusione di temi socio-sanitari nella predisposizione di politiche, piani e programmi nell'ottica di non trascurare la valutazione di possibili impatti che questi possono avere sul benessere delle popolazioni. A tale proposito, facilmente prevedibile ? l'integrazione della valutazione sanitaria come elemento di buone pratiche nell'ambito della Valutazione Ambientale Strategica(Dir.2001/42/CE) che attraverso il Rapporto Ambientale deve consentire la caratterizzazione dei rischi per la salute umana secondo una congruente base di evidenze (Protocollo VAS, Kiev, 2003). Una opportuna formazione a riguardo della VIS va quindi conseguita come base per la possibilit? di impiego reale come strumento di valutazione delle politiche non-sanitarie di futura realizzazione. In Italia un certo fermento si osserva su questo aspetto. Azioni concrete esemplari sono, per?, attualmente disponibili soprattutto in contesto sovranazionale. Sono ancora poche in Italia le esperienze che, a rigore, possono essere individuate come processi di VIS piuttosto che come attivit? per la tutela o promozione della salute. L'Agenda 21 nazionale promuove la VIS nell'ottica dello sviluppo sostenibile per creare dei percorsi di condivisione della programmazione territoriale e ponendosi come obiettivo lo sviluppo di strumenti adattatati all'ambito locale.

The Emilia-Romagna regional government decided to develop a monitoring and surveillance system, known as MonITER (Incineration Monitoring on the Emilia-Romagna Territory), in 8 areas characterized by the presence of municipal waste incinerating plants.The project was divided into 7 lines, among these the number 6 developed a procedure of Health Impact Assessments (HIA) to support the planning of new facilities for incineration or combustion. Line number 6 is divided into 3 actions action 1 aimed to developing and validating a participative HIA methodology, as well tools for the impact assessment and recommendations for implementing HIA on future plants; action 2 analysed connected issues on communication; action 3 was focused to developing a methodology for integrating HIA models into existing tools for mandatory impact assessment.Tailoring the HIA model development to the waste management context has highlighted the fundamental differences of the HIA approach with the other mandatory assessment tools, being theoretically founded on the principles of public involvement, equity, sustainable development and ethical use of evidence. ; Il Progetto Moniter della Regione Emilia-Romagna (delibera 466/2007) ha realizzato un sistema di sorveglianza ambientale e di valutazione epidemiologica nelle aree circostanti gli otto inceneritori di rifiuti urbani della regione. Il progetto ? articolato in sette linee progettuali (LP). La LP6 ha elaborato un percorso di Valutazione di impatto sulla salute (VIS) applicabile alla pianificazione di impianti di incenerimento o combustione di futura realizzazione. Essa si articola in 3 azioni: l'azione 1 ha condotto una specifica ricerca di materiali e metodi finalizzata alla stesura e validazione di una procedura di VIS partecipativa, degli strumenti di supporto al processo di valutazione e delle raccomandazioni per l'applicazione della VIS a futuri impianti; l'azione 2 ha approfondito l'analisi della comunicazione; l'azione 3 si ? occupata dell'elaborazione di modelli per l'integrazione della VIS nelle altre forme di valutazione esistenti nel territorio. Analizzando il tema dei rifiuti ? emerso con forza che la novit? della VIS rispetto alle altre valutazioni normate risiede nell'applicazione dei valori di fondo che la ispirano: partecipazione pubblica, equit?, sviluppo sostenibile e uso etico delle prove scientifiche.

Context Italy today has a number of shortcomings either in regulatory and legislative recommendations about HIA. In addition, the health component is often disregarded or treated poorly in Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) studies. The current situation prompted some regional and national institutions to collaborate for the submission of a project proposal to the Ministry of Health. The project is addressed to define HIA guidelines and disseminate them, together with specially developed HIA tools, all over the nation and among professionals and public officers. The overall aim is the inclusion of the public health assessment in Environmental Impact Studies (EIS). Methods At first, workshop sessions will provide basic knowledge and skills to manage with the Rapid-HIA tools developed by another Italian HIA project (titled "VISPA"). Then, real cases will be run in workgroups and distance-learning will improve training over 3-year. After, the first Italian online platform for professionals and experts on HIA will be provided and will include a computer-based Rapid-HIA tool, the mapping of HIAs georeferred and utilities for experts. At last HIA Guidelines will be issued. A deliberative process will validate a general Guideline and a more specific one, addressed to create a public health component into EIS. Results Public health professionals as well as applicants for EIS and stakeholders will be trained. The homogeneity of HIA tools for public health evaluation will be achieved as well as the mapping of HIAs at a wide scale. A platform, strongly web 2.0 oriented, will strengthen the networks of experts and the capacity building process. Discussion The Guidelines will be the first Italian super-regional, shared, tool that will introduce HIA in evaluations and proposals. In addition, the standardization and qualification of public health professionals' evaluations as well as of impact studies by proponents will be satisfied

Context Italy today has a number of shortcomings either in regulatory and legislative recommendations about HIA. In addition, the health component is often disregarded or treated poorly in Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) studies. The current situation prompted some regional and national institutions to collaborate for the submission of a project proposal to the Ministry of Health. The project is addressed to define HIA guidelines and disseminate them, together with specially developed HIA tools, all over the nation and among professionals and public officers. The overall aim is the inclusion of the public health assessment in Environmental Impact Studies (EIS). Methods At first, workshop sessions will provide basic knowledge and skills to manage with the Rapid-HIA tools developed by another Italian HIA project (titled "VISPA"). Then, real cases will be run in workgroups and distance-learning will improve training over 3-year. After, the first Italian online platform for professionals and experts on HIA will be provided and will include a computer-based Rapid-HIA tool, the mapping of HIAs georeferred and utilities for experts. At last HIA Guidelines will be issued. A deliberative process will validate a general Guideline and a more specific one, addressed to create a public health component into EIS. Results Public health professionals as well as applicants for EIS and stakeholders will be trained. The homogeneity of HIA tools for public health evaluation will be achieved as well as the mapping of HIAs at a wide scale. A platform, strongly web 2.0 oriented, will strengthen the networks of experts and the capacity building process. Discussion The Guidelines will be the first Italian super-regional, shared, tool that will introduce HIA in evaluations and proposals. In addition, the standardization and qualification of public health professionals' evaluations as well as of impact studies by proponents will be satisfied.

Context Arezzo Municipal solid waste (MSW) incinerator burns about 40 thousand tons of MSW/year, but expansion is expected up to 80 . The incinerator is in an industrial area, where population denounced high pollution levels and requested a health survey. This HIA project, funded by the EU Life+ Program, is developed since 2011 by Arezzo Local Health Unit, Arezzo Municipality, CNR, other research agencies. Methods The project aims to integrate HIA with Local Agenda 21 (LA21) for the evaluation of the existing and future impacts, as well as for planning future policy on waste. Main steps to be developed are: .Meetings with population, organised by LA21/forum and HIA/Working Group (WG) to identify the environmental, health and socio-economic impacts of the plant. .HIA/WG scoping on the basis of the defined indicators, gathering pre-existing data and new environmental and socio-economic data. .Evaluating and quantifying impacts by a continuous cooperation between HIA/WG and LA21/forum. .HIA/WG drafting recommendations, including criticism by LA21/forum, for the proper management of the plant and of the whole local waste cycle. .LA21/forum and HIA/WG meeting quarterly to develop measures to monitor impacts and interventions taken. Results The project is ongoing; however, the choice made by the administrators of involving population and creating real participation tools for the evaluation of effects due to the incinerator proved successful. In particular, the confidence of citizens in local institutions has grown and standing decisions, regarding the plant, has been postponed to the end of the project. Discussion Evaluating tools in the waste sector have some shortcomings, providing a quantification of impacts without the public participation. Currently participation is the utmost desired component into highly controversial policy areas. The project has the ambition of spreading a participated assessment methodology and creates an international network to disseminate findings.

Il presente Working Paper contiene il rapporto di ricerca dell'indagine Policy Delphi realizzata per contribuire alla definizione di un modello di Valutazione di Impatto Sanitario(VIS). L'esigenza di condurre questa indagine è nata per validare i contenuti teorici e metodologici della VIS proposta nell'ambito del Progetto Moniter, monitoraggio degli inceneritori nel territorio dell´Emilia-Romagna, promosso da Regione Emilia-Romagna (RER) e Agenzia per l'Ambiente regionale (con delibera 536 del 21.04.2008 della Giunta regionale). Il progetto Moniter ha l'obiettivo di "organizzare un sistema di sorveglianza ambientale e valutazione epidemiologica nelle aree circostanti gli impianti di incenerimento in Emilia- Romagna", di sistematizzare cioè le conoscenze esistenti, di uniformare le metodologie di monitoraggio ambientale degli impianti di incenerimento rifiuti, di acquisire nuove conoscenze relative alle caratteristiche qualitative e quantitative degli inquinanti emessi dagli impianti e presenti in ambiente e, soprattutto, di integrare le conoscenze ambientali con quelle epidemiologiche e sanitarie. Quest´ultimo aspetto, che rende il progetto Moniter un´attività sperimentale innovativa in Italia, si realizza attraverso la definizione di criteri per la realizzazione della Valutazione di Impatto Sanitario di impianti di combustione. L'Assessorato Politiche per la Salute della RER ha affidato tale compito all'unità operativa di Epidemiologia Ambientale del CNR di Pisa, afferente all'Istituto di Fisiologia Clinica (IFC). La particolare applicazione del metodo Policy Delphi, realizzata per la costruzione del modello di VIS da Antonio Tintori e Pietro Demurtas con la supervisione scientifica di Adriana Valente e Loredana Cerbara dell'IRPPS in collaborazione con l'IFC, ha garantito un approccio multidisciplinare alla complessità dell'obiettivo decisionale, e dimostra come una metodologia ideata per la ricerca sociale possa rivelarsi efficace nell'analisi di fenomeni afferenti a molteplici ambiti disciplinari. Tutti i documenti riferiti al progetto Moniter sono consultabili al sito internet: http://www.arpa.emr.it/moniter

Since 2007 the Emilia-Romagna Region has been implementing the MONITER Project aimed at defining an environment epidemiological surveillance and evaluation system in the areas where municipal incinerators are located. In this context, the Emilia-Romagna Region launched a Project Line to promote the adoption of Health Impact Assessment (HIA) as a tool to include the evaluation of environmental health issues during the planning process. Experience and knowledge gained on HIA resulted in an enrichment of local cultural, political and administrative context. This process has been proposed to public bodies so that they can include HIA in urban planning, including a specific focus on stakeholder involvement.

Abstract To identify and analyze the contents of scientific literature on Health Impact Assessment in relation to the environment. An integrative literature review carried out by searching for studies in the Periodicals Portal of the Coordination for the Improvement of Higher Education Personnel. A total of 38 studies were included; the period with the greatest number of publications was between 2012 and 2014, with studies developed mainly in Europe and North America. The categories that emerged were Health Impact Assessment practice; Health Impact Assessment and Urban Planning; Environmental Impact Assessment and Health Impact Assessment; and Environment and Health. There is a movement for the integration of Health Impact Assessment into Environmental Impact Assessment and the consequent institutionalization of that integration since Environmental Impact Assessment already has a consolidated legal base.

The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessmentwith special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals.