2023-12-28 06:58:33
According to the World Health Organization, environmental health includes those aspects of human health, including quality of life, determined by the physical, chemical, biological, social, psychosocial and aesthetic factors of our environment.
In Europe, environmental factors – which might be avoided – cause 1.4 million deaths per year, or 15% of deaths. In France, air pollution is responsible for 48,000 deaths per year and generates health costs of between €500 million and €1.9 billion per year.
Faced with the health and societal issues linked to environmental health, the General Inspectorate of Social Affairs wanted to learn lessons from nearly thirty reports that it produced alone or with other general inspections between 2013 and 2022. His latest publication takes stock.
There is no doubt that this so-called “capitalization” report will provide a number of elements for reflection and an important contribution to all the stakeholders concerned to reduce (as the report underlines) the exposure of populations:
- to pathogens present in the environment and responsible for infectious diseases
- to toxic substances introduced into the domestic or professional environment, food or consumer products (e.g. pesticides, lead, asbestos, etc.) which can be responsible for serious or even fatal pathologies: cancers, poisoning such as lead poisoning, diseases induced such as asthma, respiratory and cardiovascular pathologies, etc. Exposure, even in utero, to certain chemicals, particularly endocrine disruptors, can promote or induce the onset of chronic pathologies and be the cause of congenital malformations;
- to physical risks, such as noise which can be responsible for auditory (deafness, tinnitus, etc.) and extra-auditory (sleep disorders, cardiovascular pathologies, etc.) effects or even electromagnetic waves
For the authors of this report, public policy in environmental health is difficult to understand in its entirety: in question, the multitude of environmental risk factors (pollution of ambient and indoor air, noise, asbestos, endocrine disruptors, quality of water, etc.) relating to numerous areas of public action (housing, town planning, agriculture, etc.)
Recurring observations:
- Planning tools, such as the national environmental health plan (PNSE), suffer from a lack of ambition and resources;
- Interministerial coordination struggles to achieve collective ambition;
- The European procedure for authorizing chemical products has many shortcomings, because it is still too largely dependent on the information provided by companies that promote associated technologies and does not allow the cumulative effects of substances to be properly taken into account (“cocktail effects” ) ;
- The many sources of uncertainty in assessing risks and proving causality can limit public action.
Beyond the findings…what recommendations to better structure environmental health policy and adapt it to health and societal issues?
- Establish a national strategy which sets multi-annual objectives and ensures articulation with European regulations, in connection with the numerous policies concerned;
- Structuring the PNSE (The national environmental health plan) and make it more operational in order to implement this national strategy;
- Renovate governance around an interministerial structure dedicated to steering, which might be the general secretariat for ecological planning;
- Deploy initiatives to better inform populations regarding risks and integrate them into decision-making processes;
- Develop, at European level, risk assessment methods and strengthen the means of health agencies to characterize the exposome (2) and improve, in particular, the consideration of combined effects and multiple exposures;
- Clarify the skills between State services and operators, on the one hand, and with communities, on the other hand, for the different components of environmental health.
- Finally, environmental health must be fully integrated into global health approaches (such as “One Health”) and ecological planning.
(1) For more information:2022-070r.pdf (igas.gouv.fr)
Also read: A decade of IGAS work
(2) The concept of exposome designates the accumulation of exposures to environmental factors that an organism undergoes, from its conception to its end of life, including development in utero, complementing the effect of the genome.
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