Environmental risks in the developing world: exposure indicators for evaluating interventions, programmes, and policies
Open Access
- 1 January 2005
- journal article
- review article
- Published by BMJ in Journal of Epidemiology and Community Health
- Vol. 59 (1) , 15-22
- https://doi.org/10.1136/jech.2003.019471
Abstract
Background: Monitoring and empirical evaluation are essential components of evidence based public health policies and programmes. Consequently, there is a growing interest in monitoring of, and indicators for, major environmental health risks, particularly in the developing world. Current large scale data collection efforts are generally disconnected from micro-scale studies in health sciences, which in turn have insufficiently investigated the behavioural and socioeconomic factors that influence exposure. Study design: A basic framework is proposed for development of indicators of exposure to environmental health risks that would facilitate the (a) assessment of the health effects of risk factors, (b) design and evaluation of interventions and programmes to deliver the interventions, and (c) appraisal and quantification of inequalities in health effects of risk factors, and benefits of intervention programmes and policies. Specific emphasis is put on the features of environmental risks that should guide the choice of indicators, in particular the interactions of technology, the environment, and human behaviour in determining exposure. The indicators are divided into four categories: (a) access and infrastructure, (b) technology, (c) agents and vectors, and (d) behaviour. The study used water and sanitation, indoor air pollution from solid fuels, urban ambient air pollution, and malaria as illustrative examples for this framework. Conclusions: Organised and systematic indicator selection and monitoring can provide an evidence base for design and implementation of more effective and equitable technological interventions, delivery programmes, and policies for environmental health risks in resource poor settings.Keywords
This publication has 40 references indexed in Scilit:
- Effect of washing hands with soap on diarrhoea risk in the community: a systematic reviewThe Lancet Infectious Diseases, 2003
- Comparative quantification of health risks: Conceptual framework and methodological issuesPopulation Health Metrics, 2003
- Daily average exposures to respirable particulate matter from combustion of biomass fuels in rural households of southern India.Environmental Health Perspectives, 2002
- Association between mortality and indicators of traffic-related air pollution in the Netherlands: a cohort studyPublished by Elsevier ,2002
- Introducing insecticide-treated nets in the Kilombero Valley, Tanzania: the relevance of local knowledge and practice for an Information, Education and Communication (IEC) campaignTropical Medicine & International Health, 2001
- Particle concentrations in urban microenvironments.Environmental Health Perspectives, 2000
- Effect of fly control on trachoma and diar rhoeaThe Lancet, 1999
- Intersalt revisited: further analyses of 24 hour sodium excretion and blood pressure within and across populationsBMJ, 1996
- An epidemiological perspective on environmental health indicators.1995
- Biomass fuel combustion and health.1985