WHO European Centre for Environment and WHO European Centre for Environment and Health Health Survey Methods for Environmental Health Assessments Dorota Jarosinska 1,2 , Dafina Dalbokova 1 , Michal Krzyzanowski 1 1 WHO-European Centre for Environment and Health, Bonn Office 2 Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland The Future for Our Children ISEE Central Eastern European Chapter Meeting Balatonföldvár, 4-6 September 2003
WHO European Centre for Environment and Health Survey Methods for Environmental Health Assessments Dorota Jarosinska 1,2, Dafina Dalbokova 1, Michal Krzyzanowski.
Jan 04, 2016
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WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Survey Methodsfor
Environmental Health Assessments
Dorota Jarosinska1,2, Dafina Dalbokova1, Michal Krzyzanowski1
1 WHO-European Centre for Environment and Health, Bonn Office
2 Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland
The Future for Our Children ISEE Central Eastern European Chapter Meeting
Balatonföldvár, 4-6 September 2003
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Why survey methods for Environmental Health Information system?
To increase specificity and sensitivity of the indicator -based reporting focusing on the immediate living environment
To generate information not available from the routine data systems, but relevant for the policies
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Why survey methods for Environmental Health Information system?
Assessing exposures in the immediate living environment
Detecting mild health effects
Targeting vulnerable population health
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Air_A1: Composite index of the scope of ETS policies in the WHO European Region
Source: WHO Tobacco Control database: http://cisid.who.dk/tobacco/
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Air_A1: Implementation of the ETS policy components
Source: EHI pilot project countries: Bulgaria, Germany, Lithuania, Romania, Slovak Rep., Spain, Switzerland
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
No effective reporting mechanisms and
surveillance to monitor and evaluate
implementation and effectiveness of the ETS
policies in the European countries
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
To evaluate ETS policies within and across the WHO
European Region Member States harmonized and
reliable monitoring system to assess population
exposure to ETS is needed
Population exposure to ETS – survey methods
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
ECRHS II “How many people living in the home smoke inside the home: if one or more, please specify number per day smoked inside the home by the respondent and others”
EXPOLIS “Including respondent, how many people in the household (workplace) smoke inside the home (inside the room during working hours); how much do people smoke at home: per day, per week (cigarettes, cigarillos, cigars, pipe tobacco)”
Environmental Health in the Danish HIS
“How many in the household, including respondent smoke daily at home?”
“How many hours a day does respondent spend in the place where he smokes (at home, work, other places), even if he/she is the only smoker?”
WHO/GYTS “ In the past 7 days, on how many days people smoked in your presence in your home, places other than home”
US NHIS, 1991
“Does anyone smoke cigarettes, cigars, pipes anywhere in this home? On the average, about how many days per week is there smoking anywhere in this house?”
US, Kaiser Permanente Health Plan
…Time of exposure, assessed by the current average number of hours per week of exposure to tobacco cigarette, cigar, pipe smoke because of smoking of others: at home, small spaces other than home; large indoor areas …
Oslo Birth Cohort … Child’s exposure to ETS – living in a home in which one or more inhabitants smoke …
Surveys on ETS exposure - examples PHRASING
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
A good candidate of
survey tool for EH assessment
Assessing exposures
Detect mild health effects
Vulnerable subgroups
Well-defined
Feasible
Validated
Cost-effective
National and international use
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Surveys for EH assessmentsWHO Europe approach
Selection criteria: Large scale, national and multinational studiesRepresentativeRegularly conductedUsing validated tools
Inventory of the major European surveys addressing issues relevant for EH Information system
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Surveys in Europe
Environmental exposures
Indoor Air Q. Survey, France
EXPOLIS
German Environmental Surveys (I,II,III, IV)
ECRHS (I, II)
ISAAC (I, II, III)
HIS, HES
Swedish EH Survey
Danish EH Survey
Health effects
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Surveys for EH assessments WG Meeting Bonn, 18-19 November 2002
Recommended actions to propose a set of well-defined and feasible survey instruments as a part of the EH information system for the 4th Ministerial Conference, Budapest, 2004
Agreed on the scope of the issues and the survey tools for EH indicator system
Selected the best candidates of the survey methods to asses exposures and the health effects, applicable (inter)- and nationally across the WHO European Region
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Surveys for EH assessments WG Meeting, Bonn, 18-19 November 2002
Topics selected:
Indoor air quality
Housing
Respiratory health
Noise
Annoyance
Focus on children’s EH
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Surveys for EH assessments WG Meeting, Bonn, 18-19 November 2002
Recommended several well established survey tools:questionnairesobjective measurement
Example: respiratory healthasthma symptoms in adults: ECRHSasthma symptoms in children: ISAAC
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Surveys for EH assessments WG Meeting, Bonn, 18-19 November 2002
Tasks ahead
To complete the process of selecting the most appropriate survey tools
Develop the harmonized survey protocol applicable across the Member States
To propose a set of the feasible survey methods
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
EH
I SY
ST
EM
Surveys
EH policy needs
Tool for integrated assessment
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
For more information, please see …
http://www.who.dk/document/E79048.pdf
EpiMarker, 1 / 2003
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
ECRHS II “How many people living in the home smoke inside the home: if one or more, please specify number per day smoked inside the home by the respondent and others”
EXPOLIS “Including respondent, how many people in the household (workplace) smoke inside the home (inside the room during working hours); how much do people smoke at home: per day, per week (cigarettes, cigarillos, cigars, pipe tobacco)”
Environmental Health in the Danish HIS
“How many in the household, including respondent smoke daily at home?”
“How many hours a day does respondent spend in the place where he smokes (at home, work, other places), even if he/she is the only smoker?”
WHO/GYTS “ In the past 7 days, on how many days people smoked in your presence in your home, places other than home”
US NHIS, 1991
“Does anyone smoke cigarettes, cigars, pipes anywhere in this home? On the average, about how many days per week is there smoking anywhere in this house?”
US, Kaiser Permanente Health Plan
…Time of exposure, assessed by the current average number of hours per week of exposure to tobacco cigarette, cigar, pipe smoke because of smoking of others: at home, small spaces other than home; large indoor areas …
Oslo Birth Cohort … Child’s exposure to ETS – living in a home in which one or more inhabitants smoke …
Surveys on ETS exposure - examples
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Surveys in Europe
Regularly conducted general surveys
•National Health Interview Surveys (HIS)•National Health Examination Surveys (HES)•Household surveys
National representative surveys addressing EH issues
•German Environmental Surveys •French Permanent Indoor Air Quality Survey •Swedish Environmental Health Survey •Environmental Health in the Danish HIS•Dutch environmental health surveys
International projects focusing on specific EH topics
•ISAAC: International Study on Asthma and Allergies in Childhood•ECRHS: European Community Respiratory Health Survey •EXPOLIS: Exposure Distribution of Adult Urban Populations
Other surveys, within the scope of interest of the EH indicators system
•Global Youth Tobacco Survey (GYTS) •The Survey of English Housing •The UK House Condition Surveys
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