Introduction and methods: Assessing the environmental burden of disease at national and local levels
Environmental burden of disease series No. 1
This introductory guide provides the background to, and a description of, the general method for assessing the disease burden caused by environmental risk factors. Subsequent guides address the disease burdens of specific environmental risk factors. To assess a disease burden, the health impact of disease and injury needs to be assessed quantitatively at population level. This may be measured in terms of the number of deaths, or as a summary measure of population health, such as the disability-adjusted life year (DALY).
Environmental burden of disease (EBD) studies assess the disease burden attributable to environmental risk factors, and are closely linked to assessments of the disease burden for individual diseases and injuries. Indeed, the burden of disease from disease and injury has been assessed at global level, and national level data are becoming available, which can be used in EBD studies. The results of disease burden studies are generally presented by gender and by age group, and are measured in terms of deaths and DALYs. The actual calculations for an EBD assessment are relatively simple once the input data (exposure and health outcomes) have been collected in a suitable format. The method can also be adapted to the health statistics that are available for the study population.
EBD assessments do not necessarily entail large costs. In many countries and regions, environmental health indicators are already routinely assessed, but are not yet processed into health information. Certain of these indicators can be used directly as input for EBD assessments, so additional assessments may not be necessary. The accuracy of EBD assessment will, however, depend on the quality of the data used as input.
Attributing the health impacts of environmental risk factors at population level can serve several public health activities. It can help to prioritize actions for preventing or reducing health impacts in the population, and by allowing the future health burden to be estimated, an EBD assessment can inform planning for preventive action. EBD assessments can also be used to estimate performance indicators for health-supporting environments, and identify high-risk groups in the population. Finally, EBD information can also be used to predict the health gains that interventions (including regulations) will bring to a population.
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Preface, affiliations and acknowledgements
1. The WHO guides on assessing the environmental burden of disease [pdf 126 kb]
3. The Global Burden of Disease concept
4. Methods for estimating the environmental burden of disease
Annex 4.1 - DALYs for the region AMRO D, as example for format of national prior estimates
Glossary of terms for the EBD series