Environmental Health and 
           Sustainable Development
           Dr. Maria Neira
           WHO
      PUBLIC HEALTH AND ENVIRONMENT
                       World Health Organization     1
            Environmental factors cause over 25% of 
                      global burden of disease
                –important contributions to largest diseases
                              World Health Organization               2
           Public Health and Environment: preventing 
               disease through healthier environments 
             •   Reduce 25% of the global                        •    Health impact assessment and 
                 burden of disease                                    environmental burden of disease 
             •   Promote a healthier                             •    Environmental health of the health 
                 environment                                          sector
                   – intensify primary prevention                •    Occupational health 
                      and                                        •    Chemical Safety 
                   – influence public policies in all            •    Water, sanitation and health
                      sectors,  so as to                         •    Children's environmental health 
                   – address the root causes of                  •    Air pollution (in and outdoors)
                      environmental threats to                   •    Radiation safety 
                      health                                     •    Climate change and health 
                                                 World Health Organization                                           3
                                                           Impact of environment on healthImpact of environment on health
             How much disease could be prevented by modifying the environment?
                 n  40%                                                               World                           Current evidence 
                 io
                 t                                                                    average
                 c  30%
                 a                                                                                                    (best conservative estimate)= 24%
                 r
                  f
                 le 20%
                 b
                 a
                 t
                 u  10%
                 ib
                 r
                 t
                 t                                                                                                  Based on Comparative Risk Assessment, evidence 
                 A   0%                                                                                                                           synthesis and expert survey
                           D     E     -A    -B    -D    -B    D     A     B     C     B     D     A     B
                           -     -    R     R                  -     -    -     -     R-    -      -    -
                        AFR   AFR   AM    AM   AMR   EMR   EMR   EUR   EUR   EUR     A    AR   WPR WPR
                                                                                  SE    SE                         "Preventing disease through healthy environments".
                                                              Sub-region
                                                                                                                                                                       WHO, 2006
             What is the modifiable environment?
                       Pollution
                       UV and ionizing radiation, noise, EMF
                       Occupational risks
                       Built environment, incl. housing, land use, roads
                       Agricultural methods, irrigation schemes
                       Man-made climate change, ecosystem change
                       Related behaviour (e.g. handwashing)
                                                                           World Health Organization                                                                               4