EUGLOREH project
THE STATUS OF HEALTH IN THE EUROPEAN UNION:
TOWARDS A HEALTHIER EUROPE

FULL REPORT

PART III - HEALTH CAUSES, FACTORS AND DETERMINANTS

10. HEALTH DETERMINANTS

10.3. Physical environment factors

10.3.1. Physical agents

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10.3. Physical environment factors

10.3.1. Physical agents

 

Acronyms

 

DALY

Disability-Adjusted Life Year. This integrated health measure, which combines information on quality and quantity of life, gives an indication of the (potential) number of healthy life years lost in a population due to premature mortality or morbidity, the latter being weighted for the severity of the disorder.

dB(A)

Unit of A-weighted sound pressure level, where A-weighted means that the sound pressure levels in various frequency bands across the audible range have been weighted in accordance with differences in hearing sensitivity at different frequencies.

ELF

Extremely Low Frequency

EMF

Electromagnetic Fields

END

Environmental Noise Directive, Directive 2002/49/EC on

LAeq

A-weighted average sound pressure level.

LaeqT

Exposure to noise for the duration of a given time interval T (e.g. 24 hour period, a night, a day) is expressed as an equivalent sound pressure level (measured in dB(A)) over the interval in question.

Lden

The Day-Evening Night level is the equivalent sound level over 24 hours, increasing the sound levels in the evening (19-23 hours) with 5 dB(A) and those during the night (23-7 hours) with 10 dB(A).

MRI

Magnetic Resonance Imaging

SCENIHR

Scientific Committee on Emerging and Newly Identified Health Risks

UVR

UV radiation

 

10.3.1.1. Introduction

 

It is well known that human health depends on a variety of physical factors such as ambient temperature, humidity and ventilation. Moreover, main physical stressors include radon, UV radiation, electromagnetic fields and environmental noise. Radiation, radon exposure and noise have well documented associations with some diseases, annoyance and other impacts. About 40% of the population in EU countries is exposed to road traffic noise at levels exceeding 55 dB (the WHO guideline value). Monitoring and mitigation measures have to consider differences in exposure for different vulnerable groups, such as children and workers. Every European citizen today is exposed to electromagnetic fields (EMF) but whether such exposure is causing any adverse effects on health still remains unclear.

 

This chapter deals with different types of physical stressors that have, or may have, significant effects on human health. The clearest connection to health effects is for the radioactive gas radon. Exposure to radon increases significantly the risk for cancer. For another physical stressor, UV light, accumulating amount of evidence indicates that an increase in skin cancers in the Western European population is connected to an increased exposure to UV-radiation. The currently most controversial physical health stressor is electromagnetic radiation. In spite of the high public concern and several scientific studies, there is still no conclusive evidence showing that EMF has significant consequences for human health. This is particularly valid for high frequency EMF from mobile phones and other radio transmitters. However, mobile phones have been in common use for little more than 10 years and longer exposure times could be needed before health impacts become evident.

 

Noise is perceived among the public as one of the major environmental problems and environmental noise is probably the environmental factor that affects the largest number of Europeans. A key driver for the present and future magnitude of noise exposure is the growth in traffic and the increase of population living in cities. Environmental noise can affect people’s health and quality of life, as it interferes with basic activities such as sleeping, resting, studying, and communicating. Even though these impacts on human health has been known for long, recent research shows that the health impacts occurs at a lower lever than what has been known before.

 

In accordance with the Environmental Noise Directive (European Commission, 2002), exposure to noise has recently started to be monitored in the EU. The Directive provides a common basis for tackling the noise problem across the EU. Its main aim is to avoid, prevent or reduce the harmful effects of noise exposure. Not only does it require EU Member States to conduct noise mapping, action planning and other related activities, it also requires Member States to report on these activities to the European Commission. However, it does not give any limit values.

 

10.3.1.2. Data sources

 

 

This EUGLOREH assessment on physical stressors  is based on  the EEA / Joint Research Centre assessment  “Environment and health” (EEA report 10, 2005),the European Environment Agency (EEA) assessmentBelgrade report 2007 (Environment& health)”, the ENHIS-2Children's health and the Environment in Europe: a baseline assessment (in press May 2007) and the European Union Scientific Committee on Emerging  and Newly Identified Health Risks (SCENHIR) opinion on “Possible Health effects of electromagnetic fields”, adopted on 21 March 2007.

 

Noise exposure data has until now been compiled in several countries but in various extents and in a non-harmonised way. Due to differences in methodologies as assessments methods and indicators it has been difficult to compare the data between Member States. On an international level Eurostat / OECD have gathered data on noise exposure as well as on noise annoyance.

 

At the moment noise exposure data is produced and reported under the obligations under the Environmental Noise Directive. The directive requires competent authorities in Member States to produce strategic noise maps on the basis of harmonised indicators (Lden and Lnight, where Lden consists of a day period of 12 hours, an evening period of 4 hours and a night time period of 8 hours) to inform the public about noise exposure and its effects, and to draw up action plans to address noise issues. The areas where noise mapping and action planning will be carried out are the major agglomerations and along major roads, railways and airports, designated by the Member States. Noise maps will capture noise emissions from industry and transport, and assess the number of people exposed to noise. Based on this information it will be possible to assess the magnitude of annoyance and sleep-disturbance throughout Europe.

 

 

10.3.1.3. Data description and analysis

 

Radon

 

Current levels of ionising radiation in Europe are low in general, but there are regional differences due to the presence of radon. Radon is a radioactive gas formed by the radioactive decay of uranium; radon seeps out of the ground in areas with uranium-containing soils and rocks. The most important pathway for human exposure is permeation of radon gas into buildings through the ground, but radon from water, outdoor air and construction materials can also contribute to the total exposure. Radon decays to radon daughters, some of which emit high energy alpha radiation. Alpha-emitting radon daughters are adsorbed onto dust particles and can, when inhaled, cause gene damage, mutations and finally cancer. Accordingly, there is a strong relationship between exposure to radon and the development of lung cancer. The Dutch Health Council has estimated that in the Netherlands, exposure to radon in dwellings leads to 100 to 1200 extra cases of lung cancer every year. Most probable estimation is 800 extra cases. In Sweden (population 9 million), 400-700 cases of lung cancer can be ascribed to radon exposure per year (Barns, 2005). A pooled analysis of all European epidemiological studies on domestic exposure to radon establishes a clear linear relationship between lung cancer risk and the level of radon exposure (Darby et al, 2005). The study concludes that 9% of lung cancer deaths/year in Europe can be ascribed to radon, which of a total of 330 000 deaths from lung cancer/year (Bray et al, 2002) makes approximately 30 000 deaths in Europe/year. Radon is also a well known occupational cause of lung cancer, in particular for miners (Leuraud et al, 2007; Villeneuve et al, 2007), and the WHO (WHO 1987 and 2000) has used miner epidemiological data for their radon quantitative risk estimates. The WHO also considers the combined effect of radon daughter exposure and smoking is multiplicative (for the general population and the exposed workers). This makes smoking of utmost importance in determining the risk associated to radon exposure. With the numbers presented above, radon is clearly the environmental risk factor with the highest proven cancer burden. Lung cancers in children are extremely rare and it is not known if childhood exposure to radon increases the risk of lung cancer in adulthood. There are studies suggesting that radon could increase the risk of childhood leukaemia but the findings are inconclusive. Gamma radiation from radon decay in construction materials (concrete) has been indicated as a risk factor for leukaemia in one study, but other studies have failed to confirm this.

 

Indoor radon exposure caused by radon gas seeping into the building, can be reduced in existing buildings thorugh better natural ventilation in sub-floor voids or by depressurising the soil between the building by digging voids and fitting electric fans to force the gas into the outside air instead of the building. This work is inconvenient and often considered expensive especially by poorer occupants; these are common reasons why the work is never carried out. With new buildings, fitting such measures is much easier and cheaper, but measurement after the first six months of occupation is still recommended to prove the effectiveness of any preventative measure. Another source of radon exposure is building materials. Exposure is reduced by routine radon monitoring of building material and selection of radium free materials in construction. A risk outlined by some countries is the implementation of energy saving policies recommending reduced ventilation, which will likely increase indoor radon exposure. Almost all European countries have monitoring programs for radon. The intensity and the type of monitoring depend on the country and on the actual radon situation. Radon is not evenly distributed over Europe. The occurrence is patchy and varies between countries and between regions in the country. Clearly, radon monitoring and radon prevention strategies are best developed in countries with an established radon problem. Radon mitigation in these countries includes national information systems, guidance documents for buildings and local and national radon maps. The vast majority of European countries do not consider in their legislation different policies for the various population groups. Only very few countries clearly make distinction between children and the rest of the population by establishing lower reference levels for radon in schools and kindergartens or by offering additional financial support for remediation to reduce children exposure. Very few countries explicitly mention additional measurements and monitoring of workers exposed to radon at work places.

 

UV radiation

 

There is a well-established connection between skin cancers and exposure to UV radiation (UVR). UVR is divided into 3 groups depending on the wave length; UV-A (315-400 nm), UV-B (280-315 nm) and UV-C (100-280 nm). UVR reaching the earth's surface is largely composed of long-wavelength UV-A.

The atmosphere, stratospheric ozone, filters most of the shorter wavelength UV-B and the UV-C, but the current thinning of the ozone layer leads to increasing ground levels of UV-B. There are several factors influencing UVR exposure intensity such as latitude, altitude, cloud cover and reflection.

 

UV radiation has both positive and negative health effects. The positive effect is that sunlight and UV exposure stimulates the synthesis of vitamin D in the skin. Vitamin D is essential for the metabolism of calcium in the body and vitamin D deficiency leads to de-calcification of the bone (rickets). The negative effect is that UV radiation induces skin cancer and approximately 80-90% of all skin cancers can be related to UVR. In 2002, more than 21 000 new cases of melanoma were diagnosed in the population under the age of 55 in Europe and accession countries (WHO, 2007; EC, 2002). For all ages combined, melanoma caused by UVR leads to the loss of up to 250 000 DALYs (disability-adjusted life years) annually in the WHO European region (GLOBOCAN, 2002). The most important risk factors for melanoma are a light skin phototype (type I and II), a large number of naevi or atypical naevi, and a family history of skin cancer. Sun bed use (artificial sun, sunbathing in “solarium”) is also a risk factor.

Melanoma is more frequent among people of higher socio-economic status and in Northern European populations. This is probably due to more frequent, intermittent, high exposures to UVR (for example during repeated sunny holidays) and a light skin phototype. Additionally, diagnosis and case identification may be more common in this group, further increasing apparent rates.

 

Ozone depletion in the stratosphere has led to increased ground level exposure to UVR in recent years. Peak exposures will probably occur around 2020, decreasing slowly as the effects of the international ban on ozone-depleting substances begin. These environmental trends, in conjunction with the worrisome level of sun-bed use among adolescents in some countries, indicate the need for preventive action in Europe. Time trends for malignant melanoma incidence differ between European countries. Sharp increases in melanoma frequency were seen all over Europe up to the 80s and 90s. Melanoma incidence is expected to increase further in Southern European countries. However, in some Northern and Western European countries incidence rates have stabilized over more recent years, particularly among younger people. This trend may reflect the first successes of primary prevention policies and should provide strong motivation for other countries to strengthen their UVR protection activities. Good data are essential to assess preventive activities and the identification of core issues of concern. Therefore, the monitoring of melanoma time trends through high-quality cancer registries remains a high priority.

 

Electromagnetic fields

 

Every European citizen is today exposed to electromagnetic fields (EMF) which can be characterised in terms of their frequency and amplitude. The fields around power lines and electrical appliances are of low frequency. Mobile telephones and radio transmitters transmit EMF of higher frequency. The European Union Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) has recently concluded the current state of knowledge concerning health impacts of electromagnetic fields (EMF) (Lucas et al, 2006). The opinion is primarily based on scientific articles, published in English language peer-reviewed scientific journals. The opinion is divided into frequency (f) bands, namely: radio frequency (RF), intermediate frequency (IF) extremely low frequency (ELF), and static (0 Hz) (only static magnetic fields are considered).

 

The opinion concludes that extensive research efforts have been conducted over recent years regarding possible health effects of exposure to low intensity Radio Frequency Fields (RF fields, 100 kHz < f300 GHz), including epidemiologic, in vivo and in vitro research. In conclusion, no health effect has been consistently demonstrated at exposure levels below the limits of ICNIRP (International Committee on Non Ionising Radiation Protection) established in 1998. However, the database for evaluation remains limited, especially for long-term low-level exposure.

 

For Intermediate Frequency Fields, (IF fields, 300 Hz < f100 kHz), experimental and epidemiological data are very sparse. Therefore, assessment of acute health risks in the IF range is currently based on known hazards at lower frequencies and higher frequencies. Proper evaluation and assessment of possible health effects from long-term exposure to IF fields are important because human exposure to these fields is increasing due to new and emerging technologies.

 

For Extremely Low Frequency magnetic fields (ELF, 0< f300 Hz) the previous conclusion from IARC (International Agency for Research on Cancer) is still valid. IARC classified EMF as a category 2B carcinogen (possibly carcinogenic) in 2001, mainly based on the occurrence of childhood leukaemia. For breast cancer and cardiovascular disease, recent research has indicated that an association is unlikely. However, a study published in 2007, concerning the breast cancer risk in a very large occupationally exposed US women population (6213 cases, 7390 age-matched controls) suggested that “the exposure to EMF in the workplace may be associated with a slight elevation in breast cancer risk (SCENIHR, 2007). For neurodegenerative diseases and brain tumours, the link to ELF fields remains uncertain. No consistent relationship between ELF fields and self-reported symptoms (sometimes referred to as electrical hypersensitivity) has been demonstrated.

 

Adequate data for proper risk assessment of static magnetic fields are very sparse. Developments of technologies involving static magnetic fields, e.g. with MRI (Magnetic Resonance Imaging) equipment require risk assessments to be made in relation to occupational exposure.

 

The balance of epidemiologic evidence indicates that use of mobile phones less than 10 years does not pose any increased risk of brain tumour or acoustic neuroma. For longer use, data are sparse and any conclusions therefore are uncertain. From the available data, however, it does appear that there is no increased risk for brain tumours in long-term users, with the exception of acoustic neuroma for which there are some indications of an association. Risk of a tumour on the same side of the head as reported phone use was significantly raised for use for 10 years or longer (Mcelroy et al, 2007). For diseases other than cancer, very little epidemiologic data are available.

 

A particular consideration is mobile phone use by children. While no specific evidence exists, children or adolescents may be more sensitive to RF field exposure than adults in view of their continuing development. Children of today may also experience a much higher cumulative exposure than previous generations. However, no epidemiologic studies on children are currently available. RF exposure has not consistently been shown to have an effect on self-reported symptoms (e.g. headache, fatigue, dizziness and concentration difficulties) or well-being. Studies on neurological effects and reproductive effects have not indicated any health risks at exposure levels below the ICNIRP-limits established in 1998. Animal studies have not provided evidence that RF fields could induce cancer, enhance the effects of known carcinogens or accelerate the development of transplanted tumours. The open questions include adequacy of the experimental models used and scarcity of data at high exposure levels. There is no consistent indication from in vitro research that RF fields affect cells at non-thermal exposure level. In conclusion, no health effect has been consistently demonstrated at exposure levels below the ICNIRP-limits established in 1998. However, the database for this evaluation is limited especially for long-term low-level exposure.

 

Combined analyses of the epidemiological studies on the association between exposure to ELF and childhood leukaemia have strengthened the evidence of an association. However, given some inconsistencies in exposure measurements and the absence of other criteria commonly used in assessing causality (particularly a plausible explanation of underlying biological mechanisms), the association does not meet adequate criteria for being considered causal. Thus, the overall evidence for 50/60 Hz magnetic fields to produce childhood leukaemia must be regarded as being limited. The effect, if any, seems to be limited to exposures above 0.4 µT. In European countries, the proportion of children exposed to such levels is less than 1%. Assuming that the risk is doubled among the exposed, in the general population this would roughly correspond to an excess incidence of less than 1% childhood leukaemia. In European countries the incidence of leukaemia is around 45 per million children (age 0-14) per year. Whether changes of recommended exposure limits to 50/60 Hz magnetic fields ought to be recommended on this basis is a problem for risk managers (10). There is no convincing suggestion of any other carcinogenic effect of ELF on either children or adults. Current information on this respect does not provide clues for reconsidering exposure limits. Reports on possibly hypersensitive individuals require confirmation and do not provide a basis for proposing changes in the exposure limits.”

 

Noise

 

Since noise is a pollutant that is persistent and inescapable, a significant proportion of the population are exposed: about 40% of the population in EU countries is exposed to road traffic noise at levels exceeding 55 dB(A), with 20% exposed to levels exceeding 65 dB(A) during daytime. More than 30% is exposed to levels exceeding 55 dB(A) during night time (WHO, 2007). WHO guidelines for community noise require less than 55 dB(A) outdoors and less than 30 dB(A) during the night for a sleep of good quality. A Swedish questionnaire study of 19 000 twelve-year-olds identified noise as a disturbance to normal sleep for almost 8% several times a week (Swedish Environmental Health Report, 2005).

 

Compared to noise from neighbours and industry, a large proportion of people are severely annoyed by noise from transport sources (road traffic, rail traffic or air traffic). However, due to differences in the measurement of annoyance and definition of sources, only an indicative comparison between countries and regions is possible as shown in Figure 8.1.1.1.

 

Figure 10.3.1.1. The percentage of the population exposed to noise levels > 60 dB(A) in different European countries

 

The main health risks of environmental noise, apart from hearing impairment and annoyance, are interference with social behaviour and speech communication, sleep disturbance and all its consequences, cardiovascular effects, hormonal responses, including stress-induced ones, and poor performance at work or school. In spite of the limited evidence available, exposure to leisure time noise in adolescents and young adults is an increasing cause of concern for hearing impairment.

 

Noise is a potentially important influence on neurological development although the evidence is more circumstantial than direct. The physiological role of sleep is not completely known, but it is clear that sufficient long and undisturbed periods of sleep are essential for normal neurodevelopment and normal cognitive processes. Exposure of the pregnant mother to very high noise levels at workplaces may have a prenatal effect resulting in hearing disabilities later in life. Hearing develops at a late stage of neurodevelopment and it is important to protect the child from major noise impacts.

 

There are indications that there is a causal chain linking chronically strong annoyance to increased morbidity. Sleep disturbance in adults, results in significantly elevated relative risks to the cardiovascular, respiratory and musculo-skeletal systems and to depression. Many of these diseases increase with age and therefore only appear rarely in children. Significantly elevated relative risks to the respiratory system and of migraines are of great importance for children.

 

Several studies have estimated the burden of disease due to noise exposure (Knol et al., 2005; Torfs, 2003). Compared to environmental factors such as air pollution, radon and UV-radiation, the disease burden attributable to annoyance, sleep disturbance and cardiovascular disease due to noise exposure is considerable as shown in the logarithmic scale of Figure 8.1.1.2. It was also estimated that 3.2% of the myocardial infarctions in Germany might be attributable to road traffic noise exposure (Babisch, 2006).

 

Figure 10.3.1.2. The environmental disease burden in the Netherlands (based on Knol et al., 2005). The disease burden is expressed in the number of DALYs per million people

 

The overall burden of ill health due to noise in Europe has not yet been quantified. The WHO is currently developing an assessment guide, addressing several health end-points: cardiovascular disease, cognitive impairment in children, hearing impairment due to leisure noise, tinnitus, annoyance and sleep disturbance. The results are expected soon.

 

In addition, the impacts of noise might be enhanced by interacting with other environmental stressors, such as air pollution and chemicals. This may be particularly the case in urban areas, where most of these stressors coexist. This has recently been highlighted at the workshop organised by DG Joint Research Centre (JRC) in collaboration with EEA, WHO and the CALM Network (CALM, 2007).

 

Some European countries estimate that the social cost of road noise pollution is about 1% of GDP (Martin et al. 2006). In Switzerland, about 15% of the population live in areas where exposure limits of traffic noise are exceeded. An ongoing programme (started in 1986) to reduce noise exposure from traffic infrastructure, industry, trade and shooting ranges will be completed by 2018, at an overall cost of around EUR 4 billion (Boegli, 2006).

 

The existing estimates of noise exposure in Europe cover either the whole European region with generic data or parts of the European region (e.g. regions or countries) with more detailed information. One key aspect of the quality of reported data is the degree of comparability. International comparisons of the noise levels in different countries are mainly hampered by differences in the availability of input data necessary to assess noise exposure. Improvements are expected from efforts under the Environmental Noise Directive although some gaps will remain especially in the first phase of noise mapping and reporting.

 

Noise maps will capture noise emissions from industry and transport, and assess the number of people exposed to noise. Noise exposure information will geographically cover major agglomerations, defined by Member States and areas along major transportation lines and airports, above specified thresholds. The indicators to be used in noise mapping under END are also harmonised: Lden and Lnight, where Lden consists of a day period of 12 hours, an evening period of 4 hours and a night time period of 8 hours. The noise indicator for the night time period, Lnight will cover 8 hours starting at 23.00 by default; however, the start of the night time period may be altered by the Member States, and thus may vary from country to country. The use of harmonised assessments methods are foreseen in the Directive, but are as yet not in place. It has been anticipated that when the new reports under END are available, access to information at a much more detailed level will be facilitated, e.g. per sources and 5 dB band of sound level along with its geographical location. This will open up the possibility for broader analyses and integrated assessments of a higher quality. By doing this, assessments of combined environmental exposure should be facilitated.

 

International comparisons of annoyance rates are hampered by differences in the measurement and definition of annoyance. To overcome these problems, ICBEN and ISO developed standardized questions, which have been available since 2001 (ISO, 2003).

 

There is evidence that environmental noise is associated with an increased cardiovascular risk. Several epidemiological studies reported that noise is associated to adverse effects on the cardiovascular system such as increased blood pressure and increased risk of myocardial infarction. The thresholds of no-effect (reference levels) are however still debatable. Several risk estimates which can be indicatively used for further health impact assessment are available (Babisch, 2008; Van Kempen et al., 2002).

 

Physical stressors at the workplace

 

Current working conditions in Europe comprise a large variety of physical risk factors (table 10.3.1.1). Physical work load is reported differently with respect to the economic sectors. Employees working in construction, manufacturing and agriculture are affected to a large extent. In these sectors, often twice as many workers report exposures to vibrations and noise as well as forced body positions, heavy work and repetitive movements. The latter is common also in hotels and restaurants where 44% of employees state to be affected almost all the working time. Most common in men are exposures to vibrations and noise which were reported by approximately 15% as occurring almost all the working time and 39% at least one quarter of the time. Exposures to inconvenient temperatures are also rather common. Exposures in general are less often reported by women. With respect to the work tasks standing or walking, repetitive hand or arm movements and tiring or painful positions seem to be quite common in Europe affecting up to 70% of the employees at least a quarter of their working time and up to 40% almost all the time. A considerable percentage of men furthermore report their tasks involving carrying or moving heavy loads.

 

Table 10.3.1.1. Self-reported exposure to physical risk factors at work in the EU 25, by economic sector

 

10.3.1.4. Control tools and policies

 

In its task to harmonise Member Statesprovisions for the application of the basic safety standards for the health protection of the general public and workers against the dangers arising from ionizing radiation, the European Commission issued a Recommendation (21 February 1990) on the protection of the public against indoor radon exposure (90/143/Euratom). This Recommendation gives guidelines for the information of the public, the indoor radon reference level (annual average concentration of 400 Bq/m3, applicable for existing dwellings) and design levels (annual average concentration of 200 Bq/m3, for future constructions) beyond which respective remedial actions and preventive measures are to be considered.

Children are generally more susceptible to the ill health effects of UVR than adults. In a significant part of a person’s lifetime UVR exposure occurs before the age of 18, with children having more time to develop diseases with long latency. During outdoor activities, children should be protected from high UVR exposure, whilst babies should always remain in the shade. The promotion of sun protection in schools to inform children on the risks of overexposure and how to avoid it is particularly important. Recent UNEP/UNCESCO/WHO publications provide resources for teachers and children. Together with national partners, the WHO developed international recommendations on UVR protection. The actions are directed towards environmental health and focus specifically on children, when feasible. However, only a small number of countries have official regulations on UVR protection, as found in an ENHIS-CEHAPE survey on implementation of the WHO recommendations in 26 countries. Policies and actions relating to public information, the availability of the UVR index, UVR health school programmes, the regulation of sun bed use in youths and the provision of shade structures, among others, were all reviewed.

 

The Montreal Protocol and its various amendments seek to stop the depletion of the UV-protective ozone layer by phasing out ozone depleting substances. European countries have successfully implemented the protocol, and in EU countries, relevant substances have been almost entirely phased-out, with small and consecutively reduced amounts covered by licenses under the protocol. Both in Europe and globally, the continued implementation of the Montreal Protocol remains a top environmental policy priority. While it has been anticipated that the ozone layer will fully recover, it may be several decades before full UVR protection is regained.

 

In view of the lack of clear and conclusive evidence concerning negative health effects of EMF, it is premature to discuss possible policy actions and tools. The fact that ELF is suspectedpossible carcinogenic” has led to some pre-cautionary measures when localising new power lines in densely populated areas. This has been done more from a need to show political responsiveness to public concern than based on a strict scientific and social cost-benefit analysis.

 

The Green Paper on Future Noise Policy (COM(96) 540) adopted in 1996 was the first step in the development of a noise policy with the aim that no person should be exposed to noise levels which endanger health and quality of life.

The implementation of Noise Directive 153 (2002) is the main instrument for reaching the 6EAP noise objectives. In 2004, the Commission published a report assessing the existing Community framework on noise and the need for future actions taking into account recent scientific and technical evidence.

 

The European Parliament and Council adopted in 2002 the Directive relating to the assessment and management of Environmental noisehttp://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:32002L0049:EN:NOT ),whose main aim is to provide a common basis for tackling the noise problem across the EU. The underlying principles of this text, are similar to those for other overarching environment policy directives:

·          Monitoring the environmental problem;

·          Informing and consulting the public about noise exposure, its effects, and the measures considered to address noise,

·          Addressing local noise issues, and

·          Developing a long-term EU strategy.

 

 

10.3.1.5. Future developments

 

For what concerns radon, all EU Member States already have, or are drawing up, provisions for implementing the basic safety standards for the health protection of the general public and workers in case of a significant increase in exposure due to natural radiation sources (including radon) in work places, laid down in Title VII of the Council Directive 96/29/Euratom (13 May 1996). However, the gaps and needs in indoor radon policymaking vary greatly depending on the country and the local situation. Some countries have well developed radon policies, while in others there is a need for further development, including establishing radon maps, reference values for dwellings and assessment of the efficiency of the remedial actions. The difficulty in implementing new guidelines at local level is an area for improvement in many countries. Another area for improvement is the national coordination of authorities involved in radiation protection and the need to assign enforcement capabilities to one of them.

 

Protecting children from excessive UVR is an important and effective way to avoid serious health consequences for children now and later in life. Only a small number of countries have implemented a full range of UVR protection policies for children and the overall population. Thus, there are great opportunities for policy development, as well as for the harmonisation and strengthening of efforts to reduce children's excessive exposure to UVR. Excessive solar UVR exposure is best prevented by regional and local awareness-raising and information campaigns, in particular in schools. Regulations, preferably a ban for sun bed usage among children and teenagers has been adopted by a small number of countries and should be implemented at pan European level. The complete phasing-out of ozone-depleting substances will particularly benefit children, who depend on their parents, teachers and other adults to protect them against excessive UVR as they learn to enjoy the sun safely.

 

The Environmental Noise Directive will provide a basis for developing Community measures to reduce noise emitted by the major sources. The noise exposure information from Member States will be collected and published by the Commission and according to the directive, the Commission shall set up a database of information on strategic noise maps and publish a summary report of data from strategic noise maps and action plans. (Internoise paper)

Further development of the frameworks to assess environment and health linkages and translate knowledge into action should facilitate the incorporation of new scientific findings and more informed decisions. Protecting human health from environmental hazards/threats requires broad involvement of stakeholders. Good communication and cooperation in addressing environmental problems relevant to human health may still be a challenge. Continued efforts are therefore needed to strengthen intersectoral cooperation at local, national and international levels, as well as to develop methods to assess the effectiveness of the measures taken.

 

10.3.1.6. References

 

Babisch W (2006): Transportation noise and cardiovascular risk. Review and synthesis of epidemiological studies. Dose-effect Curve and Risk Estimation. Umweltbundesambt. WaBoLu Hefte 01/06. [On-line publication available at: http://www.umweltbundesamt.de/uba-info-medien/mysql_medien.php?anfrage=Kennummer&Suchwort=2997].

Babisch W (2008): Road traffic noise and cardiovascular risk. Noise Health 10(38),27-33.

Barns Miljö och Hälsa, (2005): Children’s environment and health, Socialstyrelsen, National Board of Health and Welfare, Sweden, (www.sos.se)

Boegli, H., 2006. Risk assessment of noise exposure - the Swiss perspective. EURONOISE 2006, Tampere, 2006.

Bray F, Sankila R, Ferlay J, Parkin DM (2002): Estimates of cancer incidence and mortality in Europe 1995. Eur. J. Cancer 38, 99-166.

Darby S, Hill D, Auvinen A, Barros-Dios JM, Baysson H, Bochicchio F, Deo H, Falk R, Forastiere F, Hakama M, Heid I, Kreienbrock L, Kreuzer M, Lagarde F, Mäkeläinen I, Muirhead C, Oberaigner W, Pershagen G, Ruano-Ravina A, Ruosteenoja E, A Schaffrath Rosario A, Tirmarche M, Tomáek L, Whitley E, Wichmann HE, Doll R, (2005): Radon in homes and risk of lung cancer: collaborative analysis of individual data from 13 European case-control studies. Brit. J. Med. 330, 223-230.

DH, Goh KT. Geneva: World Health Organisation, Guideline Document.

EEA (2007). Europe’s environment — The fourth assessment. European Environment Agency, Copenhagen

EEA (European Environment Agency), 2005. Environment and health. EEA report 10/2005. EEA, Copenhagen.

European Commission (2002): Noise directive (http://ec.europa.eu/environment/noise/directive.htm )

European Union Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) (2007): Possible effects of Electromagnetic Fields (EMF) on Human Health. Adopted 21 March 2007 after public consultation.

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