who european centre for environment and health, rome division integrating health concerns into...

WHO European Centre for Environment and Health, Rome Division

Integrating health concerns into Integrating health concerns into transport policies: from the Charter transport policies: from the Charter

on Transport, Environment and on Transport, Environment and Health to the Transport, Health and Health to the Transport, Health and

Environment Pan-European (THE PEP)Environment Pan-European (THE PEP)

F. RacioppiF. RacioppiWorld Health OrganizationWorld Health Organization

European Centre for Environment and Health, RomeEuropean Centre for Environment and Health, Rome


OverviewOverview

Overview of tranport-related health effectsOverview of tranport-related health effects The “Charter on Transport, Environment and The “Charter on Transport, Environment and

Health” Health” From the Charter to THE PEPFrom the Charter to THE PEP

– Joint WHO UNECE “Synthesis report”Joint WHO UNECE “Synthesis report”– 1st High Level Meeting1st High Level Meeting

THE PEP: a joint WHO UNECE way forwardTHE PEP: a joint WHO UNECE way forward


Transport policies have a broad Transport policies have a broad range of health effectsrange of health effects

International Herald Tribune, 16 April 2003 – pg 6

International Herald Tribune, 16 April 2003 – pg 6


Transport-related health Transport-related health effects are very large effects are very large

External costs of transport in western External costs of transport in western Europe: Europe:

Euro 658 billion (1995)Euro 658 billion (1995) (INFRAS/IWW, 2000)(INFRAS/IWW, 2000)


Road safety in Europe at a Road safety in Europe at a glanceglance

(source: WHO and UNECE)(source: WHO and UNECE)

Deaths: 121,000/yearDeaths: 121,000/year Disability Adjusted Life Years (DALYs): Disability Adjusted Life Years (DALYs):

nearly 3.8 millionnearly 3.8 million Injuries: more than 2,4 million/yearInjuries: more than 2,4 million/year 65 % of accidents happens in the urban 65 % of accidents happens in the urban

environment (only 5 % on highways) environment (only 5 % on highways) More than 30 % of deaths involve young More than 30 % of deaths involve young

people (< 29 yo) people (< 29 yo) Costs (in the EU15): more than Eur 166 Costs (in the EU15): more than Eur 166

billion/year ca. 2.0 % GDPbillion/year ca. 2.0 % GDP


In European High Income countries, road In European High Income countries, road injuries are the leading cause of death for injuries are the leading cause of death for

people aged 5-44 years people aged 5-44 years (source: WHO - Global Burden of Disease project for 2000)(source: WHO - Global Burden of Disease project for 2000)


In European Low-Medium Income In European Low-Medium Income countries, road injuries are among leading countries, road injuries are among leading

causes of deathcauses of death(source: WHO - Global Burden of Disease project for 2000)(source: WHO - Global Burden of Disease project for 2000)


Road safetyRoad safety Large differences exist between Large differences exist between

different parts of the Regiondifferent parts of the Region

Average standardised death rates by road traffic accidents per 100,000 population

0

5

10

15

20

25

1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

EUROPE EU average CEE average NIS average Nordic average CAR average


Air pollutionAir pollution

Air pollution is estimated to cause some Air pollution is estimated to cause some 100,000 premature deaths in the Region100,000 premature deaths in the Region

In many NIS In many NIS cities transport is responsible cities transport is responsible for up to 75% of total emission of selected for up to 75% of total emission of selected pollutants, and is solely responsible for air pollutants, and is solely responsible for air toxins like benzo(a)pyrene and soot. toxins like benzo(a)pyrene and soot.

Data on pollution levels confirm high Data on pollution levels confirm high exposure of the urban population to traffic exposure of the urban population to traffic emissionsemissions

Annual mean values of TSP ranging from Annual mean values of TSP ranging from 100 to 400 micrograms per cubic meter are 100 to 400 micrograms per cubic meter are quite common in bigger cities of the NISquite common in bigger cities of the NIS


Noise interferes with memory, Noise interferes with memory, attention and ability to deal attention and ability to deal

with analytical problemswith analytical problems

About 65% of the European About 65% of the European population (450 million) is exposed population (450 million) is exposed to noise levels exceeding 55 to noise levels exceeding 55 dB(A)Leq over 24 hoursdB(A)Leq over 24 hours

Children chronically exposed to Children chronically exposed to loud noise show impaired loud noise show impaired acquisition of reading skills, acquisition of reading skills, attention and problem-solving attention and problem-solving abilityability

Road traffic is the major source of Road traffic is the major source of exposure to noise exposure to noise


Physical inactivity is (with diet) a leading cause Physical inactivity is (with diet) a leading cause of the epidemic of obesity observed among of the epidemic of obesity observed among

childrenchildren(Source: International Obesity Task Force, 2002)(Source: International Obesity Task Force, 2002)


The attributable fraction of mortality from physical The attributable fraction of mortality from physical inactivity is estimated in the range of 5 – 10 % of inactivity is estimated in the range of 5 – 10 % of

total mortalitytotal mortality(WHO, World Health Report 2002)(WHO, World Health Report 2002)

Source: International Obesity Task Force, Source: International Obesity Task Force, 20022002

Source: International Obesity Task Force, Source: International Obesity Task Force, 20022002


Health benefits of physical activity Health benefits of physical activity (30 minutes/day)(30 minutes/day)

50 % reduction in the risk of coronary 50 % reduction in the risk of coronary health disease, type II diabetes and health disease, type II diabetes and obesityobesity

Reduction in the risk of developing Reduction in the risk of developing hypertension and in blood pressurehypertension and in blood pressure

Help to protect against osteoporosisHelp to protect against osteoporosis Improve balance, coordination, mobility, Improve balance, coordination, mobility,

strength, endurancestrength, endurance Increase self-esteem, promote overall Increase self-esteem, promote overall

psychological wellbeingpsychological wellbeing


Results of a Norwegian CBA of Results of a Norwegian CBA of investing in infrastructure for investing in infrastructure for

walking and cyclingwalking and cycling


WHO WHO programmeprogramme on on Transport, Environment Transport, Environment

and Healthand Health FFacilitateacilitatess the integration of health the integration of health

considerations in decisionsconsiderations in decisions affecting transportaffecting transport

Promotes the implementation of Promotes the implementation of strategies that address strategies that address simultaneously simultaneously allall the the environmental and health impacts environmental and health impacts of transportof transport

Informs on the evidence for the Informs on the evidence for the health effects of transport health effects of transport

Provides tools and methods to Provides tools and methods to assist Member States in integrating assist Member States in integrating health concerns into transport-health concerns into transport-related decisionsrelated decisions


Political

• 4 Negotiation meetings•Participation of member States, Inter-government Organizations and Non-Government Organizations

Scientific

•Review the evidence•Identify targets from technical perspective

CHARTER- Principles,

-Targets- Plan of action

Case-studies

Environmental health impacts of transport and their economic costs•Italy•France•Austria•Switzerland

The process to the CharterThe process to the Charter


The Charter on Transport, The Charter on Transport, Environment and HealthEnvironment and Health

Adopted by Ministers of Transport, Environment and Adopted by Ministers of Transport, Environment and Health at the 3rd Ministerial Conference on Health at the 3rd Ministerial Conference on Environment and Health (London, 16-18 June 1999)Environment and Health (London, 16-18 June 1999)

Contains:Contains:– Health targetsHealth targets for reducing injuries, air and noise pollution and for reducing injuries, air and noise pollution and

increasing opportunities for physical exercise through walking, increasing opportunities for physical exercise through walking, cycling and use of public transportcycling and use of public transport

– PrinciplesPrinciples for Transport Sustainable for Health and the Environment for Transport Sustainable for Health and the Environment– Plan of action Plan of action for the Charter implementationfor the Charter implementation

Emphasizes the need to address all health impacts of Emphasizes the need to address all health impacts of transport policies as part of the same interventionstransport policies as part of the same interventions

Establishes a Steering Group of MSs, IGOs and Establishes a Steering Group of MSs, IGOs and NGOs to facilitate its implementation NGOs to facilitate its implementation


The Charter and further The Charter and further policy developmentspolicy developments

The Charter promoted enhanced co-operation with The Charter promoted enhanced co-operation with other inter-government organizations, in particular by other inter-government organizations, in particular by calling on the WHO and UNECE to:calling on the WHO and UNECE to:

““Provide an overview of relevant existing Provide an overview of relevant existing agreements and legal instruments, with a view to agreements and legal instruments, with a view to improving and harmonizing their implementation and improving and harmonizing their implementation and further developing them as needed”further developing them as needed”


From the Charter to THE PEP:From the Charter to THE PEP:The Joint WHO - The Joint WHO - UN/ECEUN/ECE

“Overview of instruments relevant to “Overview of instruments relevant to Transport, Environment and Health and Transport, Environment and Health and Recommendations for Further StepsRecommendations for Further Steps””

• Recommended further integration of Recommended further integration of policies, and specific consideration of all policies, and specific consideration of all health impactshealth impacts through:through:• DDevelopment of a new instrument, evelopment of a new instrument, e.g.e.g. FFramework ramework

CConvention on onvention on TEH TEH

• Further development of existing instrumentsFurther development of existing instruments

• Enhanced cooperation with other organisationsEnhanced cooperation with other organisations


From the Charter to THE PEPFrom the Charter to THE PEP1st High Level Meeting on Transport,1st High Level Meeting on Transport,

Environment and Health – 4 May 2001Environment and Health – 4 May 2001

DDecided to set up a tripartite Task Force to identify the ecided to set up a tripartite Task Force to identify the possible elements of possible elements of aa Framework Convention Framework Convention on TEH on TEH

Endorsed the approach on rationalization of the UNECE Endorsed the approach on rationalization of the UNECE Vienna Plan of Joint Action (POJA) and WHO London Vienna Plan of Joint Action (POJA) and WHO London Charter follow-up processes and on prioritisation of the Charter follow-up processes and on prioritisation of the related workrelated work

PPostost--poneponedd the the decision regarding the starting the decision regarding the starting the negotiation of a Framework Convention on Transport, negotiation of a Framework Convention on Transport, Environment and Health to a Second High Level Meeting to Environment and Health to a Second High Level Meeting to be convened in 2002, before the Rio 10+ meetingbe convened in 2002, before the Rio 10+ meeting


Transport, Health and Environment Transport, Health and Environment Pan-European Programme (THE Pan-European Programme (THE

PEP)PEP)

Adopted at the 2Adopted at the 2ndnd High Level Meeting on Transport, Environment and Health (Geneva, 5 July High Level Meeting on Transport, Environment and Health (Geneva, 5 July 2002)2002)

Launched at the World Summit on Sustainable Development (Johannesburg, September 2002)Launched at the World Summit on Sustainable Development (Johannesburg, September 2002) Consolidates and rationalizes work carried out under the auspices of UNECE and WHO/Euro Consolidates and rationalizes work carried out under the auspices of UNECE and WHO/Euro Identifies the following priorities for action:Identifies the following priorities for action:

– Integration of environmental and health aspects into transport policy; Integration of environmental and health aspects into transport policy; – Demand side management and modal shift; Demand side management and modal shift; – Urban transport Urban transport – Cross-cutting issues:Cross-cutting issues:

» specific needs of the Newly Independent States (NIS) and South Eastern European Countriesspecific needs of the Newly Independent States (NIS) and South Eastern European Countries» issues related to ecologically particularly sensitive areas, and groups at higher risk, such as Childrenissues related to ecologically particularly sensitive areas, and groups at higher risk, such as Children


11stst SG Meeting of THE PEP SG Meeting of THE PEP Geneva,Geneva, 10-11 April 200310-11 April 2003

Discussed and adopted a work plan for the period 2003-2005, Discussed and adopted a work plan for the period 2003-2005, focusing on:focusing on:

– Establishment of a Clearing House on Transport, Health and Environment (in Establishment of a Clearing House on Transport, Health and Environment (in English and Russian)English and Russian)

– Elaboration and implementation of urban plans for transport sustainable for Elaboration and implementation of urban plans for transport sustainable for health and the environmenthealth and the environment (Workshop in Cyprus in Novemebr 2003) (Workshop in Cyprus in Novemebr 2003)

– Development of methods to estimate transport related health impacts and Development of methods to estimate transport related health impacts and their coststheir costs

» In collaboration between Austria, France, the Netherlands, Malta, Sweden, Switzerland, – Establishment of a set of indicators to monitor the integration of Establishment of a set of indicators to monitor the integration of

environmental and health aspects into transport policies and the impact of environmental and health aspects into transport policies and the impact of the policies on health and the environmentthe policies on health and the environment


The effects of the CharterThe effects of the Charter For International Policy developmentsFor International Policy developments

– THE PEP and its launch of at the WSSD in THE PEP and its launch of at the WSSD in JohannesburgJohannesburg

– EU Parliament Resolution on Transport and HealthEU Parliament Resolution on Transport and Health

– Influence on the negotiation of the protocol on Influence on the negotiation of the protocol on SEA to the Espoo ConventionSEA to the Espoo Convention


A European Parliament A European Parliament ResolutionResolution

2001/2067(INI) Final A5-0014/2002, 22 January 2002, 2001/2067(INI) Final A5-0014/2002, 22 January 2002,

adopted on 28 February 2002adopted on 28 February 2002.. Drawing from the WHO and Drawing from the WHO and

UNECE policy analysis, the UNECE policy analysis, the European Parliament adopted European Parliament adopted a resolution calling fora resolution calling for::

– ““a stronger integration of a stronger integration of health considerations into health considerations into transport policies, transport policies, including by carrying out including by carrying out health impact assessment health impact assessment of major transport projectsof major transport projects””


The effects of the CharterThe effects of the Charter For member States – based on the Evaluation of For member States – based on the Evaluation of

the Charter Implementationthe Charter Implementation

FFacilitatacilitateded and and/or/or startedstarted a a cross-sectoral dialogue at the cross-sectoral dialogue at the national level.national level.

CContributontributeded to bring out the to bring out the healthhealth implications of transport implications of transport policiespolicies

PPromotromoteded a greater integration a greater integration of health arguments in the of health arguments in the transport and environment transport and environment agenda at the national level agenda at the national level


The effects of the CharterThe effects of the Charter For Research and Methodological For Research and Methodological

developmentsdevelopments

Guidelines for HIA of transport policies and of Guidelines for HIA of transport policies and of effects of changes in levels of walking and cyclingeffects of changes in levels of walking and cycling

Research on integrated approaches to modelling Research on integrated approaches to modelling the health effects of urban transport policiesthe health effects of urban transport policies

– HEARTS (Health Effects and Risks of Transport Systems)HEARTS (Health Effects and Risks of Transport Systems)– ISHTAR (Integrated Software for Health, Transport efficiency ISHTAR (Integrated Software for Health, Transport efficiency

and Artistic Heritage Recovery)and Artistic Heritage Recovery) Developments on economic valuations of transport Developments on economic valuations of transport

health effectshealth effects– Further development of the Swiss-Austrian-French studyFurther development of the Swiss-Austrian-French study


Challenges to the Challenges to the implementationimplementation

LLack of resources and awareness among actors at the ack of resources and awareness among actors at the national and sub-national level national and sub-national level

LLimited cross-sectoral co-operation imited cross-sectoral co-operation LLack of enforcement tools ack of enforcement tools Other (binding) processes have been the real “driving Other (binding) processes have been the real “driving

force” for many actionsforce” for many actions Modest involvement of Modest involvement of the health sectorthe health sector Difficult to strenghten the involvement of countries with Difficult to strenghten the involvement of countries with

economies in transitioneconomies in transition– Lack of financial resources to support an active participationLack of financial resources to support an active participation– Language barrier – limited availability of texts translated into Language barrier – limited availability of texts translated into

RussianRussian


http://www.euro.who.int/transportcontact: [email protected]


www.the-pep.orgwww.the-pep.orgwww.unece.org/the-pepwww.unece.org/the-pep

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