Assessing health consequences in an environmental impact assessment: The case of Amsterdam Airport Schiphol
Introduction
Health aspects in an environmental impact assessment (EIA) are usually described as part of an inventory of environmental consequences of a planned activity. Reviews of EIAs in the Netherlands, Germany, Canada and the UK show that coverage of human health aspects in EIAs still tends to be limited and there is a lack of a systematic approach or methodology Grontmij, 1993, Fehr, 1999, British Medical Association, 1998, Eyles, 1999, Passchier et al., 2000. The evaluation of health risks is often limited to a qualitative risk assessment, including the evaluation of available scientific literature and a comparison of pollution levels with available environmental standards or guidelines Grontmij, 1993, Davies, 1991. One of the reasons for the lack of quantification of health risks in EIAs is that data needed for a quantitative risk assessment are usually lacking, e.g., exposure–response relations or population-based health data. Furthermore, there is usually little attention for indirect health aspects such as mental and social health effects (e.g., risk perception, residential satisfaction), despite recent developments in this area.
In this paper a comprehensive approach for health impact assessment as part of an EIA is described. The assessment of the health impact of aircraft-related pollution around Amsterdam Airport Schiphol is given as an example. A full report of this assessment is available in Dutch Staatsen et al., 1993, Staatsen et al., 1994.
Schiphol ranks fourth in Europe, behind London, Paris and Frankfurt, in terms of passenger totals, freight traffic and commercial traffic (Schiphol Group, 2000). The airport is situated in a densely populated area on the outskirts of Amsterdam (Fig. 1). For the expansion of the airport with a fifth runway, an EIA was mandatory, in which the impact of different expansion scenarios on the environment was evaluated. In the terms of reference for the EIA, assessment of the health impact of aircraft-related pollution was limited to a qualitative risk assessment (evaluation of the available scientific literature and comparison of aircraft-related pollution levels with available standards or guidelines) (Minister van Verkeer en Waterstaat, 1992). However, health effects can also occur at exposures below standards or exposure limits. Therefore, the State Inspectorate of Public Health, as a legal advisor in EIA procedures, recommended more extensive health impact assessment (Staatstoezicht van de Volksgezondheid, 1991). In addition to physical health effects such as cardiovascular diseases, the perception of health risks was considered important because this may be a determinant of psychosomatic disease. The recommendations were based on expert meetings and public concern about possible health effects of aircraft as expressed in consultations of local environmental groups and the local population. Following these recommendations we quantified the impact of aircraft-related pollution (number of people affected) in addition to a qualitative risk assessment. This was combined with a study of available health registry data and a small questionnaire-based survey on annoyance and risk perception.
Section snippets
Scope of the health impact assessment
Following the recommendations of the State Inspectorate of Public Health, four steps in the health impact assessment were identified:
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assessment of the current health status and potential health risks of the population in relation to environmental pollution from Schiphol airport;
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identification of gaps in knowledge about health effects from airport-related environmental pollution;
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development of proposals for future research into the gaps in knowledge;
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preparation of a programme to monitor the
Selection of indicators for environmental quality and health
Exposure to environmental pollution from Schiphol airport was studied for aircraft noise, air pollution, odour and radar installations around the airport. These were selected on the basis of a screening exercise combined with consultations of local stakeholders and expert groups.
Levels of local air pollution and odour were primarily derived from dispersion modelling. Results were compared to earlier measurements of air pollution at the airport's platform and runways and with observations by
Quantification of the number of people with health effects
The quantification of the scope of the health effects involved three steps: estimation of exposure; assessment of the number of people at risk; and calculation of the number of people affected. Quantification of the affected number of people with health effects was only possible for aircraft noise annoyance, hypertension (as a risk factor for cardiovascular disease) and odour annoyance. For other relevant aircraft-related pollutants (e.g., air pollution and radiofrequent radiation of radars
Analysis of health registry data
Available health registries were used to explore the spatial distribution of health effects (cardiovascular and respiratory diseases) and complaints about aircraft noise and odour around Schiphol airport. The quality of available health registries and their suitability for use in the health impact assessment was evaluated first (Franssen, 1994). Health registries were evaluated on five criteria: geographical reference (postal code), data quality, completeness, coverage and validity aspects. Of
Questionnaire survey and interviews on risk perception and annoyance
To gain insight into the public's concern about health and safety risks of air traffic, an interview-administered questionnaire-based survey and open interviews on annoyance and risk perception were held among adults (≥18 years) living in the vicinity of Schiphol airport (Steenbekkers and de Jong, 1993). The survey was conducted in a sample of the Dutch population (936 persons) and a sample of the population living in the Schiphol study area (479 persons). This survey was conducted between
Discussion
We described a comprehensive approach for the evaluation of possible health effects in an EIA, illustrated with the example of Amsterdam Airport Schiphol. The health impact assessment consisted of an evaluation of the available scientific literature and a comparison of aircraft-related pollution levels with available standards or guidelines. Unlike many EIAs, we also quantitatively estimated the impact of aircraft-related pollution in terms of the number of affected people for several health
Conclusion
The scope of a health impact assessment depends on the situation, available knowledge and data, concern in the population about the impact and the number of people concerned. Preceding an EIA, thorough consideration of concerns from all parties involved is important. For the EIA Schiphol this resulted in a comprehensive approach, as described in this article.
The results of this health impact assessment indicated that exposure to aircraft noise will affect the health status of the population
After the EIA
The Committee for Environmental Impact Assessment has endorsed the conclusions of the health impact assessment and adopted the recommendations (Commissie voor de Milieu-effectrapportage, 1994). Given the Committee's advice, following the EIA, a long-term research programme into health effects of environmental pollution around Schiphol airport was designed: the HIAS. This programme consists of research into the deficiencies in knowledge identified in the EIA and the development of a health
Acknowledgements
The health impact assessment for the EIA Amsterdam Airport Schiphol was commissioned by the Dutch Ministry of Housing, Spatial Planning and the Environment, the Ministry of Public Health, Welfare and Sport and the Ministry of Transport, Public Works and Water Management. It was conducted by the National Institute of Public Health and the Environment (RIVM), the Institute for Environmental Studies, TNO Prevention and Health and TNO Voeding.
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