The impact of the environment on health by country: a meta-synthesis

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Annette Pruss-Ustun , Sophie Bonjour and Corvalan

Environmental Health 2008, 7:7doi:10.1186/1476-069X-7-7

Published: 25 February 2008

Abstract (provisional) Background Health gains that environmental interventions

could achieve are main questions when choosing environmental health action to

prevent disease. The World Health Organization has recently released profiles of

environmental burden of disease for 192 countries.

Methods These country profiles provide an estimate of the health impacts from

the three major risk factors 'unsafe water, sanitation & hygiene', 'indoor air

pollution from solid fuel use' and 'outdoor air pollution'. The profiles also

provide an estimate of preventable health impacts by the environment as a whole.

While the estimates for the three risk factors are based on country exposures,

the estimates of health gains for total environmental improvements are based on

a review of the literature supplemented by expert opinion and combined with

country health statistics.

Results Between 13% and 37% of the countries' disease burden could be

prevented by environmental improvements, resulting globally in about 13 million

deaths per year. It is estimated that about four million of these could be

prevented by improving water, sanitation and hygiene, and indoor and outdoor air

alone. The number of environmental DALYs per 1000 capita per year ranges between

14 and 316 according to the country. An analysis by disease group points to main

preventions opportunities for each country.

Conclusions Not withstanding the uncertainties in their calculation, these

estimates provide an overview of opportunities for prevention through healthier

environments. The estimates show that for similar national incomes, the

environmental burden of disease can typically vary by a factor five. This

analysis also shows that safer water, sanitation and hygiene, and safer fuels

for cooking could significantly reduce child mortality, namely by more than 25%

in 20 of the lowest income countries.

The complete article is available as a provisional PDF. The fully

formatted PDF and HTML versions are in production. http://www.ehjourna

l.net/content/ 7/1/7

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