Commission Staff Working Document Progress Report on the implementation of the "European Environment and Health Action Plan 2004-2010" - Montesquieu Instituut

 

COUNCIL OFBrussels, 31 March 2010

THE EUROPEAN UNION

8201/10

ENV 206 SAN 69

COVER NOTE

from:

Secretary-General of the European Commission, signed by Mr Jordi AYET PUIGARNAU, Director

date of receipt: 29 March 2010

to: Mr Pierre de BOISSIEU, Secretary-General of the Council of the European Union

Subject: Commission Staff Working Document Progress Report on the implementation of the "European Environment and Health Action Plan 2004-2010"

Delegations will find attached Commission document SEC(2010) 387 final.

 

EUROPEAN COMMISSION

Brussels, 29.3.2010 SEC(2010)387 final

COMMISSION STAFF WORKING DOCUMENT

Progress Report on the implementation of the "European Environment and Health

Action Plan 2004-2010"

COMMISSION STAFF WORKING DOCUMENT

Progress Report on the implementation of the "European Environment and Health

Action Plan 2004-2010"

• 1. 

  INTRODUCTION

The "Mid Term Review of the European Environment and Health Action Plan 2004- 2010"

1 reported on progress during the period 2004-2007 on the implementation of

the European Environment and Health Action Plan (EHAP)2.

This Progress Report aims (1) to present the progress on the activities carried out in the Commission in the framework of the EHAP after the Mid Term Review; (2) to assess the results since 2004 and (3) to prepare for the follow-up of the Action Plan post 2010 based on the conclusions, on brainstormings held with Member States

3 and

with the Consultative Forum on Environment and Health4, and taking into account

the Council's and EU Parliament's views5.

• 2. 

  ACTIVITIES CARRIED OUT IN THE COMMISSION SINCE 2007 IN THE FRAMEWORK OF

THE ENVIRONMENT AND HEALTH ACTION PLAN

The EHAP identified 13 specific actions which are jointly implemented by the Directorates-General for Environment, Health and Consumers, Research and the Joint Research Centre. Furthermore, the EHAP is an "umbrella" bringing together all the EU initiatives in the environment, health and research sectors designed to improve environmental health. Progress on health related environment policies since 2007 is reported in section 2.3.

2.1. Human bio-monitoring

General Joint Research Centre (JRC). The conclusions of the HBM Conference, organised by the French Presidency on 4

th 5th November 20088,

also fed into the technical preparations.

• - 

  The political preparations for the pilot project were done via the established network of "Political Back-Ups"

9 and demonstrated to be efficient. The

network has been encouraged to liaise with the responsible persons in the ministries for the European Health Examination Survey and for Inspire.

• - 

  Ensuring financing for the pilot project was difficult and the lack of appropriate EU funding hampered the start of the pilot project in 2008. The Commission launched several calls for proposals under FP7

10 and LIFE+ to fund the EU

Pilot Project on HBM. Member States demonstrated strong interest and commitment by establishing consortia involving a high number of Member States and submitted different proposals in which co-funding was proposed.

11

The EU Parliament and the Council strongly supported the Commission HBM activities and urged the Commission to ensure adequate funding for the pilot project. The COPHES

12 project funded from FP7 started on 1st December

2009. It includes 35 partners from 24 EU countries and Norway.

The pilot phase will focus on capacity-building and harmonisation of procedures, on the future policy role of HBM, and on appropriate communication at individual and

at Community level.

For the post-pilot phase the Commission started to explore:

• - 

  the possibility to embed future HBM activities in an established framework such as the European Health Examination Survey

13 which the Commission

aims to set up in 2011, provided that FP7 funding will be available;

• - 

  the possibility to integrate HBM activities with the harmonisation of indoor air quality monitoring requirements in EU;

2.2. Environment and health Information

The "Environment and Health Information Review and Implementation Plan"17 made

concrete recommendations for increasing linkage and integration between existing systems, enhancing efforts on research and improving data collection procedures. A detailed overview on the implementation of the recommendations so far is made in Annex I.

The ENHIS18 projects started to collect comparable information on environment and

health in the pan-European Region. The CEHIS19 study carried out an in-depth

review of 68 information systems for environment and health in order to identify directions for dynamic data flows between environmental and human health data and proposed how to integrate disparate information into a uniform system.

In the framework of INSPIRE20, which will create an EU-wide harmonized database

with geographical information to support environmental protection policies, health data are considered as well. The INSPIRE Directive includes in Annex III the data theme "Human health and safety" and work on this data theme started in 2009. By 15

th May 2012 the Commission has to adopt Implementing Rules for the

interoperability and harmonization of spatial data sets and services for human health data. Practical steps to involve the environment and health sector representation in INSPIRE Implementing Rules development were suggested at the Consultative Forum on Environment and Health in December 2008 in Luxembourg.

The proposed Shared Environmental Information System (SEIS) is a decentralised but integrated web-enabled information system based on a network of public information providers sharing environmental data and information. A SEIS portal will be developed and when ready it will be linked to the existing EU Health portal.

2.3. Health related environment actions

The EHAP aims to ensure that human health aspects are duly taken into account in the different environment policies. A detailed overview on the initiatives since 2007, contributing to preventing adverse human health effects, is made in Annex II. The summary overview below shows that efforts have been made in the main environmental policies such as air quality, chemicals and climate change. Also, the issue of antimicrobial resistance has been addressed extensively.

chemical speciation and background monitoring that should support better health impact assessments and identification of the specific properties (composition, size, surface area etc.) that make particulate matter the most toxic air pollutant. The Directive introduced also the possibility to gain, under specific conditions, more time for compliance with the existing limit values for PM

10, NO

2 and benzene. This

provisions have until October 2009 been used by 18 Member States. Conditions are assessed by the Commission and though most notifications by the Member States until now have been objected to, the exercise creates important dynamics in better understanding air pollution situation in selected areas and development of more effective air abatement measures, and raises awareness. The Directive also brought requirement for complete overhaul of reporting requirements; they are in final stages of preparation and should in future facilitate HIA and health related actions (such as information for vulnerable population) by adhering to SEIS/INSPIRE and introduction of near-real-time exchange requirements at EU level.

The REACH Regulation21 entered into force in June 2007 and imposed on

companies the obligation to gather information on toxicological properties of chemicals by companies and submit to the EU Chemicals Agency (ECHA), which became fully operational on 1

st June 2008. Companies submitted over 2 million pre-

registrations by the deadline 2/12/2008. A first candidate list of 29 Substances of Very High Concern was established that may become subject of authorisation.

The Council22 acknowledged the challenge for human health and environment

arising from exposure to many different chemicals and invited the Commission to assess how and whether relevant existing Community legislation adequately addresses risks from exposure to multiple chemicals from different sources and pathways, and on this basis to consider appropriate modifications, guidelines and assessment methods, and report back to the Council by early 2012 at the latest.

The Thematic Strategy on the Sustainable Use of Pesticides23 aims to fill a

legislative gap regarding the use-phase of pesticides at EU level through setting minimum rules for the use of pesticides in the Community in order to reduce risks to human health and the environment from the use of pesticides. The objectives of the Thematic Strategy are reflected in four major pieces of legislation, bundled together as a "Pesticides Package" (see Annex II).

Further to the Mercury Strategy25 two legislative acts have been adopted with a view

to banning mercury for certain uses within the EU, banning mercury exports from the EU from 2011 and imposing safe storage of unused mercury (see Annex II).

The Mid Term Review announced that the focus on climate change and health will be increased in the further implementation of the Environment and Health Action Plan. The Commission's "White Paper on Adaptation to Climate Change" - adopted

on 1

st April 2009 underscores the need to ensure adequate surveillance and control of

the health impacts of climate change, such as epidemiological surveillance, the control of communicable diseases and the effect of extreme events. The White Paper is accompanied by a "Commission Staff Working Document on Human, Animal and Plant Health Impacts of Climate Change". This paper elaborates in greater detail what the European Union can do to address the challenges posed by a changing climate.

Further to the announcement in the Mid Term Review to increase the focus on antimicrobial resistance the Commission requested several scientific opinions

26 and

has prepared a Commission Working Document on Antimicrobial Resistance27

highlighting the need for an integrated cross-sector approach and laying the ground for future policy and research initiatives.

2.4. Environment and health research

The actions of the EHAP designed to fill the knowledge gap include (1) integration and strengthening of European environment and health research; (2) targeting research on diseases, disorders and exposures; (3) development of methodological systems to analyse interactions between environment and health; and (4) ensuring that emerging hazards on environment and health are addressed.

Integration and strengthening of European environment and health research

Research projects in the field of environment and health funded under the Fifth Framework Programme of Research (FP5) were analysed and their key findings together with an assessment of their relevance for EU policy were summarised in a 2007 publication

annual budget of approximately 20 MEUR for the years 2007-2009. To date, 14 new research projects were launched under this sub-activity and additional 5 are planned to be launched by the end of 2009. Among the FP7 projects launched, there is also one dedicated to enhancing the coordination among national environment and health research programmes in Europe

• 30. 

  The Commission also continued to organise and to

contribute to numerous research and policy-related events engaging a wide range of stakeholders including national and EU policy makers.

Targeting research on diseases, disorders and exposures

Under the EU Framework Programmes for Research, a number of projects have been designed to improve knowledge on the links between environmental exposures and four priority diseases (childhood respiratory diseases, neuro-developmental disorders, cancer and endocrine disrupting effects). For a more detailed account of the projects in question see Annex III. In ICT for health domain, the interaction of environmental factors with bio-medical factors will be explored through the development of models for understanding diseases.

Development of methodological systems to analyse interactions between environment and health

Under FP6, support has been provided to several projects devoted to the development of integrated risk assessment methodologies and of models for evaluating health effects of multiple environmental stressors or mixtures of pollutants (NOMIRACLE, INTARESE, HEIMTSA). In addition, other FP6 projects were devoted specifically to the valuation of environment-related health impacts on children (VERHI-CHILDREN) or to comparing the costs of emission reduction measures with their benefits in terms of reduced human health impacts (DROPS). Several major projects are still ongoing; once their results are available, suitable follow-up will be considered under FP7.

Ensuring that emerging hazards on environment and health are addressed

remaining FP7 calls. Another emerging area that has received substantial attention since 2007 concerns the possible human health impacts of nanomaterials. Under FP6, as many as 8 research projects have been supported in this area with a total EC contribution amounting to 20 million EUR. Significant support for research in this field is continuing under FP7 with 18 projects already selected for funding.

2.5. Training of professionals in environmental health

The Commission continues to promote the training of professionals. Following the completion of the INCHES project, the Commission is funding a European network for the training and development of public health environment physicians (PHEEDUNET)

• 31. 

  As the investigation of the environmental cause of ill health is

highly complex due to knowledge gaps and multi-factorial causes, there is a need for specific training of physicians and other professionals on diseases caused by environmental factors. The goal of PHEEDUNET is to coordinate this training across Europe. The TRISK project

32 will recruit 25 experienced toxicologists to offer the

risk assessment training modules.

2.6. Indoor air quality

Improving indoor air quality (IAQ) in the framework of Action 12 is focussed around two key elements: (1) addressing environmental tobacco smoke (ETS) and (2) developing networks and guidelines on other factors affecting indoor air quality by using research and exchange of best practices.

The consultation initiated in 2007 by the Commission's Green Paper "Towards a Europe free from tobacco smoke: policy options at EU level" revealed significant support both for comprehensive smoke-free policies in all enclosed workplaces and public places and for further EU action to promote smoke-free environments throughout the Member States.

The Commission adopted on 30 June 2009 a proposal for a Council Recommendation on smoke-free environments calling on all Member States to bring in laws to protect their citizens from exposure to tobacco smoke by 2012.

The EHAP succeeded to create a number of preconditions necessary to close the knowledge gaps in order to prepare the launch of a coordinated action for the next action phase. Key achievements are (1) European and international agreement on a number of key pollutants based on health effects; (2) supporting the World Health Organisation to establish health based guidelines on key pollutants; (3) creating standardised procedures and criteria for monitoring indoor air versus health effects. This will be completed by end of 2009 and it will be followed up by a pilot phase to test newly established protocols and criteria with an ad hock project in 2010; (4) creating a tool for increasing public and professionals awareness: a dedicated website on IAQ is under preparation; (5) studying the feasibility of common criteria for existing labelling schemes in EU. An ad-hoc working group has been established that is drafting a proposal for a framework of harmonised criteria for labelling schemes for building materials. This proposal will be discussed with all Member States in 2010; (6) a construction material emission database and guidance has been developed trough a research project (BUMA). Final report and access to the database is expected by end of 2009; (7) special focus to most vulnerable groups (children, elderly). A pilot project is being launched on indoor air quality in schools. Given the substantial amount of resource available (4 m) this project is expected to cover a large number of schools and Member States. Final output will be a guidance document for healthy environments in schools and a wide dissemination of this document at local (school) level. A similar project is ongoing on nursery homes; (8) related research projects are supported under FP7. A project focusing especially on indoor microbial exposures

33 was launched in April 2008 and a topic on indoor air

quality in office buildings is currently open for proposals; (9) specific projects are ongoing or under negotiation targeted at supporting Member States to implement measures on key areas. These include targeted project on radon, moisture and dampness, emission from consumer products, collection of best practises on maintenance and ventilation; (10) identification of main indoor sources, exposures routes and associated health effects and recommendations for research and policy actions (ENVIE project).

The next phase will have to put all these efforts into a policy coordinated framework based on health and focussing on the priority diseases identified by the 2003 European environment and health strategy.

address public concerns". This workshop confirmed that the political issue of the possible health effects of EMF remains very sensitive, largely because of an ongoing scientific controversy kept alive by a small international group of scientists. The workshop concluded that more research is needed to resolve these scientific uncertainties and bring the controversy to a close.

As a result, the Commission asked the SCENIHR (i) to provide more details on the research recommendations presented in its opinion on the health effects of EMF adopted on 19 January 2009, (ii) to prioritize these research recommendations and (iii) to develop a research strategy based on studies which are feasible and able to deliver results within a reasonable time-frame. The result of this work was adopted in July 2009

36 and will be used as one of the sources of ideas for future research calls at

EU level. Two research projects have already been launched in FP7, focused on potential risks of brain cancer in children and adolescents relative to mobile phone use

37, and on potential health risks of wireless technologies, respectively.

2.8. Communication

In 2005, the European Commission and the European Environment Agency (EEA) published a joint report

38 which gave an overview of current environment and human

health related issues in Europe. The report was followed in 2007 by a chapter39 in the

EEA report "Europe´s Environment The fourth assessment" prepared for the 6th UNECE Environment Ministerial Conference in Belgrade 2007. Currently, the Commission and the EEA are preparing a joint Reference Report due in 2010 summarising the current knowledge and advances in the Environment and Human Health area.

• 3. 

  ASSESSMENT OF RESULTS SINCE 2004 CONCLUSIONS

3.1. Human bio-monitoring

Both technical and political preparations for the EU Pilot Project progressed well since 2004. The lack of appropriate EU funding hampered the start of the pilot project in 2008. However, Member States demonstrated a persistent commitment by submitting new proposals and providing co-funding which resulted in the start of the EU pilot project (COPHES) in December 2009.

3.2. Environment and health information

Only limited progress has been made in the implementation of the "Environment and Health Information Review and Implementation Plan", mainly due to scarce human and financial resources. After the finalisation of the EHNIS projects, the major initiative addressing the issue of combining Environment and Health Information was the CEHIS

40 project, which was focusing on mapping data flows between

environmental and human health data and proposed how to integrate them into a uniform system.

Progress on INSPIRE41, the directive on a European spatial data infrastructure, and

SEIS42, the EU Shared Environmental Information System, provide a solid basis for

the further development of the integrated European Environment & Health Information System.

Establishing a sound integrated European Environment & Health Information System is the cornerstone of the Environment & Health Action Plan and crucial for the long- term development of evidence-based environment and health policy. Past projects (e.g. ENHIS, CEHIS), while limited in scope and time, showed the usefulness of such an infrastructure. It is important to keep in mind that the development of such a system is a complex task and must be seen as a long-term process whose benefits grow exponentially with time while creating synergies and new uses in existing sources of data. Therefore, the modest but essential human and financial resources needed to develop this integrated European Environment & Health Information System should be made available to enable the efficient implementation of the "Environment and Health Information Review and Implementation Plan".

3.3. Health related environment actions

Policies related to air quality, water quality, noise, substances (e.g. endocrine disrupters, dioxins & PCBs, pesticides, biocides, mercury, nanomaterials), climate change, and biodiversity continued to include human health aspects aiming to contribute to the protection of human health. The EHAP coordinates the ongoing health related environment activities and unites them under one single umbrella together with the environment related health activities and the environment and health research activities. This provides - together with the specific environment and health actions outlined in the Action Plan (human bio-monitoring, information system, etc.) - an integrated view on how environmental health is tackled at EU level and where we stand.

the Fifth Framework Programme of Research (FP5), which demonstrates that the adoption of the Action Plan has served as a catalyst to increase research spending at the Community level. It is important that this funding trend be maintained in the Seventh Framework Programme of Research (FP7).

The availability of extra funding has allowed the concentration and re-focusing of efforts to build up a European Research Area in specific areas of environmental health science as outlined in the European Environment and Health Strategy. The novel funding instrument of network of excellence was used in the area of environment and health to combat fragmentation of science and policy in specific areas such as allergy and asthma

44, environmental cancer risks45 or health risks of

exposure to endocrine disrupting chemicals46. These networks brought together a

large number of scientists and other stakeholders from a variety of disciplines to carry out a joint programme of activity which included, in addition to research, activities such as training, dissemination of results, education, and exchanges of expertise.

The research/policy interface was enhanced during the first phase of the Action Plan by the introduction in the FP6 of a specific 'Scientific Support to Policy' programme

47, which allowed the close exchange of ideas between research and

policy-makers and the discussion of policy options and implications of research undertaken. From this programme a number of smaller targeted research projects, addressing specific issues such as bathing water

48 or indoor air quality49 were

financed and information on these projects is available50.

The additional availability of financial resources has also allowed the Commission to fund unprecedented large-scale integrated projects, the aim of which was to support objective-driven research to address major societal needs. This funding instrument was frequently used in the environment and health area in the past six years, for example, to fund projects and increase knowledge base on improving the methods, models and tools of integrated environment and health impact assessment

51; on

impact of environmental changes on the spread of infectious diseases52; on

uncommon cancers53; or on genetic and environmental causes of asthma54.

Environment and Health sub-activity, embedded in the Environment theme of the Cooperation programme

• 55. 

  Unlike in FP6, policy aspects are embedded in all themes

of the Cooperation programme, thus providing a close and natural link between research and policy where necessary and relevant.

Relevant policy-makers have been provided with progress or final project reports and have in some cases been briefed directly on the outcome of the results. In addition, they have attended numerous workshops and conferences on specific issues such as health impacts of endocrine disrupters, indoor air pollution or electromagnetic fields. They have also served in advisory functions for some projects. These contacts have allowed the transfer of results from science to policy and vice versa, and an exchange of ideas for prioritisation of issues for future research. Policy-makers involved in risk assessment and management issues at national or EU level have been engaged by the projects in a science-policy dialogue mostly via targeted workshops and participation in conferences and project meetings in order to ensure proper policy take-up of results generated.

3.5. Indoor air quality

One important achievement since 2004 is a strengthened cooperation between stakeholders on indoor air quality, and more broadly to improve respiratory health. These actions have been so far targeted on creating tools and preconditions necessary to support a more coordinated approach in this field as requested by the European Parliament in two Parliament Resolutions. Major achievements have been the prioritisation of a small pool of pollutants based on health effects and notably the collaboration with the World Health Organisation on developing health based guidelines value for those pollutants. Important steps have been also undertaken towards the creation of a common monitoring system for key pollutants and exchange of best practices-tools to prevent radon exposure and to improve ventilation practices in buildings on the basis of health criteria.

The next action plan needs to put more emphasis on the policy side. The issue of indoor air needs to be more prominent and to have momentum. This should become part of a broader strategy on healthy environments. Work and result on Environmental Tobacco Smoke have been quite satisfactory due to engaged resources and a youth-friendly EU wide media campaign. The creation of a thematic platform on "Safe, Healthy and Sustainable Buildings in EU" is envisaged which will assist towards the sustainable implementation of several EC policies affecting the built environment (e.g, indoor air quality, noise, safety of constructions, sustainable products and resource use, etc.) in an integrated framework. The work on the platform will be carried out in close cooperation with the BUILD UP Initiative on energy efficiency of buildings and other relevant Commission initiatives.

scientist maintain this issue as a very sensitive political subject. Limited additional research as recommended by the independent experts of the SCENIHR should be sufficient to resolve the main uncertainties feeding the current scientific controversy and anxious calls for the application of the precautionary principle.

3.7. Overall Environment and Health Action Plan 2004-2010

The Action Plan demonstrated its added value by:

(1) putting in place and maintaining a strong process of coordination and collaboration between the health, environment and research sectors at Member States and EU levels;

(2) consolidating the progress made on well-defined inter-sectoral actions such as human bio-monitoring and indoor air quality thanks to coordination and integration;

(3) providing a broad and coherent framework for all the EU initiatives designed to address health issues related to the environment, whether they originated under environment policy, public health activities or research activities. The Action Plan ensured that health aspects are duly taken into account in environment policies, that environmental aspects are duly taken into account in health policies and that specific research addressing environment and health issues is funded

• 56. 

  It provided an integrated view on how the

environment & health issue is addressed at EU level and on where we stand. Key EU environmental policies such as air quality, chemicals or climate change have explicitly taken health aspects into account and will deliver health benefits to EU citizens in the long-term.

Furthermore, several Member States reported that the EU Action Plan has been a major driver for the development of national Environment & Health Action Plans (see Annex V).

(such as for human bio-monitoring and air quality/health monitoring) and other technical non research projects for the future EHAP and other initiatives.

(5) Science-policy interface: An inherent characteristic of the Environment and Health field is the multiplicity of possible factors and causes and the long lag times of the effects that make policy uptake difficult in the short-term.

Furthermore, the time between the start of the preparation of a call and the publication of the project results is very long (6 to 7 years) and it often takes a series of publications before a body of knowledge is mature enough to justify uptake by the policy sphere. Relevant policy-makers were provided with progress or final project reports and have in some cases been briefed directly on the outcome of the projects. In addition, they have attended numerous workshops and conferences. Nevertheless, the results of the many environment and health research projects funded under FP5, FP6 and FP7 and of other information gathering efforts could be better exploited at policy level. An efficient mechanism to ensure the science-policy interface should be identified.

• 4. 

  REACTIONS FROM OTHER EU INSTITUTIONS

The Council Conclusions on Environment and Health57 invited in 2007 the

Commission to ensure adequate funding for human bio-monitoring, to consolidate guidelines for indoor air quality, to develop the environment and health information system, and to increase funding for research. Furthermore, the Council urged the Commission and the Member States to develop tools for anticipating, preventing and responding to climate change and to continue to support research and to develop specific risk assessment for nanomaterials and nanoproducts.

The EU Parliament in its Resolution on the Mid Term Review of the European Environment and Health Action Plan 2004-2010

58 in 2008 regretted the insufficient

funding for human bio-monitoring, requested concrete measures on indoor air quality, expressed its concern about the lack of specific legal provisions to ensure the safety of consumer products containing nanoparticles, and requested stricter exposure limits for electromagnetic fields, and an adequate response to climate change.

in the CEHAPE. The Midterm Review has been presented in the Intergovernmental Midterm Review meeting on Environment and Health in Vienna in June 2007.

The Commission co-organised with WHO and the Spanish authorities a workshop in Madrid in October 2008 called International Public Health Symposium on Environment and Health Research: "Science for Policy, Policy for Science - Bridging the gap" to discuss how research findings can be translated into policy.

The Commission is involved in the preparation of the Fifth Ministerial Conference on Environment and Health "Protecting Children's Health in a Changing Environment" (March 2010, Italy) and attended four High Level Preparatory meetings

• 60. 

  Climate change-related health issues will be one of the main pillars in the

conference.

The Commission is also working in close collaboration with WHO concerning indoor air quality with the aim to produce health-based thresholds or guideline values for pollutants, and to gather best practices on remedial measures for moisture and mould.

• 6. 

  FOLLOW-UP OF THE ACTION PLAN POST 2010

This progress report indicates that significant efforts have been done and that progress has been made in various areas since 2004. Building on this it is now proposed to continue and consolidate the present actions in the coming years, with emphasis on :

• - 

  continued coordination and collaboration between the health, environment and research sectors at Member States and at EU level;
• - 

  focusing on well-defined inter-sectoral actions in a number of priority areas, such as human bio-monitoring, indoor air quality, the environment & health information system and disease predictive models, climate change and health, etc. for which concrete activities, responsibilities, deliverables and funding will be identified;

ANNEX I

Detailed overview of progress on Environment and Health Information

Data linkage: Task 1 of the "Environment and Health Information Review and Implementation Plan" recommended to assess the feasibility of data linkage, as a basis for identifying emerging issues, by using existing funding programmes to enable pilot work.

The Commission funded a study on "Connectivity between Environment and Health Information Systems: Supporting synergy between environment and health research and policies "

• 61. 

  Within this study, two key scientific challenges that need to be met by such

information systems are, the measurement and/or modelling of individual exposure and its effects on health, and on the other hand the identification of the cumulative effects of exposure, especially to mixtures of chemicals and other stressors. It is also essential to look continuously on the status of integration of heterogeneous architectures and promote the development of software modules which will enhance such integration and resolving the gaps in temporal and spatial dimension of existing data structures. It was found out throughout the CEHIS interviews that the benefit of achieving the integration of Environment and Health Information Systems depends entirely on who uses it, and for what purpose. Data and information are currently used by many players for many purposes, but the mechanisms for collecting, exchanging and using the data do not currently add up to something that can be described as a "shared system". Similarly the value chain of integration includes multiple actors each with their own interests. Successful deployment of integrated information systems requires suitable incentives for all actors in the value chain. Many of the most important benefits of Environment and Health information systems are for public health. Such systems should thus be regarded as a public good. This implies a key role for public expenditure in promoting deployment. It is reasonable to assume that progress towards the vision outlined above would be accompanied by a significant increase in the use that is made of environmentally-relevant data, together with a significant reduction in cost for the users. In translating the need for information into the design of a new integrated information system for environment and health, this study recommends steps to minimise duplication and to maximise prospects for integrated systems. It concludes that Information and Communication Technologies (ICT), for which a significant share of research is administered through the Information Society Programme (IST), are the main enabler of integration. Such research encompassing technologies, tools, systems and applications, are likely to trigger new areas or applications for the protection of human health and environmental sustainability. It is expected that industry take-up of ICT technologies is likely to lead into a sharp expansion of applications in exactly the same way as was done in the 90's for mobile telecommunications.

The European monitoring network has not been set up because no funding was available under the FP7 Research Infrastructure initiative. An alternative solution (with a number of restrictions due to the limited budget) was proposed, notably to fund the network via a collaborative FP7 Project. Unfortunately this did not succeed either: the ANEMONE proposal

64 submitted by a consortium of European experts to the 1st call for proposals under

the Environment theme of the FP7 Cooperation Programme (Megacities, air quality and climate) was not selected for funding. Following the third call under the Environment theme, the a TRANSPHORM project (Transport related air pollution and health impacts integrated methodologies for assessing particulate matter) was selected for funding and is currently under negotiation. It addresses part of the objectives as it focuses on the effects from transport. It will have close links with the ESCAPE project (see below).

Experts indicate that more sustainable EU Monitoring network is still needed and should be funded via Research Infrastructures.

Ambient air epidemiology: Task 3 of the "Environment and Health Information Review and Implementation Plan" recommended to develop a programme for long-term studies on ambient air pollution and health impacts across Europe.

"The European study of cohorts for air pollution effects"65, launched under FP7, aims to

measure fine particles and nitrogen dioxide at different locations in 40 areas spread over Europe and to study the relation between these pollutants and (1) low birth weight, asthma and allergy in children; (2) respiratory diseases in adults; (3) cardiovascular diseases in adults;

(4) mortality and cancer in adults.

This study is only the start for setting up a programme for long-term studies. An operational budget for a future programme should be identified.

Ambient air, health data: Task 4 of the "Environment and Health Information Review and Implementation Plan" recommended to improve and harmonise baseline frequency data for health endpoints of interest across Member States.

The proposed study related to an optimized data handling procedure was not launched due to the unavailability of funding under the Public Health Programme.

and radon. The results of this study fed into the work of SANCO's IAQ Expert Working Group.

In 2008, the DG SANCO's experts group on indoor air quality assisted by DG JRC developed an EC Inter-service website on indoor air quality and health effects

• 67. 

  This website mainly

aims at increasing public awareness on the health importance of air quality in indoor environments and giving advice on how to improve indoor air quality in the EU dwellings. The contents of the websitewill be completed during 2009.

In 2008, DG SANCO supported by the DG JRC launched a long term project for reviewing existing data on indoor air priority pollutants and their concentrations in EU Member States and establishing harmonised monitoring criteria and exposure assessment protocols which are necessary for obtaining comparable data on indoor air pollution in EU. As part of this project the INDEX exposure guidelines for indoor priority pollutants (i.e, formaldehyde, benzene, carbon monoxide, nitrogen dioxide and naphthalene) are being updated and the health effects due to exposure to indoor particulate matter are being evaluated.

With regard to construction materials (Council Directive 89/106/EEC) the Commission has established a preparatory working group led by DG JRC (and assisted by the German, French, Finnish and Danish labelling schemes for construction products) with the aim to establish common criteria between existing indoor emissions labelling schemes in the EU.

Another relevant project on building materials (BUMA68) was finalised in April 2009. BUMA

created a database of emissions from commonly used construction materials through field and chamber measurements, and developed guidance for producers, constructors and end users.

Based on mandate M/366 (within the framework of the Construction Products Directive 89/106/EEC) CEN is working on developing horizontal technical assessment methods for the emission of dangerous substances emitting from construction products into indoor air, soil and water.

DG SANCO has recently launched a call for a project69 to develop European health-based

ventilation guidelines for homes, offices and public places such as schools and nurseries. These guidelines should help Member States in revising existing building codes and practices, also in the light of energy efficiency of buildings.

The AIRMEX project (European Indoor Air Monitoring and Exposure Assessment Project)

co-odinated by the Joint Research Centre was finalised in October 2008. This project started in 2003 aimed at identifying and quantifying the main air pollutants and their sources present in public buildings, schools and kindergartens in 11 European cities. An exposure assessment and evaluation of health risks of people spending time in these indoor environments due to chronic exposure to key air pollutants was also performed.

A new project (CLEAR-UP72) was also funded by FP7 for 2008-2012 that presents a holistic

approach to ensuring a comfortable and healthy indoor environment based on resource efficient technologies. By development and novel use of nano-materials it aims to increase energy performance in heating, ventilation, air conditioning (HVAC) and lighting systems, and to improve indoor air quality using catalytic purification.

The four-year large-scale integrating NANODEVICE73 project, launched in 2009, will aim at

developing new and innovative concepts and methods for measuring and characterising airborne engineered nanoparticles with novel portable and easy-to-use device(s) for workplaces.

Drinking Water Safety Plans: Task 6 of the "Environment and Health Information Review

and Implementation Plan" recommended to assess whether Water Safety Plans (WSPs) should be mandated in the context of the revision of the Drinking Water Directive. WSPs are a Risk Assessment/Risk Management based concept, derived from 'Hazard Analysis and Critical Control Point' methodologies designed to identify contamination at any point in the treatment and supply chain.

The WHO study on WSPs74 (finalised in October 2007) co-financed by a DG ENV funded

grant gave support to the Commission in order to develop a framework for the implementation of water safety plans in the EU. The study concluded that WSPs should be included in the revision of the Drinking Water Directive. The Commission Proposal for a revision of the Drinking Water Directive is foreseen in 2010 and one of the major changes

75

will be the inclusion of WSPs.

Drinking Water Data Base: Task 7 of the "Environment and Health Information Review and Implementation Plan" recommended to develop a database of current raw monitoring data.

The ENHIS project76 developed a qualitative health impact assessment on drinking water

pollution. The aim is to develop a tool or guidance for policy makers how to understand currently available data on drinking water quality from national and international databases in terms of public health risk and health effects of drinking water pollution.

Bathing Water Epidemiology: Task 9 of the "Environment and Health Information Review and Implementation Plan" recommended to review the potential for health impact assessment

of bathing water.

EPIBATHE and VIROBATHE - two FP6 projects on the health impacts of bathing water - were finalised in 2008. Based on the final reports

77 of the studies the Commission will in 2009

issue a document reporting on the outcome of the studies and concluding on the further work to be done on the health implications of bathing water at EU level.

Food Alert System: Task 10 of the "Environment and Health Information Review and Implementation Plan" recommended to develop a system of mutual alert between environment and health monitoring agencies.

Due to the lack of human resources nothing was done.

Food Monitoring Coherence: Task 11 of the "Environment and Health Information Review and Implementation Plan" recommended to improve the general coherence of environmental and food monitoring across Member States.

Due to the lack of human resources nothing was done.

Noise Health Impact Assessment: Task 12 of the "Environment and Health Information

Review and Implementation Plan" recommended to assess the environmental noise exposure related health impacts on the population across Europe.

To date noise exposure data reported by Member States under the Environmental Noise Directive are collected and risk assessment guidelines for exposure to noise are being developed by WHO in collaboration with DG JRC. Under the Environmental Noise Directive

78, Member States were obliged to provide noise maps by 31st December 2007 for all

In 2008, DG JRC assessed the equivalence of the national assessment methods used by the EU Member States for strategic noise mapping against the interim methods, as specified in Annex II of the Directive 2002/49/EC and the EC guidelines adopted on 6 August 2003.

In October 2009, WHO published the Night Time Noise Guidelines (NNGL) for Europe and is also preparing two other publications jointly with DG JRC on "Practical guidance for risk assessment of environmental noise" and on "Aircraft Noise and Health".

The Commission launched a coordination action under FP7 "European Network on Noise and Health"

80 related to the health impacts of noise. This network will review the existing

evidence on the association of environmental noise exposure and health effects focussing on the consolidation of existing state of the art knowledge and the identification of gaps in the evidence and future research needs and hypotheses to be tested. Focus will be on noise exposure assessment in health studies in order to build more complex analytical models of noise and health effects that take into account moderating factors including the joint effects of air pollution and noise.

Health Impact Assessment and Burden of Disease Methodology: Task 13 of the "Environment and Health Information Review and Implementation Plan" recommended to progress towards the harmonisation of Health Impact Assessment (HIA) and Environmental Burden of Disease Methodology (EBDM).

HIA: the HEIMTSA81 project funded under the Sixth Framework Programme for Research

will develop a methodology for Health Impact Assessment by January 2011.

EBDM: The harmonisation work on Environmental Burden of Disease Methodologies has not yet started but will be included in one of the upcoming FP7 calls for proposals.

Enhancing public access to Environment and Health Information: Task 14 of the "Environment and Health Information Review and Implementation Plan" recommended to bring together environment and health information for scientists, policymakers and the public, through the EU Public Health Portal and the portal to be developed for the Shared Environmental Information System (SEIS), as part of an EU Communication Strategy on Environment and Health. The aim of this initiative is to maximise public availability of Environment & Health Information, give periodic feedback to stakeholders and to raise awareness.

the Commission in preparing its policy proposals for the implementation of SEIS and met for the first time on 29

th September 2008. The SEIS portal has not been developed yet and will

not be finalised before 2011.

DG RTD has revamped its Environmental research website84 and it now contains an

Environment and Health section describing activities related to research. A dedicated website on endocrine disrupters is also available

85.

Summary overview: the shaded boxes indicate where progress is made.

Tasks Description task State of play Problems encountered Future

1 Data linkage CEHIS project (Connectivity Environment Small scale feasibility Final report 2009.

and Health study. Would need more resources

Information Systems) for future Pending on available human and financial resources further data linkage pilot projects could be launched.

development

The Commission should then review overall progress and make recommendations for future data linkage activities at EU level.

2 Ambient Air, Research Infrastructure EU Monitoring Network not set

up. No FP7 Research Infrastructure funding available. ANEMONE project not selected for funding. New project covers only transport related impacts, of limited duration. The EU Monitoring Network is needed and should be funded

via Research

New project on Infrastructures.

air/health/transport has recently been

selected under FP7

Cooperation Env that partially covers objectives.

3 Ambient Air epidemiology Started: FP7 project launched (ESCAPE

86).

The programme has not been developed yet. Lack of operational budget. Operational budget to be found.

4 Ambient air, health data Study not launched. No funding available under PHP. Pending on available PHP funding.

5 Indoor Air Health Impact Assessment OK - Will be continued by SANCO and its Expert Working Group.

12 Noise Health Impact Assessment Started. - Will continue in framework of Noise Directive

13 Health Impact Assessment and Environmental Burden

of Disease Methodology.

HIA: started.

EBD: not started.

No FP7 call launched so far. Results in January 2011.

Pending on available FP7 funding.

14 Enhancing public access to Environment & Health Information Started. - Will continue.

ANNEX II

Detailed overview of progress on health related environment actions

The Environment and Health Action Plan aims to ensure that human health aspects are duly taken into account in the different environment policies. In this respect, a number of new initiatives have been adopted since 2007 with a view to decreasing the risk to human health and gathering better information. These are summarised below.

Ambient air

In June 2008 the Directive on ambient air quality and cleaner air for Europe 2008/50/EC entered into force. It merges and streamlines the existing 5 legal instruments and introduces new objectives on fine particulate matter PM

2.5. These combine, for the first time, the PM

2.5

limit value (to be achieved throughout the territory) with the specific target for public exposure reduction between 2010-2020. The latter should steer abatement actions that will maximize public health benefits. Directive also includes specific requirements for PM

2.5

chemical speciation and background monitoring that should support better health impact assessments and identification of the specific properties (composition, size, surface area etc.) that make particulate matter the most toxic air pollutant. The Directive introduced also the possibility to gain, under specific conditions, more time for compliance with the existing limit values for PM

10, NO

2 and benzene. This provisions have until October 2009 been used by 18

Member States. Conditions are assessed by the Commission and though most notifications by the Member states until now have been objected to, the exercise creates important dynamics in better understanding air pollution situation in selected areas, development of more effective air abatement measures and raises awareness. The Directive also brought requirement for complete overhaul of reporting requirements; they are in final stages of preparation and should in future facilitate HIA and health related actions (such as information for vulnerable population) by adhering to SEIS/INSPIRE and introduction of near-real-time exchange requirements at EU level.

A call for proposals on "Transport related air pollution and health impacts" was launched under FP7. This project will importantly contribute to better understanding of health effects of air pollution. A project called TRANSPHORM (Transport related air pollution and health impacts integrated methodologies for assessing particulate matter) is under negotiation. It will have close links to the ESCAPE project (European Study of Cohorts For Air Pollution Effects).

GMES Global Monitoring for Environment and Security has since 2007 developed its Atmosphere service will support actions related to the reduction of public exposure to air pollutants by providing health-relevant data on air pollution. MACC project funded under FP7 is developing the pre-operational core service, while further downstream calls have also been initiated; PASODOBLE is currently under negotiation.

Noise

The revision of the Environmental Noise Directive is foreseen for 2011. Health related issues will be duly taken into account in this revision. A European research network on noise and health (ENNAH), funded by FP7, was launched in September 2009.

Drinking water

A Commission Proposal for revising the Drinking Water Directive is foreseen for 2010. The main topics for the revision are the coherence with other water-related legislation (such as the Water Framework Directive), the integration of Water Safety Plans in the legislation, and an improved reporting on water quality of small water supplies resulting in better water quality for consumers, and a modernised and inyeractive reporting system, based upon WISE. Safe drinking water also from small supplies is an important issue. The Commission has therefore in January 2009 requested - based on article 10 of the Treaty aggregated statistical information on the monitoring results for water supplies to which the Directive applies but which are not covered by the obligation to publish reports. From 2009 on, Member States had the facility to deliver electronically the tri-annual report on drinking water quality as requested by the directive and from 2011 on, drinking water quality data will be available in an aggregated way and in graphical format on the Water Information System for Europe (WISE) website

88.

Bathing water

The Commission publishes in May of each year an EU-wide report covering all 27 Member States, both in a paper version and an internet version. Reports on individual Member States are published on the Internet. From June 2008 on the Bathing Water Atlas has been replaced by interactive maps on the Water Information System for Europe ( Most EU legislation dealing with substances is based on the evaluation of single substances. However, in reality humans are exposed to a variety of different substances in the air and through our food and water as well as other consumer products. While current approaches to the assessment of substances try to address these and other uncertainties by building in safety margins, there are concerns that this still does not provide sufficient security and that we should address the combined effects of substances in a more systematic way. The possible number of chemical combinations is potentially enormous and it is neither realistic nor useful to test every possible combination. Methodologies for assessing/estimating the combined effects of substances are being developed and used by scientists and regulators in specific circumstances but there exists no systematic, comprehensive and integrated approach. DG Environment has contracted a comprehensive study on the effects of combined exposure to many different substances as well as possible approaches for addressing this challenge. During the course of 2010 and 2011, the Commission will consult widely on the results of this study with a view to producing the report requested in the Council conclusions of 22

nd

December on the "combined effects of chemicals.

Endocrine Disrupters

Legislative actions was taken to protect human health and environment against substances having endocrine disrupting effects. The authorisation procedure for substances of very high concern under the REACH Regulation covers also substances having endocrine disrupting properties for which there is scientific evidence of probable serious effects to human health or the environment which give rise to an equivalent level of concern to those of the CMRs, PBTs and vPvBs and which are identified on a case-by-case basis. This mechanism ensures that substances having endocrine disrupting effects after being identified as substances of very high concern can be used for a particular purpose, marketed as such or as a component of a product only after authorisation has been granted by the Commission. The newly adopted Regulation on plant protection products establishes criteria under which an active substance cannot be approved for use in plant protection products. One of these criteria in relation to human health specifies that an active substance, safener or synergist shall only be approved if, on the basis of the assessment of Community or internationally agreed test guidelines or other available data and information, including a review of the scientific literature, reviewed by the Authority, it is not considered to have endocrine disrupting properties that may cause adverse effect in humans, unless the exposure of humans to that active substance, safener or synergist in a plant protection product, under realistic proposed conditions of use, is negligible. The criterion in relation to eco-toxicology states that an active substance, safener or synergist shall only be approved if, on the basis of the assessment of Community or internationally agreed test guidelines, it is not considered to have endocrine disrupting properties that may cause adverse effect on non-target organisms unless the exposure of non-target organism to that active substance in a plant protection product under realistic proposed conditions of use is negligible. These provisions ensure protection of human health and environment from plant protection products having endocrine disrupting properties.

for ED screening are also progressing under the auspices of the OECD. In particular, a draft OECD test guideline for agonist estrogenic assessment using an in vitro estrogen receptor transcriptional activation assay.

Funding of research on endocrine disrupters continued in FP7 for example under the theme 6 'Environment', activity "Environment and Health". Three projects were selected from the first call of FP7 dealing with long-term health impacts of endocrine-disrupting chemicals with an EU contribution of around 10 m. The projects form a cluster called NECTAR (Network for Environment Chemical Toxicants Affecting Reproduction

90). In the next round of FP7, an

OBELIX project was funded which is studying link between prenatal exposure to substances having endocrine disrupting effects and development of obesity later in life.

JRC continued its work on development and validation of in vitro assays for testing of endocrine disruptors and started work on preparation of database of substances having endocrine disrupting effects.

Pesticides

The objectives of the Thematic Strategy on the Sustainable Use of Pesticides 91 are reflected

in four major pieces of legislation, bundled together as a "Pesticides Package".

(1) the Framework Directive on the sustainable use of pesticides92 aims to reduce the

risks to human health and the environment from the use of pesticides with new measures that Member States will have to establish, such as access to training for professional users of pesticides, regular inspection of pesticide application equipment, a general ban of aerial spraying, and general principles of Integrated Pest Management becoming mandatory as from 2014;

(2) the Regulation on the placing of plant protection products on the market, revising Directive 91/414/EEC

93 includes several measures aiming at reinforcing the

protection of human health and the environment. New criteria for authorisation of plant protection products are introduced that are expected to reduce possible risks of exposure to the most hazardous substances. Particular emphasize has been given to the protection of vulnerable groups of the society. Furthermore, the Regulation obliges farmers to keep records on the application of plant protection products and to make this information available on request. Farmers can also be requested to give prior notice to neighbours before applying certain plant protection products which would allow them to take precautionary measures.

(4) The revision of the Machinery Directive95ensures that machinery for pesticide

application does not endanger the health or safety of people or the environment.

The Thematic Strategy called for establishing a system of information exchange at Community level involving Member States and all other relevant stakeholders in order to continuously develop and update appropriate guidance, best practice and recommendations. Article 18 of the above-mentioned Framework Directive established the Expert Group on the Thematic Strategy on the Sustainable Use of Pesticides and its priorities. The Expert Group met the first time in June 2009 and will meet again in June 2010.

Biocides

The Review Programme of the Biocides Directive continued evaluating active substances used in biocidal products for their risks to human health and the environment and 29 substances have been included in Annex I to the Directive. The Commission also adopted a proposal to replace the Biocides Directive

96 aiming to improve the protection of human health

by including specific provisions related to the scope, product authorisation and data requirements.

Antibiotic resistance being a major public health problem - has increased worldwide, leading to treatment failures in human and animal infectious diseases. The potential for biocides (disinfectants, antiseptics, preservatives, sterilants) to induce antibiotic resistance has been reported only relatively recently. The potential risk of a biocide to induce antibiotic resistance is currently not addressed in the Review Programme of the Biocides Directive where active substances used in biocidal products are currently being evaluated for their risks to human health and the environment. Directorate-General Environment requested the Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) to assess the antibiotic resistance effects of biocides. The Opinion

97 concluded that "scientific evidence

does indicate that the use of biocides may contribute to the increased occurrence of antibiotic resistance. To date, the lack of precise data makes it impossible to determine which biocides create the highest risk of generating antibiotic resistance. In view of the large and increasing use of biocides and the continuous increase of antibiotic resistance data and methodologies are urgently needed to clearly characterize the risk." SCENIHR has been asked to develop, and if necessary expand the research recommendations presented in the SCENIHR Opinion on the Assessment of the Antibiotic Resistance Effects of Biocides. This would include the definition of the main scientific gaps addressed by each recommendation, in particular related to the development of standard protocols for the evaluation of antimicrobial resistance induced by biocides. The opinion should also include methodological guidance on the experimental design and on the requirements to ensure high quality and usability of the results for risk assessment and should be finalised by March 2010.

The FP7 funded project "Confronting the clinical relevance of biocide induced antibiotic resistance" (BIOHYPO) started in June 2009 and results will be available in June 2012.

Mercury

Further to the Mercury Strategy99 two legislative acts have been adopted with a view to

banning mercury for certain uses within the EU, banning mercury exports from the EU from 2011 and imposing safe storage of unused mercury: (1) Directive 2007/51/EC of 25 September 2007 relating to restrictions on the marketing of certain measuring devices containing mercury. The restrictions concern fever thermometers (without any exception) and other measuring devices intended for sale to the general public; (2) Regulation (EC) No 1102/2008 of 22 October 2008 on the banning of exports of metallic mercury and certain mercury compounds and mixtures and the safe storage of metallic mercury.

The SCHER and SCENIHR Opinions stated that on the basis of the current information it is not possible to conclude that mercury in dental amalgam constitutes a risk for human health.

The Directorate-General Environment funded study on "Options for reducing mercury use in products and applications and the fate of mercury already circulating in society" addressing Action 10 of the Mercury Strategy was finalised in December 2008 and is available on

http://ec.europa.eu/environment/chemicals/mercury/pdf/study_report2008.pdf.

Nanotechnology Nanomaterials

In the Nanotechnology Strategy100 and European Nanotechnology Action Plan 2005-2009101

the Commission proposes concrete steps towards a "safe, integrated and responsible" development of nanotechnology, which means that environment, health and social aspects of nanotechnology need to be considered at the earliest possible stage. The implementation of the Action Plan has been reported in two Communications from 2007

102 and 2009103. In

particular, the implementation report from 2009 and its accompanying Staff Working Document includes a full review of state of the art of actions taken by the Commission in the area of Nanotechnology, including the work on environment and health safety.

to address nanomaterials explicitly, at least within the scope of legislation on chemicals, food, waste, air and water, and worker protection. The EU Parliament has also called upon the Commission to evaluate the need to review REACH, waste, air and water, and worker protection legislation on specific aspects. The Commission has undertaken to present a new report in 2011, paying particular attention to a number of points raised by the European Parliament.

Scientific knowledge about health, safety and environmental aspects of nanomaterials is a critical factor for the implementation of legislation. Therefore, research efforts have intensified over the last five years or so at the EU level, in Member States and internationally. To develop a sound knowledge base, targeted actions to address environment and health issues have been launched through the Research Framework Programmes and the Commission's Joint Research Centre, and international collaboration has been intensified, in particular within the framework or the OECD Working Party on Manufactured Nanomaterials and in ISO/CEN. A Recommendation for a Code of Conduct for responsible nanosciences and nanotechnologies research was adopted by the Commission in 2008

106.

At the request of the Commission, the EU Scientific Committees advise on the potential risks of nanomaterials and respective methodologies. According to the opinions of the EU Scientific Committees,

not all nanomaterials induce toxic effects. The Scientific Committees

stress that the hypothesis that smaller necessarily means more toxic cannot be substantiated by the published data. However, certain health and environmental hazards have been identified for certain manufactured nanomaterials, indicating potential toxic effects. Long, non- degradable, rigid nanotubes (longer than 20 micrometres) have in several experiments been found to have effects similar to hazardous asbestos, causing inflammatory reactions for instance. Experiments also indicate that carbon nanotubes with these characteristics could induce a specific form of lung cancer, mesothelioma, which is also observed in relation to asbestos exposure. Whether such nanotubes would pose a risk for humans is not known but cannot be ruled out. This means that nanomaterials are similar to other substances, in that some may be toxic and some may not, and some may be toxic only under certain exposure conditions. As there is not yet a generally applicable paradigm for the identification of potential hazards of nanomaterials, the Scientific Committees continue to recommend a case- by-case approach for the risk assessment of nanomaterials.

Climate Change and Health

The Environment and Health Action Plan 2004-2010 announced in Action 8 that the Commission will work with Member States and the WHO to address climate change and health. The Mid Term Review reported that several EU projects on climate change and health have been funded under FP6, FP7 and under the Public Health Programme; it also announced that the focus on climate change and health will be increased in the further implementation of the Environment and Health Action Plan.

The Council urged the Commission and the Member States to develop tools for anticipating, preventing and responding to potential threats from climate change

107.

The European Parliament called for enhanced multi-agency cooperation `in order to boost the early warning system and thus to curb the harmful effects which climate change has on health'

108; it also called on Member States and the Commission to respond adequately to the

new threats posed by climate change such as the increased presence of emerging viruses and undetected pathogens and therefore implement new existing pathogen reduction technologies that reduce known and undetected viruses and other pathogens transmitted by blood

109.

Directorate-General JRC was involved in the Global Air Pollution and Climate Change Action

110 on linkages between air pollution and climate change to make policy makers aware

of potential synergies and trade-offs that are imposed by the way the atmosphere and the climate system work; the European Flood Alert System

111, developed within the Weather

Driven Natural Hazard project112, will provide the Commission with information for the

preparation and management of aid during a flood crisis; the European Forest Fire Information System

113 supports the services in charge of the protection of forests against fires

in the EU and neighbours countries, and provides the Commission and the European Parliament with information on forest fires in Europe.

The Commission and the WHO Regional Office for Europe have established the Climate, Environment and Health Action Plan and Information System (CEHAPIS) project. Co-funded by the Commission, the project aims to assess the health impact of climate change in Europe;

evaluate the impact of policy options for health adaptation to climate change; and monitor trends and policies over time by establishing a set of indicators.

increase certain interactions between environment and human health with stronger and more pronounced effects than currently witnessed. Public health measures and systems in place therefore, will need to be tuned to the new situation and demands.

In the Fifth Ministerial Conference on Environment and Health to be held in Italy on 10-12 March 2010 climate change related health issues will be one of the main pillars. The Commission is actively involved in the preparations.

Biodiversity and health

The Commission funded a "Literature study on the impact of biodiversity on human health". The aim is to provide an overview of existing information concerning the impacts of biodiversity loss and changes in ecosystem services on human health, with a particular focus on infectious diseases and medicines. Results will be available in March 2010. In Green Week 2010 a session will be devoted to "Biodiversity & Health"

Antimicrobial resistance

Scientific evidence suggests that during the last decade, antibiotic resistance by various mechanisms has increased worldwide in bacterial pathogens leading to treatment failures in human and animal infections. However, the bacterial resistance against different types of biocides (including disinfectants, antiseptics, preservatives and sterilants) has been studied only recently. Furthermore, research indicates that biocides and antibiotics may share some common behaviour and properties in their respective activity and in the resistance mechanisms developed by bacteria. One of the problems within Directive 98/8/EC of the European Parliament and of the Council on the placing on the market of biocidal products

114

and directives dealing with similar kinds of substances is that cumulative risks and impacts resulting from the use of the active substance outside the scope of the Directive are not addressed in the evaluation process. This is especially problematic in view of the possibility

of cross-resistance.

In 2008 the Commission therefore asked SCENIHR to assess the antibiotic resistance effects of biocides. The SCENIHR opinion delivered in January 2009

115 confirmed that at least some

In particular, the recommendation to develop standard protocols for the evaluation of antimicrobial resistance induced by biocides would be valuable in the review programme of the Biocides Directive where active substances used in biocidal products are currently being evaluated for their risks to human health and the environment. At present biocidal active substances are evaluated without taking account this issue systematically in the testing and assessment under the review programme. Steps should be undertaken to start developing these protocols in order to properly address the concern and recommendation stated in the above- mentioned Opinion and to take account of antimicrobial resistance at the product authorisation stage (within 4-5 years) or at the first renewal of the biocidal active substances (within 10 years).

As the issue of the possible health effects of AMR remains a very sensitive political subject, more research is needed to address the issues identified. The Commission, through the 7

th

Framework Programme for Research and Development (FP7), can finance such research through calls for proposals launched on a yearly basis. As a result, and in order for the Commission to be in a position to propose the most relevant research topics on this issue for future funding, the Commission has asked the SCENIHR to develop the research recommendations presented in the SCENIHR Opinion on the Assessment of the Antibiotic Resistance Effects of Biocides and to propose a stepwise research strategy based on studies which are feasible and able to deliver results within a reasonable time-frame (5-10 years).

The Commission developed a policy discussion on antimicrobial resistance. In view of the failure of past sectoral actions, an integrated horizontal approach to antimicrobial resistance is being considered.

ANNEX III

Detailed overview of progress on environment and health research

• 1. 

  INTEGRATING AND STRENGTHENING EUROPEAN ENVIRONMENT AND HEALTH

RESEARCH

Research projects in the field of environment and health funded under the Fifth Framework Programme of Research (FP5) were analysed and their key findings together with an assessment of their relevance for EU policy were summarised in a publication in 2007

116.

Several projects funded under the Sixth Framework Programme of Research (FP6) were completed and published reviews of the current status of knowledge and research results in particular fields such as health effects of electromagnetic fields (EMF-NET

117), of indoor air

pollution (ENVIE118) and ambient air pollution (CAIR4HEALTH119). In order to strengthen

networking between researchers, policy makers and stakeholders, the HENVINET120 project

(Health and Environment Network) has been funded, bringing together over 30 partners from European as well as non-European countries.

The Seventh Framework Programme of Research (FP7), which started in 2007, includes under its Environment theme of the Cooperation Programme a sub-activity dedicated to supporting environment and health research, with an annual budget of approximately 20 MEUR. Among the projects selected in the first FP7 calls for proposals, the following ones focus particularly on research coordination and networking among actors in the environmental health domain:

ERA-ENVHEALTH121 encompasses 16 organisations involved in the funding of

environmental health research at national or regional level. The objective of the project is to review relevant national research programmes, identify joint priorities and promote greater coordination and cooperation in environmental health research in Europe.

HEREPLUS122 seeks to promote greater coordination and cooperation among

epidemiologists, biostatisticians, environmental scientists and GIS specialists in order to realise the full potential of GIS technology in environmental health research.

will create a scientific basis to ensure the safe and responsible development of engineered nanoparticles and nanotechnology-based materials and products, and will support the definition of regulatory measures and implementation of legislation in Europe.

During the second part of the Action Plan the Commission continued organising or otherwise contributing to numerous research and policy-related events engaging various stakeholders including national and EU policy makers. Examples include three research/policy workshops dealing with health risks related to indoor and ambient air quality or events dealing with the health risks related to exposure to electromagnetic fields, health risks of climate change and the cost/benefit and uncertainty analysis in the framework of environmental health research. Researchers from EU-funded projects presented numerous contributions at the International Public Health Symposium on Environment and Health Research (Madrid, 2008) of which DG Research was one of the co-organisers.

• 2. 

  TARGETING RESEARCH ON DISEASES, DISORDERS AND EXPOSURES

The aim of this action in the Environment and Health Action Plan has been to improve knowledge of the links between environmental exposures and four priority diseases (childhood respiratory diseases, neuro-developmental disorders, cancer and endocrine disrupting effects). A number of targeted research projects has been launched under the EU Framework Programmes for Research, with the following overview highlighting only some major developments:

Childhood respiratory diseases

Various aspects of allergy and asthma were addressed in 23 projects under FP5 receiving a

total EC contribution of 30 million euro. The results were analysed and published in 2007.

125

In FP6, two large-scale projects focusing on asthma and allergy were funded (GABRIEL126

and GA2LEN127). GA2LEN was completed in 2009.

Since FP7 was launched in 2007, several projects have been started to study the effects of

projects were launched at least partly addressing neuro-developmental disorders as a health end-point, receiving a total EC support of some 60 million euro.

As one of the health end-points under investigation, neuro-developmental effects are

studied in 7 projects already launched under FP7. One of the examples is the NEURONANO project studying whether nanoparticles induce neurodegenerative diseases.

Cancer

Ongoing large FP6 projects launched in 2005 and 2006 study how nutrition and genetic

disposition affect susceptibility to cancer (ECNIS129) and investigate whether maternal

exposure to dietary carcinogenic compounds results in in-utero exposure and molecular events in the embryo that may lead to increased risk of cancer in childhood (NEWGENERIS

130).

In FP7, the large-scale integrating COGS project will study the interaction between genetic

susceptibility and environmental lifestyle factors in the development of several types of cancer and to this end it will follow 200 000 individuals. A more focused project MOBI-KIDS has been initiated to assess the potential effects of exposure to radiofrequency fields on the development of brain cancer in childhood and adolescence.

Endocrine disrupting effects

Research on endocrine disrupting (ED) effects has been a high priority under FP5 with 25

relevant projects receiving a total EC contribution of 55 million euro. The results were analysed and published in 2007.

131 The projects included a cluster of four projects called

CREDO (The Cluster of Research into Endocrine Disruption in Europe), which ended in 2008, receiving a Community contribution of nearly 20 million euro.

In FP6, additional 19 projects were funded, which at least partially address endocrine

disrupting effects, with a total EC contribution of 53 million euro, including the recently finished CASCADE

132 network of excellence, which investigated the mechanisms of

action of food-borne chemical contaminants that interfere with hormone signalling.

models for evaluating health effects of multiple environmental stressors or mixtures of pollutants. They include the following integrated projects:

NOMIRACLE133, to be completed in 2009, is devoted to the development of methods for

assessing the cumulative risks from combined exposures to multiple stressors including from complex mixtures of chemical, physical, and biological agents. The project also seeks to contribute to the integration of the risk analysis of environmental and human health effects.

INTARESE134 is developing a methodological framework and a set of tools and indicators

for integrated assessment that can be applied across different environmental stressors, exposure pathways and policy areas.

HEIMTSA135 is developing a methodology for health impact assessment (HIA) and cost

benefit analysis (CBA), so that overall environment and health impacts caused by releases of substances into the environment from relevant human activities can be evaluated at the European level.The project is also contributing to the development of HIA/CBA capability

in Europe.

In addition to the above, other FP6 projects were devoted specifically to the valuation of environment-related health impacts for children (VERHI CHILDREN

• 136) 

  or to comparing the

costs of emission reduction measures with their benefits in terms of reduced human health impacts (DROPS

137).

Several major projects are still ongoing. Once their results are available, suitable follow-up will be considered under the Seventh Framework Programme of Research.

• 4. 

  RESEARCH TO ENSURE THAT POTENTIAL HAZARDS ON ENVIRONMENT AND HEALTH

ARE IDENTIFIED AND ADDRESSED

World Health Organisation has recently identified climate change impacts on human health as a priority for global public health and there has been a growing recognition of the need of research on the linkages between climate, policies addressing climate change and health outcomes. In this context, DG Research has funded under FP6 the MICRODIS project dealing with health, social and economic impacts of natural disasters and the EDEN project investigating the impacts of environmental change on the spatial and temporal distribution of human pathogenic agents (for more information see the boxes below).

The EDEN project is studying how changes in European environment and ecosystems, whether caused by altered human activity patterns or changes in climate, can influence the spatial and temporal distribution and dynamics of pathogenic agents causing diseases such as malaria, leishmaniasis or tick-borne encephalitis. It is focusing on human diseases that are sensitive to environmental changes and are either already present in Europe, can be expected to re-emerge or are spread on the fringes of Europe.

http://www.eden-fp6project.net.

Under FP7, two projects (ArcRisk, CLEAR) have been selected to examine the health risks resulting for Arctic populations from climate change induced changes in the distribution of environmental pollutants. The projects are designed to contribute also more generally to the knowledge on how environmental contaminants are affecting human reproductive health. A project on the health effects of changing surface UV radiation levels has also been launched in 2009.

Starting from the third call for proposals under the FP7 Environment theme, an area dedicated to climate change induced human health effects has been introduced under the Environment and Health sub-activity as an acknowledgement of the importance of this issue. This means that one or two relevant topics will be annually opened for research proposals in the remaining FP7 calls. The first topics opened for submission dealt with climate change and water-related health issues and with the quantification of climate change impacts on health in low-income developing countries. Following the evaluation of proposals in February and March 2009, it is likely that each of these topics will be covered by a research project which could start towards the end of 2009.

Another emerging area that has received substantial attention since 2007 concerns possible human health impacts of nanomaterials

. Under FP6, as many as 8 research projects have

been supported in this area with total EC contribution amounting to 20 million EUR. The supported projects include, for instance, CELLNANOTOX

138 investigating the correlation

between the physicochemical characteristics of nanomaterials and their toxic potential for various organs or NANOSH

139 evaluating the inflammatory and genotoxic effects of

engineered nanomaterials. Support for research in this field continues also under FP7 with 18 projects already selected and launched since 2007.

of relevant national Policy-makers have been provided with relevant final reports, have in some cases been briefed directly, and have attended numerous workshops and conferences on specific issues. research activities future research priorities,

initiatives, with a view to ensuring that these research results are taken into account in policy making. at possibly to be implemented in the

national level. Eight Framework

Programme (FP8).

The analysis of results of projects funded by the Sixth Framework Programme (FP6) has started although a majority of the projects are

still ongoing.

An impact assessment will be carried out in the latter half of 2009.

Some analysis of national research activities has been or is being carried out by the EMF-NET coordination action and the ERA-ENVHEATH project.

2 The Commission will aim to consolidate ongoing research results in the priority areas (e.g. actions on allergies and on The Commission has funded a large five-year network of excellence GA2LEN, which brought together 25 partners from the EU including The durable In the Seventh Framework Programme of Research (FP7), allergy and asthma research is funded

integration as

foreseen for

the European Academy of networks of mostly by the

national endocrine Allergology and Clinical Immunology and patient organisations. In addition to research on the genetic basis, clinical treatment, environmental aspects and social causes of asthma and allergies, the project shared data and biological resources, trained young scientists, and exchanged staff between institutes. excellence (NoE) has been problematic. Some NoEs are followed Environment and Health themes.

A joint or coordinated call for research proposals could be envisaged to pool resources to tackle a complex environmental health disease.

disrupters test strategies).

by

coordination actions in FP7.

As regards research on

endocrine disrupters, a three- project

Research on endocrine disrupting chemicals has been a high priority in the Commission since the launch of FP5, during which 25 projects with EC contribution of 55M were funded including a cluster of four projects called CREDO (The Cluster of Research into Endocrine Disruption in Europe). Another three-project cluster, NECTAR (Network for Environment Chemical Toxicants Affecting Reproduction) is being funded in FP7, which will further fill in the gaps of knowledge. In FP6, additional 19 projects with a total EC contribution of 53M have been financed. Many of these projects have contributed to improved testing strategies of endocrine disrupters and have contributed to the OECD and cluster with EC

contribution of 10M has been launched in FP7, which will elucidate the long-term health impacts of endocrine disrupting chemicals and mixtures.

Polar Symposium (2007); -health risks related to indoor and ambient air quality: three workshops

with extensive stakeholder

participation (Brussels, 2007, 2008, 2009)

• - 

  risk assessment and cost/benefit analysis: workshop on harmonisation of risk analysis of food chemicals (Brussels, 2005), contribution to DG SANCO organised 1

st international risk

assessment conference (2008), two workshops on cost/benefit and uncertainty analysis (Brussels, 2007);

• - 

  events with wide scope engaging a large number of stakeholders: Open Stakeholder

Consultation: Priorities for Environment &

Health Research in FP7 (2006); International conference on environmental epidemiology and exposure (Paris, 2006); International Public Health Symposium on Environment and Health Research (2008)

2007-2010

5 The Commission will analyse the intermediary and final results of relevant projects for policy making from various Community The final results of 90 FP5 projects have been published in a catalogue and on internet. The publication

of PHP projects

is done by DG SANCO. The final results of FP6 projects will be published once available

(by 2012).

programmes An overview of ongoing 66 FP6 projects has been published on the internet.

including the Fifth (FP5) and Sixth

(FP6) Framework

Programmes of Research and the Public Health Programme (PHP) An impact assessment will be carried out in the latter half of 2009, which will analyse also intermediary results.

6 The Commission will See above

organise workshops on

targeted environment and

health issues to highlight the research results achieved in different priority areas

7 The Commission will identify research needs for the future calls for proposals to be implemented in Community Programmes. All workshops and events listed above have to some extent contributed to the prioritisation process. In particular, the workshop organised in 2006 (Open Stakeholder Consultation: Priorities for Environment & Health Research in - Some projects such as ENNAH (European Network on Noise)

will contribute to establishing priorities in a specific domain by carrying

out reviews and

• 2. 

  TARGET RESEARCH ON DISEASES, DISORDERS AND EXPOSURES (ACTION 6)

Tasks Description of task in the State of play Problems Future

Technical Annex of EHAP encountered

and the midterm review

report

2004-2007

1 The Commission will support research on the causes of asthma and allergy focusing on complex interactions, such as changes in the environment and lifestyles In FP5 23 projects addressing some aspects of allergy and asthma were funded with a total EU contribution of around 30 million. These projects are now finished and results have been analysed in 2007 and made publically available. The results of ongoing In the Seventh Framework Programme

FP6 of Research

projects are not yet available. (FP7), allergy and asthma research is funded mostly by the Environment and Health themes. A joint or coordinated call for research proposals could be envisaged to pool resources to tackle a complex environmental health disease.

These projects have greatly

improved the database available for risk assessment as to environmental attributes of respiratory diseases such as air pollution and farming-related protective factors, wood dust, fragrances or ultraviolet radiation.

In FP6 three major allergy/asthma projects were funded: EUROPREVALL, GABRIEL and GA2LEN. Taking into account smaller- scale projects, the EC contribution was close to 60 million. An ex post evaluation will be carried out in 2009/2010, which will analyse intermediary results of these projects. The results have provided and will provide in the future scientific underpinning for EU public health policies pertaining to allergy and asthma including preventive measures.

In FP7projects, allergy/asthma is one health endpoint that is being studied in numerous projects focused, e.g., on air pollution (ESCAPE,

HITEA, TRANSPHORM),

biomarker development

(ENVIROGENOMARKERS), and GIS

applications to health (EO2HEAVEN,

HEREPLUS.

2 The Commission will support research on the causes and mechanisms 25 projects with EC contribution of around 50 million were funded in FP5 investigating the neuroimmune, neurodevelopmental and neurotoxic effects of chemical contaminants. These projects are now finished and results have been analysed in 2007 and made publically available on the internet and via targeted workshops and other events. A majority of these projects have fed directly into EU legislation on chemicals and food contaminants, and have contributed to the overall The results of ongoing A dedicated project on neuro- developmental/

FP6 neuro-toxic

of neuro-projects are not yet available. effects of environmental

immune disorders, identifying genetic and environmental risk factors, and identifying genetic and environmental factors contaminants could be

promote research into and the NEWGENERIS integrated project. Both susceptibility and prediction biomarkers,

uncommon cancers, the are identifying gene-environment could be

identification of gene-interactions in the development of cancers and ECNIS is exploring prevention strategies. considered as a topic for proposals in future calls of FP7.

environment interactions

involved in the development

of

cancer in high-risk

populations, and the In FP7 a 12 million study called COGS (Collaborative oncological gene-environment study) is to be launched by the end of 2009.

definition of prevention

strategies

4 The Commission will support research on the effects of exposure to metals in the environment and particularly those ingested from food related sources. Sources of human exposure to metals should be assessed, including via uptake by plants grown on contaminated sites. Research should An integrated project PHIME (Public health impact of long-term, low-level mixed element exposure in susceptible population strata), launched in FP6, is continuing until 2011. It aims to establish how long-term exposure to low levels of metals influences public health, in this case diseases that affect the kidney, skeleton, nervous system, cardio- and cerebro- vascular disease and diabetes. It will also map levels of exposure across Europe and in the Seychelles, Bangladesh, Ecuador, China and Morocco. In order to find solutions to the problems, the project will also do research on plants, to develop species that take up less of the metals harmful to our health. Analysis of the outcome of PHIME will allow to establish whether important knowledge gaps exist for future research

also focus on

individual susceptibility.

The analysis of results of finished projects has demonstrated that exposures of animals, especially in aquatic environments, to a number of industrial chemicals can cause severe endocrine-disrupting effects, of which the impact on reproductive functions has been studied most frequently. Due to the importance of the topic, two research clusters (CREDO and NECTAR ), receiving an EU contribution of close to 30 million, have been funded by the Framework Programmes. Exposure assessment of human populations to chemical pollutants or physiological stressors via food or the environment has revealed significant body burdens of contaminants in exposed populations, especially in children, and in some cases exposures to chemical or physical agents can be linked to negative health outcomes such as impairment in cognitive functioning and development..

2007-2010

5 The Commission will support research on the study causes of In FP7, several projects have been launched, which will study causes of environment- related diseases via EU-wide epidemiological

studies: Lack of funding precludes A feasibility study to explore the usefulness of launching a new large-scale cohort study in Europe will be launched by the end of FP7

the

environment-related launch of new large-scale cohorts studies

diseases via EU-wide

epidemiological studies

focusing on gene-

environment interactions and to -ESCAPE: on health impacts of ambient air pollution;

• - 

  HITEA: on health impacts of indoor air pollution;
• - 

  EFRAIM: on mechanisms of early protective exposures

investigate long-term

health impacts of exposure to environmental stressors such as chemicals, air pollution and noise and combinations thereof, taking advantage of existing cohorts or possibly starting new cohorts. By enhancing scientific basis of understanding of associations between

on allergy development;

• - 

  CONTAMED: on health impacts of endocrine
• 3. 

  DEVELOP METHODOLOGICAL SYSTEMS TO ANALYSE INTERACTIONS BETWEEN

ENVIRONMENT AND HEALTH (ACTION 7)

Tasks Description of task in the State of play Problems encountered Future

Technical Annex of EHAP

and the midterm review

report

2004-2007

1 The Commission will address the development of integrated risk Four FP6 projects are ongoing on this topic: INTARESE (Integrated assessment of health risks from environmental stressors in Europe), HEIMTSA It should be ensured that relevant policy-makers are aware of the tools and methods under development.

assessment

methodologies and models for evaluating cumulative effects, interaction between stressors and their influence on human health. (Health and environment

integrated methodology and toolbox for scenario assessment), NOMIRACLE (Novel methods for integrated risk assessment of cumulative stressors in Europe), 2-FUN (Full- chain and uncertainty approaches for assessing health risks in future environmental scenarios). Results will be available at the latest in 2012.

2 The Commission will address the A majority of FP7 projects selected for funding from the first three calls address issues of low dose (e.g., NECTAR cluster on endocrine disrupters), long-term effects (e.g., MOBI-KIDS on health risks of exposure to EMF; ESCAPE on long-term health impacts on a number of health end-points of exposure to air pollution and noise). Toxocogenomic approaches to improve biomarkers are used, e.g., By the end of FP7, the outcome of the projects launched so be analysed and made public

development of

methodologies, techniques,

and models to address

complexity in

environment/health interactions (multi-causality of disease, toxicogenomics, low dose, long-term exposure, combined effects, etc).

in the ENVIROGENOMARKERS

(Genomics biomarkers of environmental health) project.

3 The Commission will address the Four projects were funded in FP6:

development of METHODEX (Methods and data on

accounting frameworks environmental and health externalities:

incorporating externalities harmonising and sharing of operational estimates), DROPS (Development of macro and sectoral economic models aiming to evaluate the role of public health externalities on society), ESPREME (Integrated assessment of heavy metal releases in Europe), and VERHI

associated with various

environmental stressors, the assessment of health related externalities, and definition of sustainability thresholds.

CHILDREN (Valuation of

environment-related health impacts for

European networks to foster

co-operation

and data

exchange between

environmental monitoring

institutes and related

regulatory bodies.

7 The Commission will address the At least 18 projects have been launched in FP6 and

development and FP7 using toxicological and

validation of technologies and diagnostic epidemiological approaches employing

tools (e.g. biomarkers and cohort studies to better understand real-life exposures and health effects. Exposure, effect and susceptibility biomarkers have been developed.

biomarkers and biosensors) addressing

real-life

exposures.

8 The Commission will address the The aim of the ongoing ENVIRISK (Assessing the

harmonisation and risks of environmental stressors:

validation of risk assessment methodologies contribution to the development of integrating methodology) project is to develop an integrated

putting

emphasis on exposure methodological framework to

assessment and the identify health risks caused by exposures to environmental factors.

production of standards and reference materials.

9 The Commission will address the facilitation of networking of researchers, policy-makers and other stakeholders to disseminate best practice and validate The aim of the ongoing HENVINET coordination action (Health and environment network), is, among others, to establish long- term

cooperation between researchers,

policymakers, and other stakeholders in the field of environment and health research and assessment. It will aim at the validation and exploitation of decision support tools, led by the joint efforts of environmental experts, experts on the modelling of environmental effects on physiology and health experts.

decision-support

tools.

2007-2010

10 The Commission will analyse the policy relevance results of Community funded projects from FP5 and FP6 as regards (i) integrated risk assessment methodologies and models;

(ii) methods and tools for environment Most recent projects being funded address the complexity in environment/health interactions such

as multi-causality of disease,

toxicogenomics, low dose issues, long-term exposures, and combined effects. Review and validation of diagnostic tools such biomarkers have been carried out in a large number of projects, and the application of these to addressing real-life exposure situations have and will shed light on the multi-causality of environment-related diseases.

and health

impact assessment,

be improved for future extreme weather events, and actions can be better targeted and evaluated

• - 

  facilitate rapid assessment

of emerging threats

• - 

  launch a research action on the assessment of Global Change-driven factors linked to the risk of introducing and spreading emerging human diseases
• - 

  address topics such as a) climate change and health;
• b) 

  water pollution (e.g. emerging pathogens in drinking water sources);
• c) 

  possible environmental and human health impacts of nanoparticles. malaria, have (re)-emerged and are spread in Europe as a result of outbreaks, which could be linked to climate change, human-induced landscape changes or activities of human populations. Its final aim is to improve and validate risk maps for studying the spread and transmission of vector-borne diseases, which could integrate socio-economic and health data as well as modelling of vector behaviour. future extreme

weather events

and the rapid

assessment of

emerging threats

are not a research issues

and

therefore no

research projects have

been

The MICRODIS integrated project (Health and socio-economic impacts of extreme events) aims at strengthening the preparedness, mitigation and prevention strategies that can reduce the health, social and economic impacts of extreme events on communities and is investigating the relationship between extreme events and their health, social and economic impacts in Europe and Asia. launched

Emerging water contaminants issues are being addressed by two FP6 projects: HEALTHY WATER (Assessment of human health impacts from emerging microbial pathogens in drinking

water by molecular and

epidemiological studies) and HIWATE

(Health impacts of long-term exposure to disinfection byproducts in drinking water).

The issue of environment and health risks related to exposure to nanoparticles has gained importance, with eight research projects funded both in FP6

2007-2010

2 The Commission will To highlight the importance of potential health impacts

investigate the impact of global environmental change including extreme weather events and other effects of climate change on human health and animal health and to investigate potential risks posed by nanoparticles to human health, in synergy with the Nanotechnologies Action Plan. of climate change, in FP7

Environment and Health sub-activity a specific area called 'Health impacts of climate change' has been introduced, from which research on this emerging public health issue has been (5 projects from the first three calls for proposals) and will be financed.

After two calls for proposals, eight projects on risks posed by nanoparticles have been selected for funding in FP7.

ANNEX IV

Overview of EU funded research project on indoor air quality

The most relevant projects include:

The INDEX project140 ("Critical appraisal of setting and implementation of indoor

exposure limits in EU"), coordinate by the General Directorate Join Research Centre (2002-2004), identified a list of "priority compounds" on the basis of health impact criteria. Five compounds (formaldehyde, carbon monoxide, nitrogen dioxide, benzene and naphthalene) have been identified as high priority and suggestions and recommendations on potential exposure limits and risk management options have been formulated.

The THADE project141 ("Towards Health Air in Dwellings in Europe"), co-ordinated by

the European federation of Asthma and Allergy (2001-2003), investigated the association among indoor air pollutants and respiratory diseases. Several recommendations have been formulated for international, national and local level to improve air quality in dwellings. The results of this project confirmed that air pollution in dwellings is a relevant health problem. It is a complex problem that must be addressed at European and international levels, and it involves the medical profession, scientific societies, patients' organizations, lawmakers, architects and the building industry.

The HESE project142 ("Health Effects of Schools Environment"), co-ordinated by the

University of Siena (2002-2005), highlighted the high presence of particulate, moulds, and allergens related to poor ventilation, which appears to be extremely common in European classrooms. Poor ventilation is likely to increase airway inflammation and the risk of asthma in allergic children and could even increase the risk of sensitisation in healthy schoolchildren.

The AIRMEX project143 ("European Indoor Air Monitoring and Exposure Assessment

Project"),, funded by the General Directorate Join Research Centre (2003-) aims at: (i) identifying and quantifying the main air pollutants in public buildings, including schools and kindergartens; (ii) identifying the main sources of these pollutants; and (iii) estimating people's exposure and evaluating possible health effects due to chronic exposure to these pollutants, especially for children.

surveillance monitoring schemes of public spaces and private homes and (c3) the implementation of exposure limits.

Other important projects are still ongoing. The most relevant are:

The HITEA project145 (Health Effects of Indoor Pollutants: Integrating microbial,

toxicological and epidemiological approaches) is an FP7 project focusing on the role of indoor biological agents in the development of respiratory, inflammatory and allergic health impacts among children. The focus is on microbial exposures due to dampness problems of buildings. In addition, the role of allergens, chemicals, cleaning agents, traffic exhaust and poor ventilation is studied. The study includes a cross-sectional and a longitudinal study in school buildings in three European countries as well as new analyses of already existing birth cohorts. Since some important aspects are difficult to study among children (e.g., invasive sampling), an adult cohort with similar exposures is also included. The project started in April 2008 and is scheduled to run for 5 years.

The BUMA project146 ("Prioritization of BUilding MAterials as indoor pollution

sources"), co-ordinated by the University of Western Macedonia and the State General Laboratories of Cyprus (2006-2009). The project main objectives are: (i) the formation of a comprehensive database containing up-to-date quantified emitted compounds by construction products and other building materials; (ii) the classification and prioritisation of building materials from the developed database with respect to hazardous compounds emission factors and the relevant exposure levels; (iii) the creation of an Indoor exposure expert modelling system linked to the above mentioned data base; (iv) the production of relevant guidelines for policy-making actions.

The HealthyAIR project, ("Network of actions and activities that address the effect of

construction products on Indoor Air"), co-ordinated by the TNO Build Environment and Geosciences (The Netherlands) (2006-2009) aims at defining, initiating and developing activities that improve indoor air quality and reduce exposure to indoor air pollution sources, in particular of construction products.

GERIE - Geriatric studying Europe on health effects of air quality in nursing homes, aims

will be assessed with the objective of improving them. The assessment of potential conflicts between EU energy conservation objectives in buildings and radon control technologies will be an important objective of this project.

The INTARESE147 project ("Integrated assessment of health risks of environmental

stressors in Europe) is an ambitious project aiming at producing a new integrated risk assessment framework, based on the full chain approach (causal chain spanning sources of pollution, releases into various media, dispersion and transport, exposure medium inhalation/dermal contact/ingestion, intake, uptake, dose, health effects and impacts), based on three existing frameworks with differing approaches and aims. One policy area of concern included is housing: includes the effects both separately and in combination of environmental tobacco smoke, indoor air pollution (e.g., from cooking and heating, moulds, furnishings etc), noise and indoor climate (including temperature and dampness)

on acute and chronic health (respiratory illness, cardiovascular illness, winter mortality and infant mortality).

The EnVIE project148 "Indoor Air Quality and Health Effects", co-ordinated by IDMEC

(Portugal) (2004- 2008), has been supported under the `Scientific Support to Policies' programme. EnVIE was designed to interface science and policy making in the field of indoor air quality and collected and interpreted scientific knowledge from on-going research, in particular from EU funded projects and the Joint Research Centre's activities. The major outcome of this coordination network was policy relevant recommendations based on a better understanding of the health impacts of indoor air quality.

INDOOR-EXPO project coordinated by the General Directorate Join Research Centre.

Scope of the project is:

to perform a systematic meta-analysis of publications and projects for selected

health outcomes related to exposure to INDEX priory compounds.

to review and discuss exposure to and risks from indoor PM and prepare a draft

report on exposure guidelines for Indoor PM.

ANNEX V

Examples demonstrating the added value of the EU Action Plan for Member States

FRANCE

The Budapest Conference and the publication of the "European Environment & Health Action Plan 2004-2010" resulted in the adoption of the first National Environment and Health Action Plan (NEHAP) by the French government on June 21, 2004, for the period 2004-2008. This NEHAP put environmental health on the political and social agenda in France. The plan has also been implemented locally. Each region therefore has a regional environment and health plan, which defines action strategies according to local needs.

By drawing up a 2nd NEHAP for the period 2009-2013 France underlined the importance it

gives to this issue. In association with the EU Action Plan, 2 themes have been identified as priority action: Indoor Air Quality and Human Bio-monitoring.

The EU Action Plan has identified human bio-monitoring as a priority action. In this context, France organized a European Conference on human bio-monitoring under the French Presidency (4-5 November) to clarify key issues to be dealt with at the different levels (European, national, regional and local). For more than 15 years France has gained experience with specific HBM studies

• 149. 

  The work done at the EU level has triggered the need for a

well-defined national strategy related to HBM using the best available tools and methods developed under FP7 (ESBIO) with the following objectives:

to describe the exposure and body burden impregnation of the population in order to

establish reference values and health-based values,, to define a coherent approach to allow comparisons between MS.

to support public policies (in particular evaluation of strategies to reduce exposure)

to identify emerging risks and support early warning and alert.

This national HBM strategy is currently being developed: launch a pluri-annual programme (every 5 years) for bio-monitoring the French population, coupled with a broader health survey including the assay of emerging pollutants. This program should start in 2012.

such as the National Public Health Program, the Second National Environmental Program and the Thematic Action Program of National Environmental Protection Program, starting in 2010, confirmed by a decision of the Parliament.

The EU Environment & Health Action Plan helped Hungary take steps to reduce the spread and pollen concentration of allergenic weeds, to improve the drinking water quality, to prevent the health effects of climate change, and facilitate the adaptation, and to prepare regulations for indoor air quality. In order to follow-up and monitor the results the Environment & Health Information System was introduced. This will help to apply the INSPIRE directive, to connect environment and health data, helping to assess the impact of environmental pollution and health status. Thus, public access to environmental data could be more complete, according to the Aarhus Convention.

Hungary has applied the results and experiences gained through participation in projects supported by the European Commission (EUROHEAT; ENHIS, ENHIS 2; EUROHEIS2; IMCA II; APHEIS, APHEKOM; UNIPHE, Triple-S AGE) in planning and implementing the national programs. The Hungarian Climate Health network and early warning system initiated by PHEWE and EUROHEAT projects should be emphasized. EuroMomo and the coming Triple-S-AGE projects provide valuable assistance in formation of real time surveillance. Hungary started to develop environmental health indicator system based on the results of the ENHIS, ENHIS 2 and UNIPHE programs at national and regional level.

Hungary has adjusted the evaluation of the short-term effect of outdoor air pollution and the information of the population about the health effects of air quality based on the results of APHEIS program; and is looking forward to further explore exposure-response relationships by the APHEKOM project, particularly within the capital on district level. The results are used to develop more effective communication with the population and with decision-makers. The rapid risk assessment program (Rapid Inquiry Facility) developed by the EUROHEIS project has been successfully disseminated to the National Public Health Service. By this a method has been given to professionals working in the regions, which allows them to make rapid environmental health risk estimation and effect assessment using internationally comparable methods.

The Hungarian National Institute of Environmental Health was responsible in the Interreg-III.C. funded project ENHance Health

152 for the methodology of setting up an EHSS in the

three pilot areas in Hungary, Italy and Poland. Besides the relatively easily available statistical data, the EHSS targeted, first of all, the most vulnerable groups of population: pregnant women and young children (RPG 3 and 4 of CEHAPE). The health impacts of some air pollutants (CO and PM10) were identified and will be taken into consideration during updating the Hungarian legislation of air pollutants.

DENMARK

In Denmark specifically the focus on human bio-monitoring in the European Environment and Health Action Plan has inspired Danish participation in a European pilot project, including a cooperation between the Danish sectors on environment, food and health on co- financing an EU funded project.

For inspiration for further national work on environment and health in Denmark synergy between the processes in WHO and EU on environment and health