EARTH SUMMIT+5 Special Session of the General Assembly to Review and Appraise the Implementation of Agenda 21 New York, 23-27 June 1997 PROGRAMME FACT SHEETS

	Environmental Health Indicators for Decision-making
	Responsible Organization(s)	World Health Organization, WHO
	Description	The project has developed a framework based on the environmental health hazard pathway in order to develop indicators. This framework takes into account the Driving forces (D) which motivate and push the environmental process involved; Pressures (P) on the environment; changes in the State (S) of the environment; Exposure (E1) to human beings; health Effects (E2); and finally the Actions (A) at every level of this chain. This framework (DPSEEA) is described further in the book "Linkage methods for environment and health analysis" available from WHO. A book on Environmental Health Indicators is currently under preparation. Field studies have been carried out in several cities and further work to collect and analyze local level data is being planned.
	Issues addressed	This project addresses several chapters on Agenda 21, but in particular Chapter 6, "Protecting and promoting human health". Many of the indicators developed as Sustainable Development Indicators are relevant to this project particularly if information is collected at the local (i.e. sub-national) level.
	Objectives	The overall objective of the project is to improve information use and availability in support of the decision-making process in environmental health. It aims at making valid and useful information on the local and national health impacts of environmental hazards available to decision-makers, environmental health professionals and the community. Data produced is analyzed and converted into information presented in a form that can be understood, interpreted and acted upon by those responsible for environmental health protection.
	Results achieved	Field studies carried out in several cities of different stages of development have been instrumental in developing this work. They allowed the testing of assumptions regarding data availability, quality and feasibility of collecting further data through rapid assessments. A model' set of Environmental Health Indicators is being developed and local data will be collected for key cities.
	Lessons learned	The level of aggregation (e.g. local national, global) of the information is of relevance. Not all indicators can be used at all levels and different model' sets may be required at each level. Decisions are made at each level, however indicators are required at least at the level (or input to the level) where long-lasting decisions (higher up in the DPSEEA chain) are being formulated.
	Financing	USEPA, UNEP, German government.
	Contact	Dr. Tord Kjellstrom Dr. Y. Von Schirnding Mr. C. Corvalan Office of Global and Integrated Environmental Health, WHO