Linzalone Nunzia, Assennato Giorgio, Ballarini Adele, Cadum Ennio, Cirillo Mario, Cori Liliana, De Maio Francesca, Musmeci Loredana, Natali Marinella, Rieti Sabrina, Soggiu Maria Eleonora, Bianchi Fabrizio
Institute of Clinical Physiology, National Council of Research, via Moruzzi, Pisa, Italy.
Int J Environ Res Public Health. 2014 Dec;11(12):12683-99. doi: 10.3390/ijerph111212683.
Avoiding or minimizing potential environmental impact is the driving idea behind protecting a population's health via Environmental Impact Assessments (EIAs) and Strategic Environmental Assessments (SEAs). However, both are often carried out without any systematic approach. This paper describes the findings of a review of HIA, EIA andSEA experiences carried out by the authors, who act as institutional competent subjects at the national and regional levels in Italy. The analysis of how health is tackled in EIA and SEA procedures could support the definition of a protocol for the integration of HIA with EIA and SEA. Although EIA and SEA approaches include the aim of protecting health,significant technical and methodological gaps are present when assessing health systematically, and their basic principles regarding assessment are unsatisfactory for promoting and addressing healthcare concepts stated by the WHO. HIA is still poorly integrated into the decision-making process, screening and monitoring phases are only occasionally implemented, and operational details are not well-defined. The collaborative approach of institutions involved in environment and health is a core element in a systematic advancement toward supporting effective decisions and effective protection ofthe environment and health. At the Italian national level, the definition of guidelines and tools for HIA, also in relation with EIA and SEA, is of great interest.
通过环境影响评估（EIA）和战略环境评估（SEA）来保护人群健康，其背后的驱动理念是避免或尽量减少潜在的环境影响。然而，这两者往往都是在没有任何系统方法的情况下进行的。本文描述了作者（作为意大利国家和地区层面的机构主管主体）对健康影响评估（HIA）、环境影响评估和战略环境评估经验进行审查的结果。分析环境影响评估和战略环境评估程序中如何处理健康问题，有助于确定将健康影响评估与环境影响评估和战略环境评估相结合的方案。尽管环境影响评估和战略环境评估方法包含保护健康的目标，但在系统评估健康时仍存在重大的技术和方法差距，而且它们在评估方面的基本原则对于促进和落实世界卫生组织提出的医疗保健概念并不令人满意。健康影响评估仍未很好地融入决策过程，筛查和监测阶段只是偶尔实施，且操作细节也未明确界定。参与环境与健康事务的机构采取协作方式，是在支持有效决策以及有效保护环境与健康方面实现系统性进展的核心要素。在意大利国家层面，确定与环境影响评估和战略环境评估相关的健康影响评估指南和工具极具意义。
