Programme Note

Most major morbidities and a quarter of the global disease burden are associated with environmental risks. The risks are disproportionately concentrated in emerging markets and in the 0-5 age cohort for which the loss of healthy life years associated with environmental hazards is five times greater than for emerging market populations as a whole.

The symposium explored relationships between demographic, health, education, economic and social policies and decisions made by/for individuals, businesses and civil society organizations during the human life-course. It was grounded in a conceptual matrix featuring relationships between: (A) Chronic and communicable diseases; and (B) Elements of the natural environment (i.e. earth’s surface, air quality, water availability and quality, climate, animal and plant life) and elements of the built environment.

Many of those relationships are familiar. Others, such as relationships between loss of forest habitat, the migration of bats to human settlements and the spread of disease, less so. Well-known examples include relationships between:

• Gastro-intestinal diseases and poor sanitation, water and air pollution;
• Respiratory diseases and exposure to toxic chemicals and pesticides polluted air from manufacturing, mining, energy production, road, rail and air traffic and indoor smoke from solid fuels for cooking and heating;
• Cancers and exposure to tobacco, asbestos and other environmental carcinogens;
• Vector-borne diseases including malaria, dengue, onchocerciasis and filariasis and poorly designed irrigation and water systems, inadequate housing, ineffective waste management, unsanitary water storage facilities and deforestation;
• Cognitive damage and lead exposure; and
• Emotional disorders and climate change, overcrowding, noise pollution and occupational stress.

The agenda emphasized:

• Topics on which the EMS can expect to add to, expand or buttress existing knowledge, insight and understanding;
• Environmental factors that account for high levels of premature death, high proportions of school or work years lost to illness and/or the use of scarce healthcare resources;
• Chronic and communicable morbidities associated with environmental conditions (e.g. cancer, respiratory diseases) that occur in most or all emerging markets;
• Morbidities (e.g. HIV/Aids, Malaria) that constitute major environmental health risks in some but not all emerging markets; and
• Relationships between health outcomes and non-health policies, programmes and projects (e.g. industrial, transport, energy, urban development, infrastructure, social, ‘green economy’ and ‘circular economy’ policies) that affect environmental health.

The symposium placed relatively less emphasis on topics (e.g. carbon emissions) that have recently been thoroughly considered elsewhere.