Health and the environment A compilation of evidence March 2011 Australian Institute of Health and Welfare Canberra Cat. no. PHE 136 The Australian Institute of Health and Welfare is Australia’s national health and welfare statistics and information agency. The Institute’s mission is better information and statistics for better health and wellbeing. © Australian Institute of Health and Welfare 2011 This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced without prior written permission from the Australian Institute of Health and Welfare. Requests and enquiries concerning reproduction and rights should be directed to the Head of the Communications, Media and Marketing Unit, Australian Institute of Health and Welfare, GPO Box 570, Canberra ACT 2601. A complete list of the Institute’s publications is available from the Institute’s website <www.aihw.gov.au>. ISBN 978-1-74249-129-5 Suggested citation Australian Institute of Health and Welfare 2011. Health and the environment: a compilation of evidence. Cat. no. PHE 136. Canberra: AIHW. Australian Institute of Health and Welfare Board Chair Hon. Peter Collins, AM, QC Director David Kalisch Any enquiries about or comments on this publication should be directed to: Communications, Media and Marketing Unit Australian Institute of Health and Welfare GPO Box 570 Canberra ACT 2601 Phone: (02) 6244 1032 Email: [email protected] Published by the Australian Institute of Health and Welfare Printed by Bluestar Print Please note that there is the potential for minor revisions of data in this report. Please check the online version at <www.aihw.gov.au> for any amendments. Contents Acknowledgments............................................................................................................................... v Abbreviations ...................................................................................................................................... vi Summary ............................................................................................................................................. vii 1 Introduction .................................................................................................................................... 1 1.1 Australia’s environment at a glance ............................................................................................ 2 1.2 Environment and the global burden of disease ......................................................................... 3 1.3 Governance and policy .................................................................................................................. 3 1.4 Definition of key terms used in this report ................................................................................. 4 1.5 Selection of environmental factors ............................................................................................... 4 1.6 Review methods and scope .......................................................................................................... 5 1.7 Structure of this report .................................................................................................................. 6 2 Understanding the relationship between environment and health .................................... 7 2.1 Environmental health surveillance .............................................................................................. 7 2.2 Complications and confounders .................................................................................................. 8 3 The natural environment ........................................................................................................... 10 3.1 Introduction .................................................................................................................................. 10 3.2 Air temperature ............................................................................................................................ 11 3.3 Extreme weather events .............................................................................................................. 14 3.4 Ultraviolet radiation .................................................................................................................... 18 3.5 Food safety and water quality .................................................................................................... 20 3.6 Vector populations ....................................................................................................................... 24 3.7 Outdoor air quality ...................................................................................................................... 27 4 The built environment ............................................................................................................... 31 4.1 Introduction .................................................................................................................................. 31 4.2 Indoor air quality ......................................................................................................................... 32 4.3 Walkability .................................................................................................................................... 37 4.4 Transport ....................................................................................................................................... 40 4.5 Green space ................................................................................................................................... 43 4.6 Environmental noise .................................................................................................................... 46 4.7 Overcrowding in housing ........................................................................................................... 50 4.8 Housing condition ........................................................................................................................ 53 4.9 Hazards in and around the home .............................................................................................. 56 4.10 Water fluoridation ....................................................................................................................... 60 iii References ............................................................................................................................................ 63 List of tables ........................................................................................................................................ 77 List of figures ...................................................................................................................................... 77 List of boxes ......................................................................................................................................... 78 iv Acknowledgments The authors of this report were Lisa Sainsbury and Robert Long. Sally Bullock was extensively involved in the development of this report and her contribution is gratefully acknowledged. Valuable contributions were also received from: • Mark Cooper-Stanbury and the Population Health Unit of the Australian Institute of Health and Welfare (AIHW) • Environmental Health Section (Office of Health Protection) of the Australian Government Department of Health and Ageing • Andrew D’Addona and Narelle Mullan from the Western Australian Environmental Health Directorate • Jane Heyworth from the University of Western Australia. David Batts, Karen Bishop, Katrina Burgess, Ann Hunt, Ingrid Seebus and Adrian Webster, all from the AIHW, provided comments during the drafting of this report. Staff of the AIHW Information Services and Publishing Unit provided support with the design and publication process. v Abbreviations ABS Australian Bureau of Statistics AIHW Australian Institute of Health and Welfare BMI body mass index BoM Bureau of Meteorology CNOS Canadian National Occupancy Standard CO carbon monoxide COPD chronic obstructive pulmonary disease DALY disability-adjusted life year dB decibel DMFT decayed, missing or filled teeth (permanent teeth) dmft decayed, missing or filled teeth (deciduous teeth) DoHA Department of Health and Ageing ETS environmental tobacco smoke FSANZ Food Standards Australian and New Zealand IARC International Agency for Research on Cancer ICD-10 International Statistical Classification of Diseases and Related Health Problems, 10th Revision NHMRC National Health and Medical Research Council NO2 nitrogen dioxide OECD Organisation for Economic Co-operation and Development OR odds ratio PM (PM10 or PM2.5) particulate matter (with diameter of particles) ppb parts per billion RR rate ratio SO2 sulphur dioxide UVR ultraviolet radiation VOC volatile organic compound WHO World Health Organization vi Summary Why look at environment and health? There is increasing awareness that our health and the environment in which we live are closely linked, and in 2006 the World Health Organization (WHO) estimated that 24% of the global burden of disease was due to modifiable environmental factors. This growing awareness is reflected in recent health and environmental initiatives from governments and other organisations. How does this report help? Given the abundance and diversity of literature, it is useful to summarise and increase access to information regarding health and the environment. As new evidence is constantly emerging, this report