Air quality

Emissions from motor vehicles, industry, heating and commercial sources, as well as tobacco smoke or household fuels, pollute the air we breathe. Evidence shows that air pollution at current levels in European cities is responsible for a significant burden of disease, mortality, hospital admissions and exacerbation of symptoms, especially in relation to cardiovascular diseases. Very young children and pregnant woman are especially vulnerable to air pollutants.

WHO estimated that in children aged 0-4 years, throughout the European Region, around 700 deaths occur annually from acute respiratory infections that can be attributed to PM10 exposure (WHO, 2007b).

Food safety

Food can be contaminated with chemical or microbiological agents. The strict regulations and measures applied in European countries mean that food is generally safe, but ingestion of contaminated food may still present an important route of exposure. Children are at particular risk of illness, as their bodies are developing and they generally consume more food per kilogram of body weight than adults.

In most European countries adult intake levels of chemicals in food have been 10–30% of the provisional tolerable weekly intake (PTWI) levels, sometimes higher. The data on intake among children are very patchy. The total intake seems to be lower than in adults, but per kg body weight the intake is higher (WHO, 2007e).

Chemical safety

The number of existing chemicals is very large, and for many of them the health risks are not known. Chemicals can reach our body through different routes (e.g. food, air, water) and cause a variety of health effects. Due to the many ways in which chemicals are used and released, the many exposure routes involved, and the different mixtures of chemicals present, the public health relevance of chemicals can be extremely difficult to assess.

Children are especially sensitive to lead exposure. Elevated blood lead levels (>10ug/l) have been associated with toxicity in the developing brain and nervous system of young children, leading to lower intelligence quotient (IQ). Levels have significantly reduced since the mid-80s, but many children still have levels that may harm their health (WHO, 2007f).

Water and sanitation

Safe drinking water and sanitation are essential for health. Microbial contamination can lead to outbreaks of waterborne diseases. Chemical contamination of drinking water occurs less frequently but may also have health impacts, generally chronic and long-term.

In the eastern part of the Region, the percentage of homes with an adequate supply of piped and safe water remains rather low (ranging from 58% to 80%), albeit rising. There are important disparities between urban and rural areas: only 30–40% of rural households in eastern European countries have access to safe drinking water (WHO, 2007g). The same trend is seen for connection to waste water treatment.

The water quality of coastal zones improved steadily from 1992 to 2004 and remained high in 2005. The water quality in freshwater zones has fallen. Some of the new EU member states have experienced problems with relatively poor water quality and the organization of sampling activities.

Occupational hazards

Every day at the workplace, employees face health and safety hazards such as accidents, dust, chemicals, noise, violence or stress. The effects range from premature deaths and injuries to occupational diseases such as for example cancer and respiratory disease.

In recent years, a slightly decreasing trend was visible in the standardized incidence rates of work injuries among young workers. A clear decrease could only be noted in a few countries, indicating that overall progress in Europe is not adequate (WHO, 2007h).

UV and ionizing radiation

Various types of radiation can cause negative health effects. Solar radiation is beneficial for our body as a source of vitamin D, however, excessive exposure may pose a threat to health. Ultraviolet (UV) radiation causes premature ageing of the skin and may lead to the development of malignant melanoma. Radon is a gas emitted by certain types of soil and building materials, and can cause lung cancer.

Children are those most at risk from excess exposure to UV radiation, e.g. due to still developing skin protection mechanisms. Worldwide, the incidence of melanoma has been increasing, also in younger age groups. Moreover, many people increase their exposure through artificial sources in solariums. Raising awareness and encouraging skin protection are the most effective preventive strategies (WHO, 2007i).

Housing

Several environmental factors present indoors can cause negative health effects. Examples of such factors are indoor air quality (polluted for example by use of solid fuels), noise, humidity and mould growth, temperature, presence of hazardous substances (for example asbestos, lead and radon), hygiene and sanitation, and overcrowding. An unsafe household can cause unintentional injuries such as falls, drowning, poisoning, fires and choking.

The amount of people living in homes with self-reported problems of dampness varies greatly among countries, ranging between 10% and 30% (WHO, 2007j).

Solid fuel use in homes in the WHO European Region in 2004 varied from below 5% to over 70%. The geographical pattern shows a gradual increase from west to east of the Region (WHO, 2007k).

Mobility and transport

Transport can directly lead to health problems (injuries and death), but also indirectly (through air pollution, noise and climate change related to emissions from traffic, but also through reduced physical activity).

Increased motorized transport can lead to more road traffic injuries, which are the main cause of death among young people, especially males, and a major cause of physical disability, especially among the youngest. Motorized transport is also an important factor in the reduction of physical activity, such as for example walking and cycling. Low levels of physical activity contribute to the ongoing epidemic of overweight and obesity.

Noise

Environmental noise is expected to become one of the major environmental health issues in Europe. In 1998 it was estimated that 32 % of the European population was exposed to noise levels over 55 dB(A) and 13 % to noise levels over 65 dB(A). At present the health impact of road traffic noise on the whole European population can not be estimated due to the lack of current exposure data at European level.