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COVID-19 is the most recent respiratory pandemic to necessitate better knowledge about city planning and design. The complex connections between cities and pandemics, however challenge traditional approaches to reviewing literature. In this article we adopted a rapid review methodology. We review the historical literature on respiratory pandemics and their documented connections to urban planning and design (both broadly defined as being concerned with cities as complex systems). Our systematic search across multidisciplinary databases returned a total of 1323 sources, with 92 articles included in the final review. Findings showed that the literature represents the multi-scalar nature of cities and pandemics - pandemics are global phenomena spread through an interconnected world, but require regional, city, local and individual responses. We characterise the literature under ten themes: scale (global to local); built environment; governance; modelling; non-pharmaceutical interventions; socioeconomic factors; system preparedness; system responses; underserved and vulnerable populations; and future-proofing urban planning and design. We conclude that the historical literature captures how city planning and design intersects with a public health response to respiratory pandemics. Our thematic framework provides parameters for future research and policy responses to the varied connections between cities and respiratory pandemics. more...

More than half the world’s population lives in urban environments, and the proportion is rising. Cities provide opportunities for infectious diseases to infect large numbers of people and rapidly spread globally. Following outbreaks such as Severe Acute Respiratory Syndrome (SARS) in 2003, the Ebola outbreak in West Africa in 2014, and the Coronavirus Disease 2019 pandemic, it is evident that a whole of society approach is required to address global health threats. The role of the private sector is threefold – to safeguard its business and its stakeholders; protect and promote the wellbeing of its staff, community and clients; and support national and international public health efforts.This chapter reviews national and international guidance and the evolution of private sector preparedness and involvement in health security. Best practice principles for global health security planning and response for the private sector are provided. Several case studies are presented. more...

The development and operation of mining projects is associated both with health opportunities and with health risks for the workforce, as well as project-affected communities. Thus, mining has strong links to SDG 3, “Ensure healthy lives and promote well-being for all at all ages”, which is closely interlinked with all the other SDGs, representing determinants of health. Disease prevention and promotion of good health and wellbeing can only be achieved if a diverse group of stakeholders are partnering together. Consequently, companies need to adopt comprehensive health management systems that clarify the role and responsibilities of the different stakeholders. Internally, mining operations need to be committed to work across departments for improving long-term health outcomes, and not just focus on preventing adverse incidents. more...

Past planning for extractive projects has emphasized economic benefits but overlooked human health and wellbeing. The Sustainable Development Goals (SDGs) however recognise health as a pillar of sustainable development, with SDG 3 health focused and other SDGs as determinants of health. Recent decisions in national and regional Courts, appealing to climate change and social impacts, are challenging companies and governments to see human health and wellbeing as central to planning decisions and sustainable energy strategy. Health Impact Assessment (HIA) has consistently been the worst health leading performance indicator of the oil sector. The latest HIA guidance for extractive industries promotes an integrated approach, and national governments often have exclusively Environmental and Social Impact Assessment requirements. However research into whether health issues are adequately being considered in EIA is very limited. We investigated ‘How and to what extent are health, well-being and equity issues considered in Environmental Impact Assessments (EIAs) of major coal mining projects in New South Wales, Australia’ by using a comprehensive coding framework designed to interrogate the publicly available environmental impact statements; we then interviewed varied stakeholders in the same region; and we triangulated the above findings with our experience in impact assessment of oil and gas as well as mining project, and we demonstrated that EIAs fail to consider health and equity comprehensively. Recent decisions in the courts concerning coal mining projects (the last stop in the system for challenges or appeals) have provided legal articulation for how decision-makers should take into consideration a project's impact on human health both through climate change and social impacts as entry points. Unless these issues are addressed up front in planning, designing and assessing, oil and gas projects could not be considered sustainable, and the present paper provides a series of recommendations to address these limitations. more...

A Health Impact Assessment (HIA) is an evidence-based methodology that includes health promotion and protection goals in decision-making. HIA has been introduced and/or institutionalized to various extents in different countries. In order to promote HIA and preventive health assessments in Italy, a research methodology was followed to identify specific obstacles or facilitators. The experiences of various countries reported in the literature were analyzed in terms of facilitating or hindering the introduction and institutionalization of HIA. A consultation with the proponents of projects and plans in Italy was carried out with a multi-approach methodology in order to characterize the national context. A general implementation plan was drawn up from the international experiences. In Italy this is not yet in place. Specific areas of intervention need to be addressed, including: 1) data availability; 2) tools and methods; 3) engagement of stakeholders; 4) capacity building. The research suggests that the institutionalization of HIA in Italy rests on the government's commitment to providing specific legislation regarding HIA so that skills, intersectoral coordination and dedicated budgets can be built and maintained. more...

Attention to the determinants of health and health equity in impact assessment remains under-utilised at the project, Environmental Impact Assessment, level. Determinants focussed health impact assessment has developed at an upstream, policy level, but tends to assess draft proposals rather than form the basis of policies and plans. Project level health (risk) impact assessment tends to focus on a project by project basis, and generally eschews a broad model of health. One answer to this ‘health and impact assessment’ problem is to shift attention to the strategic level, in a similar manner to, and learning from, the development of Strategic Environmental Assessment and its theoretical and practical derivatives. In this article we explain the need for this shift both conceptually and practically by navigating the literature. Our analysis derives specifically from developing the Strategic Health Impact Assessment section of new international industry HIA guidance, coupled with work in and around health impact assessment and policy analysis for the past decade. We develop characteristics of conducting strategic health assessments for multiple industry development activities at the supra national, national or regional level. Our intended audience are public administrators, industry planners and financial sector investors. A particular focus is low and middle income countries, now seen by industry as emerging markets. more...

Emerging Infectious Diseases (EIDs) such as Ebola are a signifi cant threat to global health. It is unclear whether the mining industry has adequately considered EID risks, and more generally the challenge of communicable diseases. more...

Until recently the extractive industry has been largely unaware of the threat of emerging infectious diseases (EIDs), which have the potential to shut down entire operations. The 2014–15 West African Ebola outbreak changed this, drawing attention to the ramifications of disease outbreaks in terms of both human suffering and economic productivity. The Infectious Disease Risk Assessment and Management (IDRAM) pilot initiative in Katanga, Democratic Republic of Congo, has focused on an assessment of the kinds of risk reduction measures in place among selected companies; the industry’s attitudes towards infectious disease control interventions, and; opportunities for collaboration among multiple stakeholders. The initiative found that despite having infection and prevention control measures in place for workers in camps, extractive companies cannot control outbreaks by themselves due to the close interactions with local communities and weak local health systems. Results also showed that EID prevention and control plans benefit both the company and the community and can be feasibly implemented. Consequently, companies should strengthen their risk reduction role by properly assessing the health consequences of their projects through an integrated Environmental Impact Assessment. Finally, partnering with health authorities, other companies, and external stakeholders could help to prepare and respond to infectious disease events. more...

Notwithstanding the historical benefits of coal in aiding human and economic development, the negative health and environmental impacts of coal extraction and processing are of increasing concern. Environmental impact assessments (EIAs) are a regulated policy mechanism that can be used to predict and consider the health impacts of mining projects to determine if consent is given. The ways in which health is considered within EIA is unclear. This research investigated ‘How and to what extent are health, well-being and equity issues considered in Environmental Impact Assessments (EIAs) of major coal mining projects in New South Wales, Australia’. To this end we developed and applied a comprehensive coding framework designed to interrogate the publicly available environmental impact statements (EISs) of three mines in New South Wales (NSW), Australia, for their inclusion of health, well-being and equity issues. Analysis of the three EISs demonstrates that: the possible impacts of each mine on health and well-being were narrowly and inadequately considered; when health and well-being were considered there was a failure to assess the possible impacts specific to the particular mine and the communities potentially affected; the cumulative impacts on human health of multiple mines in the same geographical area were almost completely ignored; the discussions of intragenerational and intergenerational equity did not demonstrate a sound understanding of equity and, it is essential that governments’ requirements for the EIA include detailed analysis of the health, well-being, equity and cumulative impacts specific to the proposed mine and relevant communities. more...

Coal extraction remains supported in many countries despite a global context challenging the industry. A large evidence base links coal with negative consequences for human health. Environmental assessments (EAs) are regulated in nearly every country to assess and set conditions for large industry projects, including coal mines, but tend to exclude health impacts. This study investigated the institutional dynamics surrounding the inclusion of health in coal mining EAs in New South Wales, Australia. Semi-structured interviews with varied stakeholders were supported by a review of legislation, relevant case law and media analysis. Using insights from theories on power and institutions the findings show how EA practice is influenced by the politicization of coal mining that excludes potentially negative narratives surrounding the known human health impacts of coal. Poor EA practice is compounded by legislative ambiguity and lack of conceptual understanding about assessing health. EA's legislative purpose of approving projects undermines confidence that a balanced assessment of impacts has been made. EA is seen as a pro-industry process that disempowers those with dissenting voices. The research explains how the institutional dynamics of a policy process like EA challenge its potential to meaningfully engage with the impact of coal mining on human health. more...

The outbreak of Ebola virus in west Africa in 2014–2016 demonstrates the continued risk of emerging infectious diseases (EIDs) in Africa. It also illustrates the vulnerability of mining companies to the economic impacts of EIDs: that the outbreak forced several companies to scale back and/or terminate projects. Through its impacts on land use, human population dynamics, and biodiversity alterations, among many other behavioral and ecological changes, the mining industry creates risks for the spread of EIDs. The industry can mitigate these risks through cross-sectoral partnerships involving other private sector companies, NGOs, and local and international health authorities to help prevent, prepare for, and respond to EID outbreaks. The success of such cross-sectoral partnerships depends in part on a good understanding of past effective collaborations. Policymakers and companies should focus more on risks of EIDs during routine impact assessment of mining projects, and should better identify how the mining industry can support countries’ adherence to international frameworks and guidelines for preventing and responding to EID outbreaks. more...

Objectives Non-communicable diseases (NCDs) constitute an increasing slice of the global burden of disease, with the South-East Asia region projected to see the highest increase in NCD-related deaths over the next decade. Mining industry employees may be exposed to various factors potentially elevating their NCD risk. This study aimed to assess the distribution and 5-year longitudinal trends of key metabolic NCD risk factors in a cohort of copper–gold mining company workers in Papua, Indonesia. Methods Metabolic indicators of NCD risk were assessed among employees (15 580 at baseline, 6496 prospectively) of a large copper–gold mining operation in Papua, Indonesia, using routinely collected 5-year medical surveillance data. The study cohort comprised individuals aged 18–68 years employed for ≥1 year during 2008–2013. Assessed risk factors were based on repeat measures of cholesterol, blood glucose, blood pressure and body weight, using WHO criteria. Results Metabolic risk indicator rates were markedly high and increased significantly from baseline through 5-year follow-up (p more...

HIA and EA are approaches and processes that support better, healthier, and more sustainable policy development and decisionmaking. When undertaken well, and when valued and applied, they can also help to support better, more informed, transparent and democratic policy development and decision- making processes. However, they are not a panacea; rather, they constitute one important piece of the policy development and decision- making puzzle. Public health practitioners need to increase their knowledge and understanding of EA and HIA. They should improve their links with EA and HIA specialists. They also need to proactively and consistently undertake and commission assessments of health either within EA or as stand alone HIAs. Public health practitioners would also do well to oversee and scrutinize the scope of work for, and the findings of, EAs and HIAs that are commissioned and undertaken by others in the localities in which they work. By doing so, public health practitioners can help to advance the agenda of improving health for all by acting on the upstream determinants of health and bringing together key actors across society. more...

Within the member states of the United Nations 190 of 193 have regulated Environmental Impact Assessments (EIA) which is a systematic process to prevent and mitigate the potential environmental impacts of industry development projects before these occur. However, the routine and comprehensive assessment of health impacts within EIAs remains underdeveloped. Focusing, as an example, on the risks to global health from the global shift in the mining industry towards Low and Middle Income Countries LMIC), this viewpoint details why connecting with EIA is an essential task for the health system. Although existing knowledge is out of date in relation to global practice we identify how health has been included, to some extent, in High Income Country EIAs and the institutional requirements for doing so. Using arguments identified by industry themselves about requiring a ‘social license to operate’, we conclude that EIA regulations provide the best current mechanism to ensure health protection is a core aspect in the decision making process to approve projects. more...

As the Ebola outbreak in West Africa has demonstrated, outbreaks of infectious diseases pose a significant threat to the extractive industry. Extractive companies often operate in emerging infectious disease (EID) ‘hotspots’. The nature of extractive projects in these hotspots causes greater interaction between animals and humans which in turn, is thought to create a greater risk of infectious outbreaks. The Infectious Disease Risk Assessment and Management (IDRAM) initiative supports the extractive industry to better understand, assess and mitigate this risk through fostering partnerships between the industry, public health systems and other relevant stakeholders. During 2014 and 2015, IDRAM field tested planning and audit tools among four leading mining companies in the Katanga province, Democratic Republic of Congo; produced a qualitative study to better understand the industry's perception of EID-related risks; and conducted three desktop outbreak simulation exercises involving industry and other stakeholders. An ongoing economic evaluation study will quantify the economic impact of the Ebola outbreak at the company level. This study will focus on a single large mining company that has continued to operate throughout the epidemic. A literature review exploring past and current collaborative efforts between extractive industries and national health systems related to health emergencies is also being carried out. This will provide strong evidence-based best practice for effective partnership. These activities have highlighted that although the industry recognizes a need for collaborative approaches to managing EID risks, its response remains focused "inside the fence" with an emphasis on limiting contact between humans, wildlife and domestic animals and maintaining hygiene standards. As a result, companies are still vulnerable to disease outbreaks, due to a lack of coordination and engagement with stakeholders "outside the fence". In public health crises such as the recent Ebola outbreak, no single organization has the capacity to deal with global outbreaks on its own. Through future activities, IDRAM will facilitate oil and gas sector's contribution to national preparedness and response capabilities for EIDs and pandemics, thereby contributing to health system strengthening and improving the sustainability and coordination of disease control efforts in countries where the sector is active. more...

Health impact assessment (HIA) has matured as a form of impact assessment over the past two decades. The use of HIA methods and approaches has expanded rapidly, and it now has applications in both the public and private sectors and in an increasing number of countries around the world. This paper presents an overview of the historical and recent international developments in HIA, before detailing the existing strengths, weaknesses, opportunities and threats to practice. It draws upon the HIA literature, five workshops on ‘Current issues in HIA practice’ held at International Association for Impact Assessment (IAIA) conferences between 2006 and 2011, and the experience of the authors. more...

Issue/problem Impact assessment is an approach to estimate and anticipate the consequences of plans and policies. It is a key resources for achieving foresight in societal decisions. As such, impact assessment can and does play a crucial role in governing the health implications of policies in all sectors of society. However, human health is often not covered adequately in impact assessments focusing, for example, on environmental impacts. Health Impact Assessment (HIA) has emerged as a response. … more...

Over nearly four decades, prospective Impact Assessments (IAs) have been applied successfully to apply foresight systematically to human activities on societal level. A range of IA types has emerged focusing on environment, social issues, sustainability, economy and a host of further topics. Several forms of IA developed “cultures” of their own, including legal basis, practice, literature, actors, and ongoing debate. Impact on humans, including on human health, has been … more...

The current paper provides a narrative of the Health Impact Assessment (HIA) of a greenfield project located in a remote part of Papua New Guinea. HIA, in the context of this project, is presented as one of the processes that a company needs to go through in order to develop a site-specific Health Management System (HMS). The objective of a narrative is to tell a story; in this case the story describes how the HIA was carried out. Many guidelines on HIA exist and HIA reports are available. However, very little information is published and presented about the challenges encountered during the delivery, as well as about the management issues that need to be addressed in order to deliver an HIA in remote regions. Up to now we have focused on creating rules and structures for HIA; however, not enough attention has been given to their implementation, and even less to the consequences for not complying with the recommendations. Furthermore, impact assessments are usually described on their own or within the life cycle of the project. However, there is little information on how this process links with the other ones in the development of a site-specific Health Management System and which kind of choices are made in this regard. Projects always interact with the external environment where they are located. This environment poses health, safety and security risks for the project. At the same time this broadly defined environment, where the project is located, is altered and impacted by the project itself. Therefore, the "project" and "environment/context" are two essential parameters to understand the health challenges that a company need to manage when starting a greenfield project. The paper concludes systemizing the experience of this HIA in key practical tips for people implementing HIA of complex projects in remote locations. more...

The description of baseline information about the environmental, social, economic and health conditions existing in the project area is one of the key objectives of an impact assessment. It is also one of the key information pieces needed by project proponents and decision makers, in order to assess and monitor project interaction with the local context. The health baseline always relies on qualitative and quantitative data and is ideally compiled using primary and secondary data. The InterOil Baseline Health Survey (BLHS) generated several primary health indicators and provided a point-in-time assessment of the health status of people living in villages within the InterOil project area in Gulf Province, Papua New Guinea (PNG). It attempted to describe and quantify the type and magnitude of health-related problems affecting the catchment population, as well as identify the relevant determinants of health and potential health risks faced by the current and future population. The choice of the health indicators to include in a health baseline was project and context specific. This was an issue addressed at the beginning of the impact assessment process and it was developed taking in consideration the future use of those indicators for monitoring purposes. The health baseline information not only assisted the identification of the potential impacts, but most importantly defined recommendations and community health outreach programs as part of the project management plan. This plan can then be monitored using health indicators comparable with the ones included in the health baseline. Finally, the paper shows thatspecial attention should be given to the use of secondary data to infer any meaningful conclusion about the health status of a specific community. In the case of InterOil if no BLHS would have been conducted, then the existing secondary data for malaria and filariasis would not have been indicative of the communities and much higher than what isfound in reality with risky consequences for the project. more...

In this work we isolated a culturable endophytic aerobic heterotrophic bacterial community from the stem and root tissues of elm trees (Ulmus spp.) and analyzed its fluctuations. A total of 724 bacterial isolates were collected at different times (April, June, September and December) from two elm trees, one infected with Elm Yellows phytoplasmas, and one which was healthy-looking. The isolates were grouped into 82 haplotypes, identified by means of amplified ribosomal DNA restriction analysis (ARDRA) using the restriction enzyme AluI, suggesting that the genetic diversity of the bacterial community was very high. The taxonomic position of the isolates belonging to the twelve main haplotypes, representing more than 72% of the total population, was determined by 16S rDNA sequencing. The main genera were Bacillus, Curtobacterium, Pseudomonas, Stenotrophomonas, Sphingomonas, Enterobacter, and Staphylococcus. The fluctuations in the bacterial community, determined by different parameters (seasonal changes, plant organ, presence of phytoplasmas) were studied, revealing that they were influenced both by variations in temperature (warm or cold according to the season) and by the organ examined (roots or stems). The role of the phytopathogenic status in these fluctuations was also discussed. more...

Gary Krieger and colleagues (June 19, p 2129) present a polarising narrative, pitting themselves, as private sector consultants, against health impact assessment (HIA) as conceptualised in the Gothenburg Consensus. Krieger and colleagues represent one per spective among HIA practitioners, who all share a commitment to the protection and enhancement of health and wellbeing. The private sector’s use of HIA has not evolved independently of the public sector. Krieger and colleagues omit to note that the International Finance Corporation is a government-owned entity. Demand by govern ments for the accountability of fi nancial institutions has been a driver for the private sector’s use of impact assessment, including HIA. The interplay between public and private sectors has led to guidance for, and commissioning of, HIAs. Krieger and colleagues also do not acknowledge their role in writing the International Finance Corporation guidance for HIA. The environmental health areas frame work and the social determinants of health are not incompatible approaches. Public health is best served by acknowledging the dynamic between environmental and social factors, and refl ecting this in integrated analysis—an approach common to most HIA practice including that articulated by the environmental health areas framework. Krieger and colleagues write that the operationalis ation of HIA is the key. We state that transparency, accountability, and having a wide scope are also crucial to achieving the promise of “tangible results” from large projects. We do not agree with Krieger and colleagues’ Comment, but welcome their contribution. We call on them, and others, to come together to develop a post-Gothenburg inter national HIA consensus that moves the fi eld forward. more...