Environment and Wellbeing
Ireland’s environment is a fundamental and high-quality national asset that provides a strong foundation for healthy and contented lifes. Our most basic needs are clean air, safe drinking water and healthy food. The quality of each one of these is directly influenced by the quality of the environment. It follows that preventing damage to the environment arising from human activities also helps to protect our health and wellbeing.
Recognition of the intimate interconnections between sustainable environments and healthy lives was highlighted last year by the United Nations and in the recent World Health Organization report ‘Preventing Disease Through Healthy Environments’, whose Sustainable Development Goals (SDGs) are designed to foster improvements in human health and wellbeing.
The European Environment Agency (EEA) estimates that poor air quality contributes to 432,000 premature deaths in Europe each year. The most significant pollutant identified by the EEA was particulate matter, which mainly arises in Ireland from traffic emissions and the burning of smoky fuels for home heating. As regards Ireland, the EEA reported that 1,200 premature deaths every year can be attributed to particulate matter exposure.
The response required here is clear: policymakers, legislators and regulators need to ensure that the safest fuel and transport options are favoured and promoted to assist people in making healthier decisions. In parallel, individuals need to consider how their behaviours impact on our environment, and therefore contribute to health problems such as respiratory and heart disease in our own communities.
In 2013, the Government published the Healthy Ireland framework, which aims to bring about changes to make Ireland a place where everyone has the opportunity to live a healthful life. The inclusion of “wellbeing” in the national discussion on health marks a welcome development, as it moves our ambition beyond “disease prevention” and embraces a fuller vision of people who are living well and have a general sense of satisfaction.
Most of the 17 Sustainable Development Goals (SDGs) agreed by the United Nations are clearly relevant to improving human health, reflecting strong relationship between good health and sustainable living. Ireland’s own national strategy for sustainability, Our Sustainable Future, sets out sustainability challenges and how we might address them in order to ensure that our quality of life and general wellbeing can be improved and sustained in the decades to come.
A vibrant, inclusive and engaged community yields better health and environmental outcomes for all the residents, businesses, schools, etc. within it, i.e. outcomes are more sustainable. Sustainability in local communities is a key objective of the recently introduced Public Participation Networks (PPNs), which aim to enhance public engagement in decision making and policymaking. PPNs are now established in every county and city across Ireland, based on three “pillars”: environment, social inclusion, and community and voluntary.
At an individual level, our choices influence our health and that of our family and neighbours. Choices such as the fuel we use, the water we drink, how we manage our waste, the chemicals we use in our homes and gardens, household ventilation, the noise we create, etc., demonstrate our values and attitudes to our environment, community, health and wellbeing. The collaborative public information resource www.LiveGreen.ie gives advice and tips on how we can take action to make healthier and more sustainable choices.
Clean Air and Health
Across Europe (including Ireland), the most overtly problematic pollutants causing disease in humans are particulate matter (PM), ground-level ozone (O3) and nitrogen dioxide (NO2). Worldwide, the World Health Organization (WHO) estimates that some 80% of outdoor air pollution-related premature deaths are due to heart disease and strokes, while 14% of deaths are due to chronic pulmonary disease or acute lower respiratory infections. The risk of heart disease, which includes heart attacks, has particularly strong and consistent associations with fine particulate pollutants in air (e.g. PM2.5).
During 2013, WHO further concluded that outdoor air pollution exposes humans to carcinogens, with the particulate matter component of air pollution closely associated with an increased incidence of cancer, especially lung cancers. Fortunately, Ireland’s air quality relative to our European counterparts is good. However, values for particulate matter and ozone were above the more stringent WHO air quality guidelines at some stations. The EPA has called for movement towards the adoption of these stricter WHO guidelines, in particular for particulates and ozone, as the legal standards across Europe and in Ireland. Adherence to these new standards will deliver better health outcomes.
There are some specific exposures to air pollution in Ireland – especially around cities and towns and mostly associated with traffic emissions in cities and smoke from home heating in towns – that do not benefit from current restrictions on the sale and use of smoky fuels. In order to protect the health status of vulnerable populations and locations, the planned national ban on the sale of all ‘smoky coal’ in 2018 is a welcome development.
Odours are caused by compounds in the air, and can be pleasant, such as the smell of baking bread, or foul, such as the stench from rotting waste. The ongoing exposure to odour, even at very low levels, can bring on effects such as stress and anxiety. In some cases concentrated odours can cause health problems including headaches and nausea. Although the activities in Ireland that have most potential to cause odour are regulated, there are nonetheless ongoing occurrences, with odours representing a significant source of complaints to the EPA, particularly related to waste transfer stations, landfills, composting facilities and rendering plants. The EPA continues to target facilities that fail to comply with their licences and hold them responsible for their actions in line with its enforcement policy.
Excessive noise can seriously harm human health, including mental health. It can disturb sleep, cause cardiovascular and psychophysiological effects, reduce performance and provoke annoyance responses and changes in social behaviour. According to the World Health Organisation, Environmental noise leads to a disease burden that is second in magnitude only to that from air pollution. The EPA has recently comissioned a 3 year Noise & Health Research project which will provide a state of knowledge review of the relationship between environmental noise and health/wellbeing, and provide a national estimate of the burden of disease from environmental noise in disability-adjusted-life-years (DALYs).
In Ireland, local noise issues, including those from neighbours and local commercial facilities, represent the largest source of noise complaints which are dealt with by local authorities. The EPA, with the local authorities, recently published a standardised national guidance document to be used in the management of noise complaints. Environmental noise from major infrastructure including roads, railways and airports is governed by the EU's Environmental Noise Directive. The preparation of strategic noise maps is a major task associated with this directive. Following completion of the 3rd round noise maps, the relevant Action Planning Authorities must prepare their noise action plans which are designed to act as a means of managing environmental noise through land use planning, traffic management and control of noise sources.
Clean Water and Health
Safe drinking water is essential to public health, and therefore water must not contain microorganisms and substances at concentrations that could endanger health. Drinking water supplies must meet specific legislative requirements, the objective of which is to protect human health. The results of the 2015 drinking water monitoring programme for public water supplies show 99.9% compliance with microbiological standards and 99.4% compliance with chemical standards, based on 185,515 sample results.
While this indicates that the majority of public water supplies are safe, further improvements are necessary to improve the security of supplies and avoid long-term Boil Water Notices. In particular, the EPA has identified 108 ‘at risk’ supplies on the latest Remedial Action List which are in need of upgrade, replacement or improved operational control. The EPA has identified key priorities that need to be addressed: eliminate long-term Boil Water Notices; implement action programmes for all “at risk” supplies, particularly treatment systems to address trihalomethanes; remove lead from public buildings and homes.
There are approximately 170,000 private wells in Ireland, of which at least 30% are estimated to be contaminated by E. coli. Private wells are not regulated and are classified as “exempted supplies”. In effect, this means that the well owner is solely responsible for the quality of the well water. Many private wells are at risk of contamination from sources such as septic tanks, landspreading of slurry, animals grazing near the wellhead etc. Private wells need to be properly sited, constructed and maintained in order to reduce the risk of contamination.
Urban Waste Water
Urban waste water is one of the principal pressures on water quality in Ireland. Untreated waste water can be contaminated with harmful bacteria and viruses and must be treated before it can be released back into the environment. Without such treatment, the waste water we produce would pollute our waters and create a health risk. There has been significant investment in waste water treatment infrastructure since 2000. This has reduced the proportion of Ireland's waste water discharged without treatment from 30% in 2000, to 3% in 2016. Nonetheless, further significant investment is necessary to upgrade inadequate waste water collection and treatment systems. Improvements in the operation and management of waste water infrastructure are also needed to ensure waste water is treated to the standards set to protect the environment. You can see where urban waste water is discharged into the environment on the EPAs Sewage Treatment Map.
Domestic Waste Water Treatment Systems
There are an estimated 500,000 domestic waste water treatment systems (DWWTS), i.e. septic tanks and treatment systems, in Ireland treating waste water from houses not connected to a public sewer system. Household septic tanks can threaten public health and water quality if they are poorly constructed or fail to operate satisfactorily.
Overall, the quality of Ireland’s bathing waters is very high, with 93% of the 137 identified bathing areas meeting the minimum EU standards and achieving at least “sufficient” water quality status. In addition, 83% have met the “excellent” or “good” standards. However, six bathing waters failed to meet sufficient quality, which means they were required – for health risk reasons – to have either an “Advice against Bathing” or a “Bathing Prohibition” restriction in place for the 2016 bathing season. Members of the public can find out about bathing water quality on the EPA’s Splash website (www.bathingwater.ie), or on bathing water notice boards at the beaches.
Radioactivity in the Environment
Levels of radioactivity in the Irish environment have been routinely monitored since 1982. In 2015, EPA reported on comprehensive measurements of radioactivity in air, drinking water, marine environmental samples and a range of foods. The data confirmed that the levels of artificial radionuclides in the Irish environment are low and do not pose a significant risk to the health of the Irish population.
Radon is a naturally occurring radioactive gas formed in the ground by the radioactive decay of uranium, which is present in all rocks and soils. It is estimated that exposure to radon accounts for approximately 13% of all lung cancers in Ireland, which equates to some 250 lung cancer cases each year. High radon concentrations can be found in any part of the country; however, the EPA has identified certain areas which are more prone to radon as High Radon Areas. The EPA regularly runs local awareness campaigns in High Radon Areas in order to raise awareness of the risks from radon and to encourage homeowners to test their homes.
Climate Change, Health and Wellbeing
In Europe, the impacts of climate change on human health and wellbeing include flooding, extreme temperatures, air pollution, vector-borne disease and waterborne and food-borne diseases. Climate change is likely to alter risks to public health and wellbeing in Ireland. The key climate change-related exposures of importance to human health are likely to be increases in heatwave-related health impacts, decreases in cold-related health impacts, increases in flood-related health impacts, and an increase in the frequency of respiratory diseases due to changes in pollen and pollutant distributions.
Pharmaceuticals in the Environment
The unnecessary and excessive use of antimicrobial agents, such as antibiotics, has significantly contributed to the development and spread of antimicrobial resistance (AMR) worldwide across the human population, agriculture and the wider environment. It is estimated that AMR results in 25,000 deaths annually in Europe, plus related costs, resulting from healthcare expenses and productivity losses, of over €1.5 billion. The use of antimicrobials in the agriculture and food production sector is also substantial.
Endocrine disruptors are a diverse group of chemicals that affect hormonal function and include some pesticides, PCBs, dioxins, some synthetic pharmaceuticals and industrial chemicals. Research funded by the EPA indicates that, although some endocrine-disrupting compounds were detected in the Irish environment, levels are generally low and not regarded as a significant risk.
Whats Being Done
Regulation and Policy
Within Ireland, environment and health is an area of growing public interest and involves a large number of organisations from both health and environmental perspectives. Under its environmental protection mandate, the EPA delivers direct and indirect benefits to human health through controlling harmful substances, as well as emissions from licensed facilities; maintaining a supervisory function with regard to the provision of safe and secure drinking water; bathing water reporting; research; and monitoring ambient air quality.
The EPA’s Health Advisory Committee brings representatives from public health authorities together to advise the EPA on carrying out its functions in the context of health protection. The concept of health assessment has emerged as a component of Environmental Impact Assessment. Through this process, the potential health effects of a development on the local population are considered – in terms of both positive and negative impacts. Such assessments combine evidence from research and monitoring with independent expert opinion to provide a clear understanding of potential direct and indirect health impacts, and to identify adjustments to mitigate future problems.
From an environmental and human health point of view the concept of “health food” is largely concerned with ensuring that foods are free from contamination associated with chemical or biological pollution. Careful regulation is necessary to ensure that food-growing areas are not adversely impacted by, for example, poorly treated waste water, landspread wastes, and badly managed farm chemicals or air pollutants. Care is also required around the reintroduction of by-products into the food chain to avoid unintended contamination. Some recent incidents involving Irish producers have shown that monitoring and response systems are working well; however, the goal is clearly to avoid these circumstances arising.
Environment and Health Research
Environment and health is recognised as a fundamental and cross-cutting topic in the national environmental research programme that is managed by the EPA. The desired outcomes are to identify, characterise and manage threats from the environment to health and wellbeing, and also to recognise opportunities to use the environment to foster improvements in our health and wellbeing. Since 2007, the EPA has funded over 50 research projects on environment and health issues representing a total commitment of approximately €10 million. Recent projects have included Ecosystem Benefits of Greenspace for Health, and Nature and Environment to Attain and Restore Health.
Ireland’s environment is generally good, and generally Ireland does present a clean, safe environment to live in. The availability of green spaces (parks, woods, countryside) and blue spaces (ponds, riverbanks, lake shores and seashores), along with clean, fresh air and breathtaking landscapes, provides an enviable resource which should be valued and enjoyed.
In common with countries across Europe, key high-level environment and health issues include climate change, antimicrobial resistance and chemical pollution. In addition there are a number of national issues that require action, such as health impacts associated with localised air pollution and drinking water contamination. Some of the key challenges facing Ireland are: on-site waste water treatment systems (such as septic tanks) and urban waste water discharges impacting on water quality and amenities; urban air quality in cities and towns; nuisance and amenity impact from noise and odour; and radon in homes.
What is clear from international studies is that a clean, protected and accessible environment contributes significantly to the status of our health and quality of life, to reducing healthcare costs, and to the successful delivery of national public health policy. Accordingly, Ireland must put in place the necessary measures to ensure that our natural environment is protected and enhanced so that we can derive the associated wellbeing and life expectancy benefits.