Health effects caused by environmental factors in the Netherlands
The RIVM estimates that the environment causes approximately 2 to 5% of the total disease burden in the Netherlands. The main causes are air pollution, UV radiation, noise, an unhealthy indoor environment, and microbial contamination of food. In the Environmental Health Action Plan (VROM/VWS, 2002) the government describes its proposals for reducing the risks of the environment for health.
Developments in public health in the Netherlands
Health in the Netherlands has improved considerably in the last 150 years. For example, life expectancy has more than doubled during that time from 35 years to approximately 77 years. This development is explained to a large extent by an improvement in the quality of the infrastructure (drinking water supply, sewage, waste disposal) and housing (indoor environment). Other important factors include greater prosperity, developments in health care (compulsory vaccination, technology) and the increasingly advanced system of health protection (environment, nutrition, work).
In terms of life expectancy, therefore, a lot has already been achieved. Consequently attention is now shifting from 'longer life' to 'quality of life'. The same applies in the domain of public environmental health (Health Council, 1999).
Loss of health as a result of environmental factors
On the basis of current knowledge about health risks from environmental pollution, it is estimated that the loss of health attributable to the physical environment is around 2 to 5% of the total disease burden in the Netherlands (De Hollander, 1999; RIVM, 2000). Air pollution (particulate matter, ozone), UV radiation, noise, an unhealthy indoor environment, and microbial contamination of food and water all make relatively major contributions to environment-related loss of health.
The long list of possible harmful environmental factors from 'Zorgen voor morgen' (RIVM, 1988) has been considerably reduced. This can be accounted for, on the one hand, by improvements in our understanding of the -harmfullness (ik ben het met de eens dat gebruik van "onschadelijkheid" in dit verband niet duidelijk is) of environmental factors and, on the other, by the fact that the levels of exposure have been reduced considerably by successful environment policy.
In recent years, the public has been asking more and more questions about environmental factors that are potential threats to public health but about which not enough is yet known. Examples are mobile phone masts, mobile phones, exogenous oestrogens (endocrine-disruptive substances) and genetically modified organisms.
- See the Kompas Volksgezondheid for more information about endocrine-disruptive substances such as oestrogens.
Policy
The government wishes to strengthen the policy in the area of environment and health. To that end, it submitted the memorandum 'Gezondheid en Milieu, opmaat voor een beleidsversterking' ('Health and the Environment, an overture to more powerful policy) to the Lower House in November 2001 (Ministries of Housing, Spatial Planning and the Environment/Health, Welfare and Sport, 2001). The ministers in question elaborated this memorandum in the Environmental Health Action Plan (idem). The action programme was submitted to the House in April 2002 by the ministries.
The twin focus of the government is on reducing health effects due to environmental factors and removing, where possible, causes for concern arising from environmental risks. In the action programme, this results in three strategies:
- the establishment of an integrated government policy;
- the improvement of communications between the government and the general public;
- a new impulse for research into environmental health.
