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1. Introduction
Report | Doc. 11788 | 20 January 2009
Environment and health: better prevention of environment-related health hazards
(Former) Committee on the Environment, Agriculture and Local and Regional Affairs
Summary
There are strong links between environmental pollution and increasing health risks. Environment-related pathologies are not confined to respiratory and cardiovascular diseases and specific types of cancer, but also include other chronic and emerging pathologies which are also deemed to have links with the environment, including immune system impairment, neurological and neurodegenerative illnesses and disruptions of the hormonal and reproductive system.
Despite calls for the precautionary principle, there is still a lack of reaction to known or emerging environmental and health risks and virtually systematic delays in adopting and implementing effective preventive measures. The political authorities must act to prevent disease and health crises by adopting preventive health policies, especially at the level of the production and transformation of consumer products.
The report also calls for the recognition of environmental medicine as a new transverse medical discipline and the development of harmonised initial and further training programmes for students and physicians at the European level.
A. Draft recommendation
(open)1. The Parliamentary Assembly, like other international
organisations such as the European Union, the World Health Organization
(WHO), the European Environment Agency, etc., notes that there are
increasing links between environmental pollution and ever greater
and more obvious health risks. Environment-related pathologies are
not confined to respiratory and cardiovascular diseases and specific
types of cancer, but also include other chronic and emerging pathologies
which are also deemed to have links with the environment, including
immune system impairment, neurological and neurodegenerative illnesses
and disruptions of the hormonal and reproductive system.
2. Since embryos, foetuses, neonates and children are even more
sensitive to environmental factors than adults, the Assembly alerts
all governments and all the responsible organisations and stakeholders
to the need to protect or restore a healthy environment and thus
guarantee the future of our children and future generations.
3. The Assembly has repeatedly stressed the importance of the
states’ commitment to preserving the environment and environmental
health as set out in many conferences, charters, conventions, declarations
and protocols since the United Nations Conference on the Environment
and the “Stockholm Declaration” (1972). It more particularly welcomes
the research efforts and action plans launched since the WHO-Europe
Conference on Environment and Health (Budapest, 2004).
4. The Assembly nevertheless regrets that, despite calls for
the precautionary principle and despite all the recommendations,
declarations and a number of statutory and legislative advances,
there is still a lack of reaction to known or emerging environmental
and health risks and the virtually systematic delays in adopting and
implementing effective preventive measures. There has thus been
little improvement in the situation of multiple and chronic exposure
to multiform pollution and environmental pathologies are still as
worrying as ever.
5. In the light of the known results of scientific expertise
in this field, it considers that the political authorities must
act upstream in order to prevent disease and health crises.
6. The Assembly stresses the importance of all forms of prevention
and early detection where environmental health policy is concerned,
and believes that primary prevention of environmental risks must
be encouraged above all.
7. Risk assessment must be based solely on scientific criteria,
which means that it must be shielded from any kind of pressure exerted
by the political authorities or economic lobbies, and must take
account of the often insidious effects of chronic exposure to low
or threshold exposure doses of a range of pollutants working in combination.
Even in small doses, a “cocktail” of pollutants in the air, water,
food and in everyday consumer products, and also in building materials,
can have a serious effect on human health.
8. Such assessment must above all take account of the fact that
it is not only the dose that makes the poison but also the period
of exposure, the accumulative mechanisms and individual sensitivities
to pollutants or mixtures of pollutants.
9. For over twenty years, scientists, field doctors and environmental
physicians as well as experts and environmental specialists have
been alerting the public authorities and medical circles to the
new health risks and environmental pathologies arising out of the
insidious increase in pollution in all environments, in the food chain
and in the human organism itself.
10. The Assembly acknowledges the primordial role played by civil
society and associations working to protect the environment and
environmental health in terms not only of sounding the alarm and
denouncing health scandals but also of producing preventive strategies
and action plans.
11. Faced with the increasing risks to the environment, wildlife
and human health, particularly that of future generations, the Assembly
supports the research efforts being made at the European and international
levels to assess, with the requisite degree of certainty, the impact
of low doses of chemical pollutants and ionising and non-ionising
radiation on human health.
12. The Assembly takes note of the fact that in the environmental
health field, all the players, including toxicologists, epidemiologists
and environmental physicians, agree that environmental pollution
has a negative impact on human health and advocate improving the
prevention of health disorders linked to such pollution. Environmental
medicine is a new transverse medical discipline which has been emerging
and developing for a number of years.
13. The Assembly notes that the number of individuals actually
suffering from diseases linked to the environment is regularly growing,
in an increasingly disturbing manner.
14. Stressing the need for urgent practical action to curb the
increase in known or emerging risks, the Assembly asks the Committee
of Ministers to invite member states and observers of the Council
of Europe to:
14.1. apply the precautionary
principle in order to prevent major dramatic health crises in future
caused by environmental risk factors;
14.2. ensure that scientific experts can work in an independent,
transparent and democratic manner in accordance with the principles
of adversarial and pluridisciplinary research;
14.3. guarantee the application of transparent criteria in the
choice of the different experts and to improve their status, as
well as to enhance the protection of “whistle-blowers”;
14.4. support actively the participation of civil society in
public adversarial debates on present and future technological choices
and challenges and acceptable risk levels (impact assessment);
14.5. intensify urgently and substantially the efforts to devise
a global policy for preventing chronic diseases associated with
the environment, as well as environmental health policy action plans,
as an incentive for the sustainable and ecologically responsible
restructuring of all fields of political and human activity;
14.6. adopt prevention policies in all fields, in terms of consumer
food production and processing and service development, in order
to foster the development of a new health protection-oriented economy;
14.7. contribute actively to the establishment and reinforcement
of a more responsible chemical production policy, by withdrawing
from the market all carcinogenic, mutagenic, reprotoxic and neurotoxic substances,
implementing a firm substitution policy and encouraging industrialists
(by means of tax and financial measures) to move on to safer, less
polluting products;
14.8. support organic agriculture and regulate less pesticide-intensive
agricultural production methods, develop less polluting modes of
energy production, reduce the impact on health of road traffic and promote
a building policy that takes account of the impact of construction
and building materials on health;
14.9. take account of the warnings of the European Environment
Agency regarding electromagnetic pollution and specific health risks
attributed to mobile phone systems;
14.10. foster measures, in their prevention programmes or action
plans, to train and educate people in environmental health risks
at all levels of society, and to develop exchanges between experts
and citizens and between physicians and patients;
14.11. recognise environmental medicine as a new transverse medical
discipline and develop harmonised initial and further training programmes
for students and physicians at the European level;
14.12. reinforce and ensure the general implementation, in connection
with the problem of pollution inside houses or buildings, of the
“green ambulance” system (mobile laboratories analysing homes and buildings
at the request of the individuals concerned, in liaison with their
family doctors, and the intervention and expertise of indoor environment
counsellors), and to provide new types of training courses for medical
advisers on interior environment;
14.13. improve provision, by better reimbursement of diagnostic
and therapeutic expenses, for persons suffering from illnesses associated
with the environment, who often face major protracted suffering involving
high personal costs;
14.14. support actively, by means of subsidies, contracts and
partnership agreements, patients’ associations working in the field
of environmental health and diseases associated with the environment.
B. Explanatory memorandum, by Mr Jean Huss
(open)1. Introduction 
1. The links between environmental damage and health
problems were discussed by Hippocrates in ancient Greece in his
treatise on Air, Water and Places,
in which he writes that physicians worthy of the name should have
due regard to the seasons of the year, and the diseases they produce,
and to the state of the wind peculiar to each country and the properties
of its waters. They should carefully observe towns and their environs,
as well as noting the lifestyles of the inhabitants, particularly
their dietary habits. In other words, all the factors that might
lead to imbalance in the physiological system.
2. Hippocrates was undoubtedly the precursor of what we now term
specialists in environmental health and environmental medicine.
But the philosopher Seneca also complained of the unbreathable air
of certain districts of ancient Rome, which already contained several
hundred thousand inhabitants packed into unhygienic buildings several
storeys high giving off the stink of smoking chimneys, a situation
that can probably be compared to the shanty towns of some of today’s
poorest countries.
3. Concentrations of people in large towns and cities have always
been a cause of pollution and health and hygiene concerns. From
the Middle Ages, the combustion of first wood and then coal, and
the accumulation of rubbish in narrow streets, led to significant
air and water pollution, with damaging health consequences.
4. With the advent of heavy coal-burning and steel-making industries
in the 19th century, followed in the 20th by the growth of the chemical
industry, new types of pollutants emerged, such as heavy metals, chlorinated
products and pesticides. The post-war years have seen a growth in
chemical production and its associated risks, as well as an ever-growing
quantity of car exhaust emissions, such as nitrogen oxides, fine particles
and volatile organic compounds, which are currently polluting our
towns and cities, not to mention other health hazards such as noise
and ionising and non-ionising radiation. To complete the picture,
we should not forget such major environmental and health crises
as the London smog of the 1950s, the thousands of sick and dead
in Minamata, Japan, caused by the ingestion of mercury-contaminated
fish, the Chernobyl accident, with its serious environmental and
health effects on certain countries and regions affected by the
clouds of radioactivity, the industrial disasters at Bhopal in India
or Seveso in Italy or certain villages in China that are still today
afflicted with cancer.
5. The different scales of pollution
1.1. Local pollution
6. This is pollution resulting from local industrial
emissions – coal, steelworks, chemicals, incinerators, waste disposal
– or urban activities such as the combustion of coal and other fuels
and vehicle emissions.
7. This pollution varies between the different Council of Europe
regions and member countries according to the level of economic
and industrial development. In older industrial centres it is often
very serious and is typified by sulphur dioxide, various forms of
dust, heavy metals and dioxins, while in urban centres of more recent
economic development the pollution derives above all from the constant
rise in the number of vehicles and road traffic. Here, nitrogen
dioxides, fine particles and ozone in the lower atmosphere are causing increasingly
serious health and environmental problems.
8. Noise pollution is often another problem at local level. Noise
is an increasing feature of our environment and can become a nuisance
and even a threat to human health, with a decline in quality of
life accompanied by cardiovascular disorders and depression.
9. Another problem at local level is the disquiet or even fear
of those living close to relay stations for mobile telephone networks,
who worry about the risk of non-ionising radiation.
1.2. The regional and international level
10. To add to this local industrial and urban pollution,
since the 1960s there has been an increasing “internationalisation”
of air and water pollution and food contamination.
11. This ranges from acid rain and acidification of the soil and
of ecosystems (lakes and seas) and the effect of pesticides and
other synthetic chemical pollutants on rainfall and ecosystems,
to the gradual destruction by CFCs (chlorofluorocarbons) of the
ozone layer, which filters out ultraviolet solar rays that are harmful
to living organisms, and the greenhouse effect that has already
long been a cause of concern. It must now be acknowledged that most
of the forms of pollution that threaten ecosystems and human health
have become global problems and have to be combated at the global,
as well as regional and local, levels.
12. An increasing number of scientific studies as well as medical
experience on the ground show that there is a growing link between
environmental pollution and various forms of deteriorating health
in the general population, and particularly among children. These
links between a polluted environment and health have been recognised
not only by leading scientists but also by WHO, the European Commission
and the conferences of environment and health ministers.
13. This includes not only a growing incidence of various types
of cancer, including cancers in children, but also allergies, respiratory
disorders, asthma, reproductive disorders and certain degenerative
diseases of the central nervous system, not to mention a number
of “new syndromes” with a chemical or environmental component that
are increasingly recognised as public health problems.
2. Omnipresent pollution and all environments contaminated
14. Our society is apparently failing to recognise that
it is currently contaminating all the natural environments that
are essential to our planet’s survival, including air, soil, plant
life, rivers, seas and foodstuffs. There are now no longer any places
that are free of pollutants. Traces of heavy metals, radioactive
elements, pesticides, polychlorinated biphenyls (PCBs) and phthalates
are increasingly present in industrial regions, but also in high
mountain lakes and the Antarctic snows.
15. The continuing contamination of the atmosphere, wind and rain
by vehicle traffic and pesticides contributes further to dispersing
all these pollutants across the planet, creating a form of underlying
pollution that is a growing cause of concern.
16. Many of these chemical substances are extremely persistent
in natural environments and gradually accumulate in the food chain
before finally forming strong concentrations in the organs of major
predators such as swordfish, tuna, seals and polar bears.
17. Even human beings, at the end of the food chain, are increasingly
contaminated by all these chemicals, which accumulate in the cells
and lipophilic tissue of the human organism. During pregnancy, at
an extremely vulnerable stage of development, the embryo and the
foetus may suffer placental transfer of potentially toxic and harmful
substances such as mercury, pesticides and phthalates in the blood
of the future mother through the umbilical cord.
18. A World Wild Fund for Nature (WWF) study in December 2004
of chemicals in the blood of 14 European health and environment
ministers revealed the presence of between 33 and 43 different chemicals.
Blood tests on numerous members of the European Parliament produced
equally worrying results.
19. In the case of pregnant women and their future babies, nor
is it just the blood in the umbilical cord and the meconium that
can be contaminated, but also the mother’s milk (phthalates, pesticides,
heavy metals and so on), even though it is still very important
to breast feed.
20. All these examples of studies and campaigns concerned with
specific topics, as well as the results of more general biomonitoring
campaigns, serve the useful educational purpose of showing that
the origins of pollution are not limited in time and space – for
example to factory chimneys or vehicle exhaust systems – and that
it can also derive from other unknown sources of exposure, such
as household and cleaning materials and products, textiles, furnishings,
wrapping material and toys, and that today no one can escape it.
3. Polluted environments are a health hazard
21. No other generation in history has been so exposed
to thousands of chemical substances that are totally alien to everyday
life.
22. On the basis of ever more reliable scientific studies, independent
academic researchers and international organisations are issuing
an increasing number of warnings about the dangers of chronic chemical
pollution at low or very low doses on our organism, particularly
in the case of children and embryos during pregnancy.
23. Successive WHO ministerial conferences on environment and
health, which are milestones of a continuous process, have drawn
attention to the links between this chronic low-dose but ubiquitous
pollution and chronic disorders and illnesses, especially among
children. The same concerns are echoed in official United Nations
Environment Programme (UNEP) and Intergovernmental Forum on Chemical
Safety (IFCS) documents and in the European Commission’s environment
and health action programmes.
24. Unfortunately, all these measures and action and prevention
plans remain one-off, transitory and insufficiently comprehensive
to deal with the global hazards that now face us, even if the serious
efforts of a number of member states have to be acknowledged.
4. Short-term economic interests or the precautionary principle?
25. The industries concerned – chemicals, motor manufacture,
nuclear, foodstuffs and mobile phones – all tend to react the same
way in defence of their direct economic interests, by putting pressure
on the authorities, threatening unemployment, direct or indirect
bribery of university and laboratory researchers and doctors, non-publication
or falsification of scientific data, carefully vetted expert reports,
lobbying and infiltrating expert committees. Sir Richard Doll, who
died in 2005, a cancer epidemiologist of worldwide repute who minimised the
risk of cancer from vinyl chloride, Agent Orange, dioxins and other
organochlorine products and received significant financial contributions
from Monsanto, for whom he acted as consultant, was certainly not
the exception but rather the tip of the iceberg, even though fortunately
most scientists, physicians and other experts remain committed to
the cause of public health and environmental health and protection.
5. Complexity of the environment health link: new data for scientific risk assessment
26. In recent decades, tens of thousands of toxic substances,
pollutants and chemical products or combinations have been introduced
into industry and the manufacture of consumer goods. Polluting emissions are
dispersed daily into every natural environment. As a result, the
traditional toxicological adage that it is the dose that makes the
poison, which underlies the process of setting guidance or threshold
values, no longer offers adequate safeguards for protecting the
environment and human health. First, the chronic toxicity or immunologic
sensitisation common to most of our day-to-day exposure to pollutants
bears little relation to the acute toxicity of these substances.
For example, certain substances have a weak acute toxicity, but
are still toxic for reproduction and the foetus at low doses. Certain
so-called endocrine disrupting chemicals even appear to have a more
pronounced action at low than at high doses.
27. The classical risk-assessment model also suffers from other
deficiencies. Risk is a function not just of the dose, but also
of the period, the “window” and the duration of exposure, age and
sex, the half-life of the accumulated substances, combined exposure
– additive or synergetic effects – to several substances that are toxic
at low doses, other co-factors such as individuals’ state of health,
pre-existing allergic conditions and genetic polymorphisms causing
metabolism and affecting individuals’ detoxication capacity.
28. For example, the polluting chemical “cocktail” of cigarette
smoke may cause sickness and lead to lung cancer, but not all smokers
will die of lung cancer, even though all independent and serious
epidemiological studies reveal very close links between smoking
and extremely high health risks.
29. In the absence of unethical and unacceptable experiments on
human beings, the requirement occasionally expressed for totally
infallible evidence of a cause-effect relationship can never be
met. The known nature and characteristics of chemical substances
or a mix of substances and fairly strong epidemiological associations
should therefore be sufficient to invoke the precautionary principle
and justify preventive measures to protect the environment and human
health.
6. Established links between pollutants and health problems
30. An ever-increasing number of scientific studies and
reports have drawn the attention of policy makers, civil society
and the medical world to the links between chronic exposure at low
doses and the onset or reinforcement of numerous medical conditions,
which are sometimes deemed to have no known cause.
31. In industrialised countries and large cities there is a continued
growth in cases of severe respiratory disorders such as chronic
obstructive pulmonary bronchitis or asthma, but these conditions
are increasingly affecting young persons and children. There appear
to be substantial variations between countries studied in the percentages
of persons affected by asthma, suggesting that environmental factors
such as passive smoking, urban pollution, domestic pollution and
occupational exposure may have a critical influence.
32. According to the major International Study of Asthma and Allergies
in Childhood (ISAAC), the number of children and young persons affected
by asthma may have doubled in twenty years, among teenagers the number
of cases of asthma has risen from 7% to about 10% and of hay fever
from 7% to 14%, and of eczema from 18% in children to 25% in juveniles.
33. The Council of the European Union is “concerned about the
health problems associated with environmental determinants, such
as respiratory diseases, asthma and allergies, neurodevelopment
disorders, cancer, and endocrine disrupter effects, and particularly
those affecting vulnerable population groups such as children in
their different developmental stages, pregnant women, the elderly,
and the socio-economically disadvantaged.”
34. One example is also infertility, which affects an increasing
number of couples (1 in 7) in Europe. The main cause is the lower
quality of the sperm, but there are significant regional variations.
The same applies to the growing incidence of cancers, which vary
according to type, region and social groups concerned.
35. Further examples include the worrying rise in the incidence
of malignant tumours, such as leukaemia and brain cancer, in children.
These increases may well be explained by environmental factors such
as radioactivity, benzene, insecticides in habitats and low and
high frequency pulsed electromagnetic fields.
36. More than many other conditions, allergies, cardiovascular
diseases, hormonal disorders and psychological problems seem to
be associated, at least in part, with damage to our environment
and the quality of our foodstuffs.
37. To add to these worrying developments in environmental health,
in recent years a number of new illnesses or syndromes have made
their appearance, such as:
While in children, disturbing rises in cases of autism and attention deficit and hyperactivity syndrome seem to be linked, at least in part, to chronic exposure to low doses of essentially chemical pollutants in the environment and foodstuffs.
- MCS (multiple chemical sensitivity);
- CFS (chronic fatigue syndrome);
- dental amalgam mercury syndrome;
- hypersensitivity to electromagnetic rays;
- sick building syndrome;
- fibromyalgia.
38. Since there is no room in this report to discuss in detail
the possible, probable or established environmental causes of all
these syndromes, it will confine itself to the best known example,
that of pollution in the home or sick buildings syndrome.
7. Pollution in the home and “sick buildings”
39. For more than fifteen years, scientists, environmental
biologists, patients’ and consumers’ associations have been drawing
attention to a new form of environmental pollution and threat to
public health, namely pollution in the home or sick building syndrome.
Since the early 1990s, certain Nordic countries, Luxembourg, Belgium
and some German Länder have
set up “green ambulance” or environmental medical services to deal, among
other things, with health problems that might arise from pollution
in the home. Other countries and international organisations have
followed suit, such as France, which has established a monitoring
centre for indoor air quality and WHO Europe, who initiated the
process to create indoor air quality norms (IAQ guidelines) in 2006
focusing on dampness and mould, selected chemicals, allergens and
products of indoor combustion. Most recently, on 20 December 2007,
the Council of European Union environment ministers expressed concern
about the growing links between domestic pollution and health problems
and invited the European Commission to establish or consolidate
guidelines on healthy and safe indoor environments, giving special attention
to construction products, energy performance of buildings, chemical
substances, equipment and furniture, and so on.
40. While everyone is aware of the links between external pollution
and health, many doctors, politicians and ordinary members of the
public are unaware that the air in our homes and administrative
and public buildings, including schools and nurseries, may be much
more noxious than the air we breathe outside. Modern building techniques
often favour the use of chemically based synthetic materials that
are harmful for health.
41. The air in our homes and offices may also carry biological
contaminants, particularly moulds that are responsible for infections,
allergic reactions and chronic illnesses, as well as electromagnetic
forms of contamination that alone or in combination can have undesirable
health effects. Types and sources of inside pollution may therefore
take very diverse forms depending on building materials, furnishings
and washing and cleaning products used. Moreover, tobacco smoking
at home remains very frequent, causing indoor exposure to a chemical
cocktail of the environmental tobacco smoke of a substantial part
of population, with more than 80% of children exposed in many countries.
42. It is impossible to analyse all the sources of indoor pollution
and the mixture of all its largely chemical constituents – PCB,
pesticides, volatile organic compounds, formaldehyde, CO, phthalates,
flame retardants, solvents, radon, perfumes, heavy metals and so
on. Nevertheless, such indoor pollution poses a significant threat
to public health which must be taken into account, and efforts are
needed to prevent these health risks, which may be associated with
a wide range of disorders.
43. According to data from official agencies and other bodies
and the research findings of building biologists and environmental
health specialists, indoor pollution of homes can lead to allergic
rhinitis, respiratory and skin disorders, irritation of the eyes,
sinus and throat, respiratory infections, asthma, headaches, cardiovascular disorders,
depression and even certain forms of cancer. The list is not exhaustive.
Sick building syndrome or problems with the quality of the air in
schools and colleges may be associated with buildings’ situation, inappropriate
maintenance of ventilation systems, the building materials used,
the presence of chemically treated carpets, the use of products
to control insects, the installation of new offices, an accumulation
of electromagnetic sources and so on.
44. The health problems of individuals or groups concerned may
be very serious, and can even lead to MCS (multiple chemical sensitivity),
but there may also be very substantial financial costs, in terms
of medical costs, the cost of remedial action in the contaminated
home or offices and sometimes even the invalidity costs of persons
who are unfit to work.
45. As with other disorders associated with a polluted environment,
the toxicological explanatory model is the same, including chronic
exposure to a low dose of a cocktail of various pollutants, individual
genetic activities of detoxication enzymes, individual characteristics
of immune systems, autoimmunity, allergies, nutrient deficiencies
and so on, which generally explains why certain persons living in
the same house or occupying the same classroom can tolerate such
pollution for a fairly extended period while other, more “sensitive”,
occupants will rapidly develop sometimes very serious health disorders
and problems.
46. As with other sources and types of pollution, the best way
of dealing with these problems is to take preventive action at source
by developing less harmful, biodegradable materials and products,
according to the principles and precepts of green chemistry.
8. The role of NGOs and civil society
47. NGOs are involved in environmental issues, consumer
protection and health work at both national and international levels,
but the financial, structural and administrative resources of these
organisations, particularly patients’ associations, are generally
extremely limited and do not allow them to become genuinely involved
in developing or monitoring European environment and health policies.
48. Similarly, European NGOs such as HEAL (Health and Environment
Alliance) and WFCF (Women for a Common Future) have a limited number
of persons who can keep track of the relevant issues, but they cannot compete
with the overwhelming resources of the industrial and financial
lobbies. If the relevant official European and national bodies really
want active involvement of environmental health NGOs they will need more
resources so that they can fulfil more than just their current role
of democratic alibi.
49. The Council of Europe, as a proponent of participative democracy
and a defender of human rights, particularly those of the weakest
members of the community, is committed to strengthening the resources
of NGOs engaged in an unequal struggle to protect the environment
and individuals suffering the increasingly complex health effects
of that environment. They should be given more real opportunity
– for example, via travelling and subsistence expenses – to participate
in the debate on environmental and health hazards. This might include
the right to nominate their own members to expert committees and
to organise public hearings with professional assistance on issues
where scientific impartiality is open to question.
9. Environmental policy in Europe – What has been achieved
50. It was not until the early 1970s and in response
to a growing number of ecological problems and environmental crises
with an international dimension, concerning air, river and sea pollution,
industrial accidents and waste disposal policy, that the first European
action programmes were approved, at the same time as the Stockholm
environment summit and the establishment of the United Nations Development Programme
(UNDP).
51. The 1986 Single European Act empowered the Community to act
in the environment field (Articles 130 R, S and T) and required
the integration of environment issues into other Union policies.
The Maastricht (1992), and Amsterdam (1997) treaties went further
by giving full weight to the notion of sustainable development and allowing
member states to introduce stricter protective measures if they
were scientifically justified.
52. But despite certain progress, for example a reduction in air
pollution, the ban on leaded petrol, catalytic converters, measures
to reduce industrial pollution in power stations, incinerators and
factories, and the quality of drinking water, the results of this
European environmental policy in general have been fragmentary, inadequate
and fairly limited. This is the worrying conclusion of the European
Environment Agency, which criticises the failure to apply the precautionary
principle in many areas and calls for more serious consideration to
be given to comprehensive and preventive environmental policies
(“late lessons from early warnings”).
53. Moreover, in 2004, the European Council itself, as well as
the European Commission, noted the failure of many member states
to implement environmental measures, either by transposing them
into domestic law or by properly applying and monitoring them.
54. Certain European countries, particularly the Nordic ones,
have made a much better job of incorporating these environmental
policies and have even adopted more ambitious and binding measures
but others unfortunately remain well behind in many areas and have
had numerous infringement proceedings brought against them by the
European Commission. In the absence, therefore, of a real commitment
to more advanced environmental regulations and action, or of effective
sanctions against non-compliant member countries, the programmes
introduced by the European Commission remain generally inadequate.
They rarely go beyond the minimum regulations, in other words the
lowest common denominator, and are therefore quite inadequate to deal
with the real ecological challenges and the major crisis of environmental
health.
55. The Children’s Environment and Health Action Plan for Europe
was officially adopted by WHO Europe at the 4th Ministerial Conference
on Environment and Health in Budapest in June 2004 by all the 53
member states represented by their ministers for health and ministers
for the environment.
56. Despite the efforts of WHO, the EEA, the European Commission
and the Council of the European Union environment ministers to develop
new health and environment action programmes, it was only recently,
on 20 December 2007, that the council of environment ministers returned
to the fray and called for urgent consideration to be given to all
these programmes.
57. Discussions on the REACH (Registration, Evaluation, Accreditation
of Chemicals) regulation have led to some progress on the monitoring
of chemical products. However, the extremely powerful lobbying of
the European and American chemical industries has succeeded in minimising
the scope of the regulation, which was initially more radical, with
the result that there will only be a relative and gradual improvement
in the safety and ecological impact of chemical products over several
years. The REACH regulation is a typical example of how, in the
European Union, economic interests continue to carry more weight
than prevention and the protection of environmental interests, consumers
and public health, even though it has proved possible to put a brake
on and moderate the economic interests at least to a limited extent.
58. Different views as to what constitutes adequate protection
against the health hazards of exposure to < 10 µm and < 2.5
µm particles or to pesticides are an illustration of the way that
the European industrial sectors concerned are trying to oppose the
more preventive measures advocated by the European Commission and European
NGOs active in the environment and health fields.
59. All these organisations – Greenpeace, WWF, Health and Environment
Alliance (HEAL), Women in Europe for a Common Future (WECF), the
European Academy for Environmental Medicine, the “Paris Appeal” and
other NGOs and initiatives in the environmental health field – are
exerting pressure to try to secure the practical implementation
of health and environment action plans that have been solemnly announced
for some fifteen years.
60. Based on increasingly alarming analyses and research concerning
health problems and disorders associated with omnipresent pollutants
of all sorts, associations of NGOs, doctors and scientists are continuing to
stress the need to apply the precautionary principle. They point
to the key role of primary prevention and to the urgent need to
incorporate preventive policies into all areas of activity – economic
and industrial policy, town planning and architecture, transport,
agriculture and energy policy.
61. Against this background, it is necessary to stress the fundamental
importance of primary prevention compared with the secondary and
tertiary varieties, namely screening and measures to prevent relapse
or the advent of chronic conditions. Only primary prevention corresponds
to the precautionary principle, which requires us to take action
and even anticipate in cases of scientific uncertainty, in other
words where there is no absolute certainty but on the basis of sufficiently
well-founded evidence. This also raises the question of expertise
in environmental health, since the risks must be assessed solely
on the basis of scientific criteria founded in chronic toxicology,
exposure to health hazards, immunology, genetics, biology and physics.
10. Conflicting expert opinions on environmental health
62. At present, there are two apparently conflicting
approaches, those of economic development in a context in which
innovation has become all important, and of precaution and the prevention
of possible risks, to avoid creating irreparable health hazards
and threatening the health and life of individuals.
63. In such circumstances, expert opinions may differ. Those employed
by industries whose production methods or products are being challenged
have an obvious interest in denying or minimising the potential
risks. The main purpose of some of their research is to sow doubt
as a means of avoiding the imposition of compulsory measures or
more simply to gain time, while independent experts or those representing
civil society are clearly likely to exert pressure on behalf of
the precautionary principle and maximum possible protection of the
environment, the consumer and human health.
64. With regard to public disquiet about and mistrust of official
agencies and expert committees, there are particular problems concerning
experts’ financial independence, their training and their willingness
to accept new scientific developments and the uncertainties inherent
in the subject. There appears to be growing recognition of the need
for a multidisciplinary approach involving a range of experts and
the principle that all views should be represented. However, much
remains to be done to fill the democratic deficit and the lack of public
transparency in such cases.
65. The provision of expert advice on environmental health must
therefore be in the public domain with all parties being heard.
NGOs must be entitled to respond to the findings of national and
European research bodies, on an equal footing and in public, before
any policy decisions are taken, for example on whether authorisation
should be given or withdrawn for the sale of doubtful chemical products
or substances.
66. Citizen involvement in the process is currently limited by
the fact that NGOs active at national or European level in the public
health field have very inadequate financial resources to meet the
costs of providing counter-opinions. Moreover, this structural weakness
resembles in some respects the relative weakness of official expert
bodies in many European countries. Admittedly, the new European
Chemicals Agency established under the REACH process and located
in Helsinki may in the coming years help to resolve some of the
problems. By itself, though, it will not be able to make up for
all the delays and shortcomings in terms of transparency, democracy
and civil society participation.
67. The Council of Europe Parliamentary Assembly believes that
a democratic and transparent process involving civil society, similar
to the Australian “Hot Tube” system, in which different ideas and
expert theories can be openly compared, might be a valuable way
of resolving such conflicts, thus enabling policy makers to take
properly balanced decisions.
11. The need for new concepts in environmental health and environmental medicine
68. There is now general agreement that polluted environments
can cause or reinforce health problems. The Parliamentary Assembly
of the Council of Europe notes the increasing evidence of the health
hazards linked to the environment. It therefore considers that there
needs to be appropriate care and treatment for persons so affected.
69. In environmental health and environmental medicine, a reasonable
application of the precautionary principle and the introduction
of genuine primary prevention measures is essential.
70. In connection with primary prevention in the field of environmental
health, which is a key aspect of public health as part of an overall
health and environment policy, the Parliamentary Assembly considers
that more ecologically sustainable products and production methods
should be encouraged to avoid in advance contamination of natural
environments and the human food chain.
71. This preventive aspect of public health should be strengthened
to avoid not only the often painful and dramatic individual health
problems that may ensue but also the growing crisis of health insurance
systems, part of which is the consequence of the chronic illnesses
and conditions caused by the environment and unhealthy life styles.
12. A possible approach: an effective prevention policy
72. The concept of prevention in the field of environmental
health is a very broad one since it extends well beyond the role
of doctors and scientific researchers. It requires a multidisciplinary
approach encompassing a wide section of society, including the companies
that manufacture and sell products, the engineers and chemists who
design them, the architects and planners who are responsible for
the quality of housing and the sustainability of energy and transport
policies, the farmers who are responsible for food hygiene standards
and who could be the best protectors of nature and the quality of
our soils, and the teachers who instil in children the importance
of loving nature and wild flora and fauna, without which human life
would be devoid of meaning, and of doing everything possible to
safeguard this natural heritage, this wonder of our “mother earth”.
73. Meanwhile environmental medicine, while actively supporting
this precautionary and primary prevention approach, will be increasingly
concerned with persons whose illnesses are attributable to a polluted environment,
whether this be chemical products in the work place, materials and
furnishings that pollute the home, foodstuffs that have been polluted
or changed in character by pesticides, heavy metals used in dentistry, and
drinking and other local water supplies affected by industrial sites
that fail to comply with even elementary standards. Not to mention
emerging new hazards such as electromagnetic rays, noise pollution
and so on.
74. The Assembly considers that an increasing number of illnesses
and diseases, including cancers, neuropathies, reproductive disorders,
allergies and hypersensitivity disorders, cardiovascular and endocrine diseases,
and immune and neuropsychiatric disorders, may have environmental
causes. All those concerned require aid, support and treatment to
enable them to re-establish a satisfactory quality of life.
75. Environmental medicine is a new transversal medical specialisation
that started in Germany and the United States in the early 1990s,
and is based on university training that is still too fragmented
and varies from country to country, and in-service training for
doctors who are interested in the subject. It should now be granted
proper recognition and promoted both at European level and in the
Council of Europe’s member countries.
76. As a new medical discipline, it is primarily concerned with
identifying the causes of pathologies to ensure that adequate preventive
measures can be developed, before diagnosing and treating illnesses
and their symptoms. The Assembly considers that environmental medicine
should be actively supported and taught in all the member states
of the Council of Europe.
____________
Reporting committee: Committee on the Environment, Agriculture and Local and Regional Affairs.
Reference to committee: Doc. 10898 and Reference No. 3234 of 26 June 2006, extended on 14 April 2008 to 26 December 2008.
Draft recommendation unanimously adopted by the committee on 18 December 2008.
Members of the committee: Mr Alan Meale (Chairperson), Mrs Maria Manuela de Melo (1st Vice-Chairperson), Mr Juha Korkeaoja (2nd Vice-Chairperson), Mr Cezar Florin Preda (3rd Vice-Chairperson), Mr Ruhi Açikgöz, Mr Miloš Aligrudić, Mr Alejandro Alonso Núñez, Mr Gerolf Annemans, Mr Miguel Arias Cañete, Mr Alexander Babakov, Mr Rony Bargetze, Mr Fabio Berardi, Mrs Guðfinna S. Bjarnadóttir, Mr Ioannis Bougas, Mr Ivan Brajović, Mrs Elvira Cortajarena Iturrioz, Mr Valeriu Cosarciuc, Mr Taulant Dedja, Mr Hubert Deittert, Mr Miljenko Dorić, Mr Gianpaolo Dozzo, Mr Tomasz Dudziński, Mr József Ékes, Mr Savo Erić, Mr Bill Etherington, Mr Nigel Evans, Mr Joseph Falzon (alternate: Mr Joseph Debono Grech), Mr Gianni Farina, Mr Iván Farkas, Mr György Frunda, Ms Eva Garcia Pastor, Mr Zahari Georgiev, Mr Peter Götz, Mr Rafael Huseynov, Mr Jean Huss, Mr Fazail İbrahimli, Mr Ilie Ilaşcu, Mr Ivan Ivanov, Mr Igor Ivanovski, Mr Bjørn Jacobsen, Mr Gediminas Jakavonis, Mrs Danuta Jazłowiecka, Mr Stanisław Kalemba, Mr Ishkhan Khachatryan, Mr Haluk Koç, Mr Gerhard Kurzmann, Mr Dominique Le Mèner, Mr François Loncle, Mr Aleksei Lotman, Mrs Kerstin Lundgren (alternate: Mr Kent Olsson), Mr Theo Maissen, Mr Yevhen Marmazov, Mr Bernard Marquet, Mr Mikheil Matchavariani, Mr José Mendes Bota, Mr Pasquale Nessa (alternate: Mr Marco Zacchera), Mr Tomislav Nikolić, Mrs Carina Ohlsson, Mr Joe O’Reilly, Mr Germinal Peiro (alternate: Mr Jean-François Le Grand), Mr Ivan Popescu, Mr Jakob Presečnik, Mr René Rouquet, Mrs Anta Rugāte, Mr Giacinto Russo, Mr Fidias Sarikas, Mr Herman Scheer, Mr Andreas Schieder, Mr Hans Kristian Skibby (alternate: Mr Morten Messerschmidt), Mr Ladislav Skopal, Mr Rainder Steenblock, Mr Valeriy Sudarenkov, Mr Vilmos Szabo, Mr Vyacheslav Timchenko, Mr Bruno Tobback, Mr Nikolay Tulaev, Mr Tomáš Úlehla, Mr Mustafa Ünal, Mr Henk van Gerven, Mr Rudolf Vis, Mr Harm Evert Waalkens, Mr Hansjörg Walter, Mrs Rodoula Zissi.
NB: The names of those members present at the meeting are printed in bold.
Secretariat to the committee: Mrs Nollinger, Mr Torcătoriu and Mrs Karanjac.