Abstract
This paper offers an overview of existing international monitoring systems with relevance for environmental health surveillance. Representative monitoring systems are described that: address areas of chronic and acute exposure, and diseases and behavioural effects resulting from human-environment interactions; have an ecosystem focus with perhaps a secondary motivation of ascertaining human health impacts that may result from ecosystem conditions; and that incorporate socio-demographic and economic data that may reflect population health determinants. General conclusions on the state of environmental surveillance systems and suites of indicators reviewed are provided in relation to their utility for the development of a generic environmental health surveillance system. This review indicates, among other things, that no obvious short list of core indicators exists which spans “environmental health” to provide a sufficient set applicable in a global context. Through a summary of challenges and limitations in existing systems and indicator sets, recommendations are provided for the discussion of indicator selection and organization, and of developing general and widely applicable environmental health monitoring and surveillance systems.
Résumé
Dans cet article, les auteurs présentent un survol des réseaux de surveillance internationaux en matière d’hygiène de l’environnement. Ils décrivent des réseaux de surveillance typiques de secteurs d’exposition chronique et aiguë, de maladies et d’effets sur le comportement liés aux interactions entre les humains et l’environnement. De tels réseaux sont centrés sur les écosystèmes et ont peut-être comme intérêt secondaire l’évaluation des impacts des conditions de l’écosystème sur la santé humaine. Ils comprennent aussi des données sociodémographiques et économiques qui peuvent être à l’image des déterminants de la santé de la population. Les auteurs analysent l’état des réseaux de surveillance environnementale et étudient des groupes d’indicateurs en fonction de leur utilité pour la mise sur pied de réseaux de surveillance générale de l’hygiène de l’environnement, et tirent des conclusions générales à ce sujet. Ils soulignent notamment qu’il n’existe pas de présélection évidente d’indicateurs de base couvrant l’hygiène de l’environnement et applicables au contexte planétaire. À l’aide d’une synthèse des problèmes et des limites des réseaux et des groupes d’indicateurs actuels, les auteurs émettent des recommandations quant à l’analyse du choix et de l’organisation des indicateurs et quant à la construction de réseaux de surveillance de l’hygiène de l’environnement de portée générale et applicables à grande échelle.
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