Environment and health strategy (SCALE)[fr][de] 

There appears to be an increasing incidence of illnesses related to the environment. Air pollution, noise, chemicals and electromagnetic fields have all been linked with health problems such as allergies, asthma, respiratory illnesses, development disorders and cancer. According to the World Health Organisation (WHO), the prevalence of asthma has increased by 200 per cent between the 1970s and the 1990s. 

As one of the most vulnerable groups in society, children are increasingly exposed to the damaging effects of environmental activities. Chemicals that are harmless to adults may bring permanent damage to the developing bodies of children. But, despite the differences between adults and children, most environmental legislation is based on adult standards and norms. Furthermore, there is a considerable lack of data on the effects chemicals and other pollutant in the environment have on children.

The Strategy for Environment and Health was jointly designed by three Directorate-Generals of the Prodi Commission: Environment (Wallström) Research (Busquin) and Health (Byrne). The strategy (known as 'SCALE' for Science, Children, Awareness, Legislation and Evaluation) has five key features:

• it is based on science and look at the complex interactions between different pollutants and the body;
• it focuses on children: the Commission will launch pilot actions on pollutants with specific relevance to children, such as dioxins, heavy metals and endocrine disruptors;
• it aims to raise awareness from stakeholders and the general public;  
• EU legislation will complement national laws and be reviewed to reflect children's special situation and needs;
• actions taken will undergo constant evaluation procedures.

The European Environment and Health Strategy will be implemented in cycles, initially focusing on four priority diseases:

• childhood respiratory diseases, asthma, allergies
• neuro-developmental disorders
• childhood cancer
• endocrine disrupting effects

These illnesses are linked to environmental factors such as indoor and outdoor air quality, dioxins, heavy metals, endocrine disrupters, electromagnetic fields and the urban environment.

As a follow-up to the strategy, the Commission presented a   European Environment and Health Action Plan 2004-2010 (9 June 2004). The plan comprises 13 action points aimed at improving the co-ordination between the health, environment, and research sectors. The actions are divided into the three following areas:

• Monitoring: Developing indicators to measure the link between environment and health and understand the routes pollutants take from their source to the human body. This would for example include 'biomonitoring' (taking regular samples of blood, urine or hair) to measure human exposure to environmental pollutants.
• Research: Focusing research on four priority diseases (asthma/allergy, neuro developmental disorders, cancers and endocrine disrupting effects) to 'fill the knowledge gap'.
• Communication: Developing citizen's awareness to help them make informed health choices. Other actions include training to health professionals to make sure they are alert about environment and health interactions.

The European Public Health Alliance told EurActiv that it welcomes the new strategy: "This is the first time that protection of health has been fully integrated in the other policy areas of environment and research. The Strategy will involve pilot monitoring activities to track pollutants from the environment into the food chain and human beings. Gaps in scientific knowledge will be identified and filled. Lack of evidence will no longer be an excuse for inaction on our environmental health".

The European Chemical Industry Council (CEFIC) supports the European Commission's objective of creating a pan-European health and environment monitoring programme that is scientifically validated and harmonised across member states. Madeleine Laffont from CEFIC said: "Provided this framework addresses the full range of environmental factors - including life-style, socio-economic, physical, biological and chemical factors - it should provide helpful information to focus limited resources on priority public health needs. However, we are concerned that the incredibly rapid work schedule imposed on stakeholders (a matter of months) means that the planning phase is not as scientifically rigorous as such a challenging project requires".

On the Action Plan, CEFIC's Caroline De Bie says the draft put forward by the Commission in the consultative process placed too much emphasis on the chemicals industry and too little attention to other factors influencing environmentally-triggered diseases. "We have witnessed a substantial improvement. The final plan is much more balanced than the first draft," De Bie said.

Environmental groups criticised the EU's "lack of leadership" at the WHO European Regional Conference in Budapest (June 2004). They regretted that the Commission's proposed Environment and Health Action Plan "does not foresee any legislative action and misses the opportunity to support the upcoming REACH Regulation on chemicals". "The European Environment and Health strategy [SCALE] could be an excellent place to set indicators and monitoring for priority chemicals to be controlled under REACH, the future EU chemicals regulation," said Stefan Scheuer from the European Environmental Bureau. "But, instead, the European Commission prefers to listen to self-interested stories from the chemicals industry rather than to propose action to protect children from chemical contamination," he said.

A Commission official close to the dossier said the stakeholder negotiations that led to the final version of the Action Plan had been "very difficult". "Industry has been lobbying a lot," he explained, the problem being to strike a balance between the request for swift legislative action from the environmental groups and industry pressures to delay further legal steps until more research is undertaken. Answering to industry critics, he admitted that while "there is still a lot that we don't know, there is still a lot that we can do".