Health-based environmental indicators: approaches, potential and limitations

The concept of indicators has long been applied for describing the trends and dynamics in both the environment and in human health. In recent years, significant effort has been devoted to estimating the negative impacts of the environment on human health, as well as to developing integrated metrics for the evaluation of the adverse health outcomes attributable to environmental exposures. The health-based environmental indicators (HBEIs) are measures designed to describe the status of human health with direct reference to the environmental conditions. Important potentials and limitations of the most promising approaches for developing HBEIs are examined from both a national and New Jersey prospective. The strengths and applicability of the health-based environmental measures are discussed with respect to the complex nature of the host–environment interactions and the scientific uncertainty about the environmental causation of diseases. It is concluded that the health-based environmental indicators are only supplemental tools for understanding of the relationship between environment and public health and do not provide solutions for the problems that might be encountered. Nevertheless, they can be efficiently used for improved environmental management and policy decisions. Copyright © 1999 John Wiley & Sons, Ltd.