1. Health Impact Assessment Valutazione dell’Impatto sulla salute The effects of fine powder air pollution on the health of the population in Ticino, Switzerland Switzerland, Country coordinator Dr. med Konrade von Bremen MHEM IEMS University of Lausanne

2. Konrade von Bremen, IEMS, Lausanne, Switzerland, April 2006 2 Switzerland 7 Million inhabitants 65% German speaking 19 % French speaking 7% Italian speaking 320.000 inhabitants 26 Cantons with –26 different health care laws.

3. Konrade von Bremen, IEMS, Lausanne, Switzerland, April 2006 3 HIA in Switzerland What and where Switzerland is a crucial region for the North- South transport axis. oneMost of the North- South heavy traffic crosses Switzerland on just one motorway leading to one of the most polluted areas in Europe Il Mendrisiotto ITALIA

4. Konrade von Bremen, IEMS, Lausanne, Switzerland, April 2006 4 PTM Somma immissioni NO2 in  g/mc (proiezione 2010) Emmission chart of the region

5. Konrade von Bremen, IEMS, Lausanne, Switzerland, April 2006 5 HIA in Switzerland Il Mendrisiotto The regional transport commission Is an government instrument for planification of regional mobility, integrating aspects of territory as well as aspects of environment. Composed of representatives of all communities of the region (no professional administrators)

6. Konrade von Bremen, IEMS, Lausanne, Switzerland, April 2006 6 HIA in Switzerland Where and what first region The Italian speaking part as first region has introduced HIA under the Italian abbreviation VIS Valutazione dell’ impatto sulla salute Promotor: Department of Health and Social Affairs With a three level interest: Operational: Minimize potential negative impact on health. Maximize the potential positive impact on health. Strategic: Through HIA. Envision the synthesis between the health promoting approach and the sustainable development promoting approach, in order to guide in a coherent manner the mobility sector. Methodology: Develop a possible methodology model and procedures which can be the basis for other competencies and other areas of application..

7. Konrade von Bremen, IEMS, Lausanne, Switzerland, April 2006 7 HIA in Switzerland Mandate The transport commission Mendrisiotto asked for an evaluation of the health impact assessment and the establishment of the methodology providing operational proposals. The mandate was a jointly given between the Department of Transport and the Department of Health and Social Affairs.

8. Konrade von Bremen, IEMS, Lausanne, Switzerland, April 2006 8 The HIA Project Piano dei trasporti del Mendrisiotto The interviewees The Department of health and social sciences: 1) Responsible member of the u nity of promotion and evaluation 2) Head of the section, promotion and evaluation in health, 3) President of the transport commission PTM 4) Studi Associato, pianificazione territoriale, urbanistica e ambientale

9. Konrade von Bremen, IEMS, Lausanne, Switzerland, April 2006 9 The HIA Project Piano dei Trasporti del Mendrisiotto Aim of the project: 1.Evaluate the methodological possibilities for the integration of environmental data with health and social impact. 2.Elaborate a methodology which is capable of transforming emission charts into potential negative health effects. 3.Develop a concept of HIA in the field of transport which fits their specific mobility requirements. 4.Elaborate the outline of an HIA, quantifying timeframes and costs and required resources for the implementation of the project

10. Konrade von Bremen, IEMS, Lausanne, Switzerland, April 2006 10 The HIA Project Piano dei Trasporti del Mendrisiotto Aim: Screening and Scoping

11. Konrade von Bremen, IEMS, Lausanne, Switzerland, April 2006 11 The project was mandated to a small local consulting firm in specialised in urbanistic questions, but not experienced in HIA. Studi Associati collaborated with the transport commission and the health department from 2001 to 2005. The HIA Project Piano dei Trasporti del Mendrisiotto

12. Konrade von Bremen, IEMS, Lausanne, Switzerland, April 2006 12 The HIA Project Piano dei Trasporti del Mendrisiotto Profiling: How did the idea of conducting an HIA come about ? Request from the community: the local transport commission asked for an HIA When did the HIA take place? Between 2001 and 2005 Is the HIA following a formal model or definition ? As the first larger project in the country the task of screening and scoping was given Was there a steering group? The steering group existed and met regularly 1-2x month What were the roles and responsibilities of its members ? For the PTM yes, for the HIA no

13. Konrade von Bremen, IEMS, Lausanne, Switzerland, April 2006 13 The HIA Project Piano dei Trasporti del Mendrisiotto Which determinants did the HIA focus on? What where the assumed health impacts ? Social status and income Social support structure Level of education Social context Physical environment (air, water, noise, landscape) Life style and possibilities to adapt Biological and genetic heritage Sex Culture

14. Konrade von Bremen, IEMS, Lausanne, Switzerland, April 2006 14 The HIA Project Piano dei Trasporti del Mendrisiotto Do you think that the HIA influenced the decision (e.g. policy, programme or project) ? All interviewees agreed that the HIA has made a difference, each participant from their point of view Has the HIA (screening and scoping) achieved its aim? The methodology to implement the project exists The resources are known The political support is now 2006 given

15. Konrade von Bremen, IEMS, Lausanne, Switzerland, April 2006 15 The HIA Project Piano dei Trasporti del Mendrisiotto Dimensions of effectiveness Was the HIA effective in regard to health ? –The potential health risks are now well known, to all stakeholders –Health determinants are identified –The link between environment and impact on health is fully established Was the HIA effective in regard to equity ? –Less developed at this stage of screening an scoping –Community involvement ensures equity to be integrated Was the HIA effective in regard to community issues ? –Very much, the community was fully involved through the transport commission.

16. Konrade von Bremen, IEMS, Lausanne, Switzerland, April 2006 16 The HIA Project Piano dei Trasporti del Mendrisiotto The driving force behind the HIA –The transport commission on the local, community side and the Department of Health and Social Affairs –Leadership was given from the Department of Health and Social Affairs –The community was fully integrated in the project The HIA was actually performed by Studi Associati

17. Konrade von Bremen, IEMS, Lausanne, Switzerland, April 2006 17 The HIA Project Piano dei Trasporti del Mendrisiotto Conclusion Ticino model for HIA PTM offered the chance to create a center of competence for other environment / health projects Consequences for life style questions Social networks. HIA with the PTM combines instruments of epidemiological research methods and social disciplines.