Abstract

In this report the relation between the environment and human health is considered in a broad perspective. The starting point is a concept of "health" as an entity determined by endogenous and exogenous factors. Four categories of exogenous factors can be identified: (1) the physical environment, (2) life style factors (3) the social environment, and (4) the health care and prevention system. A consideration is given to the influences of these different factors on human health, in the past and the present. From the environmental perspective, the emphasis is on the first group, the physical environment. This includes fysical (e.g. climate, radiation), chemical (e.g. air pollution) and biotic (e.g. vectors of infectious diseases) factors. The threats to public health from these factors are divided in direct (e.g. lung disease from air pollution) and indirect effects (e.g. an epidemic of an infectious disease after a flood caused by a raising sea level. For the European situation, three fields of government action are discerned: (A) Actions aimed at the maintenance and improvement of health-promoting or health-protecting infrastructures; (B) actions aimed at the prevention of the direct health effects of environmental impairment or pollution; and (C) actions aimed at the maintenance of the basic constituents of human ecology, i.e. at the promotion of a state sustainable development.