Country-by-country data show in detail the impact of environmental factors on health.

In June, the World Health Organization (WHO) released the first ever country-by-country analysis of the impact that environmental factors have on health. The data show huge inequalities but also demonstrate that in every country, people's health could be improved by reductions in environmental risks including pollution, hazards in the work environment, UV radiation, noise, agricultural risks, and climate and ecosystem change.

The new data show that 13 million deaths worldwide could be prevented every year if environments were made healthier. In some countries, more than one-third of the disease burden could be prevented through environmental improvements. The countries most affected include Angola, Burkina Faso, and Mali, as well as Afghanistan.

In 23 countries worldwide, more than 10 percent of deaths are due to just two environmental risk factors: unsafe water, including poor sanitation and hygiene, and indoor air pollution caused by the use of solid fuel for cooking. Around the world, children under five are the main victims and make up 74 percent of deaths from diarrheal disease and lower respiratory infections.

Low-income countries suffer the most from environmental health factors, losing about 20 times more healthy years of life per person per year than high-income countries. The data show, however, that no country is immune from environmental impacts on health. Even in countries with better environmental conditions, almost one-sixth of the disease burden could be prevented, and efficient environmental interventions could significantly reduce cardiovascular disease and road traffic injuries.

"These country estimates are a first step towards assisting national decision makers in the health and environment sectors to set priorities for preventive action," said Susanne Weber-Mosdorf, WHO assistant director-general for sustainable development and healthy environments. "It is important to quantify the burden of disease from unhealthy environments. This information is key to helping countries select the appropriate interventions."

The country profiles provide a preliminary estimate of health impacts caused by environmental risks. Countries can use these figures to refine their own estimates. Despite the uncertainties involved in these estimates, the figures indicated opportunities for targeted action to prevent disease.

For the purposes of this assessment, environmental factors include pollution, occupational factors, UV radiation, noise, agricultural methods, climate and ecosystem change, the built environment, and people's behavior.

The data show that household interventions could dramatically reduce the death rate. Use of cleaner fuel such as gas or electricity, use of better cooking devices, improvement of ventilation, or modification of behavior (keeping children away from smoke, for instance) could have a major impact on respiratory infections and diseases among women and children.

Interventions at the community level or the national level would involve promoting household water treatment and safe storage, and introducing energy policies that favor development and health. For example, reducing levels of air pollution (measured in [PM.sub.10]) as set out in WHO's Air Quality Guidelines would save an estimated 865,000 lives per year.

For more information, visit www.who.int/.