Risk factors
- Hazard types:
- biological
- chemical
- nuclear
- physical
- radiological
- Occupational and setting-specific exposures
- Pollution / Contamination of:
- Climate change:
- heat
- extreme weather events
- vector-borne diseases
- forced migration / relocation
- poor food security and quality
Conditions
- Allergy
- Burns, including inhalation
- Cancers
- Cardiovascular disease
- Developmental disorders
- Drowning
- Hearing loss
- Heat-related illnesses
- Injury
- Mental illness
- Metabolic
- Motor vehicle accidents
- Neurological disease
- Renal disease
- Reproductive outcomes
- Respiratory disease
- Vector-borne diseases
- Others
Prevention
- Application of health promotion programs addressing risk factors linked to the physical environment, focusing on:
- environments that support health
- families and communities
- healthcare services
- individuals and health literacy
- policy and legislation
- Prevention approaches to complex public health challenges that manifest in environmental public health practice, including:
- climate change mitigation and adaptation
- Understanding of populations or settings at increased risk:
- Aboriginal and Torres Strait Islander peoples
- Māori (tangata whenua)
- Pacific peoples
- immigrant and non-English speaking populations
- lower socioeconomic status
- people of refugee or asylum seeker background
- residents in low-lying regions
- rural and remote communities
- Understanding of primordial, primary, secondary, and tertiary prevention of disease states linked to the physical environment
- Use of legislative frameworks and regulatory tools
Public health management
- Identify risk management objectives
- Assess risk management options and their benefits and costs
- Work with communities to identify acceptable risk
- Work with other sectors to implement risk management strategies
- Evaluate outcomes of risk management
- Use regional and local planning processes to protect and promote health:
- contribution of local environmental factors
- methods for review and audit of local government plans
- role of other agencies
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- consider the impact of the situation on individuals, workplaces, communities, the public and other relevant stakeholders when developing a management plan
- identify and analyse relevant epidemiology, disease sequelae, and public health prevention and control pathways
Manage
- advise on evidence-based public health management
- communicate environmental health risk information effectively
- conduct environmental health risk assessments
- involve multidisciplinary teams
- recognise potential environmental health risks and their management, and initiate preventative strategies
- use regulatory measures to protect health
Consider other factors
- identify the relative importance of different exposures for specific populations and cultural groups and legal responsibilities in management
Environmental health risk assessment
- Hazard identification:
- chemicals of potential concern
- Dose response assessment:
- Exposure assessment:
- identify exposed populations and exposure pathways and estimate exposure concentration
- Hazard assessment:
- risk characterisation
- evaluate uncertainty
- Risk management:
- define options and evaluate health
- economic, social, and political aspects
- take action to implement decisions
- communicate risks to audiences using appropriate media
- write a report with appropriate circulation
Chemical incident management
- Recognition of the need for an urgent and intersectoral response
- Identify actions required in appropriate time frames:
- first few hours
- first 24 hours
- remainder of the management period
- post-incident, including post-incident reporting
Emergency and disaster management
- Recognition of the need for an urgent and intersectoral response
- Application of national whole-of-government incident systems
- Preparedness
- Prevention
- Recovery
- Response
- Post-incident report, with appropriate circulation
Health impact assessment
- Establish an appropriate team, and identify relevant stakeholders and impacted communities
- Follow a stepwise process of screening, scoping, profiling, assessment, management, decision making, monitoring, and evaluation
- Consider benefits and hazards
- Use suitable qualitative and quantitative methods
- Collect and analyse results
- Communicate findings, including a written report with appropriate circulation
Environmental epidemiology
- Exposure assessment:
- exposure versus dose
- group-level versus individual level
- objective
- subjective
- Study designs and analytic tools:
- ecologic studies
- cross-sectional, case-control, and cohort
- spatial mapping, such as geographic information systems (GIS)
- Poisson regression (for modelling counts or rates of events)
- time-series analyses
- standardised incidence ratio (SIR)
- special considerations for confounding and clustering
- Climate change and its impact on human and planetary health:
- the environmental impact of health systems and sustainability within the healthcare system, including ethical, regulatory, and resource implications
- effects of climate change on communicable disease prevention and control risks
- impact of climate change on non-communicable disease
- Air quality and the impact of poor air quality on health
- National and international public health legislation and its application, including human rights legislation, treaties, charters, and the principles of effective public health regulation
- The application of One Health principles to environmental public health
- The application of environmental public health issues to specific important settings:
- early childhood education and care facilities
- homes
- hospitals (acknowledging iatrogenic harms in hospital-based service provision)
- meeting places for diverse cultural groups
- prisons and other institutions
- remote communities
- residential care facilities
- schools
- workplaces
- The development of environmental health guidelines
- Exposure to solar ultraviolet radiation and its health impacts
