This document includes a pragmatic framework for designing representative studies and developing uniform sampling guidelines to support estimates of morbidity that are explicitly linked to exposure to land-based contaminants from used lead acid battery recycling (ULAB) activities. A primary goal is to support environmental burden of disease evaluations, which attempt to attribute health outcomes to specific sources of pollution. The guidelines provide recommendations on the most appropriate and cost-effective sampling and analysis methods to ensure the collection of representative population-level data, sample size recommendations for each contaminant and environmental media, biological sampling data, household survey data, and health outcome data. These guidelines focus on small-scale ULABs that are known to generate significant amounts of lead waste through the smelting process, as well as other metals including arsenic and cadmium. A primary concern with lead exposure is the documented association with neurodevelopmental outcomes in children as demonstrated by statistically significant reduced performance on a variety of cognitive tests. These associations are evident even in the youngest children, and toxicological and epidemiologic data indicate these effects have no threshold. Other potential exposures include arsenic and cadmium, and exposure to these contaminants is also associated with neurodevelopmental outcomes in children, as well as arsenicosis; bladder, lung, and skin cancers; and renal outcomes. The primary objective of this document is to guide research to assess the relationship between environmental contamination, exposures, and health outcomes related to a subset of contaminants originating from ULAB activities for particularly vulnerable populations (such as children) and the general population within a single household in the vicinity of ULAB sites in low- and middle-income countries. To achieve this objective, biomonitoring and health outcome data are linked to household survey and environmental data (for example, soil, dust, water, and agricultural products) at the individual level from an exposed population compared to individuals from an unexposed (reference) population. Data on exposures and health outcomes in the same individual, across a representative set of individuals, is required to support an understanding of the potential impact of ULAB activities on local populations. The guidelines can also assist in building local capacity toconduct environmental assessments following a consistent methodology to facilitate comparability across ULAB sites in different geographic areas. Sampling strategies and methods are prioritized given information needs, resource availability, and other constraints or considerations. The document includes a number of supporting appendixes that provide additional resources and references on relevant topics. Data obtained following these recommendations can be used to support consistent, comparable, and standardized community risk and health impact assessments at contaminated sites in low- and middle-income countries. These data can also be used to support economic analyses and risk management decision-making for evaluating site cleanup and risk mitigation options in the most cost-effective and efficient manner. Following these recommendations will facilitate comparisons and meta-analyses across studies by standardizing data collection efforts at the community level.
The extent of urban air pollution in Pakistan—South Asia's most urbanized country—is among the world’s most severe, significantly damaging human health, quality of life, and the economy and environment of Pakistan. The harm from Pakistan's urban air pollution is among the highest in South Asia, exceeding several high-profile causes of mortality and morbidity in Pakistan. Improved air quality management (AQM) in Pakistan can have notable economic and health benefits. For example, the estimated health benefits per dollar spent on cleaner diesel are approximately US $1–1.5 for light-duty diesel vehicles and US $1.5–2.4 for large buses and trucks. This report advocates that Pakistan allocate resources to AQM, because its air quality is severely affecting millions of Pakistanis, and because experiences around the world indicate that interventions can significantly improve air quality. This report details a broad spectrum of research on Pakistan’s AQM challenges, and identifies a comprehensive set of steps to improve air quality. The research presented here underpins the conclusions that addressing Pakistan's urban air pollution requires coordinated interventions to strengthen AQM, build agencies' institutional capacity, bolster AQM's legal and regulatory framework, implement policy reforms and investments, and fill knowledge gaps. However, Pakistan's policy makers face major obstacles, including limited financial, human, and technical resources, and can pursue only a few AQM interventions at the same time. In the short term, Pakistan's AQM should give highest priority to reducing pollutants linked to high morbidity and mortality: PM2.5 (and precursors like SOx and NOx) from mobile sources. A second-level short-term priority could be PM2.5, SOx, and emissions of toxic metals from stationary sources. An important medium-term priority should be mass transportation in major cities, controlling traffic, and restricting private cars during high-pollution episodes. A long-term priority could be taxing hydrocarbons, based on their contribution to greenhouse gases.
This book identifies reforms that can help manage environmental priority problems associated with transport’s impacts on air quality, noise pollution, road safety, hazardous-materials transport, climate change, and urban sprawl. The policy options are contextualized in light of the Government of Pakistan’s 2011 Framework for Economic Growth and its strategic objectives. Appendixes A–D present additional background information, describe the economic and institutional analyses undergirding this report, and detail the report’s methodology. This analytical work by a team of World Bank specialists focuses on: • analyzing the policy and institutional adjustments required to address environmental, social, and poverty aspects of increased transportation efficiency in Pakistan; • identifying policy options for the Government of Pakistan to better serve the population, to enhance social cohesion, and to foster equitable benefit sharing with low-income or other vulnerable groups; • developing a broad participatory process to give a voice to stakeholders who could be affected by enhancements of freight transport productivity; and • making robust recommendations to strengthen governance and the institutional capacity of agencies to manage the environmental, social, and poverty consequences of freight transportation infrastructure.
This framework document provides a pragmatic approach for designing representative studies and developing uniform sampling guidelines to support estimates of morbidity that are explicitly linked to exposure to land-based contaminants from small-scale artisanal gold mining activities. A primary goal is to support environmental burden of disease evaluations, which attempt to attribute health outcomes to specific sources of pollution. The guidelines provide recommendations on the most appropriate and cost-effective sampling and analysis methods to ensure the collection of representative population-level data, sample size recommendations for each contaminant and environmental media, biological sampling data, household survey data, and health outcome data. This framework focuses on small-scale artisanal gold mining (ASGM) activities that are known to use and generate mercury (Hg) as well as other metals, such as arsenic (As) and lead (Pb), depending on the specific ores being mined. A particular concern with Hg is the conversion to methylmercury (MeHg) in aquatic environments, leading to bioaccumulation and biomagnification in fish that may be locally consumed. Exposure to Hg, MeHg, and Pb are strongly associated with neurodevelopmental health outcomes in children. Exposure to Hg and MeHg are also associated with neurological illnesses in adults. Exposures to Pb are associated with renal outcomes in children and adults, and cardiovascular outcomes in adults. Exposure to As are associated with neurodevelopmental health outcomes in children, arsenicosis and skin disorders in children and adults, and potential cancers in adults, including skin, bladder, and lung. The primary objective of this framework is to guide research to assess the relationship between environmental contamination, exposures, and health outcomes related to a subset of contaminants originating from ASGM activities for particularly vulnerable populations (such as children) and the general population within a single household in the vicinity of ASGM sites in low- and medium-income countries. To achieve this objective, biomonitoring and health outcome data are linked to household survey and environmental data (for example, soil, dust, water, agricultural products, fish) at the individual level from an exposed population compared to individuals from an unexposed (reference) population. Data on exposures and health outcomes in the same individual across a representative set of individuals is required to support an understanding of the potential impact of ASGM activities on local populations. These guidelines can also assist in building local capacity to conduct environmental assessments following a consistent methodology to facilitate comparability across ASGM sites in different geographic areas. Sampling strategies and methods are prioritized given information needs, resource availability, and other constraints or considerations. The framework includes a number of supporting appendixes that provide additional resources and references on relevant topics.
Pakistan’s development efforts are guided by its 2011 Framework for Economic Growth, which identifies actions needed to create a prosperous, industrialized Pakistan through rapid and sustainable development. Industrialization has the potential to drive Pakistan’s economic growth and contribute significantly to meeting both economic and human development goals in Pakistan. Expansions of industrialization activities, whether in highly developed or developing countries, can be stimuli for intense debate about such projects’ benefits and costs to the region in which they are to be located, to the national economy—and to human health and the environment. Pakistan’s 2011 Framework for Economic Growth recognizes that, to accelerate industrialization, Pakistan must reduce the cost of doing business and create an incentive structure designed to achieve a competitive, dynamic, and export-driven industrial sector capable of providing employment to the growing labor force. Competing in global markets requires a socially and environmentally sustainable industrialization strategy. The four main inputs for sustainable industrial growth in Pakistan discussed in this book are 1) Macroeconomic stability and sectoral policies to support industrial competitiveness by allowing long-term planning, including investments in infrastructure and cleaner production. 2) Upgraded trade facilitation and infrastructure (particularly transport and energy) to address some of industrialization’s spatial aspects. Improved transport infrastructure will lower production’s environmental costs. 3) Greening of Pakistan’s industrial sector to enhance international competitiveness—“greening” will make Pakistan a more attractive export partner for nations and firms committed to green production. 4) Strong institutions—for example, environmental management agencies to control pollution, and cleaner production centers to increase domestic awareness of international environmental standards—to implement industrialization initiatives effectively, including those for small and medium-sized enterprises. This book provides a comprehensive analysis of issues relating to the debate about Pakistan’s green industrial growth and lays out priorities and strategies for “greening” Pakistan’s industrial growth.
In 2009, more than 40,000 people died prematurely in Sindh, Pakistan because of an illness associated with an environmental health risk. This means that almost one of every five deaths that occurred that year was caused by environmental factors. Loss of natural resources and impacts from natural disasters also represent development challenges. Increased salinity and waterlogging result in loss of agricultural crops. In addition, hydro-meteorological hazards recurrently affect Sindh, as illustrated by the devastating effects of the 2010 and 2011 floods. For Sindh's population, these problems mean pain and suffering, and reduced opportunities for economic advancement. The costs of all these phenomena are equivalent to 10% of Sindh's Gross Domestic Product. Climate change may exacerbate these challenges. Sindh's environmental and climate change problems call for urgent responses. A number of feasible interventions could be carried out to address the categories of environmental degradation that have the highest impacts on Sindh's population. Many of those interventions have positive benefit-cost ratios, meaning that every rupee invested in them would result in health and social benefits worth more than one rupee. Addressing these challenges also calls for targeted institutional strengthening and policy improvements, particularly after the 18th Constitutional Amendment devolved environmental management responsibilities to provincial governments. The underlying goal of this book is to facilitate and stimulate sharing of information on these phenomena, and to provide an interdisciplinary framework for bringing about improved environmental conditions in Sindh. It includes a methodology that enables the identification of environmental and climate change priority problems; the analysis of interventions to address such problems; the establishment of a social learning mechanism to continuously improve Sindh's responses and build resilience in the face of climate variability and change; and opportunities for the potential involvement of different stakeholder groups to decisively tackle climate change and deteriorating environmental conditions.
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