1. Background and Aim

- Health impact assessment (HIA) provides with health related information and predicted results of various policies to establish public policies for improved public health. The aim of the project by Wooriwon is to institutionalize HIA and is executed by the following three scopes of the projects
○ Implementation of HIA project on local and central government policies to introduce HIA strategies.
○ Selection and execution of pilot HIA project based on health determinants and regional aspects and fabrication of HIA guideline for health determinants to construct HIA infrastructure.
○ Proposal of strategy for institutionalization by policy study and fulfillment of central role of HIA in AsiaPacific region.

- HIA projects for 2015 are; institutionalizing HIA, HIA on risk factors of air pollution, HIA on exposure to natural radiation in living environment, and application of HIA guideline on residential environment.

- Institutionalization of HIA

○ There were two attempts to institutionalize the HIA policy in 2008 and 2011, but additional research is necessary due to national and international alterations.
○ The national HIA environment has to be assessed and updated to study the essential aspects of institutionalization.

- HIA on risk factors of air pollution

○ Air pollution is one of the major health risk factors amongst the physical environmental health determinants.
○ The health impact is represented by mortality and morbidity rate associated with air pollution and this has been categorized into short-term and long-term exposures.

－ Health impact studies of air pollution have been focused on HIA under short-term exposure only
○ The general population of Korea was studied conducting HIA analysis under a long-term exposure to air pollution.

- HIA on exposure to natural radiation in living environment

○ As a result of climate change, the dynamics of atmospheric indoor pollutant and HIA are changing more rapidly.
○ Control measures of radon in living environment, as well as scientific and systematic research outcomes are insufficient in Korea.
○ Social impact factor assessment and HIA implications were studied against radon for indoor and outdoor living environments.

- Application of HIA guideline on residential environment

○ ‘Guidelines for HIA on residential policies’ presented in 2014 encompasses various health impact indices that are applied differently to ‘newly built apartments’ from ‘existing or occupied residents’.
○ For a comprehensive application of HIA guideline on residential environment, it made an effort to suggest by whom, when and how this guideline can be used

2. Main Research Topics

- Institutionalization of HIA

○ Improvements and alternatives were investigated based on the state of the current HIA system of Korea.
○ Strategy 1: the current state is maintained and an additional HIA is executed within the scope.

○ Strategy 2: an additional law that covers social, economic, personal and behavioral health risk factors is enacted within the scope of current HIA.
○ Strategy 3: a new compulsory HIA law is enacted.

- HIA on risk factors of air pollution

○ Total mortality had a correlation with both short-term and long-term exposures to nitrogen dioxide, having a higher correlation with long-term exposure.
○ Short-term and long-term exposures to sulfur dioxide was related to total mortality excluding unnatural death, which had a significant correlation to long-term exposure between 1 to 3 years.
○ Long-term exposure to fine dust had a positive correlation to total mortality excluding unnatural death.

- HIA on exposure to natural radiation in living environment

○ Target regions and the type of facility were selected for a pilot study. Natural radiation was measured in some households within the target regions and the ventilation effect was analyzed. Awareness was investigated and its change pattern according to education was analyzed.
○ A health risk reduction benefits budget was drawn for regional government associated awareness campaigns. Natural radioactive substances risk communication measures and action guidelines were established.

- Application of HIA guideline on residential environment

○ HIA indices for residences encompass 12 spheres: the land usage, traffic, energy and environmental pollution, materials and resources, water cycle management, maintenance, ecological environment, indoor environment, living environment, safety, vulnerable population, socioeconomic characteristics, and local community environment.
○ Assessment indices for existing houses include a comprehensive ‘living area’ index, which is not applicable to newly built houses.

3. Conclusions and Implications

- Institutionalization of HIA

○ The scope of HIA has to be expanded and HIA has to be conducted on biological and socioeconomic factors as well, since it is limited to physical health determinants at the moment.
○ Concrete and detailed measures for HIA are needed.

○ Discretionary power has to be granted for HIA items.

○ Participation of interested parties and specialists has to be promited and facilitated
○ There is a need to promote an awareness for a necessity of HIA and it requires development of expertise is required for a proper management.

- HIA on risk factors of air pollution

○ The risk level results of this study can be utilized for analysis on disease burden and health benefit cost related to air pollution, as well as for health and environment policy establishment to minimize the health risks due to atmospheric pollution.
○ The sources of emissions have to be identified and managed strictly to decrease the air pollution and the control of toxic fine dust emissions should be prioritized.
○ A policy that can manage vulnerable populations and the populations at a high risk of long-term exposure to air pollutants is necessary.

- HIA on exposure to natural radiation in living environment

○ A comprehensive health management system of the exposed population has to be established through the government’s multi-departmental projects.
○ As radon is a natural radioactive substance, its risk level varies according to the regions. Therefore, the role of local government is essential for development of appropriate programs and a continuous monitoring system has to be implemented.
○ Education and campaign strategies have to be developed to effectively deliver information and raise public awareness in order to promote proactive radon management for risk reduction.

- Application of HIA guideline on residential environment

○ HIA guideline for residential environment can be applied to various projects such as, urban renewal project, public health atopic asthma prevention project, and visiting health care project along with healthy city healthy house project(tentatively named) and housing complete inspection,

- Research direction of the follow-up study was established based on the results of the pilot HIA projects executed from 2008 to 2015. HIA has to be conducted on the laws, institutions and policies of the central government, so that the effects of HIA are applied nationwide.

Keywords: health impact assessment, institutionalization, atmospheric environment risk factor, natural radioactive substance, residential environment, health impact assessment guideline