World Health Organization (WHO)

http://www.who.int

AGENDA 21 CHAPTERS AND PROGRAMME AREAS OF PARTICULAR FOCUS OR INTEREST:
See check list in annex.

BRIEF DESCRIPTIONS OF AND LINKS TO INFORMATION ACTIVITIES:

Data Collection, Observation, Monitoring

National centres and their respective participating laboratories undertake the sampling and analysis and then report the data to the global data bank. Data gathered on water quality, urban air quality data, food contamination data, environmental radiation data, human exposure data. Coverage in all cases is global. In total about 70 to 80 countries participate in the programme.

Note: Each component is coordinated by itself. Reason: There is no overall coordination exercised any more by UNEP as GEMS has ceased to exist as a programme or office. Other agencies involved are UNEP, UNESCO, WMO, FAO and IAEA.

Methodologies, Quality Control, Harmonization
Standardization was achieved with regard to data reporting for air, water and food contamination data. Quality control is a cornerstone of all monitoring programmes. Quality control and performance evaluation procedures were developed and external auditing of participating laboratories introduced.

Harmonization of air quality monitoring methods was undertaken in collaboration with UNEP/HEM. Food contamination monitoring methods were also harmonized. Water analysis methods were subject to comparative evaluation. Sampling equipment was evaluated and technical guidelines were issued.

Assessment and Analysis
Air pollution assessments for the megacities of the world were undertaken and published. Water quality assessments were conducted at the global, regional and river basin level. Food contamination levels were assessed based upon the monitoring data collected. Rapid assessment methods for the quantification of air, water and soil pollution were developed and applied in several world regions.

In air pollution cooperation is mainly with UNEP and USEPA. In water pollution cooperation is with UNEP, UNESCO, WMO, Canada, USEPA, UK, Germany and Denmark scientific institutions. In food contamination cooperation is mainly with UNEP and FAO.

Various national and scientific software packages were adapted to global reporting needs and used in preparing data for interpretation. The actual assessment was through scientific expert committees.

Indicators
An expert meeting on health indicators has been held and plans made how to develop such indicators. No final results yet.

Modelling

Expert Systems/Decision-support systems
An expert systems software was developed for water quality data interpretation for the purpose of assessments and management.

Early Warning Mechanisms
Methodology was developed for early water pollution monitoring in large river basins.

Reports/Information dissemination

Regular data reports are issued which contain statistically treated data in summary form. Periodic assessments are published on air, water and food quality. Human exposure studies from human exposure assessment locations are also issued. The data reports are provided to all national centres, participating institutions and laboratories which are part of the global monitoring networks. In addition, the data sets are used by other agencies for inclusion in their data reports and assessment reports, such as WRI, EDR, UN/ECE Statistics. National and municipal authorities are provided with data reports upon request. Members of the scientific community are also given the data for specific studies upon request. The geographical scope is global.

Information dissemination coordinated among the cooperating UN agencies.

Information filters are not used, but popularized editions of the data were produced. Filters might be useful but a clear definition of their role and mode of operation would be needed. An inventory of water data systems within the UN system exists.

Promotion of information is by issue of newsletters, publication of books, presentations at relevant meetings, etc. Much effort has been made to condense the data collected and to publish them in a format which is easily understandable by decision-makers.

Network Development and Support
Networks managed are GEMS/Air, GEMS/Water, GEMS/Food, GEMS/HEAL, GERMON radiation monitoring.

Coordination among netwroks at the municipal level is most promising. Air, water and food contamination can be combined with the assessment of comprehensive human exposure to pollutants.

Interaction with WMO's GRDC, BAPMon networks.

Capacity-Building
Information is provided for municipal air pollution management offices, water authorities, food inspection services, public health authorities at local and national level.

Many training courses in all monitoring areas are held at local, national and regional level. A modular training programme on water quality monitoring, assessment and management was developed under GEMS/WATER and a guide published. An equivalent guide for GEMS/AIR is in preparation.

To fill data gaps, efforts are under way to enlarge the analytical capacity in the participating laboratories to measure a wider range of priority pollutants, and the geographical coverage is continuously expanded.

Internet Access

http://www.who.int
Information on the major programmes of the WHO. Links to regional WHO pages. World Health Report for 1996. Some newsletters. Individual issues of the Weekly Epidemiological Record downloadable in Adobe Acrobat format. WHOSIS contains links by topic to health-related information.

Current news on disease outbreaks: http://www.who.int/disease-outbreak-news/index.html

Responsible Office/Person (for inquiries or follow-up):
Dr Y. von Schirnding
Earthwatch focal point
Director a.i.
Sustainable Development and Healthy Environments
World Health Organization
20 avenue Appia
1211 Geneva 27, Switzerland
Tel: +41 22 791 3533 / 3730
Fax: +41 22 791 4123
vonschirndingy@who.ch

Dr Richard Helmer
Director
Protection of the Human Environment
WHO L-148
20 avenue Appia
1211 Geneva 27, Switzerland
Tel: +41 22 791 3761
Fax: +41 22 791 4127
helmerr@who.ch

Date of preparation: Updated 10 March 1998, addresses corrected May 1999

WHO evaluates or monitors at intervals progress toward implementation of the Global Strategy of Health for All by the Year 2000 on the basis of questionnaires sent to all Member States. The third monitoring exercise was conducted in 1994: returns from 138 of 191 countries covered 91 percent of world population and were published in the World Health Statistics Quarterly,48(3/4), 1995. The third evaluation is underway in 1997.
    WHO annually assembles and disseminates data on numbers and causes of death submitted by Member States who report cause-of-death information in an appropriate format and in which death registration coverage can be estimated as reasonably good: the process included data from 58 countries with more than 40 percent of world population for the 1995 World Health Statistics Annual.

AGENDA 21 CHAPTERS AND PROGRAMME AREAS OF PARTICULAR FOCUS OR INTEREST:
See check list in annex.

BRIEF DESCRIPTIONS OF AND LINKS TO INFORMATION ACTIVITIES:

Data Collection, Observation, Monitoring

Data collection from hard copies, magnetic tapes, diskettes and electronic transfer (e-mail). Source data are collected from Ministries of Health and Statistical Offices. Data collected as described in Agenda 21, chapter 5-Demography, Chapter 6-Human Health, Chapter 24-Women, Chapter 25-Children and Youth, Chapter 26-Indigenous People, Chapter 35-Science (and all environmental areas). Worldwide.

Health indicator data collected in coordination with UNICEF. Health situation analysis assembles inputs from all WHO technical programmes.

Methodologies, Quality Control, Harmonization
WHO coordinates the revision and maintenance of the International Classification of Diseases (ICD) as well as The International Classification of Impairments, Disabilities and Handicaps (ICIDH). Quality control via a vigorous validation of global mortality data.

Uniform data collection practices, application of standards, and presentation of information of worldwide provenance provides harmonization.

The WHO Mortality Data Base will be accessible on global electronic networks in the near future.

Assessment and Analysis
Health situation analysis and projections, and mortality assessment.

Cooperation on World Summit for Children goal monitoring with UNICEF via review and summary of data reported by Member States, independent validation and estimation.

Indicators
Seventy-four indicators have been developed for the third evaluation of progress toward Health for All, covering socioeconomic development, the environment, health status and the health sector.

Modelling
Probability of dying due to various diseases: current pattern and projections. Life expectancies at different ages. Future morbidity and disability scenarios.

Expert Systems/Decision-support systems

Early Warning Mechanisms

Reports/Information dissemination

Dissemination by publications, electronic networks, press releases, fax, telex and telephone services, correspondence, and in scientific presentations. Users are all categories of professional, political and private users. WHO programmes assist national programmes in a wide range of health issues to promote the use of WHO information.

Coordination of information publication principally with the United Nations Population Division, UNSTAT, and UNICEF, through consultations and written agreements.

Press releases, fact sheets, technical reports, reports on the world health situation and many other publications, are directed towards decision-makers.

Network Development and Support
"Network for Strengthening Health Information" managed, as well as networks of WHO collaborating centres and of experts to address specific health issues.

WHO promotes coordination of health information whenever and wherever possible, and interacts with International Health Futures Network, an NGO network.

Capacity-Building
Technical assistance to governments with WHO staff and consultants, publications and in-country seminars and presentations, help decision-makers to use the information..

District-team problem solving and rapid evaluation and many other techniques are used to train national human resources in Member States.

A rapid assessment method is being devised to determine data gaps for special attention.

Internet Access

http://www.who.int
Information on the major programmes of WHO. Links to regional WHO pages. World Health Report for 1996. Some newsletters. WHOSIS contains links by topic to health-related information.

Responsible Office/Person (for inquiries or follow-up):
Dr Y. von Schirnding
Earthwatch focal point
Director a.i.
Sustainable Development and Healthy Environments
World Health Organization
20 avenue Appia
1211 Geneva 27, Switzerland
Tel: +41 22 791 3533 / 3730
Fax: +41 22 791 4123
vonschirndingy@who.ch

Director HST
WHO
20 avenue Appia
1211 Geneva 27, Switzerland
Tel: +41 22 791 2388
Fax: +41 22 791 4194

Date of preparation: March 1997, contact updated 5 May 1999

In 1958 the World Health Assembly at its Eleventh Session, identified the need to evaluate the states of water supply and sanitation to identify needs and the impact on health. As a result in 1962 WHO produced its first report on the states of water supply and sanitation services in selected countries. Since then monitoring has been a continuously mandated function of the Division of Environmental Health of WHO. Comprehensive monitoring exercises were undertaken in 1970, 1975 and 1980. The last one was the baseline used to evaluate progress during the International Drinking Water Supply and Sanitation Decade (IDWSSD). The IDWSSD are an intensification of the monitoring efforts with information on a country, regional and global basis being collected for 1982, 1985, 1988 and 1990. This data was the numerical basis for the UN system's evaluation of the Decade and the Secretary General's reports to the General Assembly in 1985 (A/40/108) and 1990 (A/45/327).
    Following the end of the IDWSSD, in 1991 WHO joined forces with UNICEF in a Joint Water Supply and Sanitation Monitoring Programme (JMP) aimed at supporting countries to strengthen their national monitoring capability. This programme should also benefit the monitoring activities of WHO at the global level by improving the quality, accuracy and consistency, of data provided by governments.

AGENDA 21 CHAPTERS AND PROGRAMME AREAS OF PARTICULAR FOCUS OR INTEREST:
See check list in annex.

BRIEF DESCRIPTIONS OF AND LINKS TO INFORMATION ACTIVITIES:

Data Collection, Observation, Monitoring

Data is collected through questionnaires (hard copy or diskette) by Ministries of Health and Ministries responsible for water and sanitation services.

In the context of chapters of Agenda 21, the Data collected comprises: Chapter 18 D-Drinking-Water Supply/Sanitation, Chapter 18 E-Urban Water, Chapter 18 F-Rural Water, Chapter 24-Women, Chapter 25-Children/Youth, Chapter 33-Finance, Chapter 36 C-Training, Chapter 37-Capacity Building, Chapter 5 A-Demography & Sustainable Development, Chapter 6 A-Primary Health Care, Chapter 6 B-Communicable Diseases.

Data collection is co-ordinated with UNICEF through coordinated meetings every 6 months. Also data collection is co-ordinated within the UN Secretariat, and through the Interagency Steering Committee for Water Supply and Sanitation (meets annually) to respond to various reporting requirements.

Methodologies, Quality Control, Harmonization
The monitoring methodology developed for the IDWSSD contained basically a set of eight indicators:
- General information: (population, GNP, infant mortality);
- Plans and targets established for expanding service coverage;
- Present service coverage status (urban and rural, water supply and sanitation);
- Manpower, number of people of different categories employed and estimates for future needs;
- Institutional responsibility for the sector;
- Sector investments in capital construction; by government and by external support agencies; and costs of construction.
- Constraints to sector development;
- Special approaches to sector development; community participation, health and hygiene education,
  focus on women participation etc.
In the WHO/UNICEF JMP focus is on several key areas for national water supply and sanitation planning and management; coverage, funding of operation and maintenance, and capital investment. It analyses these three basis groups of indicators by national sub-division (province, district, community), analyses coverage by type of service, (house connection, public stand post, dug well, etc. and pit latrine, sewer connection, septic tank etc.), specifically collects information on peri urban population, and breaks funding down by different sources (Government, ESA, beneficiaries, etc.).

Both the methodology developed for the IDWSSD and the JMP action standardize definitions to facilitate comparison between, among and within countries. Harmonization of information is mainly undertaken through rationalization of time-series data.

Quality control is undertaken through the identification of apparent inconsistencies and/or anomalies and directly querying them with the government or original source of information.

Other methodological areas are GIS and map linkages

Assessment and Analysis
The two methodologies utilized (Decade monitoring/JMP) address several areas of Chapter 40, selecting:
Development of activities: indicators are regularly adjusted and/or introduced on the basis of data collection experience and identified national requirements.
Promotion of global use of indicators: through promotion of standard methodologies with supporting computer software, and workshops.
Improvement of data collection and use: through strengthening natural data collection and analysis capability, and the promotion of monitoring as an integral component of national sector planning and management.
Improvement of methods of data assessment and analysis: initially data access is provided through regular publication of results of monitoring and analysis/interpretation of information. Also raw data by country, regional and globally can be provided in diskette.
Establishment of comprehensive information framework: all information within WHO forms a component of the WHO health information package which considers access to water supply and sanitation as determinants of health and social development. Also, the water supply and sanitation information systems of WHO are components of the broader water resources information initiatives of the ACC Subcommittee on Water Resources.
Strengthening of the capacity for traditional information: the WHO/UNICEF JMP is built on the premise of strengthening existing national water supply and sanitation monitoring and information systems, and the use of the community in the data collection process.

In all areas WHO collaborates with UNICEF as partner in the JMP. WHO also collaborates with all members of the ACC Sub-Committee on Water Resources, directly and through the Interagency Steering Committee of Water Supply and Sanitation, which acts as a Working Group of the Sub-Committee.

The data of the status of water supply and sanitation is collected on a country by country basis. Ideally the information is provided by Government through the completion of standard questionnaires. If requested, support is provided to Government in this effort, if requested, by the WHO and/or UNICEF Country Representative's Office.

The data is forwarded to the REH Unit in the EOS Division of WHO/HQ, Geneva, where the Regional and Global analysis and reporting takes place. Analysis is also undertaken within countries for national planning and management purposes. The data is stored and analysed using the LOTUS-123 spreadsheet, and the FOXPRO database software.

Indicators

Modelling
The monitoring data is used to develop different scenarios for predicting trends and needs; coverage by certain dates if present progress is maintained, investments represented in different target options are to be attained.

Expert Systems/Decision-support systems

Early Warning Mechanisms
Although no early warning system is operational, as such, the monitoring system through annual reporting gives adequate warning of programmes following behind schedule and the need for accelerated effort/increased investment.

Reports/Information dissemination

Information is disseminated through annual reports jointly published by WHO and UNICEF, in response to direct request: World Resources Report/UNEP, and the UN Secretariat. Users are Governments/Ministries of Health, UN Agencies/Bodies, WHO/UNICEF Country Representatives and WHO Regional Offices. Information brokerage/filtration takes place at source: own country offices. Information use is promoted by continued support to countries in the development of monitoring capability as a component of institutional capacity building.

UNICEF and WHO coordinate information dissemination between themselves on the basis of lists of country offices/representatives.

The main objective of the WHO/UNICEF JMP is to develop national monitoring as a component of the management and planning/decision making process.

Network Development and Support
No network yet established for water supply and sanitation monitoring. The potential clearly exists for networking with other water resources, environmental and health information systems as well as external demographic and geographic systems.

Capacity-Building
Promotion of water supply and sanitation information systems with decision-makers as a management and planning tool.

Training in data collection assessment and transformation through national and sub-regional workshops on collection, aggregation and analysis of data and the use of computer techniques.

Identification of data gaps in existing data and systems is undertaken by mission on request to individual countries and through consultation.

Internet Access

http://www.who.int
Information on the major programmes of the WHO. Links to regional WHO pages. World Health Report for 1996. Some newsletters. Individual issues of the Weekly Epidemiological Record downloadable in Adobe Acrobat format. WHOSIS contains links by topic to health-related information.

Responsible Office/Person (for inquiries or follow-up):
Dr Y. von Schirnding
Earthwatch focal point
Director a.i.
Sustainable Development and Healthy Environments
World Health Organization
20 avenue Appia
1211 Geneva 27, Switzerland
Tel: +41 22 791 3533 / 3730
Fax: +41 22 791 4123
vonschirndingy@who.ch

Dr Dennis Warner
Chief, Rural Environmental Health (REH)
WHO
1211 Geneva 27, Switzerland
Tel: +41 22 791 3546
Fax: +41 22 791 0746
warnerd@who.ch

Date of preparation: March 1997, contact updated 5 May 1999

This programme has a dual focus. On the one hand it seeks to build and strengthen national capacities for integrated management of environmental health, while on the other it deals with health problems relating to global environmental change. It supports national capacity building efforts in environmental health by providing scientific and technical guidance and leadership based on internationally agreed upon methodologies and research findings. It will continue to work in partnership with national institutions and various international organizations to contribute to effective preventive action against health risks due to global environmental change.

AGENDA 21 CHAPTERS AND PROGRAMME AREAS OF PARTICULAR FOCUS OR INTEREST:
See check list in annex.

BRIEF DESCRIPTIONS OF AND LINKS TO INFORMATION ACTIVITIES:

Data Collection, Observation, Monitoring

Data collection is via hard copies, listings, CD ROM, diskettes, electronic transfer (data is largely meta-data). Data comes from cooperation with research institutes and research workers globally; WHO collaborative centres globally; WHO regional cooperation centres; other UN System organizations (UNEP, ILO and others); cooperation with External Support Agencies (ESAs) such as development banks, official bilateral donor agencies, UN funds, NGOs etc., concerning development activity information, analysis of DAI CD ROM (INDIX); own research.

Data gathered on development activity information in the area of Health and Environment chapter 2.C and 8.A of Agenda 21. Meta data on information, training materials, case studies, environmental health impact assessments, research resources, epidemiology and exposure assessments, health risk and impact assessments (radiation including UV), Chapter 6-Human Health, Chapter 8.B-Integrating Environment and Development in Decision-Making, Chapter 9.C-Atmosphere, Chapter 18-Freshwater Resources, Chapter 19-Toxic Chemicals, Chapter 20.A-Hazardous Wastes, Chapter 21.C-Solid Wastes and Sewage, Chapter 22-Radioactive Wastes, Chapter 24-Global Action for Women, Chapter 37-Capacity Building, Chapter 40-Information for Decision-Making.

Methodologies, Quality Control, Harmonization
Standardization via development of a glossary for Health and Environment as a part of WHOTERM. Harmonization is planned through the HEAL project.

Quality control and quality assurance is an integral part of the joint UNEP and WHO project on Human Exposure Assessment Location (HEAL). Future plans include an international guideline on reporting of quality control data and a training list in this field.

Assessment and Analysis
In particular Chapter 6-Human Health and Chapter 19-Toxic Chemicals, partly Chapter 7-Human Settlements, Chapter 18-Freshwater, Chapter 20-Hazardous Wastes, Chapter 21-Solid Wastes and Sewage and others.

Cooperation with others on subjects in Agenda 21 Chapters 6 Human Health and 19 Toxic Chemicals.

Presently considering building systems for assessments.

Indicators
The Health and Environment Analysis for Decision-making (HEADLAMP) is a joint UNEP, USEPA and WHO project. It aims at improving information support for environmental health policies. HEADLAMP makes valid and useful information on the local and national health impacts of environmental hazards available to decision-makers, environmental health professionals and the community. It combines methodologies in environmental epidemiology, human exposure assessment and other health and environment sciences to produce and analyse data, to convert this data into information and to present this information so that it can be understood, interpreted and acted upon by those responsible for environmental health protection.
    Important elements of HEADLAMP are methods for linkage of health and environment data, the use of environmental health indicators to quantify and monitor the local situation, and the interpretation and translation of resulting information into the decision-making process.
    Following the Driving force - Pressure - State - Exposure - Effect -Action (DPSEEA) framework, the project stimulates the identification and use of local Environmental Health Indicators for priority setting and decision-making. Further information is available in the publication "Linkage methods for environment and health analysis - General guidelines" (Doc. No. WHO/EHG/95.26 available from WHO).

Modelling
Modelling is planned in continuation of the HEADLAMP and the HEAL projects.

Expert Systems/Decision-support systems
Could result as an output from the HEADLAMP project.

Early Warning Mechanisms
Collaboration with WHO's Division of Emergency and Humanitarian Action (EHA) on improvement of early warning systems for health and life threatening disasters. Information exchange on emerging environmental health hazards in cooperation with GEMS, GTOS and GOOS, REMPAN and GERMON.

Reports/Information dissemination

Dissemination is via the World Wide Web (WWW). The Programme for Environmental Health (PEH) on the WHO WWW. Diskettes and printed documents. Environmental Health Newsletter and other specialized newsletters. The Global Health and Environment Library Network (GELNET) which is intended to include key libraries in every major city of developing countries. By distribution printed information to these libraries, we will ensure that a large number of users will have access to the information.

As part of a collaboration on information exchange and dissemination, UNEP Chemicals (IRPTC) and WHO GEENET have established a joint WWW site. WHO's information from this site is mostly for the Global Networks (http://who.unep.ch).

Users are the public over the WWW; more detailed and restricted information in cooperation agencies collaboration centres, institutions, libraries (GELNET), members of WHO Global Environmental Health Networks Project (3000) and Environmental Health Newsletter (2000). Promotion of use carried out through Global Environmental Health Networks, workshops

Information for UNEP Chemicals (IRPTC), ILO and USEPA can be accessed through the WHO WWW, so dissemination is easily coordinated. Ad hoc working group on electronic dissemination of information and for off-site printing and distribution (WHO, UNEP, USEPA)

Meta-information is contained in the Environmental health Reference Collection, in the Environmental health Model Reference Collection for libraries and documentation centres in bibliographic data bases and in specialized databases on training courses, training materials, research projects, research funding, etc. prepared for our networks.

Provision of information for decision-makers forms part of the HEADLAMP project. Future work will include capacity building activities related to data collection and the creation of information systems at the local level. Plans for further developing Health and Environmental Management Information System (HEMIS). This is a MIS for WHO health and environment activities globally.

Network Development and Support
Networkss managed are: Global Environmental Health Networks: Global Environmental Epidemiology Network (GEENET), Global Environmental Technology Network (GETNET), GELNET, Global Radiation Monitoring Network (GERMON), Radiation Emergency Medical Preparedness and Assistance Network (REMPAN). Tthey are coordinated by using the same formats etc.

Capacity-Building
Part of GEENET activities in the field of Environmental Epidemiologyis improving access of decision-makers to data. Planned as part of HEADLAMP activities related to information systems and data analysis.

Training in data collection, assessment and transformation is part of HEADLAMP workshops.
Major Internet training programme on Epidemiology, the Internet and Global Health with 200 lectures at http://www.pitt.edu/~super1/

Internet Access

http://www.who.int
Information on the major programmes of WHO. Links to regional WHO pages. Some newsletters. Individual issues of the Weekly Epidemiological Record downloadable in Adobe Acrobat format. WHOSIS contains links by topic to health-related information.

UNEP Chemicals/WHO-GEENET: http://who.unep.ch
Joint access to Internet resources

Epidemiology, the Internet and Global Health training: http://www.pitt.edu/~super1/

Responsible Office/Person (for inquiries or follow-up):
Dr Y. von Schirnding
Earthwatch focal point
Director a.i.
Sustainable Development and Healthy Environments
World Health Organization
20 avenue Appia
1211 Geneva 27, Switzerland
Tel: +41 22 791 3533 / 3730
Fax: +41 22 791 4123
vonschirndingy@who.ch

Date of preparation: March 1997, updated 5 May 1999

The WHO Programme for the Promotion of Chemical Safety implements the International Programme on Chemical Safety (IPCS) on behalf of WHO/ILO/UNEP. The IPCS was established in 1980 as a jointly implemented programme carrying out various chemical safety activities within the framework and mandates of these three Cooperating Organizations.
    The IPCS is a joint intersectoral programme to which each Organization contributes, both individually through their own programmes, and collectively through the WHO Programme for the Promotion of Chemical Safety. The main objectives of the Programme are to: (i) assess the risks to human health and the environment posed by chemicals, whatever their origin or wherever they are found, thus providing internationally evaluated scientific information on which Member States can base their chemical safety programmes, and (ii) strengthen national capacities for preventing and treating the harmful effects of chemicals, and for responding to any emergencies involving chemicals.
    UNCED Agenda 21, Chapter 19 called for the IPCS to be the nucleus for strengthening international cooperation on sound management of chemicals and for the establishment of an intergovernmental mechanism on chemical risk assessment and management. In response to these recommendations, the Interorganization Programme for the Sound Management of Chemicals (IOMC) has been developed by WHO, FAO, ILO, UNEP, UNIDO and OECD, and the Intergovernmental Forum on Chemical Safety (IFCS) has been established by governments. The IOMC is designed to promote coordination of policies and activities of the participating organizations, with the scientific and technical work continuing to be carried out within the existing structures of these Organizations, either individually or jointly, such as through the IPCS. The IFCS is a non institutional, independent intergovernmental mechanism consisting of governments as members, and in which inter-governmental and non-governmental international organizations participate. The international Secretariats for both the IOMC and the IFCS are administered by WHO and co-located with the IPCS, although functionally separate.

AGENDA 21 CHAPTERS AND PROGRAMME AREAS OF PARTICULAR FOCUS OR INTEREST:
See check list in annex.

BRIEF DESCRIPTIONS OF AND LINKS TO INFORMATION ACTIVITIES:

Data Collection, Observation, Monitoring

Data collection via literature surveys and questionnaires. Data arrives through the network of IPCS Participating Institutions (about 80), the IPCS Contact Points (about 100) and the IPCS/INTOX network of Poisons Control Centres (about 100) in countries in all regions of the world.

For Agenda 21 chapter 19: data on production, uses, health and environmental effects of chemicals, on diagnosis and treatment of poisoning by chemicals, on analytical toxicological methods; and legal measures for control of chemicals (through UNEP Chemicals (IRPTC)) are measured.

IPCS works closely with UNEP Chemicals (IRPTC), ILO/CIS, FAO, UNIDO, OECD, EC and various NGOs and professional bodies.

Methodologies, Quality Control, Harmonization
IPCS is developing standard short-term tests (in vivo and in vitro) for mutagenicity and carcinogenicity (see Environmental Health Criteria document 109: Summary Report on the Evaluation of Short-term Tests for Carcinogens: Collaborative Study on in vivo Tests). Standard phrases have been developed for describing physico-chemical and toxic properties for chemicals and their toxic hazards; issued in the International Chemical Safety Cards (IPCS/ICSCs). Standard phrases have been translated into some 15 languages. Standard vocabulary is also used in the IPCS/INTOX package for describing acute toxic effects of chemicals. For INTOX, English, French, Spanish and Portuguese are being used.

With respect to quality control, "Quality Management for Chemical Safety Testing" has been issued as Environment Health Criteria document 141.

The IPCS has initiated a project "Harmonization of Approaches to the Assessment of Risk from Exposure to Chemicals" to harmonize approaches to risk assessment through global understanding of how countries/organizations view specific issues and to strive for agreement on basic principles. Currently, work is addressing specific issues relating to specific toxic endpoints. Work will continue on these endpoints as well as on cross-cutting issues like the choice of uncertainty factors.

Harmonized classifications have been developed for use in the IPCS/INTOX package on recording (i) poisoning of chemical substances (adapted ILO/CIS classification); (ii) chemical features of poisoning (adapted from the WHO Adverse Drug Reaction terms); (iii) functions of uses of chemicals/products/classes of substances and products.

There is also development of methodologies for the evaluation of the effects of chemicals on: (i) body functions (e.g. reproduction, immunology and allergy, respiratory tract injury, and neurotoxic effects), (ii) hypersusceptible or other high risk sub-population groups (e.g. elderly, very young, women during pregnancy), and (iii) methodology for risk assessment (e.g. principles for assessment of health risks from exposure to chemicals, environmental epidemiology, derivation of guidance values and toxicity equivalency factors).
     International collaborative studies to validate methodologies for risk assessment e.g., short-term tests for mutagenicity and carcinogenicity.
    Methods for evaluation of the clinical efficacy of antidotes and other substances and techniques used in treating poisoned patients.

Assessment and Analysis
Area is described in Agenda 21 chapter 19 (Risk Assessment of Chemicals and Chemical Emergencies).

Cooperation with the IPCS, in cooperation with FAO, for risk assessment of pesticide residues, food additives, food contaminants, and residues of veterinary drugs in foods. The IPCS, in cooperation with UNEP Chemicals (IRPTC), OECD, EC and NGOs, including professional bodies and national institutions involved in toxicology and in environment and human health, for risk assessment in general. See also section on UNEP Chemicals (IRPTC). The IPCS with EC and professional bodies for assessment of poisoning treatment measures.

Techniques of assessment used are international independent expertise and peer review procedures.

Indicators
IPCS is involved in developing biological markers of various physiological functions and biological systems as indicators for risk assessment: (Environmental Health Criteria Document 155: "Biomarkers and Risk Assessment: Concepts and Principles" was published in 1993, and an EHC document on "Biomarkers and Risk Assessment: Validity and Validation" is being prepared); see also UNEP Chemicals (IRPTC) section.

Modelling

Expert Systems/Decision-support systems
Development of IPCS/INTOX package for diagnosis and treatment of poisoning.

Early Warning Mechanisms
In respect of Chapter 19 and effects of exposure to chemicals on human health the IPCS cooperation with WHO/EURO piloted an early warning system for toxic risks through the ENS/CARE/CAP project, which is now being further developed with poisons centres throughout the world through the IPCS INTOX Project.

Reports/Information dissemination

Dissemination through publications and CD-ROM (IPCS INCHEM issued twice/year contains all IPCS publications), also through specific networking for the IPCS/INTOX project (CD-ROM issued twice/year on medical/health information for poison control and chemical emergency response). Many ministries of health, environment and labour, and certain libraries in developing countries, receive publications free of charge. Promotion of use via GINC PROJECT. IPCS/INTOX project to disseminate information on diagnosis and treatment of poisoning by chemicals, plus training courses in use of the package. IPCS Pesticide Data Sheets.

Users are ministries of health, environment and labour; specialized institutions; other international organizations, chemical industry, workers associations, NGOs and professional bodies in the area of chemical risk assessment and management in all regions of the world.

Coordination of information dissemination through WHO regional offices and through UNEP and ILO; FAO for food toxicology. Information brokerage by peer review task groups of experts.

Metainventories maintained: Inventory of facilities for poisons information and related matters (e.g. analytical and clinical facilities) in countries. Inventory JECFA/JMPR (Summaries of JECFA/JMPR evaluations). List of priority chemicals (in preparation).

Information for decision-makers provided by IPCS Health and Safety Guides (HSGs), IPCS guidelines on specific topics.

Network Development and Support
Networks managed are the network of IPCS Participating Institutions (PIs) and Contact Points (CPs). Network of Poisons Information Centres. Electronic networking of specific persons and institutions for the INTOX project and subject discussion groups, e.g. analytical, clinical, veterinary toxicology and chemical emergencies.

Coordination among networks exists to support the implementation of recommendations of the IFCS, IPCS participants with other IOMC organizations in Global Information Network for Chemicals (GINC), through which the home pages of the organizations are linked. Network of PIs and CPs could be networked with others, such as UNEP Chemicals (IRPTC) Designated National Authorities. National designated Focal Points for Memoranda of Understanding.

There is network interacion with GELNET.

Capacity-Building
Advanced courses on safe use of pesticides for regulatory personnel and other decision-makers. Assistance to FAO and UNEP in implementation of the International Code of Conduct for the Safe Use of Pesticides and London Guidelines. IPCS INTOX courses for medical personnel and poisons information specialists.

Training provided on using INTOX data. Training on methodologies for collecting pesticide poisoning information.

Data gaps: Preparation of priority list for chemicals; Accelerating risk assessment on priority chemicals; Training to decision-makers, regulators and trainers.

Internet Access

http://www.who.int
Information on the major programmes of the WHO. Links to regional WHO pages. World Health Report for 1996. Some newsletters. Individual issues of the Weekly Epidemiological Record downloadable in Adobe Acrobat format. WHOSIS contains links by topic to health-related information.

Current news on disease outbreaks: http://www.who.int/disease-outbreak-news/index.html

IPCS: http://www.who.int/pcs/index.htm

Intergovernmental Forum on Chemical Safety (IFCS): http://www.who.int/whosis/ifcs/ifcshome.htm

Responsible Office/Person (for inquiries or follow-up):
Dr Y. von Schirnding
Earthwatch focal point
Director a.i.
Sustainable Development and Healthy Environments
World Health Organization
20 avenue Appia
1211 Geneva 27, Switzerland
Tel: +41 22 791 3533 / 3730
Fax: +41 22 791 4123
vonschirndingy@who.ch

Dr M. Mercier
Director
Programme for the Promotion of Chemical Safety
WHO
1211 Geneva 27, Switzerland
Tel: +41 22 791 3588/89
Fax: +41 22 791 48 48

Dr Judy A. Stober
Executive Secretary
Intergovernmental Forum on Chemical Safety
WHO
1211 Geneva 27, Switzerland
ifcs@who.ch / stoberj@who.ch

Date of preparation: March 1997, contacts updated 5 May 1999

ORGANIZATION: World Health Organization (WHO)