Intarese framework

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The INTARESE framework comprises all relevant aspects and builds on all relevant methods to provide guidance for a comprehensive integrated environmental health impact assessment. It recognised the concept of the DPSIR, DPSEEA and MEME frameworks but provides a more flexible and comprehensive framework. The key attributes are:

• the full chain approach, including variables and causal relationships linking the different steps in the chain from source to impact
• the logical process of assessment (steps involved in the execution of the assessment, tasks and responsibilities of the parties involved)
• information input and models (data input and processing, applying models, transforming intermediate variables into meaningful indicators and summary indices)
• appraisal of the information from multiple perspectives

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Framework	Impact Pathway Approach	Full chain	DPSIR	DPSEEA
Used by whom	ExternE	Intarese / Heimtsa	EEA	WHO
Source
Summary	The impact pathway approach allows for the determination of impacts (e.g. health effects) and damages (external costs) due to emissions of pollutants.	The full chain covers all the aspects from the other frameworks and focuses on comprehensiveness and integration. It acknowledges the importance of multi-causalities, complexity, interdependencies and uncertainty. It is limited to human health.	The causal framework for describing the interactions between society and the environment adopted by the European Environment Agency: driving forces, pressures, states, impacts, responses (extension of the PSR model developed by OECD).	The DPSEEA (Driving Forces - Pressures - State - Exposure - Effects - Actions) model is useful in designing a system of environmental health indicators within the decision-making context.
Scenarios	Scenario development / description: comparison of (a) policy option(s) to a reference scenario	Either consider the status quo or investigate scenarios
Driving forces	Activities Activities that lead to emissions, e.g. driving a car, producing energy, using hairspray	Activities Activities that lead to emissions, e.g. driving a car, producing energy, using hairspray, natural activities like volcanoe eruptions	Driving forces Areas in public life that exert pressure on the environment, e.g. economic sectors, households.	Driving forces The driving forces refer to the factors that motivate and push the environmental processes involved.
Pressures, e.g. emissions	Emissions Emissions into air, water and soil, depending on activities and emission factors; can be reduced by applying mitigation measures	Sources: emissions, releases Due to activities and processes (natural and anthropogenic)	Pressures Resulting environmental burden, e.g. due to waste and built-up areas	Pressures This result is the generation of pressures on the environment.
State of the environmental media	Concentrations / Depositions Changes in the state of the environmental media leading to impacts	Quality of environmental media: concentration After dispersion and transformation	State State of an environmental compartment that is exposed to the burden, e.g. changes in atmosphere and lithosphere	State In response to the pressures, the state of the environment is often modified.
Exposure	Concentrations / Depositions / Intake/Uptake Concentrations that effect the population intake via ingestion. Sensible area that is exposed to deposition Material that is exposed to depostion	Exposure settings: Exposure Depending on population behaviour, e.g. time-activity pattern, product use, diet		Exposure Deterioration in the state of the environment, however, poses risks to human well-being only when there is interplay between people and the hazards in the environment. Exposure is therefore rarely an automatic consequence of the existence of a hazard: it requires that people are present both at the place and at the time that the hazard occurs. Exposure to environmental hazards, in turn, leads to a wide spectrum of health effects, which may be acute or chronic. The concept of exposure is best developed in relation to pollutants in environmental media. The amount of the pollutant absorbed, i.e. the "dose", depends on the duration and intensity of the exposure.
Impacts / Effects, e.g. health effects	Impacts Impacts on the receptors, e.g. human health effects, adverse effects on crops, materials and ecosystems	Human body: dose, health effects After inhalation, dermal exposure, ingestion Pathophysiological processes lead from a dose to a health effect	Impacts Specific impact due to the environmental burden, e.g. greenhouse effect, soil pollution	Effects Some hazards may have a rapid effect following exposure, whereas others may require a long time to produce an adverse health effect.
Damages	Damages External costs of the impacts due to the emissions. Thus, the impacts are made comparable; and a cost-benefit-analysis can be conducted.	Social, cultural, political, economical and judicial settings: Impacts Taking place of valuation and weighing; risk characterisation; e.g. policy deficits, disease burden, societal (external) costs, perceptions
Answers of society / Actions			Responses Social reaction to the burden, e.g. research and laws	Actions In face of the environmental problems and consequent health effects, society attempts to adopt and implement a range of actions. These may take many forms and be targeted at different points within the environment-health continuum. Actions may be taken to reduce or control the hazards concerned, such as by limiting emissions of pollutants or introducing flood control measures. The most effective long-term actions, however, are those that are preventive in approach, aimed at eliminating or reducing the forces that drive the system.