National Strategy and Action Plan for Environmental Health

A National Strategy and Action Plan for Environmental Health United ArAb emirAtes 2010 H.E. Majid Al Mansouri, Secretary General, Environment Agency—Abu Dhabi Eng. Zaid Al Siksek, Chief Executive Officer, Health Authority—Abu Dhabi Dr. Mariam Al Matrooshi, Director, Department of Health Legislation, Ministry of Health Dr. Mariam Al Shenasi, Consultant, Minister of Environment and Water, Ministry of Environment and Water H.E. Rashid Mohamed Al Shiraiqi, General Manager, Abu Dhabi Food Control Authority H.E. Maher Hamad Al Awbad, Executive Director of Inspections, Ministry of Labor Eng. Bahkeet Salim Al Ameri, Manager, Environment, Health and Safety, Supreme Petroleum Council H.E. Khalid Ahmed El Shaikh Mubarak, Assistant Director, Finance and Administration, Dubai Health Authority Committee Members Technical Advisors Dr. M. Z. Ali Khan, World Health Organization, retired Dr. Amir Johri, World Health Organization Steering Committee Dr. Jaber Al Jaberi, Director of Environmental Policy Sector, Environment Agency—Abu Dhabi Dr. Jens Thomsen, Section Head, Occupational and Environmental Health, Public Health and Research Department, Health Authority—Abu Dhabi Dr. Mustafa Al Hashimi, Director, Preventive Medicine Department, Ministry of Health Eng. Saeed Hasan Al Bagham, Manager of Research and Extension, Ministry of Environment and Water Dr. Mariam Hareb Sultan Al Yousuf, Executive Director, Policy and Regulation Sector, Abu Dhabi Food Control Authority Kasim Mohamed Jamil, Deputy Manager, Inspection, Ministry of Labor Dr. Salaheddine Moussa, Occupational Health Team Leader, Abu Dhabi National Oil Company Dr. Ali Al Marzouqi, Director of Public Health, Dubai Health Authority Committee Members Managers Dr. Mahmoud Abdulrahim, Director, Environment Management Sector, Environment Agency—Abu Dhabi Dr. Ahmed Bashir, Acting Director, Environment Awareness Sector, Environment Agency—Abu Dhabi Technical Committee Technical Staff Ayesha Abushahab, Environment Agency—Abu Dhabi Abdullah Mohamed Al Rumaithi, Environment Agency—Abu Dhabi Ayesha Al Suweidi, Environment Agency—Abu Dhabi Ruqaya Mohamed, Environment Agency—Abu Dhabi National Strategy and Action Plan for Environmental Health United ArAb emirAtes 2010 Table of Contents Foreword 1 Introduction 2 Outdoor Air 14 Indoor Air 24 Occupational Exposures 34 Climate Change 48 Drinking Water 58 Coastal Water 66 Soil and Groundwater 74 Produce and Seafood 82 Conclusions 90 References 96 Appendix A: Workshop Participants 98 Appendix B: Science and Editorial Team 102 Appendix C: Key to Common Acronyms 104 1 Foreword The Environment Agency—Abu Dhabi (EAD) in co-operation with the University of North Carolina— Chapel Hill and other organizations, including the Health Authority—Abu Dhabi, the Ministry of Health, the Dubai Health Authority, the Ministry of Environ ment and Water, and the Abu Dhabi National Oil Company, developed this National Strategy and Ac tion Plan for Environmental Health in order to improve our environment for current residents and future gen erations. This national strategy and action plan is intended to provide a focal point for the efforts of many nation al, emirate-level, and municipal agencies in the UAE toward the important objective of reducing the environmental burden of disease. Cooperation among the entities named as stakeholders in this document will be key to achieving this objective. Initiatives to aid the achievement of both short-term (2014) and long-term (2030) goals must be acted upon without delay. Suggested time frames for the undertaking and completion of these initiatives are included. Already, we are making progress toward the targets presented in this document. Many of the listed initiatives are already under way. Our new Environment, Health and Safety Manage ment System in Abu Dhabi is designed to ensure implementation of environmental guidelines to effectively manage and protect the environment. The 2009 Abu Dhabi Water Resources Master Plan examines the role we must play in promoting sustainable use of water and energy resources. EAD has partnered with the new Center of Waste Management Abu Dhabi to imple ment and enforce waste management policies. Though these few examples focus on our efforts here in Abu Dhabi emirate, the need for national action and cooperation is real. No single agency acting alone can have the impact necessary to effect the change we need. Now is the time for all of us to work together, with full cooperation and communication, to strive for a position of world leadership on issues related to environmental health. By following the recommendations outlined here, the UAE can set an example of excellence for other nations to follow. Majid Al Mansouri Secretary General, Environment Agency—Abu Dhabi Chairman of the Steering Committee, Environmental Health Project 1 2 Introduction The World Health Organization (WHO) has estimated that 24% of the global burden of disease is attributable to environmental factors. The United Arab Emirates is increasingly taking action to reduce preventable deaths and illnesses due to exposure to environmental pollutants. This docu ment presents a national strategy and initial action plan to reduce the public health impacts of exposure to environmental pollution in the UAE. In 2007, the UAE completed a national umbrella strategy that estab lished broad goals for the country. The overarching goal of that national strategy was “to achieve sustainable and balanced development and ensure continued quality and high standards of living,” but it did not ad dress environmental issues in detail. Yet, the protection of public health in the UAE from risks associated with environmental pollution is an important component of ensuring sustainable and balanced development. This strate gy and action plan is an important step along the path to realizing the goal of sustainable long-term development for all seven emirates within the UAE. Pollution does not respect borders between emirates. This strategy is intended to unite the emirates in identifying and implementing steps to pro tect people in the UAE from health risks of environmental pollution. Agen cies in the public and private sectors across all seven emirates and at the federal level must cooperate to find effective solutions to the nation’s envi ronmental challenges. This strategy builds on many other related strategic planning efforts being carried out in government agencies throughout the emirates. It is not a replacement for these other plans, but rather it uniquely addresses envi ronmental health while weaving in common threads from other strategies. This document provides further support for the importance of implementing other, related strategies. While a wide variety of strategies and action plans have been com pleted in the UAE within the past several years, and while many of these strategies address aspects of environmental pollution and/or human health, this is the first nationwide strategy that emphasizes linkages between envi ronmental quality and human health. Table 1 (page 4) lists selected other strategy documents from the UAE that contain recommendations pertinent to the environment or health. This strategy and action plan draws relevant key performance indicators (KPIs) and initiatives from these other strate gic plans. It enhances these previous plans not only by assembling in one place the actions and KPIs relevant to protecting public health from en vironmental pollution, but also by providing new insights from the many stakeholders consulted in this process and from new scientific analyses of the environmental burden of disease in the UAE. A companion report on the environment and public health in the UAE describes the assessment of the environmental burden of disease in more detail. The Environment Agency—Abu Dhabi (EAD) funded this strategic plan ning effort to benefit the entire nation. EAD works with the UAE Ministry of Environment and Water to implement environmental laws and issue regula 3 tions in Abu Dhabi emirate. EAD has also pioneered the promotion and development of information technology (including data bases such as the Environmental Database and the Abu Dhabi Global Environmen tal Data Initiative) to unite data collection across the emirates. EAD requested the assistance of the WHO Centre for Environmental Health Activities in Amman, Jordan, to develop a framework for the strategic planning proj ect. Also, EAD established a collaborative relationship with the University of North Carolina—Chapel Hill (UNC) Gillings School of Public Health to provide scientific analysis in support of this strategy. UNC re cruited several other organizations to assist with scientific analyses, including UAE Uni versity, the RAND Corporation, Resources for the Future (RFF), and the Norwegian Institute for Air Research. • Why the UAE Needs a National Environmental Health Strategy The UAE has industrialized at a rate that is perhaps unprecedented in human his tory. Indeed, the UAE’s growth rate in gross domestic product (GDP) is among the high est in the world (see Figure 1). As a result of this development, public health in the UAE has improved dramati cally. Overall life expectancy at birth for UAE citizens reached 78.3 years in 2005 (United Nations Development Programme 2008). This is in the top tier of world life expectancies, on par with that of other de veloped nations. Paradoxically, while economic devel opment has greatly increased life expec tancy in the UAE, it has also created new kinds of health risks. The disease burden has shifted from infectious diseases to non communicable diseases, many of which can be triggered or exacerbated by expo sure to environmental pollutants. Environ mental pollution jeopardizes further gains in life expectancy. Indeed, in the future, advances due to development could result in decreases in life expectancy due to in creased exposure to environmental pollut ants and changed lifestyles. Further, as life expectancy in the UAE increases, the life time burden of pollutants to which residents are exposed increases, thus increasing the importance of minimizing environmental risk factors over a lifetime. Other countries have waited until late in the industrial development cycle to take 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2 0 2 4 6 8 10 12 14 UAE US Germany UK Japan G D P G ro w th ( A nn ua l P er ce nt a g e) Figure 1. The UAE leads the world’s major economies in GDP growth. Figure generated from World Bank data found in the Country Profiles of World Development Indicators Database (http://go.worldbank. org/4C55Z0H7Z0). steps to curb environmental pollution. In famous air pollution episodes in London, England, and in the U.S. steel manufactur ing region in the 1940s and 1950s led to hundreds of thousands of hospitalizations and thousands of deaths (Trivedi 2002, Ha mill 2008). A more recent example is the poisoning of more than 1,300 children in China in August 2009 due to lead pollution from a manganese smelter (Wines 2009). The UAE is visionary in its effort to seek a sustainable development paradigm before such severe problems emerge. The steps outlined in this document will help the UAE avoid the kinds of environmental crises that have plagued other nations. This national strategy and action plan is a component of the larger National Environ ment Health Project, which aims to identify and prevent environment-related threats to health and thus reduce the overall environ mental burden of disease in the UAE. • 4 Federal government Document Title Highlights of the UAE Government Strategy Publisher/Organization UAE government Year 2008 Emirate government Document Title Policy Agenda 2007—2008, the Emirate of Abu Dhabi Publisher/Organization Abu Dhabi Government, the Executive Council Year 2007 Abu Dhabi e-Government Strategic Targets 2008—2012 Abu Dhabi Systems and Information Committee 2007 Highlights of Dubai Strategic Plan (2015) Dubai Government 2007 Health Document Title Federal Health Strategy Publisher/Organization Ministry of Health Year 2007 HAAD Standard for Healthcare Facilities — Occupational and Indoor Air Quality Health Authority—Abu Dhabi (HAAD) 2009 HAAD Policy for Healthcare Facilities — Occupational and Indoor Air Quality HAAD 2009 Environment Document Title Abu Dhabi Environment Strategy 2008—2012 Publisher/Organization Environment Agency—Abu Dhabi (EAD) Year 2008 A Roadmap to the Future — Abu Dhabi Environment Strategy 2007—2011 EAD 2007 Draft Gap Analysis Report on Abu Dhabi Environment-Related Policies EAD 2009 Entity Strategic Plan 2009—2013 EAD 2009 Abu Dhabi Climate Change Policy (Draft) EAD 2009 Abu Dhabi Environmental Strategy and Action Plans Environmental Research and Wildlife Development Agency N/A Abu Dhabi Noise Strategy EAD 2006 Transportation Document Title Surface Transport Master Plan — Connecting Abu Dhabi 2030 Publisher/Organization Department of Transport (Abu Dhabi) Year 2007 Water Document Title Abu Dhabi Water Resources Master Plan (Draft) Publisher/Organization EAD Year 2009 Abu Dhabi Water and Electricity Authority Strategic Plan 2008—2012 Abu Dhabi Water and Electricity Authority 2008 Food Document Title Strategic Plan for Food and Agriculture Safety 2008—2012 Publisher/Organization Abu Dhabi Food Control Authority Year 2008 Waste Management Document Title Abu Dhabi Waste Management Strategy Publisher/Organization EAD Year 2008 Table 1. Selected Strategy Documents Pertinent to Environmental Health in the UAE Process for Developing This Strategy The process used to develop this strategy and action plan is consistent with recent guidelines on strategic planning presented in the Abu Dhabi Government Strategic Planning Handbook. Figure 2 shows the strategic planning steps from that handbook. The process be gins with the articulation of a vision, broad policy goals, and themes (illustrated in the top of the pyramid). The handbook defines a goal as a description of “what the government aims to achieve in the long term.” A theme, as defined in the handbook, is a “high-level statement of the topics and focus areas the government will work on in order to reach its goals.” The request for proposals that launched this planning initiative detailed the goals and themes that motivated this stra tegy and action plan. This request for proposals, entitled “National Strategy for Environment and Health, United Arab Emir ates, Request for Proposals,” was written by EAD and WHO, and it formed the basis for the process used to develop this plan. Figure 2. Steps in the strategic planning process outlined in the Abu Dhabi Government Strategic Planning Handbook, January 2007. Key Performance Indicators (KPIs) Initiatives Two-Year Targets Strategies Five-Year Targets Priority Areas Themes Goals Emirate Vision Lo ng te rm (2 0 y ea rs ) M ed iu m te rm (5 y ea rs ) Sh o rt te rm (2 y ea rs ) A b u D ha b i Po lic y A g en d a G ov er nm en t S tra te g ic P la n G ov er nm en t P la n 5 6 The request for proposals outlined these overarching goals: • Identify and prevent health threats caused by environmental factors. • Reduce the burden of disease caused by these factors. • Strengthen the capacity of the UAE gov ernment in this arena. The request for proposals also outlined key themes intended to guide the strategy: • Identify vital stakeholders, encourage strong partnerships, and promote com munication and interaction among various agencies/organizations and de partments for the provision of adequate environment and health services. • Expand the capacity of the UAE gov ernment to anticipate, recognize, and respond to environmental and health threats. • Reduce the burden of disease caused by environmental factors in the UAE. • Provide guidance through evidence based information … for improving deci sion making abilities of the UAE govern ment in environment and health issues. • Improve environment and health risk assessment and management systems within the UAE. Figure 3. Illustration of the steps used in this strategic planning process. • Provide support for the environment and health services workforce by enhancing research and development, promoting development and training programs, and planning for the future. • Raise awareness of environment and health issues at the policy, implementa tion, and general public levels and de velop educational opportunities in the field of environment and health risk com munication in the UAE. Since the request for proposals identi fied the goals and themes, this report ad dresses the lower tiers of the pyramid in Figure 2: identifying priority areas, estab lishing targets, developing initiatives and strategies to achieve the targets, and iden tifying key performance indicators (KPIs) to measure progress toward each target. This strategy and action plan deviates from the Abu Dhabi Government Strategic Planning Handbook only in time frame. The Strategic Planning Handbook separates tar gets into two groups: those that should be the focus for the next two years and those that should be the focus over five years. The request for proposals indicated that the time horizon for this planning effort is 10 years, and the planning team was later asked to extend that horizon to the year 2030. Thus, we identify priority areas and targets for 20 years (i.e., to be achieved by 2030). Similarly, the request for proposals specified that the plan should focus on identifying initiatives (actions) that can be undertaken in the next four years. The re quest for proposals stated, “Keeping the [20-year] strategy as the basis, a compre hensive plan of action would be formulated with detailed activities to be undertaken in the next four years.” Thus, although Figure 2 shows separate targets for two years and five years, this plan defines only one set of targets (for 20 years) and outlines initia tives that can be pursued during the next five years, consistent with the medium-term planning horizon of the Abu Dhabi Govern ment Strategic Planning Handbook. Figure 3 summarizes the elements of the process used to develop the priority ar eas, targets, initiatives, and KPIs presented in this document. Details on each of the steps are described in the next section. • Key Performance Indicators (KPIs) Initiatives Targets Priority Areas Themes Goals 7 Priority Areas The Abu Dhabi Government Strategic Planning Handbook defines priority ar eas as follows: “Priority areas … reflect the entity’s areas of focus and thus frame target setting and strategy formulation.” The planning team used a systematic, multistep process to identify priority areas. The starting point was this list of 13 catego ries of environmental risks to public health, described by EAD and WHO in the request for proposals: • Air (indoor and outdoor air pollution) • Water resources and water quality • Food safety and security • Land pollution • Waste management (solid, hazardous, and health care) • Noise pollution • Chemical safety • Vector-borne disease (such as diseases carried by rodents) • Climate change • Electromagnetic fields • Nonionizing radiation • Depletion of the stratospheric ozone layer • The built environment The need for a separate focus on environ mental hazards in occupational settings was also emphasized. The request for proposals indicated that in setting priorities for the UAE national environmental health strategy, the research team should take an approach that includ ed these four steps: • Hazard identification • Exposure assessment • Dose-response assessment • Risk characterization This approach is consistent with the risk-assessment framework long recom mended by the U.S. National Academy of Sciences. In the first step, hazard identifica tion, analysts assess whether the proposed source of risk might cause adverse health effects. During the second step, exposure assessment, analysts consider the pathways by which people might become exposed to the risk factor of concern. The third step, dose-response assessment, involves esti mating the relationship between the dose of a contaminant to which an individual is exposed and the resulting health effects. In the final step, risk characterization, the risk analyst estimates the total amount of health hazard that might exist as a result of expo sure to the specific environmental hazard. The strategic planning team employed the first two steps of the risk-assessment pro cess to reframe the 13 risk categories in the request for proposals. This reframing result ed in the elimination of two of the 13 risks from further consideration: vector-borne dis ease and nonionizing radiation. During the hazard identification step, scientists supporting the planning team determined that evidence of health effects associated with vector-borne disease is lacking in the UAE population. Infectious disease information from the UAE indicates no evidence of diseases that would be ex pected if animal vectors were a sanitation concern. Therefore, the planning team did not include vector-borne illnesses in further development of the strategy. Similarly, the planning team found no evidence other than radon to warrant inclu sion of nonionizing radiation in the strat egy and action plan. Data in the scientific literature indicate that background radia tion levels across the UAE are lower than global averages. While risks of exposure to nonionizing radiation may exist from fu ture accidents related to nuclear energy or nuclear materials processing in other coun tries in the region, this exposure route was not considered because it is more related to emergency response than to environmental health risk management. During the exposure assessment step, scientists supporting the planning team re organized the remaining items on the list of risk categories according to the possible routes of exposure to hazards. This reorga nization was necessary for consistency with the risk assessment framework. The routes by which humans can become exposed to contaminants in the environment are by (1) breathing contaminated air; (2) drink ing, inhaling, or coming into contact with contaminated water; (3) eating or coming into contact with contaminated soil; (4) eat ing contaminated food; (5) hearing excess ambient noise; and (6) coming into contact with harmful forms of electromagnetic ra diation. Table 2 (page 8) organizes the risks listed by EAD and WHO in the request for proposals according to these major expo sure routes (air, water, soil, food, noise, and electromagnetic radiation). Table 2 also includes a separate cat egory entitled “multiple exposure routes.” This category includes occupational expo sures and climate change. In occupational settings (for example, manufacturing facili ties, petroleum refineries, and dry cleaning shops), workers may be exposed through multiple routes, including inhaling contami nated air and direct contact with hazardous chemicals. Climate change may affect ex posures through all environmental media, due to climatic impacts on air, water, and soil quality. The planning team used the 12 envi ronmental hazards listed in the second column of Table 2 as the starting point for identifying priority areas in the National En vironmental Health Strategy. The scientists supporting the team conducted preliminary risk assessments for all of these risk areas. The results of these preliminary risk assess ments are documented in an appendix to the companion report on the state of the environment and public health in the UAE. The planning team used a systematic process for setting priorities among the en vironmental hazards listed in Table 2. This process, known as the “deliberative method for ranking risks,” is designed to overcome some of the limitations of comparative risk assessment that became evident during en vironmental health strategic planning and priority-setting projects carried out around the world during the 1980s and 1990s (Davies 1996). These limitations included a lack of systematic design, a lack of empiri cal validation, and inconsistency in results. In these previous comparative risk assess ment projects, a list of priorities developed 8 by one group of people could be com pletely different from a list of priorities de veloped by a separate but similar group of people. The planning team sought to select a process to identify the UAE’s environmen tal health priorities that would be robust across groups of stakeholders. That is, dif ferent groups composed of roughly similar kinds of stakeholders should reach the same conclusions about which risks are the high est priorities for the UAE. The deliberative method for ranking risks has been proven in numerous large studies to yield consistent results across groups (Morgan et al. 2001). Further, high levels of stakeholder satisfac tion with the results have been observed in empirical studies, and the method has now been employed in several countries around the world (Morgan et al. 2001). The deliberative method for ranking risks combines quantitative risk assessment information for each environmental risk fac tor with a process that involves stakehold ers in environmental health, both individu ally and in groups, to set priorities among the environmental health risks based on the risk information provided. Essentially, the process involves voting on priorities. Indi Environmental-Hazard Exposure Routes Environmental Hazards Evaluated for this Strategic Plan Issues Specified in Request for Proposals Air (breathing) Outdoor air pollution Outdoor air pollution Indoor air pollution in residential environments Indoor air pollution Water (drinking, bathing, inhaling droplets) Drinking water contamination Water Coastal water pollution Water Soil (dermal contact followed by ingestion) Soil and associated groundwater pollution due to solid and hazardous waste disposal Waste management Food (eating) Seafood contamination Food Produce (fruits and vegetables) contamination Food Noise (hearing) Ambient noise above healthful levels Noise pollution Electromagnetic radiation (contacting in ambient environment) Ultraviolet radiation above natural levels as a result of stratospheric ozone depletion Stratospheric ozone depletion Electromagnetic fields from power lines Electromagnetic fields Multiple exposure routes Hazardous substances in occupational environments (in industry, construction, and agriculture) Chemical safety Global climate change Global climate change Table 2. Framework for Categorizing Environmental Health Risks viduals vote on priorities based on written information about each risk. The written information about each risk follows a stan dard four-page format that includes sum mary information on the magnitude and severity of the risk (such as annual fatalities expected due to the risk in a single year), the level of scientific understanding of the risk, and an individual’s ability to control exposure to the environmental hazard. The format of these risk summary sheets was ex tensively tested in experimental studies by the developers of the analytic-deliberative method and was demonstrated to provide a means for promoting common under standing of risk information among experts and nonexperts (Florig et al. 2001). After individual participants read the risk summary sheets and cast their votes on which risks should be ranked highest, they form groups (ideally of eight to 10 people) to discuss the risks and develop a group ranking. Finally, individuals reconsider their initial votes based on the group discussion. The planning team, in cooperation with many stakeholders in environmental health from across the UAE, carried out this analytic-deliberative process for prioritizing the 12 risk categories in Table 2 (environ mental hazards evaluated). For each risk category, the team’s scientists prepared risk summary sheets, which are contained in an appendix to the companion report on the state of the environment and public health in the UAE. Then, the planning team held a series of stakeholder workshops in the UAE to rank the risks using the analytic-deli berative process. Altogether, 73 individuals participated in these workshops. Appen dix A lists the participants. Participants in cluded representatives of the UAE federal government as well as emirate agencies concerned with the environment and public health. Also present were representatives of private-sector organizations (including the petroleum industry), nongovernment organizations (including environmental advocacy groups), and educational institu tions. Participants included citizens of Abu Dhabi, Dubai, Sharjah, Fujairah, and Aj man emirates. A complete description of the workshops and results is provided in the companion report on the state of the envi ronment and public health in the UAE. Figure 4 shows the average final rank ings of the risks considered by the involved 9 stakeholders. Note that for the purposes of this risk-ranking exercise, occupational exposures were separated into three cate gories: industrial, construction-related, and agricultural. Thus, Figure 4 lists a total of 14 risk areas. The blue diamonds in Figure 4 show the average of the rankings submitted by the 56 workshop participants who submit ted final rankings. (Because some individu als were unable to participate in the entire eight-hour workshop and the recorded rank ings of others erroneously omitted some risks, this analysis could not be conducted on rankings from 17 of the 73 participants.) The horizontal bars show the 25th to 75th percentiles of these rankings. Each bar’s width provides an indication of the level of agreement or disagreement among the workshop participants, with shorter bars in dicating greater agreement and longer bars signifying disagreement. For example, the very short bar associated with outdoor air pollution indicates remarkable consensus among workshop participants that outdoor air pollution was the highest environmental health priority from among the hazards considered. In contrast, the long bar associ ated with drinking water indicates a lack of consensus on this topic. Twenty-five percent of workshop participants ranked drinking water contamination among the top prior ity risks, even though, on average, it was ranked ninth in the list of 14 hazards. Also, 25% of participants ranked drinking water contamination as 12th in importance or lower, as can be seen from the 75th per centile value illustrated in Figure 4. Figure 4 shows that, according to these rankings, strong consensus exists that the highest priority environmental health risks in the UAE are (1) outdoor air pollution; (2) indoor air pollution; and (3) occupational exposures in industry, construction, and agriculture. The final rankings produced by groups involved in these workshops sup ported these results. Upon discussion of the results from the workshops with EAD and WHO, the plan ning team retained on the list of priorities the following five environmental hazards, even though these were not identified as among the highest priorities in the priority-setting workshops: (1) climate change, (2) drink ing water pollution, (3) coastal water pol lution, (4) soil and groundwater pollution (from solid and hazardous wastes), and (5) contamination of food (fruits, vegetables, and seafood). The planning team decided that although not the highest environmental health priorities for the UAE, these environ mental health areas could become increas ingly important if development in the UAE continues at its current, rapid pace. The remainder of this document focuses on actions that can be used to reduce pub lic health risks due to the eight priority areas identified during the stakeholder workshops and in further discussions among members of the planning team. In summary, these eight priority areas are (1) outdoor air pol lution; (2) indoor air pollution; (3) occupa tional exposures in industry, construction, and agriculture; (4) climate change; (5) drinking water contamination; (6) coastal water pollution; (7) soil and groundwa ter pollution due to solid and hazardous waste; and (8) contamination of produce and seafood with environmental pollutants. For simplicity and clarity in this docu ment, the sections covering each of these priority areas in detail are titled as follows: 1. Outdoor Air 2. Indoor Air 3. Occupational Exposures 4. Climate Change 5. Drinking Water 6. Coastal Water 7. Soil and Groundwater 8. Produce and Seafood • Outdoor air pollution Indoor air pollution Occupational exposures in industry Occupational exposures in construction Occupational exposures in agriculture Seafood contamination Global climate change Produce (fruits and vegetables) contamination Drinking water contamination Stratospheric ozone depletion Electromagnetic fields Coastal recreational water pollution Ambient noise Residential soil contamination 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Final Ranking Average Ranking Among Individuals 25th to 75th Percentiles Figure 4. Final rankings of 14 environmental health hazards by 56 stakeholders in environmental health in the UAE. 10 The Abu Dhabi Government Strategic Planning Handbook indicates that the purpose of defining targets is to “reflect what the strategy is ultimately planning to achieve … based on the identified prior ity areas. It communicates the desired out comes and thus sets the stage for and ori ents strategy formulation.” The planning team set broad targets for environmental health improvement based on common themes that emerged in analyzing options for managing risks in each of the eight priority areas. Regardless of the priority area, protect ing public health from environmental risks will require reductions in levels of pollutants in the environment and/or reduced expo sures of humans to those pollutants. In addi tion, for all of the priority areas, improved data on and scientific understanding of pol lutant levels, exposures, and health effects are needed to make informed decisions. The UAE also needs to build its human and institutional capacity to address each of the priority areas. Further, any effort to reduce environmental risks to public health must consider the effects of continued urban de velopment on the quality of the environment and on human health. In fact, environmental risks to public health in the UAE are driven to a great extent by the pace and type of development occurring in the country, espe cially in its urban areas. Finally, improved environmental awareness among the public is an essential target, since many initiatives that might be pursued to decrease environ mental risks to public health require both public participation and a public mandate. Based on these themes, the planning team identified the six targets seen in Figure 5, applicable in general to each priority area. The priority areas and targets can be thought of as representing a two-dimension al matrix (Table 3) for organizing initiatives to improve environmental health. The initia tives that can be pursued to achieve the tar gets for each priority area fill in the cells of the matrix. • Targets Figure 5. The six broad targets of this strategy and action plan. Target 1 Reduce pollutant levels and human exposures to pollutants Target 2 Improve data quantity and availability Target 3 Improve scientific understanding of environmental health risks Target 4 Build sustainable human and institutional capacity Target 5 Support urban development that promotes environmental health Target 6 Improve environmental awareness Priority Areas Outdoor Air Indoor Air Occupational Exposures Climate Change Drinking Water Coastal Water Soil and Groundwater Produce and Seafood Number of Initiatives ( Number of KPIs ) Target 1 Reduce pollutant levels and human exposures to pollutants 16 ( 22 ) 9 ( 5 ) 19 ( 15 ) 26 ( 5 ) 11 ( 10 ) 5 ( 6 ) 6 ( 7 ) 4 ( 6 ) Target 2 Improve data quantity and availability 9 ( 7 ) 5 ( 6 ) 8 ( 7 ) 5 ( 1 ) 3 ( 3 ) 2 ( 2 ) 2 ( 3 ) 3 ( 3 ) Target 3 Improve scientific under standing of environmental health risks 3 ( 2 ) 4 ( none ) 1 ( 1 ) 7 ( 1 ) 1 ( none ) 2 ( 3 ) 1 ( 1 ) 0 ( none ) Target 4 Build sustainable human and institutional capacity 3 ( 4 ) 3 ( 4 ) 11 ( 9 ) 3 ( 3 ) 1 ( 1 ) 1 ( 3 ) 4 ( 2 ) 5 ( 7 ) Target 5 Support urban devel opment that promotes environmental health 3 ( 4 ) 2 ( 1 ) 0 ( none) 1 ( 2 ) 1 ( 1 ) 1 ( 1 ) 3 ( 1 ) 1 ( 1 ) Target 6 Improve environmental awareness 2 ( 2 ) 3 ( 4 ) 4 ( 2 ) 3 ( 4 ) 2 ( 1 ) 1 ( 1 ) 5 ( 3 ) 3 ( 2 ) Table 3. Organization of Initiatives and KPIs into Priority Areas and Targets for This Strategy and Action Plan 11 “Initiatives show how an entity will at-tain the previously defined … targets in a concrete and specific way,” according to the Abu Dhabi Government Strategic Planning Handbook. The planning team worked with stakeholders in the UAE to identify initiatives for each priority area and each target. First, scientific experts supporting the team drafted lists of potential initiatives in each priority area to meet each target, based on their own expertise, their expe riences in environmental health protection around the world, reviews of relevant pub lished literature, and written documentation on current environmental health practices in the UAE. Then, the planning team held workshops with a variety of environmental health stakeholders in the UAE. Appendix A lists participants in these workshops, held in January, April, and June 2009 in Abu Dhabi and Dubai. Stakeholders were divid ed into groups according to the eight pri ority areas. Each group reviewed and dis cussed the proposed initiatives. The groups then modified the initiatives to reflect each group’s consensus. The groups also, in most cases, developed suggested timelines for each initiative. The remaining sections of this strategy and action plan describe in detail the rec ommended initiatives for each priority area and each target. Each section presents the recommended initiatives in the format of a chart that presents the suggested timing for each activity based on the estimates of planning-workshop participants and team scientists. (See Table 3, page 10, for the number of initiatives per target for each pri ority area.) Additional analysis is needed to assess the feasibility of completing the recommended initiatives in the suggested time frames. The specific initiatives recommended differ for each priority area, but common themes emerged for the different targets, as described below. Reduce pollutant levels and exposure to pollutants. Two common themes across priority areas are the need to review exist ing pollution control regulations to identify pollutant discharges or exposure routes that currently are not adequately controlled and the need for improved enforcement of exist ing regulations. Also important is the need for greater standardization of regulations across emirates. Improve data quantity and availability. While the UAE has made substantial strides in collecting and organizing data through initiatives such as the Abu Dhabi Global Environmental Data Initiative, participants in the strategic planning process identified a number of additional needs related to collection and organization of data. These include the need to increase the number of environmental monitoring stations and to progressively centralize relevant databases (including developing linkages between government and private-sector data sets and linkages among databases compiled by different government entities). Increased compliance with existing data reporting requirements also emerged as a general need. Improve scientific understanding of en vironmental health risks. Broad consen sus emerged among those involved in the strategic planning process that a substantial increase is needed in the UAE’s commit ment to research aimed at understanding environmental health risks in the UAE. Key topics for additional research include devel opment of improved environmental models, epidemiologic studies of environmental health risks unique to the UAE, studies of exposure pathways and health threats as sociated with specific environmental factors (such as hazardous waste and desalinated water), new environmental-control and waste-reduction technologies, and cost-ben efit analysis of alternative policy options. Build sustainable human and institu tional capacity. Across priority areas, it is clear that additional human resource ca pacity is needed in the UAE to address the broad array of environmental problems ad dressed in this strategy. Capacity-building recommendations address people, infra structure, and systems and include: • Establishing additional graduate-level training programs in the UAE (especially PhD-level programs in fields related to environmental health) • Increasing the number of graduate stu dents trained in programs in the UAE in disciplinary areas relevant to environ mental health • Creating additional opportunities for em ployees of UAE environment and health agencies to pursue graduate training at universities abroad • Creating career paths for those with such training or certification (for exam ple, government positions requiring such qualifications) • Developing additional in-service train ing opportunities • Expanding laboratory capacity for ana lyzing environmental health data • Creating additional research groups within existing agencies focused on spe cific environmental health priorities • Increasing communication and informa tion flows across emirates and between organizations/agencies within emirates Support urban development that pro motes environmental health. Urban development that promotes environmental health is a theme that tracks through nearly all of the priority environmental risk areas. In general, improved processes are needed to account for and reduce potential envi ronmental impacts of new industrial, com mercial, and residential developments. Improve environmental awareness. The initiatives in the subsequent sections iden tify steps to improve public awareness of environmental health risks, including infor mation campaigns (such as consumer prod uct labeling); public alert systems (such as warning systems for beach closures and for periods during which air pollutant levels are high); and education programs for at risk populations such as pregnant women, families with children, and workers exposed to hazards in their places of employment. • Initiatives 12 Key Performance Indicators (KPIs) “Key performance indicators (KPIs) are needed to measure how much an entity is progressing (or not progressing) towards its objective, rather than ‘why’ such progress is or is not being made,” accord ing to the Abu Dhabi Government Strategic Planning Handbook. The KPI charts in this document list a wide variety of measures the UAE can use to track progress in reducing the burden of disease due to environmental health risks. The process for developing KPIs for each priority area was similar to that used to de velop recommended initiatives. Science experts supporting the plan ning team drafted lists of possible KPIs based on their previous experience, a review of literature on KPIs, and a review of selected existing strategic plans in the UAE. Then, the planning team convened workshops of stakeholders in environmen tal health to review these KPIs and modify them as needed. In some cases, the stakeholder groups identified five-year and 20-year goals for the KPIs. These values are not based on quantitative analysis and need to be revis ited as implementation of the strategy and action plan proceeds. Additional analysis is needed to determine the feasibility of achieving the specified goals. Baseline val ues for these goals need to be established so that progress can be measured against existing conditions. Many of the short- and long-term goals for the KPIs are labeled “To be determined.” The strategic planning team lacked suf ficient information to quantify these goals. The UAE should take steps in the near fu ture to develop baseline estimates of the na tion’s current status in meeting these goals and should then set achievable objectives for making progress along these indicators. A number of the KPIs listed in this document are also included in other strate gic planning documents in the UAE. While these KPIs may be included in other plan ning documents, it is important to include them in tracking of progress toward reduc ing the environmental burden of disease. See Table 3 on page 10 for the exact number of KPIs recommended for each of the six targets within each of the eight prio rity areas. • The next eight sections provide details on initiatives and KPIs that can be used to improve environmental health in the UAE in each of the eight priority areas, for each of six targets. Each section is organized into five main parts: • Problem Overview, which provides an overview of the priority area and the po tential public health impacts • Main Achievements and Successes, which describes the UAE’s primary ac complishments thus far in reducing pub lic health risks for the priority area • Main Unresolved Issues, which out lines issues that should be addressed to make further improvements to public health • Recommendations, which provides general steps to be taken toward meet ing each of the targets applicable to the priority area • Initiatives and KPIs, which list detailed information about specific initiatives (ac tions) for the next five years to improve environmental health and KPIs to mea sure progress toward achieving the tar gets for the priority areas Organization of This Document The concluding section of the docu ment describes additional steps needed for successful implementation of this strategy and for making substantial further improve ments in environmental health. It includes a final set of overarching initiatives and KPIs that can be used to combine all the com mon threads of this strategy. • A Note on Numbering Initiatives and KPIs are identi fied via a three-part numbering scheme: EH-# Priority Area T-# Target I-# or K-# Item Number These codes are combined to con struct a unique identification num ber for each KPI or initiative. “EH” stands for “Environmental Health,” which identifies this doc ument. “T” stands for “Target,” “I” for “Initiative,” and “K” for “KPI.” For example, the first KPI for the first target in the first priority area is numbered EH-1 / T-1 / K-1. 13 Outdoor Air Problem Overview Poor air quality is apparent in the UAE, as can be seen from ambient measurements and degraded visibility. This poor air quality is a significant concern because air pollutants have been demon strated, mainly in the United States and Europe, to cause many impairments to human health, including premature death and respiratory diseases such as asthma and chronic obstructive pulmonary disease. Specifically, exposures to particulate matter (PM), ozone, and toxic compounds in the air are of major concern for the health of the population in the UAE. As an example, PM mea sured in Abu Dhabi exceeded the emirate’s standard on about one-third of the days at each location where air quality was monitored during 2007. PM is composed of many different types of particles, which differ in size, chemical com position, and origin. PM is typically classified according to the size of the particles: PM 10 represents particles with diameters smaller than 10 μm, while PM 2.5 represents particles with diameters smaller than 2.5 μm. Because of the arid climate in the UAE, a significant fraction of PM 10 can be attributable to natural dust emissions. The highest measurements of PM 10 concentration coincide with periodic dust storms. PM 2.5 is potentially of greater concern for human health because smaller particles can penetrate more deeply into the lungs and thus cause more extensive damage. PM 2.5 most commonly results from anthropogenic emissions. To date, no data exist in the UAE to enable estimates of the fraction of PM 10 that is PM 2.5 . Similarly lacking are data on the chemical composition of the particles. Such analyses would more clearly indicate the fraction of natural origin (dust or sea salt) and of anthropogenic origin (such as that generated by transportation and industrial activities). Ozone is a pollutant of particular concern for human health, and it may affect health even at concentrations well below the regulatory standard. Ozone concentrations might be expected to be high in the UAE due to its climate and significant emissions of ozone precur sors. These precursors include emissions of volatile organic compounds (VOCs) and nitrogen oxides (NO x ) from the petroleum industry, transportation, and power plants. Global-scale modeling predicts high ozone concentrations over the Arabian Gulf with significant trans port of ozone from Europe and from elsewhere in the Middle East (Li et al. 2001; Liu et al. 2009; Lelieveld et al. 2008; Duncan et al. 2008; Reid et al. 2005). In addition, high ozone concentrations are observed in satellites, suggesting that ozone concentrations may be high above the surface (Liu et al. 2009; Duncan et al. 2008; Reid et al. 2005). Concentrations of ozone and of other gaseous compounds (SO 2 , NO 2 ) measured routinely in Abu Dhabi emir ate, however, do not exceed the emirate standard. This may be an artifact of measurement procedures, including the location of monitors. Ozone may be suppressed at urban measurement stations by reaction with fresh emis sions of nitrogen oxides from automobiles. If this hypothesis is correct, ozone may be signifi cantly higher in other locations or may grow rapidly if emissions increase in the future. Toxic compounds in air (such as benzene, toluene, ethylbenzene, and xylenes) are also a concern for human health, given that the petroleum industry has facilities near large popula tions in Abu Dhabi and Dubai. Few measurements of the concentrations of toxic compounds in the air are available, in cluding only select aromatic compounds at a few measurement stations. This makes the extent of health effects due to toxic compounds difficult to determine. • 14 15 Within the UAE, air quality man-agement is growing and matur ing through a tapestry of UAE-wide and emirate-specific policies and regulations. Several emirates have succeeded in estab lishing surface monitoring programs for rou tine measurement of air quality. Individual emi rates have either adopted their own air quality standards or are using the stan dards established by the UAE government. The federal government also has made strides in regulating air pollutant emissions from large industries by requiring environ mental impact assessments and permits for new projects and environmental inspections for existing facilities. Federal laws set stan dards for emissions of air pollutants from in dustries and vehicles. In many cases, these federal laws are implemented by individual emirates, which may have their own regula Main Achievements and Successes tions. It is unclear how stringently the fed eral laws are enforced. As a major source of industrial pollut ants, the Abu Dhabi National Oil Company (ADNOC) has initiated projects to monitor and curb its emissions through projects to reduce flaring and improve operational effi ciency. ADNOC’s projects have become a model for other UAE oil and gas industries. The emirate of Abu Dhabi likewise has im plemented policies to promote compressed natural gas as a fuel for transportation and to reduce the sulfur in diesel to 10 ppm by 2015. Abu Dhabi also is considering laws that would require imported vehicles to have catalytic converters. Finally, because natural dust storms are an important problem, early warning systems have been established to alert the public. • While the federal government and in-dividual emirates have made strides to understand, regulate, and control air pol lutant emissions, important knowledge and regulatory gaps remain. Air pollutants are regularly transported across national and emirate boundaries, requiring a compre hensive regional analysis. Air quality mea surements in individual emirates, however, have not been compiled to provide a more comprehensive picture of air quality in the UAE, nor is there a comprehensive plan to organize and improve air quality measure ments throughout the nation. The relative contribution of various sources to air pollution in the UAE has not been resolved because a detailed and comprehensive inventory of all pollutant emissions (known as an emissions inven tory) to outdoor air is lacking. Creating a comprehensive inventory is a large task requiring detailed reporting and ac counting of every air-pollution source in the UAE. This inventory can then be incorporated into a regulatory air quality model that can be used to test the inventory against ambient measurements, to improve understanding of the sources and transport of pollutants, and to evaluate proposed emission control actions. In addition, the nature and sources of PM remain uncertain. The Abu Dhabi Air and Climate Institute (ADACI) has begun to measure PM 2.5 routinely at three monitoring stations. PM 2.5 measurements will help re solve the question of what fraction of PM is fine and what fraction is coarse, providing important information on the likely sources of the particles (coarse particles are likely composed primarily of dust). The mea surements also will provide a basis for future PM 2.5 standards. Chemical-com position analysis of particles will more clearly identify their sources. Finally, clear assessments are needed to determine how effectively existing laws are being implemented in each emirate. These assessments should address the pro cedures through which outdoor air stan dards and emissions standards (such as for industrial facilities or motor vehicles) are de termined, revised, applied, and enforced. These are crucial steps for improving air quality in the future. • Main Unresolved and Emerging Issues Priority Area 1: Outdoor Air The UAE can pursue a variety of opportunities to improve out-door air quality, which is perhaps the most important con tributor to the environmental burden of disease in the UAE. To reduce the potential for related health risks, the UAE should: Reduce pollutant levels and human exposure to pollutants. Air quality standards in the UAE should be periodically reviewed and revised, and responsible agencies should develop expertise and processes for establishing and updating standards. The UAE should likewise consider adopting uniform air quality standards, rather than separate standards and processes in individual emi rates. Responsible agencies need to develop procedures for de claring violations of outdoor air standards and plans for enforce ment of the standards. In particular, new standards for PM 2.5 are needed because PM 2.5 is important for human health and is typi cally dominated by anthropogenic emissions. ADACI recently began measuring PM 2.5 . Decisions concerning a new standard should be informed by a thorough analysis of at least one year of PM 2.5 measurements. Similarly, emissions standards are needed for industry and motor vehicles, including procedures and criteria for setting, re vising, implementing, and enforcing them. The process for issu ing environmental permits and auditing for compliance should likewise be reviewed for its overall effectiveness and improved in all emirates. Industrial emissions can be controlled through (1) adopting best practices in all industries, including the elimi nation of flaring; (2) improving the efficiency of and emission controls for power generation and desalination; (3) increasingly adopting alternative sources of electricity, including renewable sources; and (4) evaluating the use of nuclear power. Improve data quantity and availability. An emissions inven tory is a critical element of air quality management. ADACI is working to improve available information to support the develop ment of an emissions database. This work should aim to produce a comprehensive inventory of all relevant air emissions (NO x , VOCs, CO, SO 2 , PM 10 , PM 2.5 , etc.) for all emirates every three years and for all relevant source categories (mobile, point, area, and biogenic). It is important to follow international standards for emissions inventories and for relevant government institutions to develop infrastructure for managing, updating, and dissemi nating large amounts of data to the public. Industrial emissions are an important source of uncertainty in assessing options to im prove air quality. Improving self-reporting of emissions by large industries, particularly petroleum, is critical. Industry should ex pand the continuous monitoring of emissions and make emissions data readily available to responsible government agencies. In dustry should also consider VOC leak-detection technologies that can be employed on a large scale. Improve scientific understanding of environmental health risks. Incomplete understanding of air pollution limits the ability to quantify the efficacy of policy actions toward controlling out door air pollution. Therefore, as it moves forward to improve air quality, the UAE should emphasize actions to improve emissions inventories, ambient measurements of air quality and meterologi cal parameters, and air quality modeling tools, which together will improve knowledge infrastructure, permit identification of key problems, and support implementation of effective regulations. Build sustainable human and institutional capacity. Exist ing outdoor-air monitoring networks should be expanded and improved based on the recent findings discussed above and the UNC review of UAE air quality monitoring programs to be com pleted in 2010. Some specific recommendations include (1) im proving standards and training in quality assurance practices for operation of air monitoring stations; (2) increasing the monitoring of PM 2.5 at selected monitoring stations; (3) conducting measure ments of the chemical speciation of PM 2.5 and PM 10 , as ADACI is planning; (4) encouraging coordination among air monitoring activities in all emirates; and (5) expanding the monitoring of air toxics, especially those emitted by petroleum industries. Air quality modeling tools should be improved to support regulatory decisions, as recommended in the findings of the UNC project, forthcoming in 2010. Support urban development that promotes environmen tal health. It is clear that cars and trucks are an important and growing source of emissions in urban areas such as Abu Dhabi and Dubai. Traffic in these urban areas is a critical problem on its own, in addition to causing air pollutant emissions. Land-use and transportation planning to reduce traffic should be encouraged. The development of mass transit facilities, including the urban rail system being constructed in Dubai, will reduce motor vehicle traf fic, as will subsidies for public transportation or other economic instruments such as raising gasoline prices or instituting conges tion pricing in city centers. Laws should be established to require that imported vehicles include strict emission-control technologies, such as to match Eu ropean or U.S. standards. Inspection of existing vehicles can be a cost-effective means to identify highly polluting vehicles and re quire that they be repaired to remain in service. Efforts to reduce sulfur in fuel and to increase the percentage of vehicles fueled by compressed natural gas are beneficial. Improve environmental awareness. The UAE should strength en efforts to improve public awareness of health risks associated with air pollution, including the improvement of existing alert sys tems for high air pollution episodes such as those caused by dust storms or temperature inversions. Such efforts should make clear how the public can avoid or reduce exposure and when such actions would be desirable. • Recommendations 16 17 Outdoor Air (EH-1): Initiatives to Reduce the Burden of Disease Due to Outdoor Air Pollution Target 1: Reduce pollutant levels and human exposure to pollutants Stakeholders EH-1 / T-1 / I-1 Assign responsible parties across emirates to a working group for ensuring International Organization for Standardiza tion (ISO) 14001 standard for environmental management systems. 2010 ? MOEW EH-1 / T-1 / I-2 Issue policy directives on criteria to be used for updating and setting concentration limits for outdoor air pollutants. The directive should apply to all emirates. 2010 ? MOEW EH-1 / T-1 / I-3 Update the process for setting sector-specific emissions standards, such as for motor vehicles and major industries, and update the standards according to this process on a periodic basis. Appropriate emirate agencies 2010 ? MOEW EH-1 / T-1 / I-4 Establish system for determining the air quality attainment status of each emirate and sets of activities that the emirates must put in place when one or more outdoor air quality standards is violated. • Develop the legal framework to permit governments to carry out actions to analyze and achieve compliance. • Develop protocols for assessing compliance status. • Consider use of permitting as an inducement to obtain compliance, with industrial permits denied if emirate is not making progress toward compliance. Appropriate emirate agencies 2010 ? MOEW EH-1 / T-1 / I-5 Continually update Executive Bylaw 12/2006 to Federal Law 24 of 1999 to develop and achieve appropriate air quality standards. 2010 ? MOEW EH-1 / T-1 / I-6 Develop legal framework to set PM 2.5 standards. Establish and enforce daily and yearly standards. 2010 ? MOEW Section Overview # of Initiatives # of KPIs 36 41 TOTAL 16 22 Target 1 9 7 Target 2 3 2 Target 3 3 4 Target 4 3 4 Target 5 2 2 Target 6 Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: MOI MOEW MOJ MOH HAAD MOEcon ADWEA ADPD DOT NTA Abu Dhabi Police Department Abu Dhabi Water and Electricity Authority Abu Dhabi Department of Transport Health Authority—Abu Dhabi Ministry of Economy Ministry of Environment and Water Ministry of Health Ministry of Interior Ministry of Justice National Transport Authority Environment Agency—Abu DhabiEAD Estidama UPC ADNOC Urban Planning Council (Abu Dhabi) Abu Dhabi National Oil Company Estidama Initiative (Abu Dhabi) Initiatives specific to Abu Dhabi are marked with an asterisk. Priority Area 1: Outdoor Air 18 EH-1 / T-1 / I-7 Develop protocols for estimating costs and benefits of new outdoor air quality regulations, using appropriate outdoor air quality model as an input. 20142010 2011 2012 2013 MOEcon EH-1 / T-1 / I-8 Review adequacy of current reporting and auditing procedures for emissions from stationary sources. Require or enforce requirement of audit and inspection to renew permit to operate. Appropriate emirate agencies 2010 ? MOEW EH-1 / T-1 / I-9 Develop best practices manuals for control of air emissions from all sources. Appropriate emirate agencies 2010 ? MOEW EH-1 / T-1 / I-10 Establish through permitting program a mandate to detect, control, and repair fugitive emissions of VOCs and oil from industrial facilities, storage tanks, pipelines, and barges. This task includes establishing methods and mandatory report ing procedures. Appropriate emirate agencies 20142010 2011 2012 2013 MOEW EH-1 / T-1 / I-11 Introduce regulations and efficiency initiatives to reduce power sector emissions. Review retirement or replacement of current power plants. Appropriate emirate agencies 2010 ? MOEW ADWEA EH-1 / T-1 / I-12 Work with oil and gas sector to reduce flaring caused by shutdowns in the petroleum sector. 20142010 2011 2012 2013 Representatives from oil and gas industries in every emirate EH-1 / T-1 / I-13 Update standards for emissions of NO x and other pollutants from all motor vehicles. Appropriate emirate agencies 20142010 2011 2012 2013 MOEW EH-1 / T-1 / I-14 Improve motor vehicle inspection and maintenance programs to require emission testing of hydrocarbons, nitrogen oxides, and carbon monoxide; establish remote roadside testing program. Appropriate emirate agencies 2010 ? MOI EH-1 / T-1 / I-15 Develop policies to reduce emissions from aviation and ships at UAE ports. Unknown for federal and other emirates 2010 ? DOT EH-1 / T-1 / I-16* Increase the cost of driving and freight by road through demand management systems and methods. 2010 ? DOT NTA Target 2: Improve data quantity and availability Stakeholders EH-1 / T-2 / I-1 Continue process of developing monitoring protocols and data entry/storage/output systems for linking outdoor air quality monitors throughout UAE into centralized database. Appropriate emirate agencies 20142010 2011 2012 2013 MOEW 19 Priority Area 1: Outdoor Air Section Overview # of Initiatives # of KPIs 36 41 TOTAL 16 22 Target 1 9 7 Target 2 3 2 Target 3 3 4 Target 4 3 4 Target 5 2 2 Target 6 EH-1 / T-2 / I-2 Mandate submissions of cardiopulmonary and respiratory disease cases (including cancers) and deaths by all medical facilities. Standardize reporting procedures, format, and frequency. Appropriate emirate agencies 2010 ? MOH HAAD EH-1 / T-2 / I-3 Ensure data availability and accessibility for all emirates. 2010 OngOing To be determined EH-1 / T-2 / I-4 Establish a national methodology for developing emissions inventories. The development of the emissions inventory and repository of data should take place at the emirate level. Appropriate emirate agencies 2010 OngOing MOEW EH-1 / T-2 / I-5 Standardize and increase self-reporting and public disclosure of emissions by large industries. 2010 OngOing To be determined EH-1 / T-2 / I-6 Continue to improve outdoor air quality monitoring stations. Appropriate emirate agencies 2010 OngOing MOEW EH-1 / T-2 / I-7* Install additional PM 2.5 monitors to determine baseline and track ambient concentrations. 2010 OngOing EAD EH-1 / T-2 / I-8* Establish plan for monitoring carbon monoxide levels in road and metro tunnels (including future underground roadways). Install continuous monitors. Develop emergency management plan. 2010 ? EAD DOT ADPD EH-1 / T-2 / I-9* Quantify benefit of possible increased use of compressed natural gas vehicles. 2010 ? EAD *Specific to Abu Dhabi Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: MOI MOEW MOJ MOH HAAD MOEcon ADWEA ADPD DOT NTA Abu Dhabi Police Department Abu Dhabi Water and Electricity Authority Abu Dhabi Department of Transport Health Authority—Abu Dhabi Ministry of Economy Ministry of Environment and Water Ministry of Health Ministry of Interior Ministry of Justice National Transport Authority Environment Agency—Abu DhabiEAD Estidama UPC ADNOC Urban Planning Council (Abu Dhabi) Abu Dhabi National Oil Company Estidama Initiative (Abu Dhabi) 20 Target 3: Improve scientific understanding of environmental health risks Stakeholders EH-1 / T-3 / I-1 Build UAE capacity to produce air quality model inputs and predictions. 2010 OngOing To be determined EH-1 / T-3 / I-2 Design and conduct field campaigns and advanced studies to answer relevant questions about health and outdoor air. Appropriate emirate agencies 20142010 2011 2012 2013 MOEW EH-1 / T-3 / I-3 Enhance research capability in all scientific fields, including air quality. 2010 OngOing To be determined Target 4: Build sustainable human and institutional capacity Stakeholders EH-1 / T-4 / I-1 Develop national capacity in outdoor air quality by providing environment and health agency employees with educa tional opportunities and training in the atmospheric sciences through internships or university programs. Appropriate emirate agencies 2010 OngOing MOEW EH-1 / T-4 / I-2 Create an infrastructure and organization to oversee updating and dissemination of the emissions inventory every three years. 2010 OngOing To be determined EH-1 / T-4 / I-3 Establish procedures for enforcement of violations of outdoor air quality standards Appropriate emirate agencies 2010 ? MOEW MOJ Target 5: Support urban development that promotes environmental health Stakeholders EH-1 / T-5 / I-1 Take measures to increase the availability and convenience of public transit. Appropriate emirate agencies 2010 ? DOT NTA EH-1 / T-5 / I-2* Establish energy efficient building and product standards to reduce power demands. 2010 ? EstidamaUPC EH-1 / T-5 / I-3* Support Masdar Initiative to help demonstrate viability of wind and solar power, hydrogen fuel cells, and carbon capture and sequestration technologies. Issue regular progress reports on the status of Masdar and these technologies. 2010 OngOing ADNOC EAD DOT Target 6: Increase environmental awareness Stakeholders EH-1 / T-6 / I-1 Conduct public information campaigns about the risks of outdoor air pollution, and conduct surveys to gauge aware ness and gaps in knowledge surrounding air quality risks. Appropriate emirate agencies 2010 ? MOEW 21 Outdoor Air (EH-1): Key Performance Indicators KPI No. Description 2014 Goal 2030 Goal Target 1: Reduce pollutant levels and human exposure to pollutants EH-1 / T-1 / K-1 Incidence of acute respiratory infections in children under five years of age To be determined To be determined EH-1 / T-1 / K-2 Mortality rates due to respiratory disease (asthma, acute respiratory infections, chronic obstructive pulmonary disease): 1. Total mortality 2. Total respiratory disease mortality 3. Cause-specific mortality, all ages 4. Total respiratory disease mortality in children younger than 5 5. Total respiratory disease mortality in elderly adults To be determined To be determined EH-1 / T-1 / K-3 Percentage of UAE-wide Environmental, Health and Safety Management System (EHSMS) that is fully operational (to include outdoor air emissions data and health data) 100% 100% operational and available EH-1 / T-1 / K-4 Percentage of time that each of the following pollutants is found at levels that exceed standards (given that rules may allow for a number of hours/days that exceed stan dards): NO 2 , SO 2 , O 3 , CO, and PM 10 To be determined 0% EH-1 / T-1 / K-5 Percentage of time that PM 2.5 exceeds new standard(s) To be determined 0% EH-1 / T-1 / K-6 Amount by which concentrations of each of the following pollutants exceeds ambient standard, on average (expressed as the ratio of average concentration exceeding standard to the standard): NO 2 , SO 2 , O 3 , CO, and PM 10 To be determined 0 EH-1 / T-1 / K-7 Amount by which concentration of PM 2.5 exceeds the new standard(s), on average (expressed as ratio of average concentration when standard is exceeded to standard value) To be determined 0 EH-1 / T-1 / K-8 Percentage of industrial sectors with updated emissions standards To be determined 100% Priority Area 1: Outdoor Air Section Overview # of Initiatives # of KPIs 36 41 TOTAL 16 22 Target 1 9 7 Target 2 3 2 Target 3 3 4 Target 4 3 4 Target 5 2 2 Target 6 EH-1 / T-6 / I-2* Develop an outdoor air quality index and a Web site, newsletters, and e-mail lists of sensitive individuals for advance notification of high-pollution days. 2010 OngOing EAD *Specific to Abu Dhabi Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: MOI MOEW MOJ MOH HAAD MOEcon ADWEA ADPD DOT NTA Abu Dhabi Police Department Abu Dhabi Water and Electricity Authority Abu Dhabi Department of Transport Health Authority—Abu Dhabi Ministry of Economy Ministry of Environment and Water Ministry of Health Ministry of Interior Ministry of Justice National Transport Authority Environment Agency—Abu DhabiEAD Estidama UPC ADNOC Urban Planning Council (Abu Dhabi) Abu Dhabi National Oil Company Estidama Initiative (Abu Dhabi) 22 KPI No. Description 2014 Goal 2030 Goal EH-1 / T-1 / K-9 Percentage of industrial facilities that comply with emissions standards To be determined 100% EH-1 / T-1 / K-10 Percentage of stationary emissions sources that are audited annually To be determined To be determined EH-1 / T-1 / K-11 Total mass or volume of VOC leaks and spills from all industrial sources, including industrial facilities, storage tanks, pipelines, and barges To be determined To be determined EH-1 / T-1 / K-12 Tons per year of emissions from the power sector, industrial sources, and commercial point sources 10% decrease compared with 2000, for two sectors To be determined EH-1 / T-1 / K-13 Percentage of electricity generated from renewable sources To be determined 7% (by 2020) EH-1 / T-1 / K-14 Volume of gas flared 0 0 EH-1 / T-1 / K-15 Percentage of taxis, government cars, and training vehicles that are fueled by com pressed natural gas 20% (by 2012) To be determined EH-1 / T-1 / K-16 Percentage of registered vehicles meeting updated standards To be determined To be determined EH-1 / T-1 / K-17 Percentage of diesel fuel consumed that contains 10 ppm sulfur (percent by volume) To be determined To be determined EH-1 / T-1 / K-18 Percentage of transportation fuels from renewable sources (expressed as percentage of all fuels by gasoline gallon equivalents) To be determined To be determined EH-1 / T-1 / K-19 Annual reduction in freight sector emissions (in tons) of PM 2.5 , NO X , and SO 2 To be determined To be determined EH-1 / T-1 / K-20 Annual reduction in maritime emissions (in tons) of PM 2.5 , NO X , and SO 2 To be determined To be determined EH-1 / T-1 / K-21 Annual reduction in emissions of PM 2.5 , NO X , and SO 2 (in tons) from light-duty vehicles To be determined To be determined EH-1 / T-1 / K-22 Annual reduction in emissions of PM 2.5 , NO X , and SO 2 (in tons) from heavy-duty vehicles To be determined To be determined Target 2: Improve data quantity and availability EH-1 / T-2 / K-1 Percentage of stationary sources providing all emissions data to centralized database To be determined To be determined EH-1 / T-2 / K-2 Percentage of health-care facilities reporting cardiopulmonary and respiratory disease cases and deaths (expressed as # of facilities reporting each month / # of facilities required to report, or as % of facilities submitting at least 10 monthly reports per year within one month of due date) To be determined To be determined EH-1 / T-2 / K-3 Number of chemical species monitored by continuous monitors in each industrial sector (by emirate) To be determined To be determined EH-1 / T-2 / K-4 Percentage of existing outdoor air pollutant monitors that are in UAE-wide outdoor-air monitoring network 100% of currently operating monitors To be determined EH-1 / T-2 / K-5 Percentage of regulated sources submitting emissions data to centralized Spatial Data Infrastructure (SDI) database To be determined To be determined EH-1 / T-2 / K-6 Government agencies (including federal and emirate level) with access to SDI EAD, parallel institutions in other emirates To be determined EH-1 / T-2 / K-7 Interval (in months) between updates of national emissions inventory To be determined To be determined 23 KPI No. Description 2014 Goal 2030 Goal Target 3: Improve scientific understanding of environmental health risks EH-1 / T-3 / K-1 Dirhams per year spent on research to improve understanding of outdoor air pollution To be determined To be determined EH-1 / T-3 / K-2 Modeling of ambient ozone, PM, their precursors, and other air pollutants important for health in both the UAE and the entire Middle East is operational and continuously updated To be determined To be determined Target 4: Build sustainable human and institutional capacity EH-1 / T-4 / K-1 Number of continuous emissions monitors in each industrial sector (by emirate) To be determined To be determined EH-1 / T-4 / K-2 Number of outdoor-air monitors in the national air-quality monitoring network operated by trained and certified technicians To be determined To be determined EH-1 / T-4 / K-3 Number of PM 2.5 monitors in the air-quality monitoring network nationally To be determined To be determined EH-1 / T-4 / K-4 Number of employees studying outdoor air pollution in each relevant government agency To be determined To be determined Target 5: Support urban development that promotes environmental health EH-1 / T-5 / K-1 Number of people living within 100 m of a major road To be determined To be determined EH-1 / T-5 / K-2 Average commute time by mode Zero increase in average commute time, compared with 2009 To be determined EH-1 / T-5 / K-3 Percentage of journeys taken on public transit To be determined To be determined EH-1 / T-5 / K-4 Percentage of freight moved by non-road haulers To be determined To be determined Target 6: Increase environmental awareness EH-1 / T-6 / K-1 Percentage of population with basic understanding of how to reduce risk of disease from outdoor air pollution To be determined To be determined EH-1 / T-6 / K-2 Percentage of population displaying avoidance behavior, such as staying indoors or avoiding outdoor exercise on high pollution days To be determined To be determined Priority Area 1: Outdoor Air Section Overview # of Initiatives # of KPIs 36 41 TOTAL 16 22 Target 1 9 7 Target 2 3 2 Target 3 3 4 Target 4 3 4 Target 5 2 2 Target 6 Indoor Air Problem Overview Air pollution exposure has long been identified as a control-lable cause of preventable diseases. Historically, the bulk of the research on air pollution has focused on the outdoor air com ponent, with results repeatedly showing an association between air pollution and adverse health effects (Dockery et al. 1993; Cohen et al. 2005; Pope 1991). More recently, however, recognition of indoor air pollution as a high priority environmental health risk has increased around the globe. In the last several years, risk-ranking exercises by a number of organizations have placed indoor air pollution in the highest category of environmental risks (California Air Resources Board 2005; De Brouwere et al. 2007). Indoor air pollution ranked as the second-highest risk of concern in the recent UAE national-scale ranking of environmental risks (Figure 4, page 9). Several factors may be contributing to increased awareness of indoor air pollution as a significant environmental health risk: (1) the recognition that people spend a majority of their time indoors; (2) the identification of many potential sources of air pollutants in indoor environments; (3) a growing body of evidence document ing that indoor concentrations of air pollutants can exceed health thresholds and present increased risks; and (4) the realization that energy-efficient buildings are potentially contributing to increased risk due to tight sealing of the building envelope, which increases the accumulation of pollutants indoors. Indoor air pollutant concentrations are a function of indoor source emissions and the infiltration of outdoor air pollution into dwellings via building leakage. Many indoor pollutants are similar to outdoor air pollutants and have the potential to trigger compa rable adverse health effects. Time is an important factor when assessing health risks due to indoor pollutants. Exposure to indoor pollutants is a function of the concentration of indoor pollutants and the time spent in that micro environment. When these two factors are taken into account, per sonal exposure to a given pollutant may be 10 to 50 times higher indoors than outdoors (U.S. EPA 1998). In the United States, Kle peis et al. (2001) report that people spend approximately 87% of their time indoors. In more extreme climates, such as in the UAE, the percentage of time spent indoors may be even higher and so, too, may be the health risk from exposure to indoor pollutants (Dales et al. 2008). Multiple sources of indoor pollutants can be found in any home, and concentrations may vary considerably from one home 24 25 Priority Area 2: Indoor Air to another. Frequently identified sources include combustion products such as gas, wood, or kerosene; tobacco products in any form; damp building materials or high humidity environments that result in surface condensation and mold growth; manufac tured wood products; chemicals associated with furnishings such as carpets and uphol stery; cleaning products; deteriorating or damaged lead-based paint; and asbestos Numerous initiatives to reduce the health risk attributable to indoor air pollutants have been undertaken in the UAE, in Abu Dhabi emirate in particular. Banning the import and use of asbes tos and lead in products that may be used in residential and commercial environments is a large step toward reducing exposure to two well-characterized hazardous ma terials associated with numerous chronic and potentially life-threatening health con ditions. The recent organization of the Emi rates Standardization and Metrology Au thority (ESMA) will increase the control and organization of other similar initiatives. Cur rently, there are efforts to monitor the entry of hazardous materials at six points along the country’s border. Also, EAD has taken the lead to implement an electronic track ing system that, when fully operational, will provide coordinated oversight for all haz ardous materials entering the country. A progressive ban on smoking in pub lic areas is another example of a policy the UAE has implemented to protect the health and well-being of the public, especially susceptible populations such as children and the elderly. Educational awareness Main Achievements and Successes campaigns related to smoking have be come more prominent and frequent. While smoking is unlikely to be banned in private residences, as is also the case in other coun tries, the effort to educate the public and reduce exposure to secondhand smoke in public areas may indirectly influence smoking habits in residential environ ments. The recently organized Urban Planning Council (UPC) in Abu Dhabi and other UAE organizations are involved in a large initiative to introduce environmentally friendly “green” requirements into building construction/renovation and promote sus tainability. Efforts such as this will reduce background levels of numerous pollutants that are routinely identified in indoor envi ronments and recognized as health risks. UPC has drafted a comprehensive document that addresses many critical indoor air issues, including: emissions of formaldehyde and other chemicals from building materials; ventilation; manage ment of asbestos-containing building mate rials; elimination of environmental tobacco smoke; and indoor air quality management. Implementation of the recommendations of such a document across all emirates will im prove indoor air quality in the UAE. Additionally, EAD has taken the lead in developing environmental, health, and safety protection policies as part of the new Abu Dhabi Environment, Health and Safety Management System (EHSMS). The indoor air quality component of the EHSMS addresses indoor air issues that may be confronted in commercial and public buildings. This proactive approach by EAD in cludes the specification of indicators (e.g., carbon dioxide) and acceptable indicator levels for indoor air quality, as well as di rectives for indoor air quality management. Dubai Municipality has also made great strides in addressing indoor air qual ity issues, including the formation of a unit that responds to complaints and concerns from the public. Trained engineers within the unit inspect ventilation equipment and collect measurements for various indica tors of poor indoor air quality (e.g., carbon dioxide levels, ventilation parameters). Re sults are used to guide recommendations for improving indoor air quality for building occupants. • containing building materials. Other sources contributing to poor indoor air quality that are not necessar ily emitted within the building envelope include radon gas, which may permeate through the soil and enter the home through cracks and other breaches in the founda tion, and outdoor air pollution, which can infiltrate through open windows or other points of entry. • The UAE is undergoing unprecedented growth and urbanization, and the im pacts on public health from this expansion are numerous. With leadership from EAD, Abu Dhabi emirate is making significant progress on indoor air quality issues. Dubai Municipal ity is serving as a leader as well through its inspection services and recommendations Main Unresolved and Emerging Issues for improving indoor air quality to anyone requesting the service. Unfortunately, initiatives in other emi rates are lacking. The primary unresolved and emerging issue for the UAE is a need for all emirates and municipalities to adopt and abide by similar measures as those in stituted by EAD and Dubai Municipality. For the UAE to see a positive impact on public health at a national level with regard to indoor air issues, a unified approach that is at least comparable in effort to that of EAD and Dubai Municipality needs to oc cur across all emirates. Additionally, exist ing laws and regulations (e.g., a federal ban on asbestos) that have potential to af fect indoor air quality need to be enforced in all emirates and municipalities. • To reduce the potential for health risks due to indoor air pol-lution, the UAE should: Reduce pollutant levels and human exposure to pollut ants. Government agencies should focus attention on mechan ical ventilation systems and ensure their adequacy for minimiz ing exposure to indoor pollutants. In extreme climates, such as in the UAE, the use of mechanical ventilation systems is more extensive, which necessitates more oversight through measures such as building code requirements. Requiring compliance with recognized ventilation guidelines and standards for these sys tems is critical to controlling indoor contaminants and reduc ing human exposures. In addition, actions designed to restrict contaminant-generating activities in populated spaces (e.g., smoking in public areas, renovation or demolition activities in occupied buildings) should be implemented. Improve data quantity and availability. Surveys of a number of indoor pollutants in a representative number of residential, commercial, and public buildings are necessary to establish baseline information about indoor air quality. EAD has already demonstrated commitment to this type of initiative through the 700-home epidemiologic study scheduled to con clude in the spring of 2010 that will measure indoor concen trations of several common pollutants (e.g., particulate matter, carbon monoxide) nationwide. Comparable efforts for radon, lead-based paint, and asbestos-containing building materials are advisable. Additionally, tandem efforts to implement and/ or improve surveillance systems for tracking diseases associ ated with indoor pollutant exposures are critical to gathering information about the potential adverse health effects of indoor air pollution. Improve scientific understanding of environmental health risks. The UAE government should sponsor additional research to identify factors that influence indoor air pollutant concentrations and occupant exposures. For example, surveys to measure air exchange rates in residential areas could be conducted to identify whether certain types of housing affect exposure more than others. Also, these surveys could assess the effect of geographical differences on exposures to indoor air pollutants. Build sustainable human and institutional capacity. As the UAE advances its programs on indoor air quality, it should increase educational opportunities for professional personnel concerned with indoor air quality. Educational needs include training programs for building engineers as well as graduate level education for those conducting field assessments or ma na ging larger indoor air programs at the federal, emirate, or municipal level. Support urban development that promotes environmen tal health. The UAE has undergone unprecedented growth in the last two decades. The UAE will save money in the long run and help protect its population from indoor air pollution by being cognizant during the design phase of how material sub stitution, ventilation requirements, and land use affect indoor air quality in new buildings. Improve environmental awareness. UAE government lead ers (federal, emirate, and municipal) need to encourage public participation in activities designed to curtail exposure to indoor air pollution and promote behaviors that improve indoor air quality. The UAE could initiate product-labeling or building-ma terial substitution campaigns in addition to campaigns aimed at behaviors (e.g., smoking) that should be modified to reduce indoor air pollution and exposure to pollutants. Other countries and regions have successfully implemented similar programs and could serve as models for the UAE. • Recommendations 26 27 Priority Area 2: Indoor Air 27 28 Target 1: Reduce pollutant levels and human exposure to pollutants Stakeholders EH-2 / T-1 / I-1 Commission an independent review of the adequacy of existing residential and commercial building codes (and the enforcement of these codes) to minimize indoor air pollution through minimizing sources of indoor air pollutants and maximizing efficiency of ventilation rates. Follow International Code Council (http://www.iccsafe.org) codes as ap propriate. Emirate environment agencies, municipalities 20142010 2011 2012 2013 MOEW EH-2 / T-1 / I-2 Identify and adopt international best practices in building ventilation standards. Emirate environment agencies, municipalities 20142010 2011 2012 2013 MOEW EH-2 / T-1 / I-3 Review and assess indoor air quality guidelines and regulations for new residential, public, and commercial buildings. Use existing Dubai Municipality, European Union, and U.S. guidelines as examples. Emirate environment agencies, municipalities 20142010 2011 2012 2013 MOEW EH-2 / T-1 / I-4 Review and assess feasibility of mandatory annual inspection and monitoring of heating, ventilating, and air-condition ing (HVAC) systems in all commercial and public buildings. • Identify building HVAC mechanical engineers and assign inspection duties. • Require inspector certification through American Society of Heating, Refrigerating, and Air-Conditioning Engineers Operations and Performance Personnel Certification (http://www.ashrae.org/certification/page/1899). • Develop procedures for establishing indoor air quality management plans if poor conditions are identified. • Establish a process to notify building owner of confirmed poor indoor air quality conditions and permit legal action if remediation is not completed within a certain time. Emirate environment agencies, municipalities 20142010 2011 2012 2013 MOEW EH-2 / T-1 / I-5 Control and eventually ban smoking of all tobacco products in all public buildings, including restaurants, cafes, and office buildings. Emirate environment agencies, municipalities MOEW MOH MOI 2010 2011 2012 2013 2014 EAD HAAD EH-2 / T-1 / I-6 Require all hazardous materials to be removed prior to demolition of buildings and personnel removing them to be trained in proper removal and disposal procedures, following best international practices. Emirate environment agencies, municipalities 20142010 2011 2012 2013 MOEW EH-2 / T-1 / I-7 Establish an assistance program for workers, renters, and others exposed to indoor air pollutants in commercial, resi dential, and public buildings. Emirate environment agencies 20142010 2011 2012 2013 MOEW MOH EH-2 / T-1 / I-8 Establish health inspection units within each emirate that can respond to complaints of residential and commercial oc cupants related to poor indoor air quality, following the example of Dubai Municipality. Unknown for federal and other emirates 2010 2011 2012 2013 2015 MOEW MOH Indoor Air (EH-2): Initiatives to Reduce the Burden of Disease Due to Indoor Air Pollution 29 EH-2 / T-1 / I-9 Require reporting of radon levels, presence of asbestos, presence of lead-based paint, and HVAC cleanliness and performance prior to rental or sale of all residential dwellings. • Encourage unit testing through incentive programs or subsidies to owners and management companies. • Implement law that requires disclosure by owner and management company at contract signing. • Provide avenue for occupant to pursue action against owner if testing is not conducted and suspected health impacts result. Emirate environment agencies, municipalities 2010 OngOing2011 MOEW MOP Target 2: Improve data quantity and availability Stakeholders EH-2 / T-2 / I-1 Conduct baseline survey for presence of asbestos-containing materials in residential, commercial, and public buildings across the UAE. • Use trained, qualified asbestos inspectors who can assess conditions and recommend appropriate remediation. • Conduct asbestos air sampling in buildings where asbestos-containing materials are damaged or highly friable. Emirate health agencies MOEW MOH MOP 2010 2011 2012 2013 2015–2019 UPC EH-2 / T-2 / I-2 Design and carry out studies of indoor air quality in public buildings in the UAE. • Visually inspect buildings for conditions that could exacerbate poor indoor air quality (e.g., leaky roof, improper storage of chemicals, pressed-wood furniture, inadequate ventilation). • Interview occupants for concerns or symptoms. • Use qualified personnel to conduct indoor air quality inspection, including measuring airborne pollutants of interest. • Compare results against appropriate international guidelines and standards. Municipalities, universities (UAE and international) 2010 2011 2012 2013 2016 MOEW EH-2 / T-2 / I-3 Conduct baseline radon survey across all emirates, and map hot spots. Enlist a hired contractor or appropriately trained EAD personnel to conduct sampling in a representative number of homes across the UAE. Municipalities, universities (UAE and international), consultants 2010 2011 2012 2013 2014 MOEW UPC EH-2 / T-2 / I-4 Establish and fund an independent surveillance body and system for tracking occurrences of diseases associated with indoor air pollution, including carbon monoxide poisoning, childhood lead poisoning, lung cancer, allergies, asthma, mesothelioma, Legionnaires’ disease, and sick building syndrome. Emirate environment and health agencies, university research units 2010 2011 2012 2013 2020 MOEW MOH Priority Area 2: Indoor Air Section Overview # of Initiatives # of KPIs 26 20 TOTAL 9 5 Target 1 5 6 Target 2 4 0 Target 3 3 4 Target 4 2 1 Target 5 3 4 Target 6 MOP MOHEnvironment Agency—Abu Dhabi Health Authority—Abu Dhabi Ministry of Higher Education and Scientific Research Ministry of Environment and Water Ministry of Health Ministry of Planning Urban Planning Council (Abu Dhabi)MOEW HAAD EAD UPC Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: MHESR MOI Ministry of Interior 30 EH-2 / T-2 / I-5 Establish routine monitoring of blood lead levels in all children ages 1-5 as part of regular check-ups. • Establish and fund an independent research body. • Require physicians and medical facilities to report blood lead levels above the threshold to an emirate agency for follow-up. Use internationally accepted threshold for reference. • Require local health agencies to report elevated blood lead levels to the Ministry of Health, where a central surveil lance database is developed and maintained. • Organize a health unit within each emirate that investigates elevated blood lead levels by inspecting homes and schools for conditions or sources that may be contributing to lead exposure. • Request remediation of those conditions or sources upon discovery. • Make lead remediation enforceable by law. Local universities, health agencies, and environment agencies 20142010 2011 2012 2013 MOEW MOH Target 3: Improve scientific understanding of environmental health risks Stakeholders EH-2 / T-3 / I-1 Conduct studies to identify the areas and specific building types most vulnerable to infiltration of pollutants from out door air. Establish a research body to conduct these studies in collaboration with universities and funded by the Urban Planning Council, federal ministries, and local authorities. Universities, local health agencies, municipalities 2010 2011 2012 2013 2015 UPC EH-2 / T-3 / I-2 Conduct studies to measure air exchange rates in different building types. 2010 2011 2012 2013 2015 Municipalities, universities, appropri ate ministries and emirate agencies EH-2 / T-3 / I-3 Study indoor air quality in green design; compare with traditionally designed and constructed buildings. 2010 2011 2012 2013 2015 Municipalities, universities, appropri ate ministries and emirate agencies EH-2 / T-3 / I-4 Study indoor air issues associated with arid climates relative to climates with greater humidity; include special focus on microbiological pollutants. 2010 2011 2012 2013 2015 Municipalities, universities, appropri ate ministries and emirate agencies Target 4: Build sustainable human and institutional capacity Stakeholders EH-2 / T-4 / I-1 Increase number of staff in key UAE environmental agencies with graduate-level training in indoor air quality by fund ing mechanical engineering and other indoor-air-related programs at local universities. 2010 2011 2012 2013 2015 MHESR EH-2 / T-4 / I-2 Increase number of staff in key UAE environmental agencies with doctoral degrees focused on air quality engineering or environmental-health-related disciplines with an indoor air quality component by funding programs at one or more local universities. 2010 2011 2012 2013 2015 MHESR EH-2 / T-4 / I-3 Implement an annual audit and evaluation of staff expertise in indoor air in each emirate. Emirate environment agencies, municipalities 20142010 2011 2012 2013 MOEW MOH 31 Target 5: Support urban development that promotes environmental health Stakeholders EH-2 / T-5 / I-1 Determine whether a green building-certification program is feasible and how indoor air quality could be incorporated into such a program. Municipalities 2010 2011 2012 2013 2015–2020 MOEW EH-2 / T-5 / I-2 Evaluate urban planning strategies and regulations to determine how indoor air is incorporated and whether measures are sufficient to contribute to improvement of indoor air quality. Municipalities 20142010 2011 2012 2013 MOEW UPC Target 6: Increase environmental awareness Stakeholders EH-2 / T-6 / I-1 Establish product standards and a labeling program for all consumer products that are potentially sources of indoor air pollution (e.g., cleaning products, pesticides, rodenticides, fabrics, particle board, floor finishes, paints, cosmetics, disinfectants). • Identify and categorize potentially harmful products. • Institute a program similar to the European Union’s REACH (Registration, Evaluation, Authorization, and Restriction of Chemical substances) regulation on chemicals and their safe use. • Establish central database to monitor and manage information on chemicals brought into the UAE. • Establish an agency to test the potential effects of consumer products on indoor air quality. • Supplement product labeling program with consumer education campaigns. Emirate environment agencies 2010 2011 2012 2013 2014 MOEW EH-2 / T-6 / I-2 Develop public information campaigns about risks due to indoor air pollution, including secondhand smoke, radon, and other contaminants. • Consult model programs developed by other nations. • Consider using TV campaigns, newspaper ads, and radio spots. • Initiate incentives or subsidies during campaign period for the action wanted, e.g., government subsidies for, or giveaway of, carbon monoxide detectors. • Develop calendars, brochures, and magnets with tips and reminders. Emirate environment and health agencies 2010 OngOing MOEW MOH EH-2 / T-6 / I-3 Encourage installation of carbon monoxide monitors in all residential rental units and private homes through educa tional awareness campaigns. Emirate environment agencies, municipalities 2010 OngOing MOEW Priority Area 2: Indoor Air Section Overview # of Initiatives # of KPIs 26 20 TOTAL 9 5 Target 1 5 6 Target 2 4 0 Target 3 3 4 Target 4 2 1 Target 5 3 4 Target 6 MOP MOHEnvironment Agency—Abu Dhabi Health Authority—Abu Dhabi Ministry of Higher Education and Scientific Research Ministry of Environment and Water Ministry of Health Ministry of Planning Urban Planning Council (Abu Dhabi)MOEW HAAD EAD UPC Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: MHESR MOI Ministry of Interior 32 Indoor Air (EH-2): Key Performance Indicators KPI No. Description 2014 Goal 2030 Goal Target 1: Reduce pollutant levels and human exposure to pollutants EH-2 / T-1 / K-1 Percentage of emirates adopting a system for establishing and updating indoor air quality guidelines and regulations 100% To be determined EH-2 / T-1 / K-2 Establishment of system for annual inspection and monitoring of heating, ventilating, and air-conditioning (HVAC) systems in public and commercial buildings: 1. Percentage of residential buildings inspected as part of this system 2. Percentage of residential buildings meeting requirements 3. Percentage of commercial buildings inspected 4. Percentage of commercial buildings meeting requirements 50% 100% EH-2 / T-1 / K-3 Percentage of public buildings in the following categories that enforce bans on smok ing and tobacco products: 1. Federal government buildings 2. Emirate government buildings 3. Public transportation facilities (airports, bus terminals, etc.) 4. Restaurants 75% 100% EH-2 / T-1 / K-4 Percentage of renovation or demolition projects in the following categories that use ap propriate engineering controls to minimize exposures to hazardous materials contain ing asbestos, lead, mercury, PCBs, or other materials banned or regulated by other international agencies: 1. Residential buildings 2. Commercial buildings 3. Decommissioned laboratories 4. Decommissioned industrial facilities 75% To be determined EH-2 / T-1 / K-5 Percentage of residential rental units with carbon monoxide monitors in place 75% 100% Target 2: Improve data quantity and availability EH-2 / T-2 / K-1 Percentage of buildings tested to identify the presence and condition of asbestos-con taining building materials that may potentially present a health risk: 1. Residential buildings 2. Commercial buildings 3. Public buildings 30% 100% 33 Priority Area 2: Indoor Air KPI No. Description 2014 Goal 2030 Goal EH-2 / T-2 / K-2 Percentage of schools and public buildings with contaminant levels below internation ally acceptable concentrations or threshold levels for lead, mercury, formaldehyde, asbestos, radon, and mold. 100% 100% EH-2 / T-2 / K-3 Percentage of residential, commercial, and public building exceeding radon thresh olds. <25% <5% EH-2 / T-2 / K-4 Incidence of diagnosed cases of illnesses associated with indoor air pollution (per 100,000 population) To be determined To be determined EH-2 / T-2 / K-5 Mortality due to illnesses associated with indoor air pollution (deaths per 100,000 population) To be determined To be determined EH-2 / T-2 / K-6 Percentage of children ages 1-5 with blood lead levels above internationally accept able levels 0% 0% Target 3: Improve scientific understanding of environmental health risks No pertinent KPIs Target 4: Build sustainable human and institutional capacity EH-2 / T-4 / K-1 Percentage increase in the number of indoor air quality experts in UAE with graduate level training 50% 100% EH-2 / T-4 / K-2 Percentage increase in the number of PhD-trained indoor air quality experts in the UAE government 25% 75% EH-2 / T-4 / K-3 Percentage of municipalities with expert indoor air services 50% 100% EH-2 / T-4 / K-4 Percentage increase in the number of building and construction management staff who are trained in indoor air quality 75% 100% Target 5: Support urban development that promotes environmental health EH-2 / T-5 / K-1 Percentage of UAE urban planning strategies and regulations that incorporate indoor air quality mitigation measures 50% 100% Target 6: Increase environmental awareness EH-2 / T-6 / K-1 Percentage of consumer products that may contribute to indoor air quality problems that are properly labeled 30% 100% EH-2 / T-6 / K-2 Percentage of consumers who can demonstrate understanding of warning labels on products that may cause indoor air problems 25% 75% EH-2 / T-6 / K-3 Percentage of the public who can demonstrate awareness of indoor air pollution risks 50% 100% EH-2 / T-6 / K-4 Percentage of population displaying avoidance behavior, such as staying indoors or avoiding outdoor exercise on high pollution days To be determined To be determined Section Overview # of Initiatives # of KPIs 26 20 TOTAL 9 5 Target 1 5 6 Target 2 4 0 Target 3 3 4 Target 4 2 1 Target 5 3 4 Target 6 34 Problem Overview Workers in many occupations are at risk of being exposed to various physical, chemical, and biological hazards that may lead to illness. Depending on the dose, the route and duration of exposure, and the chemi cal properties of the hazardous sub stance, exposures may lead to symp toms ranging from mild discomfort to debilitating conditions, even death. Sud den exposure to a large amount of a toxic compound may lead to acute poisoning, whereas chronic exposure to even trace amounts of other substances may cause se rious health effects such as cancer or repro ductive effects years after the exposure has ceased. Workers may also put their families at risk by carrying toxic substances to their homes on contaminated work clothes or vehicles (Curl et al. 2002; Thompson et al. 2003). Due to rapid economic growth and the related huge demand for labor, the work force in the UAE has been growing at an unforeseen rate in recent years. The vast number of development projects makes it challenging to ensure the health and safety of all workers. The UAE’s labor law, established in 1980, was modified in 2007 to update the penalties for violations. Except for that Occupational Exposures update, however, the law has changed little since 1980 and remains outdated in many respects. When compared with in ternational best practices and standards, the occupational exposure limits in the law are outdated. The law lacks the spe cial regulations needed to protect workers in high-risk occupations and does not provide for assessment and management of risks, including adverse health outcomes attributable to occupa tional exposures. In addition, as a result of insufficient capacity in both federal and local agencies, the law is enforced neither effectively nor consistently. Occupational health and safety (OHS) inspectors trained to monitor conditions and compliance with OHS regulations at workplaces are in short supply. In addition, due to a lack of person nel, equipment, and specific guidelines, the requirement for screening the health status of workers before, during, and after em ployment is not fulfilled as intended in the UAE’s labor law. Occupational illnesses, injuries, and deaths are seriously underestimated in the UAE because they may not be coded systematically as being work related. In addition, employers and hospitals are not required to document and report work-re lated incidents. Health-care facilities have a strong in centive not to document and report work related injuries and diseases to health insurance companies as being work re lated because such health outcomes are excluded from insurance claim reimburse ment (as in Abu Dhabi, for example). The health-care sector bears the majority of the costs of treating occupational diseases and injuries because many employers of injured workers fail to pay for treatment. In addition, injury and illness data are neither centrally stored nor exchanged among concerned authorities, which pre vents easy access for surveillance purpos es. The lack of reliable information on the prevalence of work-related illnesses ham pers the early detection of occupational ill nesses and the ability to link occupational exposures with adverse health outcomes. This, in turn, makes it challenging to hold employers liable for violating OHS regu lations. More information is also needed on the levels of occupational exposures at workplaces. This requires the development of industrial hygiene capacity within the UAE in both government and private com panies that can offer consulting services to industry. An accredited reference laborato ry capable of analyzing samples collected in occupational settings is also needed. • The importance of protecting the health and safety of the labor force is gaining recogni tion across different sectors in the UAE. New federal and local government regulations and projects are under way, as well as an increasing number of environmental and OHS programs in businesses, particularly in larger companies. The Ministry of Labor (MOL) has established new departments for environmental health and safety management and for occupational acci dents that will focus on improving occupational health and safety in the UAE. MOL is also in the process of preparing health and safety stan dards for workplaces. In addition, plans are in progress for new regulations of the construction industry to ensure better safety for workers and harsher penalties for companies that do not comply. Construction work is also prohibited during the hottest part of the day in the summer. Guidelines were recently passed to regulate the quarrying industry in an effort to reduce air pollution and noise. The enormous development boom in the UAE has placed a huge demand on MOL for workplace inspections, particularly at construc tion sites. Even though the shortage of trained labor inspectors is severe, the number of inspec tors has been increased and workshops are under way to educate the inspectors on basic hazard identification and the labor law. Training sessions have also been offered for farm laborers on the safe application of ag ricultural pesticides and associated risks. To de crease the use of harmful chemical pesticides, only approved pesticides can be used, and the government is promoting organic farming and research on biological pest control. Of the seven emirates, Abu Dhabi has taken the lead in raising awareness of OHS is sues. The Health Authority—Abu Dhabi (HAAD) has several projects under way to improve the safety of workers, including development of a program for the management of work in hot environments. Extreme summer heat in the UAE causes a significant health risk and affects a large number of outdoor workers, particularly in construction and in the oil and gas industries. Thus, HAAD is developing a heat-stress index and launching a heat-stress campaign to pro vide training materials and increase awareness of heat-related issues. HAAD is also developing guidelines for pre-employment and periodic health screening for workers in high-risk occupations and has drafted a policy to manage occupational and indoor air risks at health-care facilities. Another extensive initiative under way in Abu Dhabi emirate is the Environment, Health, and Safety Management System (EHSMS), which aims to ensure effective management and protection of the environment, human health, and worker safety through implementation of environmental guidelines across all major eco nomic sectors (EAD 2009b). • Main Achievements and Successes Priority Area 3: Occupational Exposures Main Unresolved and Emerging Issues The UAE federal labor law was amended in 2007, but the modifications concerned only penalties. The law lags behind international exposure standards and neither covers many of the hazardous substances present at work places nor sufficiently protects workers in high risk occupations (e.g., agriculture, construction). The legislation also lacks adequate compensa tion for work-related illnesses and injuries, and it covers only a small number of health conditions (such as poisonings) while excluding a wide range of work-related diseases (such as cancers and respiratory problems). Employers are not routinely held liable with penalties for violations of OHS regulations, and many fail to pay for worker treatment. The extremely fast rate of development, rapidly growing population, and unique com position of the labor force all pose challenges for ensuring workers’ health and safety in the UAE. Government agencies at the federal and local levels are understaffed and lack resourc es. Further, personnel trained in occupational health and safety and occupational hygiene 35 Recommendations 36 are needed in the numerous companies where workers are poten tially exposed to occupational hazards. Exposure and risk assess ment, hazard-control programs, and worker-education programs are more common in large international entities but are lacking in smaller local companies. Very limited information is available on hazardous workplace exposures and occupational illnesses and injuries in the UAE. Em ployers are not required to systematically monitor and report ex posures, and work-site inspections lag seriously behind the grow ing need. Inspectors trained in hazard identification, exposure and risk assessment, and the labor law are lacking. Also, even though the labor law indicates that employers who do not comply must face penalties, in practice employers are rarely penalized for vio lating regulations because enforcement is inconsistent. In addition to insufficient monitoring of conditions and man agement of risks at workplaces, occupational health-status screen ing of workers is inadequate, particularly for workers in high-risk occupations. The intended purpose of occupational health check is to ensure the worker is fit to perform the tasks safely and to detect any possible adverse health effects early. At present, how ever, the occupational health checks are used to screen workers for certain infectious diseases only to fulfill visa requirements for foreign workers. Follow-up periodic health screening is important but largely not undertaken. Health-care facilities lack personnel and equipment for health screening of workers, and occupation specific guidelines are nonexistent. Due to problems with recognition and coding of injuries and illnesses due to occupational exposures as being work related and a lack of injury surveillance and reporting programs, occupational illnesses and injuries are grossly underreported in the UAE. Under the current insurance and hospital cost-recovery scheme, employ ers are able to avoid liability for occupational illnesses and in juries, and the cost of medical treatment falls on the health-care system. The fact that occupational illnesses are not covered under the health-insurance system encourages the withholding of the true cause of work-related adverse health effects. The UAE has neither a national reference laboratory nor enough accredited private and public laboratories capable of analyzing environmental and biological samples collected in oc cupational settings. Occupational hygiene services are needed to help companies comply with requirements of law, particularly for smaller companies that may not have enough knowledge or resources themselves. In general, the larger emirates have more resources for promoting prevention of occupational illnesses and injuries, and their local OHS legislation may be ahead of that of other emirates. Overall, the labor law in its current form and lenient enforce ment do not adequately guarantee the health and safety of work ers in the UAE. In addition, the tendency to assign blame for acci dents and injuries discourages investigations to reveal root causes and reporting of true causes. In turn, failure to identify and report true causes of workplace illnesses, injuries, and fatalities hinders subsequent follow-up action to avoid repetition of such incidents. • To reduce the potential for health risks due to oc-cupational exposures, the UAE should: Reduce pollutant levels and human exposure to pollutants. Effective enforcement of occupational health and safety laws across the whole UAE is a key component of the strategy. A clearly defined federal body or system of local authorities should be estab lished to oversee the implementation of regulations and to promote occupational health and safety. Updating the UAE labor law is also critical. This includes revising the exposure limits to correspond with the latest science-based international occupa tional health and safety standards, and the iden tification and inclusion of hazards and high-risk oc cupations that are not currently covered by the law. Whistle-blower programs and up-to-date regulations for compensation for occupational illnesses, injuries, and fatalities should be incorporated into the law as well. Strict penalties for employers in violation of oc cupational health and safety laws should be enforced under the law. Compliance with occupational health and safety requirements needs to be monitored by regular in spections. This, in turn, requires developing a priority based inspection plan, increasing the number of prop erly trained inspectors, and educating inspectors in key areas such as hazard identification and exposure assessment as well as the requirements of the labor law. Developing a system to record inspection results, including violations observed and corrective actions taken, will allow fines and the cancellation of permits and commercial licenses to be used to force employ ers to comply with regulations. To control hazardous exposures at workplaces, employers should be required to conduct hazard identification as well as exposure- and risk-assess ment processes. Where these assessments reveal undue risk, employers should implement appropriate risk-management strategies. As part of a risk-based control program, employers should be required to provide information and training for employees on occupational hazards and appropriate control mea sures. Incentives should be provided to encourage monitoring and reporting of occupational exposures 37 and adverse health effects, and for organization of and participation in educational programs. Improve data quantity and availability. Reliable infor mation on the true incidence and prevalence of occupa tional diseases, injuries, and fatalities is the basis for direct ing protection measures at the right places and informing updates in policies, regulations, and guidelines to protect workers. Mandatory pre-employment and periodic health screenings should be performed and systematically docu mented based on occupation-specific guidelines, paying special attention to workers in high-risk occupations such as agriculture, construction, and mining. To facilitate sur veillance of work-related diseases, injuries, and fatalities, the health-care-facility-based reporting and surveillance system should be revised to better capture work-related conditions. It is important to teach health-care personnel how to correctly document causes and diagnoses of work related illness based on the new ICD-10 international diagnostic coding system, so that work-related adverse health effects can be linked with occupational exposures, to the extent possible. The exclusion of occupational injuries and diseases from health-insurance coverage needs to be addressed, with the costs being borne by employers of injured workers through a premium-based insurance system as opposed to being borne by the health-care system and workers, which is the current practice. Employers should also be required to have a reporting program in place for occupational ill nesses, injuries, and fatalities. A centralized system to store occupational exposure and health outcome data should be established. Improve scientific understanding of environmen tal health risks. Key problems in occupational settings can be identified by conducting monitoring and surveys, including hazard identification, risk assessment, and ex posure assessment. Reliable information on the levels of contaminants at workplaces is important for setting target levels, identifying the most effective control measures, and implementing occupational health and safety regulations. Build sustainable human and institutional capacity. Since occupational health and safety laws and regulations work as intended only if implemented and enforced ef fectively, capacity building is a critical part of the strategy. Recommendations An important goal is to increase the number of trained occupational health and safety personnel at both federal and local agencies and at workplaces where workers are potentially exposed to occupational hazards. This can be achieved by creating educational programs at various levels, such as graduate-level programs at universities and training opportunities for relevant government officials and small business managers. This is a rich area of capacity development for people in the UAE, with opportunities for new careers and advancement in an area of need that could help set a leading example for all Gulf Coopera tion Council countries. Certification programs should be developed for workers in high-risk jobs such as pesticide application, welding, and confined-space work. Occupational-health services should be available for companies, especially small ones, to help them comply with requirements for monitoring workplace exposures and reporting occupational illnesses, injuries, and fatali ties. An accredited national reference laboratory should be established, as should accredited public and private laboratories capable of analyzing samples collected in occupational settings. Support urban development that promotes environ mental health. No recommendations at this time. Improve environmental awareness. Awareness of oc cupational risks and the related health effects can improve commitment to prevention programs and provide guid ance in the selection of effective control measures. Increas ing such awareness among employers and employees is important. Workplace managers need to be visibly com mitted to minimizing occupational exposures, implement ing occupational health and safety programs, and promot ing safe working practices. Workshops and other training sessions should be offered for employers, occupational health and safety personnel, and workers in high-risk jobs. Additionally, educational materials should be distributed at workplaces and information made available online. To address these issues, the Ministry of Labor has established an awareness sector that holds lectures and workshops and distributes materials that promote occupational health and safety to both managers and employees. Overall, effective risk management and prevention of occupational illnesses, injuries, and fatalities are beneficial for both workers and employers. • Priority Area 3: Occupational Exposures 37 CAPTION HERE: This photograph needs a caption. Please write a caption here, approximately four lines long to fill this space. 38 39 Priority Area 3: Occupational Exposures Target 1: Reduce pollutant levels and human exposure to pollutants Stakeholders EH-3 / T-1 / I-1 Establish a clearly defined higher federal committee and local authorities (e.g., Occupational Health Authority of Abu Dhabi or Dubai) to regulate occupational health and safety (OHS) laws in the UAE. Emirate environment and health agencies MOEW MOH MOI 20142010 2011 2012 2013 MOL EH-3 / T-1 / I-2 Adopt nationwide the Environment, Health and Safety Management System (EHSMS) class 1 indicators adopted by Abu Dhabi (Code of Practice 15—Hazardous Materials, version 1.2, July 2009). In addition: • Identify and assess occupational health workplace hazards and develop a risk management system in line with international standards and best practices. • Implement risk management strategies and controls, applying hierarchy of control principles. • Conduct periodic review and monitoring of the effectiveness of applied occupational-health control measures. Emirate environment and health agencies, along with industry and labor representatives 20142010 2011 2012 2013 MOEW MOH MOL EH-3 / T-1 / I-3 Compare the UAE federal labor law with international standards, following the EHSMS regulatory framework. Revise the law as appropriate. In addition: • Establish new standards for exposures relevant to the UAE, where these do not exist presently under UAE law. • Consider developing one federal standard, as a minimum, which must be implemented in all emirates. • Consider the adoption of international occupational exposure standards and biological exposure indices, such as the American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit values, U.K. workplace exposure limits, and German Research Foundation (DFG) standards. Emirate environment and health agencies 20142010 2011 2012 2013 MOEW MOH MOL EH-3 / T-1 / I-4 Revise emirate laws regarding OHS and update annually; and harmonize federal and emirate regulations. Emirate environment and health agencies MOEW MOH MOI 20142010 2011 2012 2013 MOL EH-3 / T-1 / I-5 Implement, inspect, and enforce occupational exposure standards. Appropriate emirate agencies 20142010 2011 2012 2013 MOH MOL EH-3 / T-1 / I-6 Increase the size and competency of work-site inspection teams in relevant federal ministries and emirate authorities. Appropriate emirate agencies 20142010 2011 2012 2013 MOH MOI MOL Occupational Exposures (EH-3): Initiatives to Reduce the Burden of Disease Due to Occupational Exposures Section Overview # of Initiatives # of KPIs 43 34 TOTAL 19 15 Target 1 8 7 Target 2 1 1 Target 3 11 9 Target 4 0 0 Target 5 4 2 Target 6 MOEW MOL Ministry of Higher Education and Scientific Research Ministry of Education Ministry of Environment and Water Ministry of Health MOI Ministry of Interior Ministry of Labor Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: MHESR MOE MOH MOF Ministry of Finance 40 EH-3 / T-1 / I-7 Educate inspectors on basic occupational hygiene principles, hazard identification, occupational hygiene monitoring, risk assessment techniques, occupational exposure and indoor air quality standards, biological monitoring principles, biological exposure indices and standards, and labor law requirements (including reporting requirements for occupa tional health incidents). (This step may be facilitated by establishing accredited training programs.) Appropriate emirate agencies MOEW MOH MOL 20142010 2011 2012 2013 MHESR EH-3 / T-1 / I-8 Develop and implement a system to record the results of workplace inspections, observed violations, and actions taken by companies to correct violations. Consider a federal list of facilities with repeated violations and a procedure for removal of facilities from this list following adequate remedial action. Potentially restrict the issuance of government contracts for those in breach of regulations. Emirate environment and health agencies 20142010 2011 2012 2013 MOH MOI MOL EH-3 / T-1 / I-9 Develop and implement a system to record workplace accidents and injuries and to document actions taken by the company, employer, or entity to prevent them. Emirate environment and health agencies 20142010 2011 2012 2013 MOH MOL EH-3 / T-1 / I-10 Design an inspection plan with priorities based on a site-specific targeting program, focusing on high-risk industries, workplaces with a poor track record of accidents and illnesses, and those with poor compliance with notification or other OHS requirements. Emirate environment and health agencies 20142010 2011 2012 2013 MOH MOL EH-3 / T-1 / I-11 Develop a notification process for employee reporting of hazards and risks to work-site inspection teams. Emirate environment and health agencies 20142010 2011 2012 2013 MOH MOL EH-3 / T-1 / I-12 Provide training on hazards and risks in the workplace as well as take-home and other secondary exposures. Provide training on risk control measures according to the hierarchy of control and the use of personal protective equipment. Emirate environment and health agencies 20142010 2011 2012 2013 MOH MOL EH-3 / T-1 / I-13 Provide accessible health and safety information to employees. Emirate environment and health agencies 20142010 2011 2012 2013 MOH MOI MOL EH-3 / T-1 / I-14 Provide incentives for employers to encourage development and maintenance of worker training programs and appropriate safety measures to reduce worker exposures. Emirate environment and health agencies 20142010 2011 2012 2013 MOH MOI MOL EH-3 / T-1 / I-15 Implement, inspect, and enforce training and risk management control requirements. Link approval of a work process to provision of a training program, adequate engineering controls, and provision of personal protective equipment. Emirate environment and health agencies 20142010 2011 2012 2013 MOH MOL EH-3 / T-1 / I-16 Establish a system to review and compare compensation guidelines in the federal labor law with best practices. • Guidelines should cover compensation for lost wages, cost of medical treatment and rehabilitation, and permanent disability. • The initial accident inspection should be conducted by an independent work-site inspection team, e.g., MOL or appropriate local agencies. Emirate health agencies 20142010 2011 2012 2013 MOH MOL 41 Priority Area 3: Occupational Exposures EH-3 / T-1 / I-17 Conduct government-led economic assessment of revised financial compensation guidelines for occupational illnesses and injuries. 20142010 2011 2012 2013 MOF MOL EH-3 / T-1 / I-18 Implement, inspect, and enforce compensation requirements of the labor law. 20142010 2011 2012 2013 MOF MOL EH-3 / T-1 / I-19 Extend federal labor law penalties to violations of occupational health laws. Use inspections and audits to document violations and to apply, renew, and cancel permits. Appropriate emirate agencies 20142010 2011 2012 2013 MOL Target 2: Improve data quantity and availability Stakeholders EH-3 / T-2 / I-1 Develop OHS screening and/or surveillance standards for employees in specified occupations, and develop and register screening programs. • Programs should screen health before employment, periodically during employment, after sickness, and upon termination of employment, with a view to assessing impact on the safe performance of work. • Programs may include specific occupation-based screening and/or surveillance standards, beginning with those in high-risk occupations (e.g., workers exposed to noise, heat, or chemicals such as inorganic lead or asbestos). Appropriate emirate agencies 20142010 2011 2012 2013 MOH MOL EH-3 / T-2 / I-2 Implement, inspect, and enforce occupational-health screening and/or surveillance requirements of the UAE labor law. • Enforce mandatory health-screening and/or surveillance programs for workers. • Establish a system that allows follow-up of individual workers using a unique identifier (e.g., Emirates ID number). • Provide incentives for tracking and reporting employee health over time. • Conduct audits to ensure that relevant health screenings are conducted periodically. • Link approval process of workplace operating permits to maintenance of adequate health-screening programs in high-risk industries and workplaces. Appropriate emirate agencies 20142010 2011 2012 2013 MOH MOL EH-3 / T-2 / I-3 Implement a hospital-based work-related injury and illness identification and reporting program in each emirate. Educate health-care personnel on the importance of documenting the source and diagnosis of the illness so that it can be accurately coded. Appropriate emirate agencies 20142010 2011 2012 2013 MOH MOL EH-3 / T-2 / I-4 Revise hospital treatment cost-recovery schemes and insurance so that employers are held responsible for medical costs of work-related injuries and diseases. Appropriate emirate agencies 20142010 2011 2012 2013 MOH MOL Section Overview # of Initiatives # of KPIs 43 34 TOTAL 19 15 Target 1 8 7 Target 2 1 1 Target 3 11 9 Target 4 0 0 Target 5 4 2 Target 6 MOEW MOL MOI Ministry of Higher Education and Scientific Research Ministry of Education Ministry of Environment and Water Ministry of Health Ministry of Interior Ministry of Labor Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: MHESR MOE MOH MOF Ministry of Finance 42 EH-3 / T-2 / I-5 Establish standards for risk-based monitoring of occupational exposures by employer, or by government-approved consultants for employers that lack the capacity to do so themselves (e.g., small companies). Set up industrial hygiene services or accredited providers to help companies comply with this monitoring requirement. Appropriate emirate agencies 20142010 2011 2012 2013 MOH MOL EH-3 / T-2 / I-6 Conduct audits and inspections to ensure that risk assessments have been conducted and that exposure monitoring and appropriate hazard and risk management programs are in place. • Enforce penalties for violations of the law and/or codes of practice. • Provide incentives to encourage development and maintenance of monitoring programs. • Conduct random assessments of exposure levels in companies. • Link approval process to the presence and registration of a monitoring program. Appropriate emirate agencies 20142010 2011 2012 2013 MOH MOL EH-3 / T-2 / I-7 Periodically report lost time due to notifiable occupational diseases, injuries, and deaths to the entity established by EH-3 / T-1 / I-1 or to local health authorities. • Provide guidance to entities on what to report, set up OHS services to help companies comply with this reporting requirement, provide incentives to develop programs, and conduct audits to ensure programs are in place. • Link workplace operating-permit approval process to presence and registration of reporting program. Appropriate emirate agencies 20142010 2011 2012 2013 MOH MOL EH-3 / T-2 / I-8 Establish a centralized system for storing occupational exposure and periodic health screening and/or surveillance data (thus linking exposure monitoring results with health data). • Allocate funds to create cross-agency (health, environment, safety) division to store, maintain, and analyze data. • Allocate and train personnel. • Designate how data will be obtained from employers. • Pilot test the system. • Revise and scale up the system. Appropriate emirate agencies 20142010 2011 2012 2013 MOH MOL Target 3: Improve scientific understanding of human health risks Stakeholders EH-3 / T-3 / I-1 Establish baseline occupational exposure information for each sector (as defined in the Abu Dhabi EHSMS regulatory framework), and then set appropriate targets. Appropriate emirate agencies 20142010 2011 2012 2013 MOH MOL Target 4: Build sustainable human and institutional capacity Stakeholders EH-3 / T-4 / I-1 Conduct a needs assessment, and prepare a report on staffing and training needs related to OHS specialties in MOL, MOH, appropriate emirate agencies, and in the private sector. • Determine the type and number of industrial hygienists, occupational physicians, occupational health nurses, safety practitioners, and other OHS specialists needed in the UAE, in both the public and private sectors. • Form a committee from the responsible entities to delineate the types of positions, type of accreditation required, and accrediting organizations. Review needs annually (or at an appropriate frequency, to be determined). Emirate environment and health agencies, education authorities, universities and colleges 20142010 2011 2012 2013 MOH MOL EH-3 / T-4 / I-2 Develop OHS training programs for general physicians and other health-care personnel. Emirate environment and health agencies, education authorities, universities and colleges 20142010 2011 2012 2013 MOH MOL EH-3 / T-4 / I-3 Collaborate with local and foreign universities and other institutions to share research results and to develop special ized training programs. Emirate environment and health agencies, education authorities, universities and colleges 20142010 2011 2012 2013 MOH MOL 43 Priority Area 3: Occupational Exposures Section Overview # of Initiatives # of KPIs 43 34 TOTAL 19 15 Target 1 8 7 Target 2 1 1 Target 3 11 9 Target 4 0 0 Target 5 4 2 Target 6 EH-3 / T-4 / I-4 Increase awareness of these programs and potential OHS employment opportunities among prospective students. Emirate environment and health agencies, education authorities, universities and colleges 20142010 2011 2012 2013 MOH MOL EH-3 / T-4 / I-5 Designate funds from the emirates and the federal government for scholarships in OHS specialties. Emirate environment and health agencies, education authorities, universities and colleges 20142010 2011 2012 2013 MOH MOL EH-3 / T-4 / I-6 Determine what constitutes “credentialed” for occupational health purposes (e.g., only those with formal training, or those with more general training who could be grandfathered in with specified years of experience). Emirate environment and health agencies, education authorities, uni versities and colleges, the committee defined in EH-3 / T-1 / I-1 20142010 2011 2012 2013 MOH MOL EH-3 / T-4 / I-7 Increase number of staff with graduate-level training in OHS in MOL, MOH, and environment and health agencies in individual emirates. • Provide professional training opportunities in OHS for government personnel in relevant agencies. • Provide incentives for personnel to take OHS-related courses. Emirate environment and health agencies, education authorities, uni versities and colleges, the committee defined in EH-3 / T-1 / I-1 20142010 2011 2012 2013 MOH MOL EH-3 / T-4 / I-8 Develop a training center with government support or create capacity to train OHS personnel to assist companies in complying with OHS requirements. Emirate environment and health agencies 20142010 2011 2012 2013 MOH MOI MOL EH-3 / T-4 / I-9 Establish a whistle-blower protection law or regulations and programs to protect workers who report OHS violations to employers and regulatory agencies. Legislature, emirate environment and health agencies 20142010 2011 2012 2013 MOH MOL EH-3 / T-4 / I-10 Develop certification programs in workplace safety for workers in high-risk fields such as pesticide application, weld ing, and working in confined spaces. • Develop workshops and short courses. • Link certification with employee work permits and employer permits. Emirate environment and health agencies 20142010 2011 2012 2013 MOH MOI MOL MOEW MOL MOI Ministry of Higher Education and Scientific Research Ministry of Education Ministry of Environment and Water Ministry of Health Ministry of Interior Ministry of Labor Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: MHESR MOE MOH MOF Ministry of Finance 44 EH-3 / T-4 / I-11 Develop a nationally accredited environmental and occupational health reference laboratory for the UAE, and increase the number of private or public accredited laboratories capable of analyzing biological or environmental samples collected in occupational exposure settings. • Determine specific needs for laboratory services in each emirate. • Allocate funding and personnel for labs. • Establish fully functional reference laboratory for the UAE. Emirate environment and health agencies 20142010 2011 2012 2013 MOH MOL Target 5: Support urban development that promotes environmental health No recommendations at this time. Target 6: Increase environmental awareness Stakeholders EH-3 / T-6 / I-1 Develop OHS materials such as posters, leaflets, Web sites, and videos relevant to the issues and culture of the UAE; distribute at workplaces. Emirate environment and health agencies 20142010 2011 2012 2013 MOH MOI MOL EH-3 / T-6 / I-2 Provide workshops or short courses on OHS for employers, OHS personnel, and high-risk workers. Emirate environment and health agencies, universities, training organizations 20142010 2011 2012 2013 MOH MOI MOL EH-3 / T-6 / I-3 Require companies to register with a regulatory agency (e.g., HAAD) to receive information packages (e.g., training manuals on working in heat) so that the potential impact can be measured. Emirate environment and health agencies, universities, training organizations 20142010 2011 2012 2013 MOH MOL EH-3 / T-6 / I-4 Develop OHS educational programs in secondary schools, colleges, and universities. 20142010 2011 2012 2013 MOE MHESR 45 Priority Area 3: Occupational Exposures Section Overview # of Initiatives # of KPIs 43 34 TOTAL 19 15 Target 1 8 7 Target 2 1 1 Target 3 11 9 Target 4 0 0 Target 5 4 2 Target 6 Occupational Exposures (EH-3): Key Performance Indicators KPI No. Description 2014 Goal 2030 Goal Target 1: Reduce pollutant levels and human exposure to pollutants EH-3 / T-1 / K-1 Number and percentage of entities using required risk assessment process required of employers: 1. Number of emirate governments 2. Percentage of emirate government entities 3. Percentage of regulated facilities that meet standard, by emirate, in all employ ment sectors including health, transport, industry, tourism, oil and gas, building and construction, waste, agriculture, and mining / quarrying 1. 3-4 2. 100% in 3-4 emirates 3. 25% in 3-4 emirates 1. All emirates 2. 100% 3. 70% EH-3 / T-1 / K-2 Government entities that have revised occupational exposure limits and that are imple menting these limits: 1. Federal government 2. Number of emirate governments 3. Percentage of emirate governments implementing standards in policy 1. Yes 2. 3-4 3. 100% in 3-4 emirates 1. Yes 2. All emirates 3. 100% EH-3 / T-1 / K-3 Percentage of regulated facilities that meet the new occupational exposure standards, by emirate, in all employment sectors 25% in 3-4 emirates 70% EH-3 / T-1 / K-4 Number of emirates providing and maintaining evidence of risk-based employee train ing, instruction, and information on occupational hazards 3-4 All emirates EH-3 / T-1 / K-5 Percentage of emirate government entities providing and maintaining evidence of risk based employee training, instruction, and information on occupational hazards 100% in 3-4 emirates 100% EH-3 / T-1 / K-6 Percentage of employers of regulated facilities that provide and maintain evidence of risk-based employee training, instruction, and information on occupational hazards 25% in 3-4 emirates 70% EH-3 / T-1 / K-7 Percentage of regulated facilities in each employment sector (e.g., health, transport, etc., as specified above) with risk-based control program in place (e.g., through EHSMS) 20% in each sector 70% in each sector EH-3 / T-1 / K-8 Number of work-site inspections conducted (for each type of regulated facility) per year To be determined To be determined EH-3 / T-1 / K-9 Percentage of occupational health and safety violations adequately addressed within one year, by employment sector and emirate 20% 70% EH-3 / T-1 / K-10 Percentage of regulated facilities that exceed occupational exposure limits per year, by employment sector and emirate <70% <20% EH-3 / T-1 / K-11 Percentage of facilities with any employee exceeding biological exposure indices, by employment sector and emirate <70% <20% EH-3 / T-1 / K-12 Percentage of regulated facilities that meet biological exposure indices standard, by sector and emirate 20% 70% MOEW MOL MOI Ministry of Higher Education and Scientific Research Ministry of Education Ministry of Environment and Water Ministry of Health Ministry of Interior Ministry of Labor Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: MHESR MOE MOH MOF Ministry of Finance 46 KPI No. Description 2014 Goal 2030 Goal EH-3 / T-1 / K-13 Incidence of total reportable cases of injury or illness by sector, based on interna tional benchmarks (8.8 per million worker hours for Australia and 13.1 for the United States, including fatalities and nonfatalities; 6.6 for the United Kingdom, including only nonfatalities) To be determined 10 per million worker hours per year (international benchmark) EH-3 / T-1 / K-14 Federal labor law revised to incorporate international standards for compensation of work-related illnesses, injuries, and fatalities Yes Yes EH-3 / T-1 / K-15 Statutory authority extended to include penalties for violation of occupational health laws Yes Yes Target 2: Improve data quantity and availability EH-3 / T-2 / K-1 Percentage of emirate governments and emirate government entities with potential workplace hazards that have pre-employment and periodic health screening programs for workers in place, by emirate 100% in 3-4 emirates 100% EH-3 / T-2 / K-2 Percentage of regulated facilities that meet requirements for pre-employment and periodic health screenings of workers, by sector and emirate 25% in 3-4 emirates 70% in all emirates EH-3 / T-2 / K-3 Percentage of health-care facilities adopting ICD-10 coding to attribute illnesses, injuries, and deaths to workplace exposures / hazards, specified according to the fol lowing categories of facility: (a) public hospitals, (b) private hospitals, and (c) all other health-care facilities 25% 100% EH-3 / T-2 / K-4 Percentage of companies with a risk-based occupational exposure monitoring program that is registered with local and federal authorities To be determined To be determined EH-3 / T-2 / K-5 Percentage of emirate government entities with a program for reporting workplace health incidents (injuries and illnesses) 100% in 3-4 emirates 100% in all emirates EH-3 / T-2 / K-6 Percentage of regulated facilities with a program for reporting workplace health inci dents (injuries and illnesses), by employment sector and emirate 25% in 3-4 emirates 70% in all emirates EH-3 / T-2 / K-7 Number of emirates with a centralized occupational health data system 2 All emirates Target 3: Improve scientific understanding of environmental health risks EH-3 / T-3 / K-1 Annual funding for occupational health research for each major employment sector To be determined To be determined Target 4: Build sustainable human and institutional capacity EH-3 / T-4 / K-1 Number of dedicated government positions requiring OHS-credentialed employees, by year, for the following categories: 1. Occupational medicine 2. OHS 3. Industrial hygiene 4. Workplace inspection To be determined To be determined EH-3 / T-4 / K-2 Number of accredited UAE-based graduate OHS training programs, in the following areas: 1. Occupational medicine 2. OHS 3. Industrial hygiene 4. Workplace inspection To be determined To be determined EH-3 / T-4 / K-3 Number of graduates from UAE-based graduate-level OHS training, in each of the following areas: 1. Occupational medicine 2. OHS 3. Industrial hygiene 4. Workplace inspection To be determined To be determined 47 Section Overview # of Initiatives # of KPIs 43 34 TOTAL 19 15 Target 1 8 7 Target 2 1 1 Target 3 11 9 Target 4 0 0 Target 5 4 2 Target 6 KPI No. Description 2014 Goal 2030 Goal EH-3 / T-4 / K-4 Number of scholarships granted for OHS-related study To be determined To be determined EH-3 / T-4 / K-5 Number of credentialed government OHS employees in federal, emirate, and emirate entity positions, for each of the following employment categories: 1. Occupational medicine 2. OHS 3. Industrial hygiene 4. Workplace inspection To be determined To be determined EH-3 / T-4 / K-6 Percentage of high-risk workers who receive required training (including introductory and refresher training) related to relevant specific hazards for each of the following categories of employers: 1. Federal government 2. Emirate government 3. Emirate government entity 4. Regulated facility (by employment sector and emirate) Increasing trend Increasing trend EH-3 / T-4 / K-7 Number of emirates with occupational whistle-blower programs To be determined All emirates EH-3 / T-4 / K-8 Establishment and enforcement of worker safety certification programs: 1. Number established, federal government 2. Percentage enforcement, federal government 3. Number established in each emirate 4. Percentage enforcement in each emirate To be determined 1. To be determined 2. To be determined 3. To be determined 4. To be determined EH-3 / T-4 / K-9 Accredited national reference laboratories established with the following specific capabilities: 1. Occupational medicine 2. Industrial hygiene 3. Environmental health 1-3: Yes 1-3: Yes Target 5: Support urban development that promotes environmental health No pertinent KPIs Target 6: Increase environmental awareness EH-3 / T-6 / K-1 Number of government OHS initiatives, programs, or awareness campaigns conducted per year by: 1. The federal government 2. Emirate governments 3. Emirate government entities 1. 2 2. 2 3. 2 1. 2 2. 2 3. 2 EH-3 / T-6 / K-2 Percentage of the workforce that can demonstrate awareness or other desired out comes (e.g., behaviors) associated with OHS To be determined 100% Priority Area 3: Occupational Exposures 48 Climate Change Problem Overview Climate change is an important and long-term global problem associated with greenhouse gas (GHG) emissions from energy use, industrial processes, transportation, agriculture, land-use change, and waste management. This extremely complex problem has large variations in its regional sources and impacts. Be cause the UAE is hot and arid, expected changes in the climate may be particularly important. The Intergovern mental Panel on Climate Change (IPCC) projects that average surface temperatures in the Arabian Peninsula region will likely increase 1-2°C by 2030—2050, with increases predicted in winter regional precipitation lev els as well (Watson et al. 1997). Future climate change will have a variety of impacts in the UAE, but few of these impacts can be precisely estimated because regional data and models on climate change impacts for the UAE are limited and require fur ther study. Significant influences on human health could include an increase in mortality and morbidity due to increased drought, increased frequency and intensity of heat waves, a rise in sea level, and potential changes in disease vector ecology (Campbell-Lendrum and Wood ruff 2007). Climate change will also be an important influence on water resources through changes in precipi tation, increased evaporation, and the increased salinity of groundwater near the coast, affecting natural ecosys tems and agriculture. Further, as development along the coast continues, coastal infrastructure will be increas ingly vulnerable to a future rise in sea level. Because the climate change problem is caused by global GHG emissions, the UAE cannot fully decrease climate change impacts by reducing its own emissions. The UAE will need to continue to work with other nations to reduce global emissions. Future climate change is in evitable, so it is important for the UAE to plan effectively to anticipate and adapt to impending change. • 49 Priority Area 4: Climate Change The UAE is already a participant in in-ternational efforts to address climate change. It has signed the United Nations Framework Convention on Climate Change (UNFCCC) and participates in the Kyoto Protocol. The UAE ratified the UNFCCC in 1995 and has submitted one national communication as part of its obligations under this treaty. The country ratified the Kyoto Protocol in January 2005, though it is not subject to binding targets due to its non–Annex-I status. The UAE has also been a recipient of foreign investment to reduce GHG emissions through the Clean Devel opment Mechanism of the Kyoto Protocol. Efforts to reduce desertification help reduce the impacts of climate change. The UAE issued the National Action Program Main Achievements and Successes and Strategy for Combating Desertification in 2003 (UAE Ministry of Energy 2006). The government has invested in planting mangrove forests along the coastline and subsidizes the planting of new trees by Emi ratis. The UAE also has launched numerous initiatives to reduce energy consumption. It hosted the first World Summit on Energy for the Future in January 2008. Abu Dhabi has been a leader in promoting the deve lopment of energy-conserving technology with its multibillion dollar Masdar initia tive, part of which includes Masdar City. This 50,000-person city is intended to be the world’s first carbon-neutral city pow ered by solar, wind, and other alternative power sources (Craft 2008). Abu Dhabi has also announced a $15 billion initiative to develop clean energy technologies using hydrogen. In addition, Abu Dhabi’s forthcoming energy policy includes a target of 7% renewable energy use by 2020, and Abu Dhabi has launched a green building initiative, Estidama (EAD 2009a). EAD’s forthcoming Abu Dhabi Climate Change Policy exemplifies the ini tiatives of the emirate toward reducing the rate of global warming. Dubai has recently implemented pro gressive policies, including building codes to conserve energy, incrementally higher pricing for water and electricity, solar-pow ered parking meters, and a green building initiative (Kazim 2007). • Greenhouse-gas emissions are likely to continue to grow as the UAE popula tion and economy grow. The UAE has not adopted a binding economy-wide target for emission reductions. In order to develop appropriate poli cies, the UAE will need an accurate and detailed inventory of its current sources and sinks of GHGs. The existing GHG inven tory in the UAE, from 1994 (UAE Ministry of Energy 2006), is outdated. Many of the emissios estimates from the 1994 inventory were based on international emissions fac tors, such as from the IPCC, rather than on UAE-specific factors. The post–Kyoto-Protocol era of inter national climate policy is quickly emerging, and the UAE must be prepared to be an effective participant in these negotiations. An up-to-date, accurate GHG emissions in ventory is imperative to support the UAE’s Main Unresolved and Emerging Issues participation. Such an inventory will allow the UAE to determine effective and realis tic targets for its own GHG emissions, as well as to help shape effective international GHG emissions targets. The UAE’s initial communication (2006) to the UNFCCC recommends that these data quality issues be addressed through strengthening institutional capac ity, developing local emission factors, and reducing information gaps for the energy, industrial, agriculture, waste, land-use change, and forestry sectors. Information gaps about the emissions sources for each emirate are also significant. While the UAE’s total GHG emissions are lower than in many countries, the UAE has the second highest per-capita GHG emissions in the world, partly due to the country’s high rates of energy use for water desalination and other activities (Baumert, Herzog, and Pershing 2005). Effective greenhouse gas mitigation strategies will need to address these underlying trends of high rates of energy use and per-capita emissions. Because the public may have limited awareness of the climate change problem, educational strategies will be im portant in encouraging both mitigation and adaptation. A global response to climate change will likely have a significant impact on oil-producing nations, including the UAE. Although the UAE has been diversifying its economy for several decades to avoid relying solely on revenue from fossil fuel ex ports, global GHG mitigation actions will likely reduce fossil fuel consumption and negatively impact the national economy. Planning for these global changes will be an important part of a long-term national climate-change strategy. • Recommendations Solving the climate change problem will require mitigation measures to stabilize global atmospheric GHG concentra tions as well as adaptation measures to reduce the effects of climate change that will occur in the emirates. To develop a successful mitigation and adaptation strategy, the UAE must: Reduce GHG emissions. Increasing energy efficiency, in creasing the market share of clean energy sources, decreasing GHG emissions from the transportation sector, and develop ing and implementing carbon capture and sequestration tech nology will all help reduce total GHG emissions. Worldwide, the primary source of GHG emissions is the extraction and combustion of fossil fuels. The UAE can directly reduce GHG emissions by substituting renewable energy sources for natu ral gas or oil combustion. In this regard, the UAE has shown leadership in some forward-looking and high-profile actions to reduce emissions, such as through the development of Masdar City. The UAE should continue to implement renewable energy projects and support further research and development on these technologies, as this will lead to growth in the energy sector. The UAE has only recently begun to implement energy conservation and efficiency measures and should continue these efforts, especially in the industrial sector and in desalina tion plants because energy use in these sectors accounts for 95% of the UAE’s GHG emissions (UAE Ministry of Energy 2006). The UAE can play an important role in international nego tiations on climate change, which are now focusing on binding emissions reductions for the post–Kyoto-Protocol period after 2012. In particular, the UAE can take a leading role in reduc ing emissions, as its per-capita GHG emissions are currently among the highest in the world (Baumert, Herzog, and Persh ing 2005). The Abu Dhabi Climate Change Policy already calls for a GHG registry system to track, monitor, and raise awareness of GHG emissions. The UAE should also explore the possibility of making a public commitment to reduce GHG emissions. Although the UAE is not required to make reduc tions under existing international climate agreements, a bind ing commitment to reduce emissions would demonstrate strong leadership and a forward-thinking approach to addressing this critical issue. Improve data quantity and availability. An accurate inven tory of the UAE’s GHG emissions is the key ingredient needed to guide future climate change strategies in the UAE. The seven emirates vary significantly in terms of population, develop 50 51 ment, local circumstances, and resources, implying intranational variation in the sources and impacts of climate change in the UAE. In order for a mitigation and adaptation strategy to be effective, it is essential to consider these regional variations in the development of climate change policies. Therefore, while a national GHG inventory is critical, GHG inventories should be emirate-specific as well. Once an appropriate system is in place to conduct accu rate GHG inventories, updating emissions data annually will permit the UAE to track the progress and success of policy measures. In addition, an increase in available climate change data specific to the UAE will improve the accuracy of emissions estimates. This system would encourage the development of a GHG registry and software to assist in tracking GHG emissions. Improve scientific understanding of environmental health risks. An important first step toward adapting to climate change will be to conduct a dedicated study of how global climate change will impact the UAE——an analysis that should be coordinated and undertaken by the federal government. It is essential that the UAE begin now to actively anticipate the consequences of global climate change and to adapt to them, in order to reduce the impacts and costs. Once climate change impacts are better understood, additional adaptation policies can be explored and implemented. For example, an expanded health infrastructure is one key priority for adapting effective ly to climate change. Actions should be taken to improve the overall understanding of how climate change will affect human health, including improving the monitoring of conditions likely to result from climate change; educating health-care professionals on climate-related health impacts; and identifying priority ac tions for health protection, disease prevention, and health-care infrastructure to address climate-related health impacts. A sys tem for early warning and effective protection against extreme heat waves, for instance, is one highly recommended measure to decrease heat-related illnesses. Water availability is a critical issue in the UAE, and water supply may be impacted by accelerated global warming. Some regional climate models predict that the Arabian Peninsula may experience slightly increased precipitation as a result of climate change (Watson et al. 1997), whereas other models project decreased precipitation. These effects have not been precisely estimated for the UAE. Consequently, it will be important to study the expected impacts on national water supply in more detail, continuing the efforts of the Climate Change Impact Study on Water Resources in Abu Dhabi. Water conservation Recommendations can help reduce vulnerability through implementing water ef ficiency measures, increasing public awareness, and water pric ing policies. Water conservation will help prepare the nation in the event that climate change decreases water supply, and it will help mitigate climate change by using less energy for de salination plant operations. Build sustainable human and institutional capacity. Build ing institutional capacity and interorganizational cooperation is important to facilitate updating and maintenance of the UAE’s GHG inventory. The UAE can also increase research on carbon capture and sequestration (CCS) technology. Globally, only a few demonstration CCS projects exist, but this technology has the potential to grow rapidly. In the UAE, CCS could take the form of using CO 2 for enhanced oil recovery to increase ex traction of oil from existing wells through injection. New power plants could be designed and built to allow for future CCS. Support urban development that promotes environmen tal health. The transportation sector in the UAE is steadily expanding and is likely to be an even larger source of GHG emissions in the future. Strengthening fuel efficiency standards, increasing mass transportation, switching fuels to varieties with lower GHG emissions, and discouraging driving via congestion pricing are all policy tools that could reduce GHG emissions from transportation. The UAE can also adopt policies to assist with adaptation to the economic and social impacts of climate change. These would include building farther away from the coast, planning now for the consequences of an increase in sea level in the emirates’ extensive seaside urban areas and infrastructure, and modifying the built environment to reduce the heat island effect. Developing methods for ranking the cost and benefits of mitiga tion and adaptation measures, including public investment costs as well as GDP impacts and externalities, will provide essential support for cost-effective action against climate change. Improve environmental awareness. Public awareness cam paigns can be a catalyst for measures to mitigate and adapt to climate change. Energy conservation programs to raise public awareness as well as energy pricing to encourage conservation are highly recommended. The government can also improve en ergy efficiency through mandated energy efficiency standards in building construction, appliances, and air conditioners, both in homes and in larger commercial, office, and multifamily resi dential buildings. • Priority Area 4: Climate Change 51 52 Target 1: Reduce GHG emissions Stakeholders EH-4 / T-1 / I-1* Convene technical committee to oversee climate change policy. Appropriate emirate agencies 20142010 2011 2012 2013 MOEW EAD EH-4 / T-1 / I-2 Commission climate change adaptation plan for the entire UAE, with additional adaptation plans for specific emirates. Committee created by EH-4 / T-1 / I-1, appropriate emirate agencies 2010 ? MOEW EH-4 / T-1 / I-3 Develop early warning systems for heat episodes, using improved meteorological data collection and prediction. Emirate and municipal agencies 2010 ? MOH EH-4 / T-1 / I-4* Create plans to ensure water availability under future climate change, particularly in areas relying on groundwater. Appropriate emirate agencies 20142010 2011 2012 2013 ADWEAMOEW EH-4 / T-1 / I-5* Develop plans for coastal development, accounting for future climate change. 2010 ? MOEW EAD UPC EH-4 / T-1 / I-6 Develop nationally coordinated policies and regulations for the management of sensitive ecosystems, accounting for future climate change. Appropriate emirate agencies 2010 ? MOEW EH-4 / T-1 / I-7* Develop an emergency plan for coastal areas. Appropriate emirate agencies 2010 ? MOEW EH-4 / T-1 / I-8* Commission a comprehensive energy supply and GHG mitigation plan for the UAE, including delineation of federal and emirate responsibilities. Committee created by EH-4 / T-1 / I-1, energy agencies 2010 ? MOEW EH-4 / T-1 / I-9 Accept binding GHG reduction targets that specify the amount of reduction and target date, for the entire economy or for particular sectors, subject to the availability of emissions inventories of sufficient quality. Industry 2010 ? ADNOCMOEW EH-4 / T-1 / I-10 Consider cap-and-trade program to reduce carbon emissions, subject to the availability of emissions inventories of sufficient quality. Industry 2010 ? ADNOCMOEW EH-4 / T-1 / I-11 Reduce subsidies for electric power, gasoline, and diesel, possibly in phases. Energy agencies 2010 2011 2012 2013 2015 MOEW Climate Change (EH-4): Initiatives to Reduce the Burden of Disease Due to Global Climate Change Note that Target 1 is worded differently for this priority area. 53 Priority Area 4: Climate Change EH-4 / T-1 / I-12 Establish standards for energy-efficient products (e.g., lighting, air conditioning, appliances). 20142010 2011 2012 2013 To be determined EH-4 / T-1 / I-13 Establish and/or tighten fuel-efficiency standards for vehicles. To be determined 20142010 2011 2012 2013 ADNOC EH-4 / T-1 / I-14* Investigate opportunities for carbon capture and sequestration (CCS) technology, including enhanced oil recovery. To be determined 2010 OngOing ADNOC EH-4 / T-1 / I-15 Plan the construction of new power plants to allow the future addition of CCS technology. To be determined 2010 OngOing ADNOC EH-4 / T-1 / I-16* Introduce a renewable portfolio standard for electricity generation, mandating a fraction of power to be generated from renewable sources (e.g., wind, solar). Emirate and local energy agencies, other appropriate emirate agencies 20142010 2011 2012 2013 MOEW EH-4 / T-1 / I-17 Provide subsidies as an incentive for renewable power generation (e.g., wind, solar). 2010 ? Emirate and local energy agencies EH-4 / T-1 / I-18* Promote microgeneration by setting targets for small-scale renewable power production and household adoption of other renewable energy technology such as solar water heaters and solar cooling. 20142010 2011 2012 2013 Emirate and local energy agencies EH-4 / T-1 / I-19 Establish a feed-in tariff system to pay for home power generation. 2010 ? Emirate and local energy agencies EH-4 / T-1 / I-20* Establish green building standards in all emirates. Environment and urban planning agencies 20142010 2011 2012 2013 UPC EH-4 / T-1 / I-21 Provide subsidies and/or awards for green building construction. Environment and urban planning agencies 2010 ? UPC *Included in Abu Dhabi Climate Change Policy Section Overview # of Initiatives # of KPIs 45 16 TOTAL 26 5 Target 1 5 1 Target 2 7 1 Target 3 3 3 Target 4 1 2 Target 5 3 4 Target 6 ADWEA EAD Khalifa Masdar Emirates Abu Dhabi Water and Electricity Authority Environment Agency—Abu Dhabi Emirates Foundation Khalifa Foundation Abu Dhabi Future Energy Company Ministry of Education Ministry of Environment and Water Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: MOE MOFHAAD Health Authority—Abu Dhabi UPC NILU MOH Ministry of Finance Ministry of Health Norwegian Institute for Air Research Urban Planning Council MOEW ADNOC Abu Dhabi National Oil Company 54 EH-4 / T-1 / I-22 Implement the Masdar City initiative. 2010 2011 2012 2013 2016 Masdar EH-4 / T-1 / I-23* Improve the efficiency of power generation and water desalination. 2010 OngOing Emirate-level water and electricity authorities EH-4 / T-1 / I-24 Identify and implement actions that will be particularly effective at reducing emissions of both air pollutants and green house gases. 2010 ? To be determined EH-4 / T-1 / I-25 Submit the Second National Communication to the United Nations Framework Convention on Climate Change. 20142010 2011 2012 2013 Committee created by EH-4 / T-1 / I-1 EH-4 / T-1 / I-26 Engage positively in international negotiations on possible post–Kyoto-Protocol international agreements. 2010 OngOing To be determined Target 2: Improve data quantity and availability Stakeholders EH-4 / T-2 / I-1* Develop GHG registry system for all major sources of GHG emissions for each emirate and for the entire UAE. Committee created by EH-4 / T-1 / I-1, appropriate local agencies 20142010 2011 2012 2013 MOEW EH-4 / T-2 / I-2 Construct/improve UAE national carbon accounting (GHG registry) by designating responsible parties in each agency. Emirate environment agencies 20142010 2011 2012 2013 MOEW EH-4 / T-2 / I-3* Design and develop a software tool to be shared across all emirates that can be used by emitters to track and report GHG emissions. Appropriate emirate agencies 20142010 2011 2012 2013 MOEW EH-4 / T-2 / I-4* Publicize GHG registry/emissions data, at least for largest emitters. 2010 OngOing20132011 2012 To be decided EH-4 / T-2 / I-5 Complete an updated comprehensive national GHG emissions inventory, including all relevant sources, and make this available to the public. Committee created by EH-4 / T-1 / I-1 20142010 2011 2012 2013 MOEW NILU Target 3: Improve scientific understanding of environmental health risks Stakeholders EH-4 / T-3 / I-1 Commission and perform studies in the UAE to determine actions that will reduce vulnerabilities to climate change, using the Stockholm Environmental Institute’s work for the UAE as starting point. Committee created by EH-4 / T-1 / I-1 2010 ? MOEW 55 EH-4 / T-3 / I-2 Commission studies on the threats of climate change to human health, to include suggested priority actions for health care and other urban infrastructure. Universities, consultants, emirate environment agencies 20142010 2011 2012 2013 HAAD UPC EH-4 / T-3 / I-3 Fund research and development of new energy technologies with lower GHG emissions, including renewable energy sources (e.g., solar), efficiency improvements, and carbon capture and sequestration. MasdarMOE MOF 2010 ? KhalifaEmirates EH-4 / T-3 / I-4 Conduct evaluations of adaptation and mitigation options (e.g., costs and benefits), and rank in terms of feasibility. 20142010 2011 2012 2013 To be determined EH-4 / T-3 / I-5* Commission improvements to meteorological prediction capabilities, including regional scale studies of the effects of climate change. Appropriate emirate agencies, other Gulf Cooperation Council nations 2010 ? MOEW EH-4 / T-3 / I-6 Disseminate meteorological prediction and studies of the effects of climate change to federal, emirate, and local agen cies for developing adaptation plans. Appropriate emirate agencies, other Gulf Cooperation Council nations 2010 ? MOEW EH-4 / T-3 / I-7 Designate emirate-level committees to explore and oversee government research and development funding for low carbon technologies. 2010 ? To be determined Target 4: Build sustainable human and institutional capacity Stakeholders EH-4 / T-4 / I-1 Develop governmental capabilities to coordinate actions to address air quality and climate change, and evaluate strategies’ cost effectiveness for addressing both problems. 2010 ? To be determined EH-4 / T-4 / I-2* Develop new office for climate change mitigation and adaptation within the federal and emirate governments. Link cli mate change centers in emirate agencies to other relevant agencies (e.g., transport, energy) through official channels. Emirate environment agencies 20142010 2011 2012 2013 MOEW Priority Area 4: Climate Change *Included in Abu Dhabi Climate Change Policy Section Overview # of Initiatives # of KPIs 45 16 TOTAL 26 5 Target 1 5 1 Target 2 7 1 Target 3 3 3 Target 4 1 2 Target 5 3 4 Target 6 ADWEA EAD Khalifa Masdar Emirates Abu Dhabi Water and Electricity Authority Environment Agency—Abu Dhabi Emirates Foundation Khalifa Foundation Abu Dhabi Future Energy Company Ministry of Education Ministry of Environment and Water Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: MOE MOFHAAD Health Authority—Abu Dhabi UPC NILU MOH Ministry of Finance Ministry of Health Norwegian Institute for Air Research Urban Planning Council MOEW ADNOC Abu Dhabi National Oil Company 56 EH-4 / T-4 / I-3 Establish curriculum and certification programs on climate change in relevant professional education programs. 2010 ? Universities Target 5: Support urban development that promotes environmental health Stakeholders EH-4 / T-5 / I-1 Convene a UAE working group on carbon-reducing urban planning options to share and disseminate knowledge across emirates and cities. 2010 ? Federal government (e.g., Higher Committee on Climate Change) Target 6: Increase environmental awareness Stakeholders EH-4 / T-6 / I-1 Establish consumer labeling system to identify efficient appliances for energy use and life-cycle emissions. 2010 ? Appropriate federal and local agencies EH-4 / T-6 / I-2 Establish residential-, commercial-, and industrial-building energy audit programs in all emirates. 2010 ? To be determined EH-4 / T-6 / I-3* Design and develop public awareness campaigns at the emirate level on climate change risks and individual mitiga tion strategies. Campaign materials should be based on surveys that identify key gaps in public understanding of climate change issues. 2010 OngOing To be determined *Included in Abu Dhabi Climate Change Policy Climate Change (EH-4): Key Performance Indicators KPI No. Description 2014 Goal 2030 Goal Target 1: Reduce greenhouse-gas (GHG) emissions and adapt to global warming EH-4 / T-1 / K-1 Total amount of GHG (CO 2 equivalent) emissions from energy production and use: 1. Total CO 2 production 2. Carbon intensity To be determined To be determined EH-4 / T-1 / K-2 Percentage of obligations achieved under the United Nations Framework Convention on Climate Change (UNFCCC) To be determined 100% EH-4 / T-1 / K-3 Total amount of electricity generated by renewable and low-carbon1 sources: 1. Total renewable generation 2. % of total power generation To be determined 1. To be determined 2. 10% EH-4 / T-1 / K-4 Percentage of newly constructed commercial buildings that meet or exceed green building standards per year: 1. Total for UAE 2. By emirate To be determined To be determined EH-4 / T-1 / K-5 Rates of heat-related cases and fatalities To be determined To be determined 57 KPI No. Description 2014 Goal 2030 Goal Target 2: Improve data quantity and availability EH-4 / T-2 / K-1 GHG inventory coverage: 1. Number of emirates covered 2. Percentage of sectors covered by emirate 3. Number of major GHGs2 included in inventory 4. Frequency of public reporting 1. To be determined 2. 50% 3. To be determined 4. To be determined 1. All emirates 2. 100% 3. To be determined 4. Annually Target 3: Improve scientific understanding of environmental health risks EH-4 / T-3 / K-1 Funding per year for research into carbon-reducing technologies by emirate: 1. Total 2. As a percentage of all energy research and development funding To be determined To be determined Target 4: Build sustainable human and institutional capacity EH-4 / T-4 / K-1 Percentage of students who can demonstrate awareness of climate change (by level of education) To be determined To be determined EH-4 / T-4 / K-2 Percentage of health-care workers who can demonstrate awareness of potential health impacts To be determined To be determined EH-4 / T-4 / K-3 Number of emirates with climate change adaptation plans 4 All emirates Target 5: Support urban development that promotes environmental health EH-4 / T-5 / K-1 Cities per emirate with plans addressing adaptation to climate change To be determined To be determined EH-4 / T-5 / K-2 Cities per emirate with plans addressing mitigation options for climate change To be determined To be determined Target 6: Increase environmental awareness EH-4 / T-6 / K-1 Number of products that have CO 2 emissions labeling, including upstream and down stream emissions To be determined To be determined EH-4 / T-6 / K-2 Percentage of products with efficiency ratings labeling (e.g., energy factor) To be determined To be determined EH-4 / T-6 / K-3 Number of completed energy audits: 1. Residential 2. Commercial 3. Industrial To be determined To be determined EH-4 / T-6 / K-4 Percentage of the public aware of climate change risks and the link between GHG emissions and climate change To be determined To be determined 1 E.g., wind, solar, ocean-based, nuclear 2 Carbon dioxide, methane, nitrogen oxides, hydrofluorocarbons, perfluorocarbons, and sulfur hexafluoride Priority Area 4: Climate Change Section Overview # of Initiatives # of KPIs 45 16 TOTAL 26 5 Target 1 5 1 Target 2 7 1 Target 3 3 3 Target 4 1 2 Target 5 3 4 Target 6 ADWEA EAD Khalifa Masdar Emirates Abu Dhabi Water and Electricity Authority Environment Agency—Abu Dhabi Emirates Foundation Khalifa Foundation Abu Dhabi Future Energy Company Ministry of Education Ministry of Environment and Water Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: MOE MOFHAAD Health Authority—Abu Dhabi UPC NILU MOH Ministry of Finance Ministry of Health Norwegian Institute for Air Research Urban Planning Council MOEW ADNOC Abu Dhabi National Oil Company 58 Drinking Water Problem Overview As a country with one of the lowest supplies of fresh wa-ter in the world (World Bank 2005), the UAE relies on desalinated water as its main source of drinking water (Ali Murad, Al Nuaimi, and Al Hammadi 2007). Desalinated water meets more than 95% of the domestic water use de mand in Abu Dhabi emirate (EAD 2009c), and a similarly high percentage is estimated for the other emirates. Although it is believed that water leaving the desalination plants and transported through the major trunk lines is of high quality, concerns exist about contaminants that might be introduced when water is transported to the point of use either as bottled water or through a piped distribution system. Microbial contamination, which can result in gastrointes tinal diseases, may be introduced at bottling plants or wher ever breaks or cross-connections occur in a piped distribution system. Disinfection chemicals such as chlorine are used, as they are in most modern systems, to reduce microbial contami nation, but this process also produces disinfection by-products that have been associated with certain cancers and negative reproductive outcomes (WHO 2000). For bottled water there are concerns about chemicals that could migrate from bottles into the water, but recent stud ies have shown either that there are no detectable levels of these chemicals in the most widely used type of bottles (Al Mudhaf, Alsharifi, and Abu Shady 2009) and that the chemi cals themselves are not a concern at the levels seen (Agluk kaq 2008). The demineralization that occurs during desalination is generally reversed through blending of highly mineralized water or the addition of additives in order to protect infra structure and to address concerns that drinking demineralized water may be unhealthy (WHO 2005). • 59 Priority Area 5: Drinking Water Main Achievements and Successes Main Unresolved and Emerging Issues By all accounts, the construction and op-eration of the many desalination plants in the UAE has been done well. New plants incorporate the latest technology, such as reverse osmosis, to produce water with far less energy and cost. The finished water leaving these plants is believed to be of high quality (Elshorbagy and Abdulkarim 2006). The UAE has established water qual ity regulations for drinking water that are comparable to international guidelines (EAD 2004). These regulations include monitoring requirements, recordkeeping provisions, and the assurance of public ac cess to monitoring results. The Abu Dhabi Water Resources Master Plan for the emir ate of Abu Dhabi (EAD 2009c) addresses concerns over energy use associated with desalinating water and general sustainabil ity concerns. It documents issues such as unaccounted-for water and other indicators of breaches in distribution system integrity. Regulations, oversight, and education concerning water supply have been im proving (e.g., Regulation and Supervision Bureau 2009) and actions are being taken in response to data obtained through moni toring, as was done to eliminate bromate contamination (Shamseddine 2006). • Ensuring the quality of drinking water as it travels through the piped distribu tion systems of the various municipalities is a challenge. Rapid population growth has stressed existing distribution systems and water supply and has resulted in the expan sion of distribution systems with a conse quential increase in water residence times. Contamination can happen through physi cal breaks that occur in every distribution system, the same breaks that are respon sible for water loss through leakage. Water supply challenges have resulted in intermit tent water supply in some areas, creating low-pressure events that allow infiltration of contaminated water through these leak age sites. There are direct health risks from the contaminants themselves as well as in creased risks from disinfection by-products resulting from the higher disinfection loads needed to address the potential contamina tion. Bottled water is the prevalent source of drinking water for those who can afford it. Tap water is seen as unhealthy due to the historic use of high-saline groundwater and the perceived degradation of water quality during storage in rooftop and underground storage tanks. Although standards exist in some emirates as to how new storage tanks should be built (RSB 2009), it is un known whether the existing infrastructure meets these standards and whether the water quality is degraded because of the high ambient temperatures to which these tanks are exposed, airborne contamination through vents, and lack of mixing within the tanks. Monitoring by the distribution system companies ends just before water reaches residences so the microbial, disinfection by product, and other pollutant concentrations at the point of use are unknown. • To reduce the potential for health risks due to contamina-tion of potable water, the UAE should emphasize steps to increase water quality monitoring, prevent contamina tion through infiltration into the piped distribution system, and prevent water degradation in local storage tanks. Some emirates have already implemented many of the recommendations presented here, and their expertise will facilitate the national implementation of these practices. Reduce pollutant levels and human exposure to pol lutants. Addressing infiltration requires improving the inte grity of the distribution system and reducing the number of low-pressure episodes. Distribution companies should doc ument current leakage rates and develop programs that allow them to monitor the integrity of their systems while reducing the leakage rates to an acceptable level. National standards that ensure the proper mainte nance and oversight of distribution systems are also recom mended. Improve data quantity and availability. The UAE should implement routine monitoring efforts throughout the distribution system and at the point of use. Statistically sam pling water throughout the system will allow the assessment of water quality against drinking water quality standards that incorporate international standards and local needs. Similar testing is needed for groundwater when it is used as a drinking water source and for bottled water. Uniform national standards would facilitate this effort, and adherence to nationally recognized standards of sam ple tracking and testing will ensure the validity of the results. Improve scientific understanding of environmental health risks. Storage tanks have been identified as a con cern, and it is recommended that steps be taken to under stand their role in water quality and the degree to which they are maintained so as to ensure healthy drinking wa ter. Statistical sampling of water quality and maintenance levels of less than 1% of such systems should provide a wealth of information that would allow these systems to be improved and to allay public concern over the quality of tap water. There are special concerns associated with desali nated marine water, such as how to best remineralize the treated water, how to manage disinfection by-products, and how the water may degrade in distribution systems and storage tanks. Funding targeted research into these and other areas will provide knowledge on how to best tailor water quality standards, treatment, and distribution to the unique conditions found in the UAE. Build sustainable human and institutional capacity. The increase in water monitoring will require the develop ment of increased capacity for accurate and rapid water quality testing along with advanced data systems to record, organize, and report these data to the appropriate water managers and oversight institutions. The results of this test ing should be available not only to the managers of the water production and distribution systems but also to the water users. Using these data in an ongoing public health assessment and review of the safety and acceptability of drinking water supplies would contribute to the protection of public health by promoting improvement of the quality, quantity, and accessibility of water supplies. Support urban development that promotes environ mental health. Preventing infiltration also requires con stant pressure in the distribution system so that the unavoid able breaks in the system result in water flowing out of the system, not into it. It is understood that some systems in the UAE experience intermittent water supply and therefore have periods of low pressure. It is recommended that goals for reducing the number of low-pressure events be esta blished; that analyses be performed to identify loss reduc tion, capacity building, and demand management strate gies to bring systems within the established target; and that monitoring be implemented to measure progress towards these goals. Urban planning needs to include the development of drinking water supplies to ensure new development can be served adequately. Improve environmental awareness. The likelihood of drinking water being contaminated increases as the quality of the source water decreases. It is therefore important that programs to protect drinking water sources be expanded and that development plans include environmental impact assessments evaluating the effects of development on drink ing water supply and source water quality. The agricultural community also needs to be aware of the effects of pesticides and fertilizers on groundwater sources. • Recommendations 60 61 Priority Area 5: Drinking Water 61 62 Target 1: Reduce pollutant levels and human exposure to pollutants Stakeholders EH-5 / T-1 / I-1 Review adoption and enforcement mechanism of national water quality criteria for all drinking water (municipal and bottled). • Review adopted national standard. • Compile and evaluate emirate exceptions to the standards, and decide whether exceptions should be adopted nationally. • Review science associated with candidate changes to potable water standards. • Identify national and emirate agencies responsible for interpreting, promulgating, and enforcing these standards. Emirate food-control and environment agencies, distribution companies MOEW ESMA HAAD 20142010 2011 2012 2013 RSB EH-5 / T-1 / I-2 Establish and integrate monitoring of public drinking water at treatment facilities, in water-distribution system, and at point of use. • Establish sampling locations representative of overall population. • Establish sampling protocol including collection method, preservation, and chain of custody. • Determine protocol for reporting noncompliance of various contaminants. • Test for contaminants in a timely manner. • Make results of tests available to oversight authority through electronic access to database and periodic reports. Emirate food-control and environment agencies, distribution companies 20142010 2011 2012 2013 RSB EH-5 / T-1 / I-3 Establish minimum pressure requirements for all potable-water distribution systems that are consistent with international standards. • Evaluate infrastructure, supply, and water consumption to determine causes of low-pressure events. • Develop plan to upgrade infrastructure and manage supply and water use to comply with benchmarks for mainte nance of pressure in the distribution system. • Initiate plan while evaluating progress through monitoring for low-pressure events. Emirate environment agencies, distribution companies 20142010 2011 2012 2013 MOEW FEWA RSB EH-5 / T-1 / I-4 Improve the integrity of water distribution systems to minimize distribution system intrusion and leakage. • Implement improvements recommended by EH-5 / T-1 / I-3 to avoid low-pressure incidents. • Perform water audit to understand extent of integrity breaches. • Establish integrity goals for each system. • Upgrade systems to meet integrity targets. Emirate environment agencies, distribution companies 2010 2011 2012 2013 2014 MOEW FEWA RSB EH-5 / T-1 / I-5 Establish standards for stabilizing demineralized and desalinated water with a balanced composition of food-grade minerals. Emirate food-control and environment agencies, distribution companies MOEW FEWA HAAD 20142010 2011 2012 2013 RSB EH-5 / T-1 / I-6 Expand programs to protect sources of drinking water (marine and groundwater) from contamination. • Identify drinking water sources. • For groundwater wells providing drinking water, establish permitting system that mandates monitoring. • Review land-use practices in areas where groundwater is used for drinking, and address activities with potential to contaminate groundwater. • Establish maximum pollutant-loading criteria for pollutants of concern in the marine environment. • Establish system of monitoring and limiting point discharges to ensure total loading is below allowable limit. • Periodically review permissible maximum pollutant loading to ensure effectiveness. Emirate environment agencies 20142010 2011 2012 2013 MOEW FEWA Drinking Water (EH-5): Initiatives to Reduce the Burden of Disease Due to Drinking Water Contamination 63 Priority Area 5: Drinking Water Section Overview # of Initiatives # of KPIs 19 16 TOTAL 11 10 Target 1 3 3 Target 2 1 0 Target 3 1 1 Target 4 1 1 Target 5 2 1 Target 6 MOEW HAAD FEWA MOH Emirates Authority for Standardization and Metrology Federal Electricity and Water Authority Health Authority—Abu Dhabi Ministry of Environment and Water Ministry of Health Regulation and Supervision Bureau Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: ESMA RSB EH-5 / T-1 / I-7 Establish system for conducting routine surveys of groundwater quality where groundwater is a drinking water source. Emirate environment agencies 20142010 2011 2012 2013 MOEW ESMA EH-5 / T-1 / I-8 Ensure that existing testing programs for bottled water include tests for microbes, disinfection by-products, and other potential contaminants; ensure that programs are carried out in all emirates. Emirate food-control agencies 20142010 2011 2012 2013 ESMA EH-5 / T-1 / I-9 Create guidelines for bottled-water industry best manufacturing practices, process control, and bottled-water transport and storage, accounting for temperature and duration of storage. 20142010 2011 2012 2013 Emirate food-control and environment agencies EH-5 / T-1 / I-10 Monitor the new UAE unified surveillance system for infectious diseases for waterborne disease outbreaks. Emirate food-control and health agencies 20142010 2011 2012 2013 MOH HAAD EH-5 / T-1 / I-11 Establish a public-health assessment and review process of the safety and acceptability of drinking water supplies. Emirate food-control and environment agencies, distribution companies 20142010 2011 2012 2013 FEWAMOEW ESMA Target 2: Improve data quantity and availability Stakeholders EH-5 / T-2 / I-1 Develop systems of reporting and action to ensure compliance with standards for potable water. • Create uniform electronic reporting format for finished water quality results. • Create system for creating summary reports. • Continue and expand as necessary the independent review of water quality results. • Develop response plan for detection of unacceptable levels of particular contaminants. Emirate food-control and environment agencies, distribution companies MOEW ESMA FEWA 20142010 2011 2012 2013 HAAD EH-5 / T-2 / I-2 Establish an online database with all potable-water quality testing and compliance results from all water providers and water distribution companies. Emirate food-control and environment agencies, distribution companies 20142010 2011 2012 2013 FEWAMOEW ESMA EH-5 / T-2 / I-3 Quantify the fraction of the population in each category of drinking water source (e.g., desalinated marine water, desalinated groundwater, treated groundwater, untreated groundwater, mineral water, bottled desalinated water), by supplier and location. Emirate food-control and environment agencies 20142010 2011 2012 2013 FEWAMOEW ESMA 64 Target 3: Improve scientific understanding of environmental health risks Stakeholders EH-5 / T-3 / I-1 Fund research into potential health threats due to reliance on desalinated water (including low mineral content and disinfection by-product formation). • Determine research priorities. • Identify research team. • Design research protocol. • Obtain funding. • Implement research. • Publish and disseminate findings, including to UAE policy makers. 2010 OngOing MOEW ESMA HAAD Target 4: Build sustainable human and institutional capacity Stakeholders EH-5 / T-4 / I-1 Improve methods for measuring water quality, including new detection methods. • Establish labs of adequate capacity to measure contaminant levels. • Develop quality-assurance and quality-control procedures. • Determine protocol for reporting noncompliance of various contaminants. • Test for contaminants in a timely manner. • Make results of tests available to oversight authorities through electronic access to database and periodic reports. Emirate food-control and environment agencies, distribution companies 20142010 2011 2012 2013 FEWAMOEW ESMA Target 5: Support urban development that promotes environmental health Stakeholders EH-5 / T-5 / I-1 For all new development projects, require assessment of impact on drinking water supply and demand. 20142010 2011 2012 2013 Emirate environment agencies, distribution companies Target 6: Increase environmental awareness Stakeholders EH-5 / T-6 / I-1 Provide residents with information on the quality of tap water. • Determine water quality metrics easily understood by the public. • Require water distributors to perform adequate testing to calculate these metrics. • Establish a uniform reporting format for both online and printed distribution. • Require periodic distribution of water quality information. 2010 2011 2012 2013 2014 Emirate food-control and environment agencies, distribution companies EH-5 / T-6 / I-2 Increase public awareness of proper installation and maintenance of water storage tanks. • Develop research program to assess water quality issues associated with different types of rooftop storage tanks. • Create national installation and maintenance criteria that preserve stored water quality. • Develop and implement program of education, incentives, and permitting to ensure appropriate installation and maintenance. Emirate food-control and environment agencies 2010 2011 2012 2013 2014 MOEW ESMA HAAD Drinking Water (EH-5): Key Performance Indicators KPI No. Description 2014 Goal 2030 Goal Target 1: Reduce pollutant levels and human exposure to pollutants EH-5 / T-1 / K-1 Percentage of water treatment facilities that produce finished water that meets required standards 100% 100% EH-5 / T-1 / K-2 Percentage of water treatment facilities that comply with treatment technique standards each year 100% 100% 65 Priority Area 5: Drinking Water Section Overview # of Initiatives # of KPIs 19 16 TOTAL 11 10 Target 1 3 3 Target 2 1 0 Target 3 1 1 Target 4 1 1 Target 5 2 1 Target 6 MOEW HAAD FEWA MOH Emirates Authority for Standardization and Metrology Federal Electricity and Water Authority Health Authority—Abu Dhabi Ministry of Environment and Water Ministry of Health Regulation and Supervision Bureau Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: ESMA RSB KPI No. Description 2014 Goal 2030 Goal EH-5 / T-1 / K-3 Percentage of water samples taken from points of use (e.g., public buildings and fire stations) that comply with potable water quality standards each year >95% >99% EH-5 / T-1 / K-4 Percentage of groundwater samples that exceed standards for nitrate, fertilizers, and pesticides To be determined To be determined EH-5 / T-1 / K-5 Annual number of incidents of low pressure in water distribution system To be determined To be determined EH-5 / T-1 / K-6 Percentage of water distribution systems with active programs for addressing the physi cal integrity of the system 95% 100% EH-5 / T-1 / K-7 Percentage of treated water lost through leaks in the distribution system <15% <10% EH-5 / T-1 / K-8 Percentage of bottled water companies that comply with standards for mineral, chemi cal, and microbial content 100% 100% EH-5 / T-1 / K-9 Number of waterborne disease outbreaks per year 0 0 EH-5 / T-1 / K-10 Percentage of sampled storage tanks that are properly maintained 80% 95% Target 2: Improve data quantity and availability EH-5 / T-2 / K-1 Percentage of water quality test results provided to oversight authority each year >90% To be determined EH-5 / T-2 / K-2 Percentage of entities involved in potable water production and distribution that meet frequency requirements for water quality testing each year >90% 100% EH-5 / T-2 / K-3 Percentage of population aware of the composition of public and bottled drinking water To be determined To be determined Target 3: Improve scientific understanding of environmental health risks No pertinent KPIs Target 4: Build sustainable human and institutional capacity EH-5 / T-4 / K-1 Capacity of drinking water quality labs to process samples (number of samples per unit time) To be determined To be determined Target 5: Support urban development that promotes environmental health EH-5 / T-5 / K-1 Percentage of development plans containing environmental impact assessments evaluat ing the effects of development on drinking water supply and source water quality 100% 100% Target 6: Increase environmental awareness EH-5 / T-6 / K-1 Percentage of farmers and others aware of effects of pesticides and fertilizers on groundwater quality To be determined To be determined 66 Coastal Water Problem Overview Coastal recreational activities, including swimming, fishing, and sailing, are popular in the UAE. Tour ism related in part to these activities is a major industry, especially in Dubai and Abu Dhabi, attracting millions of foreign visitors annually (Dubai Department of Tourism and Commerce Marketing 2007). Contamination of these coastal waters by sewage or other fecal pollution can result in the transmission of in fectious diseases of various etiologies among swimmers and other users. Gastrointestinal diseases are the most common type of illness resulting from recreational expo sure to contaminated waters, but skin diseases, respirato ry illness, and fevers are also possible (Craun, Calderon, and Craun 2005; Wade et al. 2003; Pruss 1998). Coastal waters can also threaten public health if rec reational areas are contaminated by chemicals from in dustrial effluents, oil spills, and/or toxin-producing algal blooms (“red tides”). As industrial effluents appear to be sufficiently regulated with no recorded violations, and catastrophic single incidents such as oil spills or red tides would be highly visible and would be expected to deter any swim ming/wading in affected areas, the primary focus of this section is microbiological contamination. The phenomenon of algal blooms is also addressed in Priority Area 8: Produce and Seafood, page 82. • 67 Priority Area 6: Coastal Water Main Achievements and Successes Main Unresolved and Emerging Issues Microbiological contamination of coastal water quality is generally considered a lesser concern in developed nations, such as the UAE, that require treat ment of municipal wastewater prior to dis charge. Past investigations of indicator or ganism concentrations in the Arabian Gulf generally support this assumption, report ing very low average concentrations of co liforms along the coast (Banat et al. 1998; Banat et al. 1993; Abu Hilal et al. 1994). EAD currently monitors two beach ar eas monthly within the city of Abu Dhabi: Al Raha beach and the public beach. Observed fecal streptococci (enterococ cus subgroup) levels only occasionally ex ceeded WHO or U.S. EPA recommended bathing water standard levels at one beach during one of the two years for which moni toring data were available. • Unprecedented rapid development and rapid population growth throughout the nation appear to be straining available water treatment facilities. Chronic overload ing of wastewater treatment plants results in decreased hydraulic retention times and re duces effluent quality, potentially discharg ing high concentrations of microorganisms to coastal tributaries. Additionally, a heavy reliance on tanker trucks to transport sew age from areas lacking sewers may result in some illegal dumping into storm drains or directly into the Arabian Gulf. Although EAD has established water quality standards for recreational areas within the emirate of Abu Dhabi, it is un clear whether all emirates have adopted similar standards or instituted monitoring programs. Anecdotal evidence suggests that a lack of public notice detailing ex isting water quality or necessary beach closures may be creating some concern among tourists and residents that swimming presents an elevated health risk due to fe cal pollution (Setrakian 2009; Telegraph 2009). It is unclear whether these concerns are well-founded or simply the result of a lack of official information. • Recommendations To reduce the health risks associated with exposure to pollutants in coastal water, the UAE should: Reduce pollutant levels and human exposure to pollutants. Virtually immediate reductions in health risks related to recreational waters can be achieved through increased monitoring of fecal indi cator bacteria concentrations at local beaches and closure of areas in violation of international recommended standards until adequate reductions in microbial concentrations are achieved. National standards for coastal water quality monitoring and beach closures will prevent exposure to waterborne pathogens but will not reduce actual coastal contamination. In order to achieve this ultimate goal, the establishment of consistent national discharge standards for point-source effluents, including mandatory daily moni toring for pathogen indicators and chemical contaminants of con cern (e.g. dioxins, PCBs, etc.), is needed to ensure consistently safe recreational areas throughout the nation. Although some discharge recommendations currently exist, con siderable confusion remains at the emirate level as to which gov ernment entities are responsible for monitoring and enforcement of standards. Without enforcement, including the levying of tangible fines or penalties in response to recorded violations, improvements in water quality will not be achieved. Clarification of the roles and responsibilities of each government entity in ensuring adherence to national discharge standards at the emirate level is therefore urgent ly required. Improve data quantity and availability. Ideally, to provide con sistent public health safeguards throughout the nation, a standard ized coastal water monitoring program should be instituted at the federal level by the Ministry of Environment and Water and imple mented by relevant emirate-level agencies. Beaches throughout the nation should be monitored frequently for enterococci bacteria (fe cal streptococci), which have been identified as the most useful fecal indicator organism for regulation of marine water quality by WHO (Boehm et al. 2009). Although the necessary frequency of sample collection may dif fer due to the specific popularity of a given location and the proxim ity of potential pollution sources, it is worth noting that currently pro posed monthly sampling regimens will only be expected to record 5% of actual daily standard violations (i.e., days where swimming would pose an elevated risk of illness) (Leecaster and Weisberg 2001). The establishment of a national database as a repository for required beach monitoring data is highly recommended to allow for continued examination of water quality trends over time and to en courage collaboration among all emirates to preserve the shared waters along the coast. Adherence to these recom mendations should enable beaches throughout the UAE to join the international Blue Flag Programme, which certifies beaches as eco-conscious and swimmer friendly, currently a major goal of Dubai’s tourism industry. Improve scientific understanding of environmental health risks. Although the cities of both Abu Dhabi and Dubai are planning to expand their coastal water quality monitoring programs, these plans differ in targeted indi cator organisms, analytical methods, and proposed sam 68 pling frequencies. No information on similar existing or planned programs in other cities or emirates is currently available. Build sustainable human and institutional capacity. Future planned expansions of major municipal wastewater treatment plants, which are point sources of particular concern, will un doubtedly reduce the overloading of current facilities and im prove effluent quality, and should continue in order to minimize use of tanker trucks and illegal dumping. Support urban development that promotes environmen tal health. Increased sewage treatment and improved effluent quality will not only reduce pathogen concentrations and swim mer illness, but will also reduce nutrient loadings to the Gulf, which are likely at least partially responsible for increasing num bers of hazardous algal blooms (Anderson et al. 2002; Gilbert et al. 2002). Improve environmental awareness. Consistent national guidelines for beach closures due to periodic high enterococci concentrations should be established, specifying concentration levels necessary to trigger closure, reductions in concentration required to permit reopening, and procedures for public notifi cation. • 69 Priority Area 6: Coastal Water 70 Target 1: Reduce pollutant levels and human exposure to pollutants Stakeholders EH-6 / T-1 / I-1 Identify priority pollutants, and establish national effluent standards (for bacteria, nutrients, and total suspended solids at a minimum) for industrial and municipal discharges. Appropriate emirate agencies 20142010 2011 2012 2013 MOEW EH-6 / T-1 / I-2 Establish standard laboratory procedures and quality-assurance and quality-control checks for monitoring discharges to coastal water. Establish national program for routine inspection of effluent monitoring reports. 20142010 2011 2012 2013 ADFCAMOEW DCL EH-6 / T-1 / I-3 Increase current wastewater treatment plant design capacities to adequately meet established effluent discharge stan dards through sufficient treatment times. 20142010 2011 2012 2013 ADWEA DED EH-6 / T-1 / I-4 Increase percentage of permanent homes and buildings connected to municipal sewage pipes, and simultaneously reduce required number of tanker trucks transporting sewage. 20142010 2011 2012 2013 ADWEA DED EH-6 / T-1 / I-5 Include septic tank codes in rural and coastal building codes. 20142010 2011 2012 2013 To be determined Target 2: Improve data quantity and availability Stakeholders EH-6 / T-2 / I-1 Clarify emirate and federal agencies’ roles and responsibilities, especially with respect to enforcement of existing guidelines. 20142010 2011 2012 2013 MOEW EAD EH-6 / T-2 / I-2 Strengthen programs for monitoring coastal water quality. • Institute national standards based on scientific literature. • Identify priority areas (frequented beaches, fishing areas, etc.) and establish sampling regimen (ideally five samples per week). • Develop central database for storage of historical coastal water quality data in all seven emirates. 20142010 2011 2012 2013 DEDMOEW EAD Target 3: Improve scientific understanding of environmental health risks Stakeholders EH-6 / T-3 / I-1 Continue to study the effects of development and resultant water quality contamination on marine ecology, especially red tides. 2010 OngOing DEDMOEW EAD EH-6 / T-3 / I-2 Monitor the new UAE unified disease-surveillance system for infectious diseases for waterborne disease outbreaks. 2010 OngOing MOH Coastal Water (EH-6): Initiatives to Reduce the Burden of Disease Due to Coastal Water Pollution 71 ADFCA MOEW EAD UPC MOH ADWEA DCL Abu Dhabi Food Control Authority Abu Dhabi Water and Electricity Authority Dubai Central Laboratory Dubai Municipality Environment Department Environment Agency—Abu Dhabi Ministry of Environment and Water Ministry of Health Urban Planning Council Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: DED Target 4: Build sustainable human and institutional capacity Stakeholders EH-6 / T-4 / I-1 Increase enrollment of undergraduate and graduate students in related programs at UAE universities. Universities 20142010 2011 2012 2013 MOEW Target 5: Support urban development that promotes environmental health Stakeholders EH-6 / T-5 / I-1 Require coastal water quality impact assessment for new development. 2010 OngOing DEDEAD UPC Target 6: Increase environmental awareness Stakeholders EH-6 / T-6 / I-1 Establish national programs for beach closures in the event that water quality standards are exceeded. • Establish beach closure and reopening protocols. • Develop public communications strategy and messages. • Issue beach closure warnings when needed. 2010 OngOing DEDMOEW EAD Priority Area 6: Coastal Water Section Overview # of Initiatives # of KPIs 12 16 TOTAL 5 6 Target 1 2 2 Target 2 2 3 Target 3 1 3 Target 4 1 1 Target 5 1 1 Target 6 Coastal Water (EH-6): Key Performance Indicators KPI No. Description 2014 Goal 2030 Goal Target 1: Reduce pollutant levels and human exposure to pollutants EH-6 / T-1 / K-1 Percentage of samples of wastewater discharges to the environment (coastal creeks, gulf, etc.) compliant with water quality standards 90% 95% EH-6 / T-1 / K-2 Percentage of permanent homes and buildings on sewage system 90% 95% EH-6 / T-1 / K-3 Percentage of point-source discharges in compliance with water discharge permits 90% 100% EH-6 / T-1 / K-4 Percentage of coastal water samples with fecal coliform and enterococci concentra tions that meet recommended standards 90% 95% EH-6 / T-1 / K-5 Number of gastroenteritis outbreaks associated with coastal recreational water To be determined To be determined EH-6 / T-1 / K-6 Number of fish kills per year To be determined To be determined CAPTION HERE: This photograph needs a caption. Please write a caption here, approximately four lines long to fill this space. 72 73 Priority Area 6: Coastal Water Section Overview # of Initiatives # of KPIs 12 16 TOTAL 5 6 Target 1 2 2 Target 2 2 3 Target 3 1 3 Target 4 1 1 Target 5 1 1 Target 6 KPI No. Description 2014 Goal 2030 Goal Target 2: Improve data quantity and availability EH-6 / T-2 / K-1 Number of coastal water quality monitors in place and operating To be determined To be determined EH-6 / T-2 / K-2 Average number of samples collected per coastal water quality monitor per unit time To be determined To be determined Target 3: Improve scientific understanding of environmental health risks EH-6 / T-3 / K-1 Number of studies using intensive sampling (i.e., multiple samples per day) to investi gate transport of microorganisms along coast (effects of tides, diurnal cycles, etc.) To be determined To be determined EH-6 / T-3 / K-2 Number of studies determining typical chemical / metal concentrations in industrial efflu ents, particularly those associated with oil refineries To be determined To be determined EH-6 / T-3 / K-3 Number of studies investigating effects of ambient nutrient concentrations, temperature, organics, etc., on development of “red tides” (hazardous algal blooms) To be determined To be determined Target 4: Build sustainable human and institutional capacity EH-6 / T-4 / K-1 Number of students graduating from universities in the UAE with master’s degrees related to water quality protection To be determined To be determined EH-6 / T-4 / K-2 Number of students graduating from universities in the UAE with PhD degrees related to water quality protection To be determined To be determined EH-6 / T-4 / K-3 Number of personnel from UAE government agencies completing training programs offered through the Arab Water Academy To be determined To be determined Target 5: Support urban development that promotes environmental health EH-6 / T-5 / K-1 Percentage of environmental impact assessments addressing impact on coastal water quality 100% 100% Target 6: Increase environmental awareness EH-6 / T-6 / K-1 Percentage of general public aware of causes and meanings of beach closure warn ings To be determined To be determined 74 Problem Overview Soil and groundwater can become contami-nated through improper disposal of solid and hazardous wastes. Municipal solid waste, construction and demolition waste, hazardous waste, and medical waste all can carry compo nents that are harmful to the environment and human health. Improper agricultural practices can also contribute to soil and groundwater contamination, but the focus of this section is proper waste-disposal practices. If wastes are not treated and disposed of appropriately, the soil and groundwater around disposal sites may be contaminated, providing potential pathways for human exposure to hazardous substances contained in the wastes. It is clear that treatment and disposal fa cilities in the UAE must respond to the ever growing amounts of waste generated by rapid urbanization, industrialization, and economic diversification. Some facilities seem inadequate to handle wastes according to current interna tional best practices, both in terms of manage ment and engineering. Reports exist of improp er treatment and disposal practices, such as illegal dumping in the desert and disposal of liquid and hazardous wastes in unlined land fills (EAD 2009d). At such uncontrolled and illegal disposal sites, the probability is high that hazardous substances in the wastes will accumulate in the soil surface layer or leak into groundwater. Al though there are no reports yet on morbidity and mortality from exposure to contaminated soil and groundwater due to hazardous and Soil and Groundwater medical wastes in the UAE, people who live or use wells near disposal sites are potentially at risk. Moreover, new residential areas that will be developed due to rapid population growth might be at risk if they are placed near rehabili tated former dump sites or in the desert where illegal dumping has been reported. In the absence of rigorous monitoring and control of waste disposal, the UAE might face problems of significant public exposure to con taminated soil and groundwater. Such expo sures have occurred in other countries around the world. As an example, the best-known such case in the United States was the contamina tion of the neighborhood around a former waste disposal site in the Love Canal area of New York. After the landfill was closed, the surrounding area was extensively developed, including construction of a public elementary school and private homes. Subsequently, the school and many homes were contaminated by leakage of hazardous substances from the landfill site. In the late 1970s, the federal gov ernment evacuated approximately 950 fami lies from a 10-square-block area surrounding the landfill and permanently closed their homes (U.S. EPA 2008). To prevent similar incidents and problems, stakeholders across the UAE should minimize waste generation and improve waste manage ment to prevent soil and groundwater pollution, as well as to prevent human exposure to con taminated soil and groundwater in the areas around disposal or rehabilitated sites. • 74 75 In the UAE, Dubai and Abu Dhabi emir-ates especially have considered adverse effects on the environment and public health from increasing waste generation and poor waste management. Examples of federal and emirate-wide laws created to improve waste management include Feder al Law 24 of 1999 and its executive bylaws on the handling of hazardous materials, hazardous wastes, and medical wastes; Federal Law 1 of 2002 and its executive bylaws on protection from ionizing radia tion hazards; and Law 21 of 2005 on solid waste management in Abu Dhabi emirate (EAD 2007b). In Abu Dhabi emirate, EAD has developed strategic plans and KPIs for improving waste management. Dubai implemented its first compre hensive solid waste management system in 1992, and new industrial and medical haz ardous waste treatment facilities were op erational in 2001 (Al Qaydi 2006). In the city of Dubai, hazardous waste manage ment is made easier by industrial zoning and regular workshops on industrial waste management. Soon after private-sector waste collection and transportation servic es were introduced in the city of Dubai, the proper collection of hazardous wastes im proved (Al Qaydi 2006). With continued population, commercial and industrial growth, however, pressure may be put on existing waste collection and treatment infrastructure and services. An additional facility to process and store industrial hazardous waste will probably be needed by 2015, for which Dubai is making plans (Al Qaydi 2006). Abu Dhabi has made similar strides. In 2008, the Center of Waste Manage ment (CWM) Abu Dhabi was established to serve as the implementer of waste man agement policies at the operational level, while EAD is still responsible for legisla tion, regulation, and monitoring of waste management policies at the emirate level. Government authorities are accountable for regulating and monitoring their own sec tors. For example, the Abu Dhabi National Oil Company is in charge of the oil and gas sector (EAD 2009d). CWM is drafting a waste management strategy for Abu Dhabi emirate that focuses on four primary sectors: municipal solid Main Unresolved and Emerging Issues Although the UAE has taken many steps to eliminate or reduce problems in the waste sector, a number of limitations and unresolved issues persist. The 2007 Waste Locations Aerial Sur vey indicated that much illegal dumping of asbestos, concrete, garbage, metal, plas tic, tire, and wood occurs in the nonurban areas of Abu Dhabi emirate, especially in the desert (EAD 2008). Further, compli ance with and enforcement of existing or proposed policies and laws (e.g., Federal Law 24 of 1999 and its executive bylaws, Abu Dhabi Law 21, and others), is lacking (EAD 2009d). The insufficiency of waste manage ment requirements at the federal level is implicitly blamed for the problems. No facilities are specifically designed for the treatment and disposal of hazardous wastes from industries other than oil (EAD 2009d). These wastes are usually disposed of in existing facilities (mainly landfills) by Abu Dhabi Municipality, even though these landfills are not designed for liquid hazard ous wastes. Though the current disposal technique for medical waste (infectious waste) has shifted to nonincineration technologies (chemical and thermal treatment), these methods still leave some pathogens in the treated waste because of the nature of the technologies and an inability to handle the large amount of waste (EAD 2007b). The UAE lacks reliable informa tion about waste generation rates, waste characterization, waste flows, and the ef ficiency and safety of handling methods waste, construction and demolition waste, hazardous waste, and medical waste. The waste management strategy includes many principles from international best prac tices, including deposit-refund sys tems; award schemes; the “polluter pays” principle; financial incentives and new markets for recycling; tariffs; and educational awareness campaigns about waste reduction at the source. This strategy provides a framework for reformatting the waste management system in 2010 (EAD 2009d). Abu Dhabi emirate has recognized its lack of waste treatment and disposal facilities as a problem. CWM plans to upgrade existing facilities or develop new ones and promote private-sector participa tion in waste management (EAD 2009d). It also plans to close and rehabilitate exist ing landfill sites (EAD 2008). In addition, EAD closed many incinerators used for dis posing of infectious medical wastes due to unacceptable performance and now treats these wastes with nonincineration technolo gies that are more environmentally friendly (EAD 2007b). • Main Achievements and Successes Priority Area 7: Soil and Groundwater (EAD 2009d). Data about contaminants in soil and groundwater are needed to sup port dump-site rehabilitation projects (EAD 2008). Completing new, permanent waste-dis posal facilities that the government plans to develop will take approximately 15 years. In the meantime, mobile treatment and dis posal technologies will be developed as a temporarily solution; however, the effi ciency of these solutions remains uncertain. Further, upcoming tariffs on landfills may increase the rate of dumping in the desert. Little research by academic institutions on hazardous and medical waste manage ment or on exposure to contaminated soil and groundwater exists. Most available in formation comes from governmental orga nizations’ annual or project reports. • 76 To mitigate any existing or future soil or groundwater con-tamination from hazardous wastes or to reduce the burden of disease due to such contamination, the UAE should take ac tion as follows: Reduce pollutant levels and human exposure to pollut ants. The federal government should develop minimum na tional waste-management standards. Each emirate should be required to develop waste-management policies that comply with the national standards. Emirate governments should also monitor illegal and improper disposal practices and the perfor mance of each treatment and disposal site in meeting required standards or best practices. The federal government should assess current guidelines and practice manuals for each waste stream and revise them to meet international best practices. In addition, each emirate should list potential contaminat ed sites and develop guidelines and procedures for health risk estimation and rehabilitation. A system of fines and other pun ishments should be developed to discourage illegal/improper disposal practices. Improve data quantity and availability. UAE environmen tal agencies should work together to develop centralized haz ardous and medical waste databases that compile monthly or annual data about waste generation rates, characterization, waste flows, and the efficiency and safety of handling meth ods. Another database should be developed to collect infor mation on properties of and contaminants in soil and ground water, as well as other dump site data related to rehabilitation. In addition, industrial and medical facilities should be required to report on waste generation and management. Improve scientific understanding of the environmental health risk. UAE environmental agencies should work coop eratively on research related to the potential for exposure to hazardous and medical wastes. Academic institutions should be encouraged to participate. Build sustainable human and institutional capacity. UAE environmental agencies should ensure that they have a suffi cient number of staff with technical expertise in waste manage ment to ensure implementation and enforcement of waste man agement policies. These agencies should hold workshops or trainings for licensed hazardous and medical waste handlers to enhance their knowledge of waste management. Support urban development that promotes environmen tal health. UAE government agencies involved with waste management should cooperate to establish risk estimation methods and standards for residential soil based on interna tional limits and develop guidelines for urban planning in po tentially contaminated areas. Improve environmental awareness. UAE agencies in volved in waste management should work together to imple ment a public awareness campaign on household hazardous waste management and the risk of exposure to contaminated soil and groundwater due to improper disposal of hazardous and medical waste. • Recommendations Target 1: Reduce pollutant levels and human exposure to pollutants Stakeholders EH-7 / T-1 / I-1 Design policies to minimize waste production upstream of disposal. Emirate environment agencies EADMOEW ADWEA 2010 ? ADNOC Soil and Groundwater (EH-7): Initiatives to Reduce the Burden of Disease from Soil and Groundwater Pollution Due to Hazardous and Solid Waste 77 Priority Area 7: Soil and Groundwater Section Overview # of Initiatives # of KPIs 21 17 TOTAL 6 7 Target 1 2 3 Target 2 1 1 Target 3 4 2 Target 4 3 1 Target 5 5 3 Target 6 ADWEA Abu Dhabi National Oil Company Abu Dhabi Water and Electricity Authority Center of Waste Management Abu Dhabi Environment Agency—Abu Dhabi Health Authority—Abu Dhabi Ministry of Environment and Water Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: MOEW EADADNOC HAAD CWM EH-7 / T-1 / I-2 Implement an integrated national system to regulate, manage, track, treat, and dispose of hazardous wastes. • Draft law requiring compliance with new requirements for hazardous waste import/export, production, transport, handling, processing, treatment, and disposal. • Identify and notify covered sources of the responsibility to report their hazardous waste operations under the new regulations. Consider allowing an amnesty period to allow companies time to comply. • Publicize new regulations and hold seminars to train communities and companies on compliance. • Create inspection guidelines for hazardous waste treatment, storage, and disposal facilities (by sector and facility). • Research possible establishment of a federal or multiemirate compact for waste management facilities. • Create a system to minimize redundancy and maximize compatibility of programs developed by various agencies, both within an emirate and across emirates. • Establish enforcement mechanisms for solid and industrial wastes. HAADEADMOEW 20142010 2011 2012 2013 CWM EH-7 / T-1 / I-3 Continue contract process in Abu Dhabi to design and build treatment and disposal facilities for industrial and medical wastes. Emulate this program in other emirates. 2010 ? CWM EH-7 / T-1 / I-4 Establish program to identify and classify sites where soil and/or groundwater are contaminated due to current and past waste disposal practices. • Develop program for sampling soil and groundwater at such sites. • Identify potential threats to the environment from waste disposal sites. • Develop system for rating such sites and consequences of the rating system (e.g., limited access to area, revocation of license, etc.). • Develop ranking system for prioritizing the most hazardous/highest risk sites in each emirate. • Establish program to clean up sites and a mechanism to assess the success of cleanup efforts. 20142010 2011 2012 2013 To be determined EH-7 / T-1 / I-5 Establish or refine existing emergency preparedness and response policies in all emirates for the accidental release of hazardous wastes and other hazardous substances. • Verify that existing and new policies include hazardous waste in the definition of hazardous substances. • Coordinate emergency response systems across all emirates. 20142010 2011 2012 2013 To be determined EH-7 / T-1 / I-6 Develop programs and construct facilities to encourage recycling of both industrial waste and residential/commercial solid waste. 2010 OngOing To be determined 78 Target 2: Improve data quantity and availability Stakeholders EH-7 / T-2 / I-1 Complete national database for integrated hazardous waste management across all emirates. • Inventory all waste sources. • Establish a mechanism for waste generators to report waste quantities accurately, subject to verification by inspec tion and penalties for false information. • Update and expand database as needed. • Make accessible to government agencies and public as appropriate. Appropriate emirate agencies 20142010 2011 2012 2013 CWMMOEW EH-7 / T-2 / I-2 Create national database of hazardous waste generators. • Assign unique ID codes for each hauler, generator, and disposal facility. • Require manifesting of all hazardous waste and annual reports from each ID code. 2010 OngOing CWM Target 3: Improve scientific understanding of human health risks Stakeholders EH-7 / T-3 / I-1 Fund research to better understand the exposure pathways between hazardous and medical waste and human recep tors in the UAE. Research potential threat from exposure to contaminants accumulated in soil and groundwater due to irrigation with treated wastewater. 20142010 2011 2012 2013 To be determined Target 4: Build sustainable human and institutional capacity Stakeholders EH-7 / T-4 / I-1 Ensure that centralized database of information on hazardous waste treatment, storage, and disposal sites is available to all appropriate agencies across the UAE. 2010 OngOing2011 To be determined EH-7 / T-4 / I-2 Identify priority work sectors for training in better hazardous waste practices. Establish education programs to raise awareness of hazardous waste management for workers in medical and industrial facilities. 20142010 2011 2012 2013 To be determined EH-7 / T-4 / I-3 Create a system for publicizing waste management policies and sharing best practices across all emirates. 20142010 2011 2012 2013 To be determined EH-7 / T-4 / I-4 Ensure that hazardous waste inspectors are adequately trained and that their number keeps pace with development. Inspectors should report results to central database. 2010 OngOing To be decided Target 5: Support urban development that promotes environmental health Stakeholders EH-7 / T-5 / I-1 Establish standards for publicly accessible soil in urban or residential areas based on international limits. Develop regu lations for the quality and acceptable uses of compost derived from waste materials. 20142010 2011 2012 2013 To be determined 79 Priority Area 7: Soil and Groundwater Section Overview # of Initiatives # of KPIs 21 17 TOTAL 6 7 Target 1 2 3 Target 2 1 1 Target 3 4 2 Target 4 3 1 Target 5 5 3 Target 6 EH-7 / T-5 / I-2 Incorporate hazardous-waste inspection of soil into impact statements and criteria for the environmental review and permit process for any new construction or sale of property. 20142010 2011 2012 2013 To be determined EH-7 / T-5 / I-3 Establish disclosure and public participation processes to inform and involve residents in potential urban plans that may result in hazardous wastes in their neighborhoods. 20142010 2011 2012 2013 To be determined Target 6: Increase environmental awareness Stakeholders EH-7 / T-6 / I-1 Develop a program for labeling consumer products classified as hazardous household wastes. • Develop a list of products that are classified as household hazardous wastes. • Develop labels adequate to communicate risk of handling or improper use of product as well as proper disposal practices and how to treat humans if exposed. • Establish mandate for application of label at point of manufacture. • Inspect products deemed household hazardous wastes for labels. • Develop procedures to enforce labeling requirements. 20142010 2011 2012 2013 To be determined EH-7 / T-6 / I-2 Develop programs to educate residents on proper handling and disposal of household hazardous waste. • Conduct survey to determine needs for public education. • Create materials (written, Web-based), including a regulatory guide, for education on household hazardous waste (e.g., from batteries, mercury thermometers, antifreeze, etc.), for the end-user community. • Create campaigns/methods to disseminate materials, possibly including public meetings. 20142010 2011 2012 2013 To be determined EH-7 / T-6 / I-3 Perform trash analysis to see what people are throwing away. 20142010 2011 2012 2013 To be determined EH-7 / T-6 / I-4 Organize and advertise household hazardous waste collection days. 2010 OngOing To be determined EH-7 / T-6 / I-5 Require signs with health warnings for hazardous spills at contaminated sites. • Create guidelines for signage. • Create enforcement mechanisms for noncompliance. 20142010 2011 2012 2013 To be determined ADWEA Abu Dhabi National Oil Company Abu Dhabi Water and Electricity Authority Center of Waste Management Abu Dhabi Environment Agency—Abu Dhabi Health Authority—Abu Dhabi Ministry of Environment and Water Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: MOEW EADADNOC HAAD CWM 80 Soil and Groundwater (EH-7): Key Performance Indicators KPI No. Description 2014 Goal 2030 Goal Target 1: Reduce pollutant levels and human exposure to pollutants EH-7 / T-1 / K-1 Waste generated per person per year, in these categories: 1. Hazardous 2. Medical 3. Household hazardous To be determined To be determined EH-7 / T-1 / K-2 Percentage of hazardous waste that is processed, in these categories, by emirate: 1. Industrial 2. Medical To be determined To be determined EH-7 / T-1 / K-3 Percent noncompliance of inspected licensed facilities, by industry (e.g., medical, indus trial, etc.) and facility type (e.g., hazardous waste producers, processors, treatment or disposal sites) To be determined 0% EH-7 / T-1 / K-4 Number of contaminated sites (by emirate), measured as: 1. Number of sites identified and inspected 2. Percentage of sites rated, i.e., put on a national priority list or declared contami nated To be determined To be determined EH-7 / T-1 / K-5 Number of sites declared contaminated that have been cleaned (by emirate), ex pressed according to level of cleanup To be determined To be determined EH-7 / T-1 / K-6 Percentage of disposal sites in noncompliance with handling, treatment, and disposal standards To be determined To be determined EH-7 / T-1 / K-7 Monetary value of property or health damage avoided through emergency response to release of toxic or hazardous wastes to soil and groundwater To be determined To be determined 81 Priority Area 7: Soil and Groundwater Section Overview # of Initiatives # of KPIs 21 17 TOTAL 6 7 Target 1 2 3 Target 2 1 1 Target 3 4 2 Target 4 3 1 Target 5 5 3 Target 6 KPI No. Description 2014 Goal 2030 Goal Target 2: Improve data quantity and availability EH-7 / T-2 / K-1 Percent completion of centralized hazardous waste database including: 1. All regulated wastes 2. Sources (perhaps classified as large and small quantity generator, and exempted) 3. Manifest tracking records 4. Licensed treatment / disposal site operators and haulers 5. Priority list for contaminated sites 6. Sites undergoing hazardous waste remediation 7. List of laws, guidelines, etc., for sources To be determined To be determined EH-7 / T-2 / K-2 Percentage of licensed hazardous waste facilities that comply with annual submission of reports to centralized database To be determined To be determined EH-7 / T-2 / K-3 Percent completion of database for contaminated soil and groundwater around landfill sites, including: 1. Physical properties 2. Chemical properties 3. Characteristics, quantity, toxicity, and exposure pathway of contaminants To be determined To be determined Target 3: Improve scientific understanding of environmental health risks EH-7 / T-3 / K-1 Funding for one or more research projects on potential exposures to hazardous and medical waste To be determined To be determined Target 4: Build sustainable human and institutional capacity EH-7 / T-4 / K-1 Percentage of licensed hazardous waste handlers (in each emirate and relevant indus trial sector) who have attended training workshops To be determined To be determined EH-7 / T-4 / K-2 Percentage of workers who are aware of proper segregation, collection, and disposal practices for hazardous waste: 1. Health-care workers 2. Industrial workers (by size and type of operation) To be determined To be determined Target 5: Support urban development that promotes environmental health EH-7 / T-5 / K-1 In the future, as construction sites move into the desert where there is reported illegal dumping, the percentage of new construction sites (in these categories) with hazardous substances in soil that exceed existing standards: 1. Residential 2. Public / open space 3. Commercial 4. Other To be determined To be determined Target 6: Increase environmental awareness EH-7 / T-6 / K-1 Percentage of inspected hazardous waste products that meet labeling requirements To be determined To be determined EH-7 / T-6 / K-2 Percentage of the population who can demonstrate awareness of household hazardous products and how and where to properly dispose of such waste after use To be determined To be determined EH-7 / T-6 / K-3 Percentage of overall household hazardous waste that is improperly disposed of with municipal solid waste To be determined To be determined 82 Problem Overview Eating fruits and vegetables has docu-mented health benefits, but it also ex poses people to risk if the produce contains hazardous contaminants. Two potential contaminants are human pathogens (e.g., salmonella, Escherichia coli) and agricul tural pesticides (e.g., organophosphates, carbamates), both of which can be re duced with proper food handling and preparation. Food-borne pathogens cause and contribute to an array of human illnesses, from acute illnesses——including gastrointestinal distress and nausea——to chronic conditions such as organ failure, arthritis, and heart disease. Exposure to two commonly used classes of pesticides, organophosphates and carbamates, po tentially could cause subtle neurological ef fects. However, such effects have been doc umented only for high doses of pesticides that can occur through occupational expo sures or accidental ingestion. Very limited data on clinical effects of chronic, low-level exposure to pesticides (at levels that typi cally might be found as residues on food) are available, and research is ongoing to estimate the occurrence of subtle effects. Limited pesticide residue data from Abu Dhabi and worst-case assumptions of both (1) low pesticide removal during food preparation and (2) high consumption of a Produce and Seafood single vegetable (i.e., high exposure to a single pesticide type) suggest virtually no acute risk and minimal chronic risk from pesticide exposure via consumption of fruits and vegetables in the UAE. Large percent ages of fruits, vegetables, grains, and le gumes consumed in the UAE are produced abroad. Pesticide use in countries exporting to the UAE will also affect pesticide resi dues consumed in the UAE. Appropriate handling of food can minimize food-borne environmen tal hazards. Properly cooking produce con taminated with pathogens can eliminate risk of food-to-human microbial pathogen transmission. But recent outbreaks of illness in the United States show that peeling and washing alone may not eliminate and may even increase pathogen hazard in raw food products. Seafood is a primary staple of the UAE diet, as it is in many coastal countries. More than 90% of residents consume fish at least once a week (Badrinath et al. 2002). Con sumption of seafood provides many health benefits; however, fish can also serve as vectors for pathogenic microorganisms (e.g., Vibrio spp.) or heavy metals and tox ins (e.g., dioxin, mercury) if contaminated by polluted coastal waters. While the risk from pathogenic micro organisms can be minimized by good food handling procedures and proper cooking, the risk from toxins and heavy metals can not. Prevention of exposure to heavy met als and toxins in seafood depends on lim iting consumption (particularly by sensitive groups such as pregnant women or small children) and reducing pollutant levels in the coastal environment. Toxin-producing algal blooms (“red tides”) can also be a source of seafood contamination. The number of red tide inci dents has increased in UAE coastal waters in recent years. EAD recorded only one in cident in 2002 but eight in 2008. Red tides have forced recent temporary closures of the Sharjah desalination plant (Sambidge 2008) and Dubai beaches (Menon 2009). Red tides appear to be associated with elevated nutrient levels that can come from human sewage, agricultural runoff, and elevated water temperature. Evidence sug gests that consumption of fish exposed to red tide toxins can result in serious health effects, though there is also a good deal of uncertainty about the resultant rates of hu man illness (Graneli and Turner 2006). Although this discussion primarily con siders food as encompassing fruit and veg etable produce and seafood, the accom panying key performance indicators chart (page 88) broadens this scope to include general food safety. • The federal government has passed sev-eral regulations to combat inappropri ate pesticide use. At least 88 pesticides have been banned as a result of the fed eral Pesticides, Agricultural Additives, and Fertilizers law (Decision 37, 2001) and regulations of the Ministry of Agriculture and Fisheries (Decision 193, 2004). Ad ditionally, the manufacture and formulation of any pesticide is prohibited in the UAE, and only pesticides registered by MOEW can be imported or used legally in the UAE (Al Ashram 2005). Pathogen and pesticide monitoring activities are conducted by the food con trol departments of individual emirates. In 2002, for example, the Pesticide Residue Analysis Section at the Food and Environ ment Control Center of Abu Dhabi (now the Abu Dhabi Food Control Authority) found that 5% of tested samples of locally grown vegetables (and 0% of locally grown fruits) exceeded maximum legally allowable resi due levels (Khaleej Times 2002). Numerous scientific studies have inves tigated toxin and heavy metal concentra tions in fish harvested along the UAE coast. The majority of observed concentrations were below WHO tolerable weekly doses or toxic levels for the general population, and so consumption would not be expected to result in adverse health outcomes. Initial monitoring of coastal waters by EAD has determined that mercury is not detectable and dioxin levels were lower than 0.4 ppm at all sites except one with a concentration of 1 ppm (EAD 2007). The UAE has instituted several relevant pieces of legislation to continue to preserve coastal water and seafood quality, includ ing Federal Law 24 of 1999, which aims to protect the marine environment from pol lution (UAE Federal Government 1999). Experimental studies are in pro gress to determine the potential effects of oil/fuel on fish, and regional conventions aimed at preventing contamination of the Arabian Gulf——particularly by oil spills——have been ratified. Another innovative policy being adopt ed in the UAE is the encouragement of the use of Good Agricultural Practices (GAP), as classified by the Food and Agricultural Organization (FAO) of the United Nations. This provides a more holistic means of pre venting contamination of food whether with pesticides or pathogens. Good Agricultural Practices stress the importance of adopt ing integrated pest management strate gies——pest-resistant cultivar selection, crop rotation sequences, beneficial insects——in an effort to reduce the need for pesticides (Poisot, Speedy, and Kueneman 2004). Initial analysis suggests some overlap between the authority and duties of farm er/resident outreach and education activi ties conducted by MOEW and the jointly staffed UAE-AGRICENT Agricultural Infor mation Center, including manure manage ment practices that can help prevent food from becoming contaminated with patho gens. The UAE should also consider requir ing use of GAP by those who export foods to the UAE. Despite significant efforts to increase agricultural production, the UAE is heavily dependent on imported foods and is likely to remain so for the foreseeable future. Im port safety policy will also remain critical to assuring UAE food safety. Little information is available on sampling and testing results of foods imported to the UAE. From 2001 to 2003, 6–7% of imported shipments into the UAE were rejected for violation of lo cal food safety standards (FAO and WHO 2005). • Main Achievements and Successes Priority Area 8: Produce and Seafood 83 84 85 To reduce the burden of disease due to exposure to contami-nated fruits, vegetables, and seafood, the UAE should take action as follows: Reduce pollutant levels and human exposure to pol lutants. Emirate-wide Farmers Services Centers and similar UAE agencies should draft and implement GAP as defined by FAO. Pesticide-residue standards, codes of practice, and auditing and enforcement procedures need to be developed and coordinated across all seven emirates. A standardized, risk-based, food-imports inspection protocol, based on interna tional norms, should be adopted by all emirates. Improve data quantity and availability. Agencies from all seven emirates must continue efforts toward establishing a na tional medical-records surveillance system and ensure that all medical centers report cases of disease suspected as or con sistent with food-borne illness. The UAE must include adequate funding for staff to analyze food-borne disease incidence based on this national database. Periodic screenings must be carried out across all emirate coastal zones to determine heavy metal concentrations in domestically produced fish. Ap propriate contingency strategies need to be developed. Build sustainable human and institutional capacity. The Ministry of Environment and Water, emirate food-control au thorities, and similar agencies must continue to provide leader ship on efforts to improve food safety policy and practices, especially via the UAE Codex Committee (operating in con junction with WHO and FAO). Public health-authority staff must improve capacity for conducting outreach activities for farmers, physicians, and residents. The need for additional food testing capacity via additional laboratories must be assessed. Support urban development that promotes environmen tal health. Communication procedures between emirate-wide food control authorities and urban planning offices must be im plemented and expanded to ensure that environmental impact statements consider food contamination issues (such as effects of additional waste discharges into the coastal environment). Improve environmental awareness. Pertinent agencies within the UAE should design and conduct proactive public safety information campaigns on food-related issues (pesti cides, pathogens, seafood heavy metals, etc.). UAE-wide or ganic farming standards should be adopted, with provisions for proper labeling. Seafood consumption advisories related to red tide conditions (offshore algal bloom events) and persis tent seafood pollutants must be adopted and extended across all seven emirates. • Recommendations if compared with standards for inorganic arsenic in drinking water; however, the vast majority of arsenic in fish tissue is organic and may be less completely metabolized and more rapidly excreted (i.e., inorganic arsenic standards may be inappropriately conservative). Of greater general concern, compari son of fish tissue studies completed over the past 20 years reveals a distinct increasing trend in heavy metal concentrations over time. Continuation of this trend could ren der local seafood unsafe for regular human consumption. • Main Unresolved and Emerging Issues When pesticides are restricted, farm-ers must generally substitute other means of pest control. In addition, pesti cide-use restriction or cancellation can also increase the cost of particular foods, lead ing consumers to substitute other foods or food from other sources. Either action can have an effect on the risk consumers actu ally experience and should be considered in policy decisions (Gray and Hammitt 2000). The UAE is also still in the process of examining issues related to the inadvertent or unwanted introduction of genetically modified organisms (GMOs) into UAE farm crops or imported food supplies. The long term health effects of GMOs are still under going study (Croucher 2009). UAE food labeling laws do not require GMOs to be identified. Although the majority of scientific stud ies have confirmed that toxin and heavy metal concentrations in fish tissue were below levels posing a health risk to con sumers, mercury levels in some fish exceed WHO recommended levels for pregnant women. Arsenic levels may exceed recom mended levels for the general population Priority Area 8: Produce and Seafood 85 86 Target 1: Reduce pollutant levels and human exposure to pollutants Stakeholders EH-8 / T-1 / I-1 Complete drafting and implementation of Good Agricultural Practices (GAP) code of practice. Establish training pro grams for staff and farmers. Develop systems for compliance inspections and enforcement. Emirate food-control agencies 2010 2011 2012 2013 2014 FSCMOEW EH-8 / T-1 / I-2 Harmonize emirate pesticide residue standards. Emirate food-control agencies 20142010 2011 2012 2013 ESMAMOEW EH-8 / T-1 / I-3 Design and implement system of certification of pesticide applicators in all emirates. • Develop code of practice for use of pesticides. • Certify companies to conduct training. • Audit training companies annually. • Establish exam centers to administer examination for certification. • Establish and enforce system of enforcing certification in all emirates. Appropriate emirate agencies 20142010 2011 2012 2013 MOEW EH-8 / T-1 / I-4 Strengthen risk-based system for inspecting imported foods for environmental pollutants. • Re-establish baseline compliance based on new risk-based inspection system. • Continue sampling and laboratory testing of import shipments in accordance with the risk-based system. • Complete updating and implementation of risk-based inspection system. • Harmonize standards across emirates. • Coordinate food sampling across emirates to ensure that there are no opportunities for entry and sale of contami nated foods. • Monitor the implementation of the inspection and testing system. 2010 2011 2012 2013 2018 Emirate food-control agencies Target 2: Improve data quantity and availability Stakeholders EH-8 / T-2 / I-1 Establish a national surveillance system, including use of electronic medical records, that includes adequate staffing to identify occurrences of food-borne illness. • Develop system to ensure that all medical centers report to database cases of disease suspected as or consistent with food-borne illness. • Ensure that surveillance and electronic medical-record systems use symptom coding appropriate for detection of potential food-borne illness. • Develop training system for participants in the national surveillance and electronic medical-record systems and conduct training annually. • Fund staffing for analysis of surveillance and electronic medical-records data to identify food-borne disease syn dromes. 2010 2011 2012 2013 2015 MOH EH-8 / T-2 / I-2 Establish a national electronic laboratory reporting system that includes adequate staffing to identify occurrences of food-borne illness. Fund staffing for analysis of food-borne disease incidence based on these data. 2010 2011 2012 2013 2014 Emirate food-control agencies Produce and Seafood (EH-8): Initiatives to Reduce the Burden of Disease Due to Contamination of Food 87 EH-8 / T-2 / I-3 Conduct periodic screening studies of heavy metal concentrations in domestically produced fish to determine if further action is required. Coordinate screening studies across emirates to avoid duplication of effort. Develop strategy for response contingent on need. 20142010 2011 2012 2013 Emirate food-control agencies Target 3: Improve scientific understanding of environmental health risks No recommendations at this time. Target 4: Build sustainable human and institutional capacity Stakeholders EH-8 / T-4 / I-1 Continue to provide regional leadership in efforts to improve food-safety policy practices through the UAE Codex com mittee that was established in February 2009. 2010 OngOing Emirate food-control agencies EH-8 / T-4 / I-2 Increase staff to conduct outreach activities to UAE farmers for purposes of preventing and reporting of illnesses that may be food-borne. 20142010 2011 2012 2013 FSC EH-8 / T-4 / I-3 Increase public-health agency staff to conduct outreach activities and train physicians on reporting of illnesses that may be food-borne. 20142010 2011 2012 2013 MOH EH-8 / T-4 / I-4 Improve coordination between emirate public-health and food-control agencies. 20142010 2011 2012 2013 Emirate food-control agencies EH-8 / T-4 / I-5 Assess need for additional accredited food-testing laboratories and accredited testing capacity. 2010 2011 2012 2013 2014 Emirate food-control agencies Priority Area 8: Produce and Seafood Section Overview # of Initiatives # of KPIs 16 19 TOTAL 4 6 Target 1 3 3 Target 2 0 0 Target 3 5 7 Target 4 1 1 Target 5 3 2 Target 6 EAD MOEW MOH Environment Agency—Abu Dhabi Emirates Authority for Standardization and Metrology Abu Dhabi Farmers Services Centers Ministry of Environment and Water Ministry of Health UAE Coast Guard Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: FSC ESMA UAE CG 88 Target 5: Support urban development that promotes environmental health Stakeholders EH-8 / T-5 / I-1 Establish a procedure for communication between emirate food-control agencies and urban-planning offices to ensure that environmental impact statements consider food-safety issues (such as effects of additional waste discharges into the coastal environment). 20142010 2011 2012 2013 MOEW EAD Target 6: Increase environmental awareness Stakeholders EH-8 / T-6 / I-1 Design and conduct public information campaigns on food safety. 20142010 2011 2012 2013 Emirate food-control agencies EH-8 / T-6 / I-2 Adopt UAE-wide organic labeling. Extend MOEW food-labeling program across all emirates. 20142010 2011 2012 2013 MOEW EH-8 / T-6 / I-3 Establish consumption advisory related to red tides and to persistent pollutants in fish and seafood. Emirate food-control agencies 20142010 2011 2012 2013 MOEW EAD UAE CG Produce and Seafood (EH-8): Key Performance Indicators KPI No. Description 2014 Goal 2030 Goal Target 1: Reduce pollutant levels and human exposure to pollutants EH-8 / T-1 / K-1 Monthly percentage of food product shipments imported into the UAE that comply with UAE technical rules and applicable regulations 100% 100% EH-8 / T-1 / K-2 Percentage of food produced in the UAE every year that complies with UAE pesticide residue levels To be determined To be determined EH-8 / T-1 / K-3 Percentage of domestic fish and seafood samples that comply with established heavy metal standards each year To be determined To be determined EH-8 / T-1 / K-4 Percentage of imported fish and seafood samples that comply with established heavy metal standards each year To be determined To be determined EH-8 / T-1 / K-5 Number of food-borne outbreaks per year To be determined To be determined EH-8 / T-1 / K-6 Incidence of childhood neurological impairment To be determined To be determined Target 2: Improve data quantity and availability EH-8 / T-2 / K-1 Percentage of suspected food-borne illness outbreaks that are investigated annually (e.g., epidemiologic outbreak investigation) To be determined To be determined EH-8 / T-2 / K-2 The extent to which a national electronic medical record system is operational, preva lent and used for food-borne illness surveillance: 1. Percentage of physicians participating in the system in a given year 2. Percentage of emergency rooms participating in the system in a given year 3. Percentage of hospitals participating in the system in a given year To be determined To be determined EH-8 / T-2 / K-3 Percentage of health laboratories in UAE that participate in electronic laboratory reporting system 80% 100% 89 Priority Area 8: Produce and Seafood Section Overview # of Initiatives # of KPIs 16 19 TOTAL 4 6 Target 1 3 3 Target 2 0 0 Target 3 5 7 Target 4 1 1 Target 5 3 2 Target 6 EAD MOEW MOH Environment Agency—Abu Dhabi Emirates Authority for Standardization and Metrology Abu Dhabi Farmers Services Centers Ministry of Environment and Water Ministry of Health UAE Coast Guard Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: FSC ESMA UAE CG KPI No. Description 2014 Goal 2030 Goal Target 3: Improve scientific understanding of environmental health risks No pertinent KPIs Target 4: Build sustainable human and institutional capacity EH-8 / T-4 / K-1 Percentage of UAE food manufacturers, hotels, and caterers that implement food safety management systems based on Hazard Analysis and Critical Control Points on a continual basis 70% 100% EH-8 / T-4 / K-2 Percentage of farms in the UAE that implement GAP on a continual basis 70% 100% EH-8 / T-4 / K-3 Percentage of pesticide applicators who are certified 40–60% 100% EH-8 / T-4 / K-4 Percentage of physicians who receive outreach information every year related to re quired surveillance reporting requirements for specified illnesses or pathogens isolated from cases To be determined To be determined EH-8 / T-4 / K-5 Percentage of providers from whom reports are expected (e.g., sentinel) who submit at least 90% of expected annual reports on specified illnesses (e.g., diarrheal disease or specified pathogens) To be determined To be determined EH-8 / T-4 / K-6 Percentage of need for accredited food-safety laboratories met 80% 100% EH-8 / T-4 / K-7 Percentage of providers in the national electronic medical record system who receive annual training on the system, specifically: 1. Percentage of physicians who receive annual training 2. Percentage of emergency room administrators who receive annual training 3. Percentage of hospitals with a medical records officer who receives annual training 100% 100% Target 5: Support urban development that promotes environmental health EH-8 / T-5 / K-1 Percentage of emirates with procedures implemented to liaise between food and plan ning authorities 90% 100% Target 6: Increase environmental awareness EH-8 / T-6 / K-1 Percentage of UAE consumers aware of risks associated with pesticide residues on foods 85% To be determined EH-8 / T-6 / K-2 Percentage of fishermen aware of water quality issues affecting fish To be determined To be determined 90 Conclusions The vision and ambitious directions encompassed within this plan call for harmony with other strategic efforts in the country, sound management and coordination in implementation, responsible enforcement, ongoing monitoring and vigilance, re search to advance the knowledge base, and country leadership that can extend to the entire region and beyond. Overarching objectives in these areas are described below, and related initiatives and KPIs are provided in the charts that follow. 1 Connect relevant elements of this plan with other strategic plans. The science team has identified a number of strategic plans and relevant guidance documents at the federal and emirate level that are pertinent to this environmental health strategy and action plan. To the extent possible, we have incorporated and documented indicators from such documents so that plans across emirates and sec tors are harmonized and compatible with one another. This will help avoid both unnecessary creation of new indicators and conflicting or contradictory indicators across plans. 2 Coordinate implementation and promote communication across emir-ates and agencies. While the aspiration to achieve an environment that pos es minimal burden on human health across the UAE is clear in the recommendations for the eight priority areas, it is equally clear that stakeholders must coordinate imple mentation of these recommendations across agencies and across emirates. Two pos sible mechanisms with which to do so would be the establishment of one or more new coordinating committees or the development of additional tasks for relevant existing committees. Committee members should be aware of one another, and committees should meet in person and/or virtually as often as stakeholders deem appropriate to keep one another informed, monitor progress, address operational decisions, etc. For example, a committee that brings together representatives from environmental agencies or local environmental authorities from each emirate could share informa tion about effective policies, coordinate actions to implement the strategy, and help build capacity. 3 Build local human resource capacity. As noted across all eight priority ar-eas, the establishment or further development of graduate professional educa tion programs, certificate training, and in-service (on-the-job) training across the UAE is the foundation for the development of a UAE environmental health workforce that is well qualified and of sufficient size to manage environmental health policies and programs at all levels. A coherent approach to the development of such educational and training programs should transcend all priority areas. Overarching Objectives 90 4 Promote sound policy enforcement mechanisms. Poli-cies are only valuable if they are implemented; enforcement is a critical early step to effective policy implementation, before more distal downstream health effects occur. Thematically across the eight priority areas, environmental health enforcement mech anisms in this strategic plan address compliance with required re porting of environmental and health monitoring; compliance with regulations to avoid or reduce pollution or contamination (e.g., related to generation of outdoor air emissions, hazardous waste or occupational exposures, hazard analysis, and critical point control monitoring for food safety); and inspections and audits (e.g., indoor air quality, energy). Across all of these areas, rel evant authorities should continually assess enforcement activities and ensure that the policies in place are actively being enforced. 5 Monitor health outcomes and risk on an ongoing basis to detect emerging threats. The ultimate goal of the UAE environmental health strategy is to reduce the burden of disease associated with environmental pollution. The strategy describes two major ways to assess this burden over time: (1) burden of disease modeling for specific environmental risks and (2) routine monitoring of health outcomes of interest, e.g., through public health surveillance, disease registries, or data mining from electronic medical records. The modeling is described in detail in a companion report on the state of the environment and pub lic health in the UAE. Routine monitoring is addressed here, as it reflects assessment of the ultimate outcome of interest along the pathway from pollution to exposure to disease. Monitoring diseases and other health outcomes associated with specific envi ronmental pollutants will allow policy makers to track the charac teristics of disease occurrence (e.g., in terms of who is affected, locations where disease is concentrated, and trends over time). As effective environmental policies are implemented, health out comes should improve. In the meantime, routine monitoring will allow tracking of trends and detection of outbreaks or clusters of disease that should be investigated to help target further interven tions. In the context of a rapidly developing and ever-changing country, it is important to recognize that tomorrow’s environmen tal health threats may not be the same as those of today——new threats may emerge. Similarly, threats that are currently relatively unimportant may become more important over time. Therefore, an environmental health strategic plan must remain dynamic and policy makers vigilant to the emergence of new and evolving environmental factors or new types of exposures that negatively impact human health. Such vigilance will rely upon established monitoring systems and astute observation of unexpected or un usual events and patterns that arise. UAE policy makers may wish to consider both periodically repeating risk assessments——such as that undertaken for this strategic plan——and also ad hoc inves tigations of new risks as they arise. Effective monitoring will also require enhancing current systems to ensure they are robust and provide information that is useful to decision makers. 6 Invest in a sound environmental health research agenda. Proposed research priorities across the eight priority areas range from the fundamental understanding of the pathways from environmental exposure to disease (and the cor responding unique environmental health risks in the UAE) to the development of new technologies and more in-depth economic analyses of alternative policies to reduce the environmental bur den of disease. A coherent research agenda will help the country make sound investments in improving the scientific understanding of environmental health in the country and ways to improve it. 7 Provide national and regional leadership. UAE policy makers are ambitious and confident about their vision for improving environmental health across the country. Leadership across emirates and across sectors must be developed and nur tured as an explicit element of building human resource capacity, e.g., through leadership training, development, and mentorship. Moreover, leadership can also apply to the exemplary environ mental health policies and practices in the country. For example, policy makers may wish to consider establishment of one or more environmental health centers of excellence, including the possi bility of attaining designation as a WHO Collaborating Center for environmental health. Such designation by the WHO reflects regional and international stature, with such centers serving as a model or reference center for other countries. • 91 92 Implementation and Refinement of the Strategy and Action Plan This strategy and action plan document is but the first of many steps to-ward improving the protection of public health from environmental risks in the UAE. Collection of additional data and further quantitative analyses will strengthen future versions of the strategy and action plan. As the UAE moves forward with the strategy and action plan, it should establish a regular process for refining the KPIs and recommended initia tives. The KPIs and initiatives presented here are based on the collective input of a wide variety of stakeholders in environmental health from the UAE and the science team. They represent a strong starting point for mak ing progress in environmental health, but the KPIs and initiatives should be refined based on future data collection and quantitative analysis. Future work to improve the strategy and action plan should include (1) gathering baseline information on the KPIs, (2) conducting quantita tive analyses to determine what levels of improvement along the KPIs are technically feasible, (3) prioritizing KPIs based on analyses of the strength of association of the KPIs to environmental health, and (4) prioritizing initia tives based on their potential to improve public health and on cost-benefit analysis. UNC has developed an integrated tool for estimating the environmen tal burden of disease in the UAE that can provide a foundation for carrying out some of these steps: the United Arab Emirates Environmental Burden of Disease Model, which can be used to prioritize data collection so that data collection efforts are focused on information with the greatest poten tial to inform decisions to protect environmental health. The model can help identify the factors with the greatest influence on the environmental burden of disease and which of these factors contribute the greatest uncertainty to estimates of the effects of environmental pollutants on public health. It can be used to provide input to future cost-benefit analyses. The results of the cost-benefit analyses could inform decisions about which actions or initia tives may have the greatest net benefit for public health. The companion report on the state of the environment and public health in the UAE describes the structure of the UAE environmental bur den of disease model in detail. The model itself is available from UNC or through EAD. It is supported by the software package Analytica. Through implementation of this strategy and action plan, the UAE can continue to realize the vision of its first president, H. H. Sheikh Zayed bin Sultan Al Nahyan. Sheikh Zayed long recognized the connections be tween the environment and human health. He observed, We cherish our environment because it is an integral part of our country, our history and our heritage. On land and in the sea, our forefathers lived and survived in this environment. They were able to do so only because they recognized the need to conserve it, to take from it only what they needed to live and to preserve it for succeeding generations. This strategy and action plan is designed to help guide the UAE in its stewardship of the environment for the health of current and future gen erations, consistent with Sheikh Zayed’s vision. The cooperation of many agencies and organizations across the UAE will ensure the success of this effort. • 92 93 Target 1: Connect relevant elements of this plan with other strategic plans EH-9 / T-1 / I-1 Collect all strategic planning documents pertinent to reducing environmental impacts on public health in the UAE from all agencies with missions relevant to the environment and public health. Review the strategic plans, and identify com mon elements. EADMOEW MOH 20142010 2011 2012 2013 HAAD Target 2: Coordinate implementation and promote communication across emirates and agencies EH-9 / T-2 / I-1 Establish an interagency committee to devise an approach for coordinating implementation of existing strategic plans with the UAE National Strategy and Action Plan for Environmental Health. Emirate environment agencies EADMOEW MOH 20142010 2011 2012 2013 HAAD DHA Target 3: Build local human resource capacity See pertinent initiatives recommended for each priority area. Target 4: Promote sound policy enforcement mechanisms See pertinent initiatives recommended for each priority area. Target 5: Monitor health outcomes and risk on an ongoing basis Stakeholders EH-9 / T-5 / I-1 Review and update the United Arab Emirates Environmental Burden of Disease Model at least every two years. Emirate environment agencies MOEW MOH HAAD 2010 OngOing20132011 2012 DHA EH-9 / T-5 / I-2 Establish a biological monitoring program that would provide serial cross-sectional or longitudinal data on the human body burden of environmental contaminants and of environmentally related health conditions, such as asthma or neurological disorders. 20142010 2011 2012 2013 DHAMOH HAAD EH-9 / T-5 / I-3 Consider behavioral risk factor surveillance. 2010 ? DHAMOH HAAD Overarching Objectives (EH-9): Initiatives to Reduce the Burden of Disease Across Multiple Areas Section Overview # of Initiatives # of KPIs 10 14 TOTAL 1 1 Target 1 1 2 Target 2 0 2 Target 3 0 1 Target 4 4 5 Target 5 1 1 Target 6 3 2 Target 7 Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: MOHDubai Health Authority Health Authority—Abu Dhabi Ministry of Environment and Water Ministry of Health National Research Foundation UAE University NRF DHA HAAD MOEW UAEU EAD Environment Agency—Abu Dhabi 94 KPI No. Description 2014 Goal 2030 Goal Target 1: Connect relevant elements of this plan with other strategic plans EH-9 / T-1 / K-1 Percentage of revised KPIs that are compatible with other relevant strategic plans (federal and emirate level) 100% 100% Target 2: Coordinate implementation and promote communication across emirates and agencies EH-9 / T-2 / K-1 Number of sectors or entities represented in committees and meetings to coordinate plan implementation To be determined To be determined EH-9 / T-2 / K-2 Number of coordinating committee meetings in the preceding six months To be determined To be determined Target 3: Build local human resource capacity EH-9 / T-3 / K-1 Number of accredited programs offering graduate-level degrees in specified disciplines relevant to environmental health, e.g., environmental sciences and engineering, occupational medicine, epidemiology, toxicology To be determined To be determined EH-9 / T-3 / K-2 Number of graduates per year with master’s and PhD degrees in specified disciplines relevant to environmental health To be determined To be determined Target 4: Promote sound policy enforcement mechanisms EH-9 / T-4 / K-1 Number of emirates with policies, laws and/or regulations in place to provide for adequate enforcement of all requirements for each priority area 3-4 emirates for each priority area All emirates, all priority areas EH-9 / T-5 / I-4 Establish a list of health outcomes of interest for purposes of monitoring health effects associated with the eight priority areas, and ensure that routine data are collected throughout the country for these outcomes, e.g., through surveillance, case registries, analysis of electronic medical records. 20142010 2011 2012 2013 DHAMOH HAAD Target 6: Invest in a sound environmental health research agenda Stakeholders EH-9 / T-6 / I-1 Develop a national environmental health research agenda consistent with the needs of the UAE national research agenda, and review it annually. Note also that MOH is working on a national health research agenda. Environmental and health authorities, occupational health authorities 20142010 2011 2012 2013 UAEU Target 7: Provide national and regional leadership Stakeholders EH-9 / T-7 / I-1 Continue to support centers of excellence related to environmental health in the UAE. Note that 10 such centers already exist or are planned. 2010 ? NRF EH-9 / T-7 / I-2 Establish a WHO Collaborating Centre for Environmental Health in the UAE. Begin with annual assessments of readiness to apply for such designation. Environmental and health authorities 2010 OngOing UAEU EH-9 / T-7 / I-3 Support study tours in environmental health in the UAE. 2010 ? To be determined Overarching Objectives (EH-9): Key Performance Indicators 95 Section Overview # of Initiatives # of KPIs 10 14 TOTAL 1 1 Target 1 1 2 Target 2 0 2 Target 3 0 1 Target 4 4 5 Target 5 1 1 Target 6 3 2 Target 7 KPI No. Description 2014 Goal 2030 Goal Target 5: Monitor health outcomes and risk on an ongoing basis EH-9 / T-5 / K-1 Total estimated environmental burden of disease (expressed as disability-adjusted life years) in the UAE To be determined To be determined EH-9 / T-5 / K-2 Number of emirates monitoring at least 90% of health outcomes of interest on a routine basis 3-4 All emirates EH-9 / T-5 / K-3 Percentage of required surveillance reports for one year that are submitted within one week of due date (by emirate) 50% 100% EH-9 / T-5 / K-4 Number of outbreaks or case clusters of health outcomes of interest detected per year by each emirate Not applicable Not applicable EH-9 / T-5 / K-5 Number of input parameters in environmental burden of disease model updated per year To be determined To be determined Target 6: Invest in a sound environmental health research agenda EH-9 / T-6 / K-1 Number of research findings concretely applied to environmental health policy or programming per year To be determined To be determined Target 7: Provide national and regional leadership EH-9 / T-7 / K-1 Number of designated environmental health centers of excellence in the UAE To be determined To be determined EH-9 / T-7 / K-2 Number of environmental health study tours hosted per year: 1. From region 2. From elsewhere To be determined To be determined 95 Stakeholders are organizations that should cooperate in the planning and achievement of each initiative. They may include nonspecific entities as well as these specific entities: MOHDubai Health Authority Health Authority—Abu Dhabi Ministry of Environment and Water Ministry of Health National Research Foundation UAE University NRF DHA HAAD MOEW UAEU EAD Environment Agency—Abu Dhabi 96 Abu Hilal, A. H., A. B. Adam, I. M. Banat, and E. S. Hassan. 1994. Sanitary conditions in three creeks in Dubai, Sharjah, and Ajman emirates on the Arabian Gulf (UAE). Environmental Monitoring and Assessment 32:21—36. Aglukkaq, L. 2008. Minister’s remarks on bisphenol A. Speech given by Canadian Minister of Health on April 18. http://www. hc-sc.c.ca/ahc-asc/minist/speeches-discours/008 04 18 e. html. Al Ashram, O. 2005. Pond wastes and pollution sources in Abu Dhabi emirate. AGEDI, EAD. Al Mudhaf, A. F., F. A. Alsharifi, and A.-S. I. Abu Shady. 2009. A survey of organic contaminants in household and bottled drinking waters in Kuwait. Science of the Total Environment 407:1658—68. Ali Murad, A., H. Al Nuaimi, and M. Al Hammadi. 2007. Comprehensive assessment of water resources in the United Arab Emirates (UAE). Water Resource Management 21:1449— 63. Al Qaydi, S. 2006. Industrial solid waste disposal in Dubai, UAE: A study in economic geography. Cities 23(2): 140—8. Badrinath, P., Q. A. Al Shboul, T. Zoubeidi, T., A. S. Gargoum, R. Ghubash, and O. E. El Rufaie. 2002. Measuring the health of the nation: United Arab Emirates health and lifestyle survey 2000. UAE University. Banat, I. M., E. S. Hassan, A. H. Abu Hilal, and A. B. Adam. 1993. Microbial and nutrient pollution assessment of coastal and creek waters of northern UAE. Environment International 19(6): 569— 78. Banat, I. M., E. S. Hassan, M. S. El Shahawi, and A. H. Abu Hilal. 1998. Post Gulf War assessment of nutrients, heavy metal ions, hydrocarbons, and bacterial pollution levels in the United Arab Emirates coastal waters. Environment International 24(1/2): 109—16. Baumert, K. A., T. Herzog, and J. Pershing. 2005. Navigating the numbers: Greenhouse gas data and international climate policy. World Resources Institute, 21—24. http://pdf.wri.org/ navigating numbers chapter4.pdf. Boehm, A. B., N. J. Ashbolt, J. M. Colford, L. E. Dunbar, L. E. Fleming, M. A. Gold, and J. A. Hansel et al. 2009. A sea change ahead for recreational water quality criteria. Journal of Water and Health 7(1): 9—20. California Air Resources Board. 2005. Report to the California legislature: Indoor air pollution in California. http://www.arb. ca.gov/research/indoor/ab1173/rpt0705.pdf. Campbell-Lendrum, D. H., and R. Woodruff. 2007. Climate change: Quantifying the health impact at national and local levels. World Health Organization Environmental Burden of Disease Series, no. 14. http://whqlibdoc.who.int/ publications/2007/9789241595674 eng.pdf. Cohen, A. J., H. R. Anderson, B. Ostro, K. D. Pandey, M. Krzyzanowski, N. Künzli, K. Gutschmidt, A. Pope, I. Romieu, J. M. Samet, and K. Smith. 2005. The global burden of disease due to outdoor air pollution. Journal of Toxicology and Environmental Health, Part A 68:1301—7. Craft, M. 2008. Utopia in the Desert. Forbes, November 24. Craun, G. F., R. L. Calderon, and M. F. Craun. 2005. Outbreaks associated with recreational water in the United States. International Journal of Environmental Health Research 15(4): 243—62. Croucher, M. 2009. Genetically modified foods not clearly labeled. Khaleej Times, February 25. Curl, C. A., R. A. Fenske, J. C. Kissel, J. H. Shirai, T. F. Moate, W. Griffith, G. Coronado, and B. Thompson. 2002. Evaluation of take-home organophosphorus pesticide exposure among agricultural workers and their children. Environmental Health Perspectives 110(12): A 787—92. http://www.pubmedcentral. nih.gov/picrender.fcgi?artid=1241133&blobtype=pdf. Davies, J. C., ed. 1996. Comparing Environmental Risks: Tools for Setting Government Priorities. Washington, D.C.: Resources for the Future. Davis, D. L., and C. Forrester. 2004. Past and present environmental health challenges in Southwestern Pennsylvania: some comments on the right to a clean environment. American Journal of Law and Medicine 30:305—332. De Brouwere, K., E. Goelen, M. Spruyt, and R. Torfs. 2007. Ranking indoor health problems using health impact assessment. VITO—Flemish Institute for Technological Research. 2007/ IMS/R/394. http://www.vito.be/VITO/OpenWoDocument. a s p x ? wov i t o g u i d = C 87 8 0 D D 9 - 1 A 9 D - 4 5 8 D - 97 3 5 A3A39C2E9A35. Dockery, D. W., C. A. Pope, X. Xu, J. D. Spengler, J. H. Ware, M. E. Fay, B. G. Ferris, and F. E. Speizer. 1993. An association between air pollution and mortality in six U.S. cities. New England Journal of Medicine 329:1753—1759. Dubai Department of Tourism and Commerce Marketing. 2007. Hotel Statistics Summary. http://www.dubaitourism.ae/EServices/ HotelStatistics/tabid/167/language/en-US/Default.aspx. Duncan, B. N., J. J. West, Y. Yoshida, A. M. Fiore, and J. R. Ziemke. 2008. The influence of European pollution on ozone in the Near East and northern Africa. Atmospheric Chemistry and Physics Discussions 8:1913—1950. http://hal. a r c h i v e s - o u v e r t e s . f r / d o c s / 0 0 / 3 0 / 3 2 / 7 8 / P D F / acpd-8-1913-2008.pdf. Elshorbagy, W., and M. Abdulkarim. 2006. Chlorination byproducts in drinking water produced from thermal desalination in United Arab Emirates. Environmental Monitoring and Assessment 123(1-3): 313—31. Environment Agency—Abu Dhabi. 2004. Water Quality Regulations. Regulation and Supervision Bureau for the Water and Electricity Sector. ED/R01/001. http://www.rsb.gov.ae/PDFs/law9.pdf. ——————. 2007. Report on water quality of Abu Dhabi coastal waters. ——————. 2008. Waste & Pollution Sources of Abu Dhabi Emirate, United Arab Emirates. Abu Dhabi Global Environmental Data Initiative program. Abu Dhabi: EAD. ——————. 2009a. Abu Dhabi Climate Change Policy. Draft, February. ——————. 2009b. Abu Dhabi Environment, Health and Safety Regu la tory Framework (AD EHSMS). http://www.ead.ae/en/portal/ ad. ehsms.aspx. ——————. 2009c. Abu Dhabi Water Resources Master Plan. Draft, January. ——————. 2009d. Gap Analysis Report on Abu Dhabi Environment Related Policies. Draft. Florig, H. K., M. G. Morgan, K. M. Morgan, K. E. Jenni, B. Fischhoff, P. S. Fischbeck, and M. L. DeKay. 2001. A deliberative method References 97 for ranking risks (1): overview and test bed development. Risk Analysis 21(5): 913—921. Frumkin, H., ed. 2005. Environmental Health: From Global to Local. San Francisco: Jossey-Bass. Graneli, E., and J. T. Turner. 2006. An introduction to harmful algae. In Ecology of Harmful Algae, eds. E. Graneli and J. T. Turner, 3—21. Berlin: Springer. Gray, G. G., and J. K. Hammitt. 2000. Risk/risk trade-offs in pesticide regulation: An exploratory analysis of the public health effects of a ban on organophosphate and carbamate pesticides. Risk Analysis (5): 665—80. Hamill, S. D. 2008. Unveiling a museum, a Pennsylvania town remembers the smog that killed 20. The New York Times, November 1. http://www.nytimes.com/2008/11/02/us/ 02smog. html. Kazim, A. M. 2007. Assessments of primary energy consumption and its environmental consequences in the United Arab Emirates. Renewable and Sustainable Energy Reviews 11:426—46. Khaleej Times. 2002. Fruits and vegetables safe from pesticides: Study. November 30. Klepeis, N. E., W. C. Nelson, W. R. Ott, J. P. Robinson, A. M. Tsang, P. Switzer, J. V. Behar, S. C. Hern, and W. H. Engelmann. 2001. The National Human Activity Pattern Survey (NHAPS): A resource for assessing exposure to environmental pollutants. Journal of Exposure Analysis and Environmental Epidemiology 11:231—52. Leecaster, M. K., and S. B. Weisberg. 2001. Effect of sampling frequency on shoreline microbiology assessments. Marine Pollution Bulletin 42(11): 1150—4. Lelieveld, J., P. Hoor, P. Jöckel, A. Pozzer, P. Hadjinicolaou, J.-P. Cammas, and S. Beirle. 2009. Severe ozone air pollution in the Persian Gulf region. Atmospheric Chemistry and Physics Discussions 9:1393—1406. Li, Q., D. J. Jacob, J. A. Logan, I. Bey, R. M. Yantosca, H Liu, and R.V. Martin et al. 2001. A tropospheric ozone maximum over the Middle East. Geophysical Research Letters 28(17): 3235—8. Liu, J. J., D. B. A. Jones, J. R. Worden, D. Noone, M. Parrington, and J. Kar. 2009. Analysis of the summertime buildup of tropospheric ozone abundances over the Middle East and North Africa as observed by the Tropospheric Emission Spectrometer instrument. Journal of Geophysical Research 114:D05304. Menon, P. 2009. Red tide closes two Dubai beaches. The National, April 7. http://www.thenational.ae/article/20090407/ NATIONAL/138119746/1186. Morgan, K. M., M. L. DeKay, P. S. Fischbeck, M. G. Morgan, B. Fischhoff, and H. K. Florig. 2001. A deliberative method for ranking risks (II): evaluation of validity and agreement among risk managers. Risk Analysis 21(5): 923—937. National Academy of Sciences. 1983. Risk Assessment in the Federal Government. Washington, D.C.: National Academies Press. Poisot, A., A. Speedy, and E. Kueneman. 2004. Good agricultural practices — A working concept. FAO Agriculture Department. Pope, C. A. III. Respiratory hospital admissions associated with PM10 pollution in Utah, Salt Lake, and Cache Valleys. Archives of Environmental Health 46:90—7. Pruss, A. 1998. Review of epidemiological studies on health effects from exposure to recreational water. International Journal of Epidemiology 27:1—9. Reid, J. S., S. J. Piketh, R. Kahn, R. T. Bruintjes, and B. L. Holben. 2005. A summary of first year activities of the United Arab Emirates Unified Aerosol Experiment: UAE2. Naval Research Laboratory Report NRL/MR/7534—05-8899. http://uae2.gsfc.nasa.gov/. Regulation and Supervision Bureau (RSB). 2009. Guide to water supply regulations. Sambidge, A. 2008. “Red tide” forces desalination plant closure. ArabianBusiness.com, November 17. http://www. arabianbusiness.com/538468-red-tide-forces-desalination plant-closure. Setrakian, L. 2009. Filthy rich: Dubai choking on sewage. ABC News, February 1. http://abcnews.go.com/International/ Story? id=6781673&page=1. Shamseddine, M. 2006. Abu Dhabi to free water of chemical. Gulf News, January 2. http://archive.gulfnews.com/articles/ 06/01/02/10008790.html. Telegraph. 2009. Dubai’s polluted beaches closed to public. January 29. http://www.telegraph.co.uk/travel/travelnews/4380051/ Dubais-polluted-beaches-closed-to-public.html. Thompson, B., G. D. Coronado, J. E. Grossman, K. Puschel, C. C. Solomon, I. Islas, C. L. Curl, J. H. Shirai, J. C. Kissel, and R. A. Fenske. 2003. Pesticide take-home pathway among children of agricultural workers: study design, methods, and baseline findings. Journal of Occupational and Environmental Medicine 45(1): 42—53. Trivedi, C. 2002. The great smog of London. BBC News Online, December 5. http://news.bbc.co.uk/2/hi/uk news/england/ 2545759.stm. UAE Federal Government. 1999. Protection and development of the environment. Federal Law 24. UAE Ministry of Energy. 2006. Initial national communication to the United Nations Framework Convention on Climate Change. http://unfccc.int/resource/docs/natc/arenc1.pdf. United Nations Development Programme. 2008. 2007/2008 Human Development Report. http://hdrstats.undp.org/ countries/country fact sheets/cty fs ARE.html. U.S. Environmental Protection Agency (EPA). 1998. A comparison of indoor and outdoor concentrations of hazardous air pollutants. Inside IAQ 002:1—7. http://www.epa.gov/appcdwww/iemb/ insideiaq/ss98.pdf. ——————. 2008. Love Canal Superfund site. Region 2. http://www. epa.gov/Region2/superfund/npl/lovecanal/. Wade, T. J., N. Pai, J. N. Eisenberg, and J. M. Colford Jr. 2003. Do U.S. Environmental Protection Agency water quality guidelines for recreational waters prevent gastrointestinal illness? A systematic review and meta-analysis. Environmental Health Perspectives 111(8): 1102—9. Watson, R. T., M.C. Zinyowera, R. H. Moss, and D. J. Dokken, eds. 1997. The regional impacts of climate change: An assessment of vulnerability. Intergovernmental Panel on Climate Change. http://www.ipcc.ch/pdf/special-reports/spm/region-en.pdf. Wines, M. 2009. Lead sickens 1,300 children in China. The New York Times, August 21. http://www.nytimes.com/2009/08/21/ world/asia/21china.html. Willis, H., et al. 2008. Preliminary Situational Analysis Report of Environmental Health Risks in the United Arab Emirates. RAND. World Bank. 2005. A water sector assessment report on the countries of the cooperation council of the Arab states of the Gulf. Water, Environment, Social and Rural Development Department, Middle East and North Africa Region, no. 32539-MNA. World Health Organization (WHO). 2000. Disinfectants and disinfection by-products. Environmental Health Criteria 216. http://www.inchem.org/documents/ehc/ehc/ehc216.htm. ——————. 2005. Nutrients in drinking water. Water, Sanitation and Health. http://www.who.int/water sanitation health/dwq/ nutrientsindw.pdf. • 98 Appendix A January 25-26, 2009, Abu Dhabi Hazem Abuahmad Abu Dhabi National Oil Company, Supreme Petroleum Council Ayesha Abushahab Environment Agency—Abu Dhabi Faisal Al Hammadi Environment Agency—Abu Dhabi Taha Nagy Al Hosary National Center for Meteorology Salha Al Humairi Environment Agency—Abu Dhabi Mohammad Al Hosani Abu Dhabi Municipality Yousif Al Husani Armed Forces, UAE Defense, Medical Services Ahmed Saeed Al Junaibi Amer Al Kindi Abu Dhabi Education Council Mohammad Al Marzouqi Abu Dhabi Municipality Khawla Al Muhairi Family Environment Foundation Muthana Al Omar Abu Dhabi Water and Electricity Authority Abdulla Al Rumaithi Environment Agency—Abu Dhabi Ayesha Al Suweidi Environment Agency—Abu Dhabi Shirina Al Suweidi UAE University Salem Al Sueiki Environment Agency—Abu Dhabi Mariam H. Al Yousuf Abu Dhabi Food Control Authority Wafa Eissa Al Zaabi General Women Union Mohammed Hag Ali Armed Forces, UAE Defense, Medical Services Ahmed Ali Roshdy Joseph Bularzik Abu Dhabi University Holley Chant Urban Planning Council Lutfi Desougi Federal Environment Agency Ibrahim El Labadidi Abu Dhabi Council for Heritage and Culture Olabode Esan Abu Dhabi Municipality Khalid A. Gelle Environment Agency—Abu Dhabi Abdul Salam Husain Environment Agency—Abu Dhabi Darren Joubert Health Authority—Abu Dhabi Walid Abdel Kader Environment Agency—Abu Dhabi Zainab Khazaal Abu Dhabi Health Services Company (SEHA) Huden Kunz United Nations Development Programme Gabrielle Z. Mailloux Abu Dhabi University Neil Mallen Urban Planning Council Ruqaya Mohamed Environment Agency—Abu Dhabi Workshop Participants 99 Mohammed A. Abdullah Ajman Municipality Thowaibi Ahli Ministry of Environment and Water Badir Al Ali Emirates National Oil Company Saber Al Ammar Emirates National Oil Company Raed Al Marzouq Dubai Municipality Ali Al Marzouqi Dubai Health Authority Ahmad S. Al Nagaz Dubai Municipality Hareth Al Omary Dubai Municipality Asma S. Al Suweidi Sharjah Municipality Kaltham Al Shaibani Um Almomine Association Saeed Al Shamsi Department of Health Nasser Ali Emirates National Oil Company Alia Ali Busamra Emirates Environment Group Shareifa Ali Saeed Fujairah Municipality Khadija A. Alloghani Sharjah Municipality, Food Lab Shereen Besiso Emirates Environment Group Rashed Karkain Dubai Municipality Abdulsalem Mohmd Dubai Municipality Environment Department Hafiz Omar University of Sharjah Redha H. Salman Dubai Municipality Moayad Yacoub Emirates Environment Group Ahmed Nabeel Ministry of Health Annemarie Neubecker Abu Dhabi Education Council Alena Pristiskayah Al Noor Hospital Dhirajal Radadiya Abu Dhabi National Oil Company, Supreme Petroleum Council Khamis Raddad Ministry of Economy, Census Kevin Reid Urban Planning Council, Environment Yasmin Saddah Masdar City Initiative Abdurrahman Saleh Armed Forces, UAE Defense, Chemical Defense Fareed Saleh Abu Dhabi Health Services Company (SEHA) Humeid Said Ministry of Interior, Civil Defense Doa’a Hamdy Sorour Federal Environment Agency Rex Taylor Zayed University Alan Thomson Abu Dhabi Sewage Services Company Mark Vine Department of Transport Sanaa Omair Bin Yousef Family Environment Foundation Amin Mohamed Yousif Abu Dhabi Municipality January 28-29, 2009, Dubai 100 April 15, 2009, Abu Dhabi Abdullah Al Aameri Environment Agency—Abu Dhabi Omar Al Ashram Environment Agency—Abu Dhabi Salem Al Braiki Environment Agency—Abu Dhabi Huda Mohamed Ajaraj Al Dhafar Abu Dhabi Food Control Authority Manal Al Hashemi Abu Dhabi Food Control Authority Awatif Al Hosani Environment Agency—Abu Dhabi Ahmed Awad Ali Al Kathery Armed Forces Abdul Rahman Al Marzouqi Environment Agency—Abu Dhabi Ali Al Marzouqi Dubai Health Authority Khaled Ateeq Al Mazrouki Environment Agency—Abu Dhabi Nabeel Saleh Al Olaqi Environment Agency—Abu Dhabi Abdulla Al Rumaithi Environment Agency—Abu Dhabi Ayesha Al Suweidi Environment Agency—Abu Dhabi Mariam H. Al Yousuf Abu Dhabi Food Control Authority Abdul Salam BaAqeel Environment Agency—Abu Dhabi Dhabia Bhakhit Department of Transport Ahmed Bashir Environment Agency—Abu Dhabi Khalid A. Gelle Environment Agency—Abu Dhabi Qasem Hilles Abu Dhabi Food Control Authority Darren Joubert Health Authority—Abu Dhabi Mustafa Lotfi Environment Agency—Abu Dhabi Salah Moussa Abu Dhabi National Oil Company, Supreme Petroleum Council Asma Abdi Mohamed Abu Dhabi Food Control Authority Ruqaya Mohamed Environment Agency—Abu Dhabi Hazem H. Qawasmeh Environment Agency—Abu Dhabi Katherine Rain Health Authority—Abu Dhabi Zuleykha Rasolova Department of Transport Pritpal Soorae Environment Agency—Abu Dhabi Jens Thomsen Health Authority—Abu Dhabi Mark Vine Department of Transport June 3, 2009, Abu Dhabi Mahmoud Abdelfattah Environment Agency—Abu Dhabi Ayesha Abushahab Environment Agency—Abu Dhabi Shakeel Ahmad Abu Dhabi Food Control Authority Abdulla Al Aameri Environment Agency—Abu Dhabi Omar Al Ashram Environment Agency—Abu Dhabi Abdulnaser Al Faihan Dubai Municipality Saif Al Ghais UAE University Appendix A (cont.): Workshop Participants 101 Manal Al Hashemi Abu Dhabi Food Control Authority Khaled Al Junadi Environment Agency—Abu Dhabi Saif Rateb Al Kubaisy Dubai Municipality Nabil Al Madalal Center of Waste Management Abu Dhabi Saif Al Qaydi UAE University Buthaina Salem Al Qubaisi Abu Dhabi Food Control Authority Abdulla Al Rumaithi Environment Agency—Abu Dhabi Ayesha Al Suweidi Environment Agency—Abu Dhabi Husein Ghani Ali Environment Agency—Abu Dhabi Muhammad Altaf Dubai Municipality Food Control Department Tar-Ching Aw UAE University Gregorio B. Balerite Dubai Municipality Environment Department Dhabia Bhakhit Department of Transport Iain Blair UAE University Trond Bohler Norwegian Institute for Air Research Victoria Brown Urban Planning Council Housam Chahin Environment Agency—Abu Dhabi Mohamed El Sadig UAE University Stanley Falconer ICAD Industrial Waste Treatment Services Khalid A. Gelle Environment Agency—Abu Dhabi Husein Hamed Norwegian Institute for Air Research Mohamed Hasan Dubai Municipality Qasem Hilles Abu Dhabi Food Control Authority Darren Joubert Health Authority—Abu Dhabi Mona Kazwah Environment Agency—Abu Dhabi Shadab Alem Khan Dubai Municipality Mustafa Lotfi Environment Agency—Abu Dhabi Asma Abdi Mohamed Abu Dhabi Food Control Authority Ruqaya Mohamed Environment Agency—Abu Dhabi Nasir Ahmed Ali Mohammed Ministry of Health Ahmed Nabil Ministry of Health Hafiz Omar University of Sharjah Hazem Qawasmeh Environment Agency—Abu Dhabi Katherine Rain Health Authority—Abu Dhabi Anbiah Rajan Environment Agency—Abu Dhabi Zuleykha Rasulova Department of Transport Saeed Yousef A. Abdel Razeq UAE University Kevin Reid Urban Planning Council Sufyan Sabri UAE University John Schneider UAE University Pritpal Soorae Environment Agency—Abu Dhabi Jens Thomsen Health Authority—Abu Dhabi Mark Vine Department of Transport Andy Wheatley UAE University 102 Team Leadership Dr. Jacqueline MacDonald Gibson University of North Carolina—Chapel Hill Dr. Zeinab Farah University of North Carolina—Chapel Hill Dr. Melinda Moore RAND Corporation Dr. Henry Willis RAND Corporation Hanine Salem RAND Corporation Priority Area 1: Outdoor Air Dr. William Vizuete University of North Carolina—Chapel Hill Dr. J. Jason West University of North Carolina—Chapel Hill Dr. Alan Krupnick Resources for the Future Dr. Kenneth G. Sexton University of North Carolina—Chapel Hill Dr. Zuber Farooqui University of North Carolina—Chapel Hill Dr. Regina Shih RAND Corporation Dr. Ying Li University of North Carolina—Chapel Hill Priority Area 2: Indoor Air Chris Trent University of North Carolina—Chapel Hill Dr. Michael Flynn University of North Carolina—Chapel Hill Dr. Regina Shih RAND Corporation Priority Area 3: Occupational Exposures Dr. Leena Nylander-French University of North Carolina—Chapel Hill Tiina Folley University of North Carolina—Chapel Hill Dr. Melinda Moore RAND Corporation Dr. Regina Shih RAND Corporation Appendix B Science and Editorial Team 103 Priority Area 4: Climate Change Dr. J. Jason West University of North Carolina—Chapel Hill Dr. Richard Andrews University of North Carolina—Chapel Hill Dr. Nicholas Burger RAND Corporation Leslie Chinery University of North Carolina—Chapel Hill Elizabeth S. Harder University of North Carolina—Chapel Hill Dr. Sandra Geschwind RAND Corporation Priority Area 5: Drinking Water Dr. Greg Characklis University of North Carolina—Chapel Hill Joseph Lobuglio University of North Carolina—Chapel Hill Dr. Gary Cecchine RAND Corporation Priority Area 6: Coastal Water Dr. Greg Characklis University of North Carolina—Chapel Hill Dr. Leigh-Anne Krometis University of North Carolina—Chapel Hill Dr. Gary Cecchine RAND Corporation Priority Area 7: Soil and Groundwater Dr. Michael Aitken University of North Carolina—Chapel Hill Dr. Ying Li University of North Carolina—Chapel Hill Chidsanuphong Chart-asa University of North Carolina—Chapel Hill Sarah Szambelan Resources for the Future Dr. Sandra Geschwind RAND Corporation Dr. Nicholas Burger RAND Corporation Priority Area 8: Produce and Seafood Dr. Sandra Hoffmann Resources for the Future Christopher Davidson University of North Carolina—Chapel Hill Dr. Leigh-Anne Krometis University of North Carolina—Chapel Hill Dr. Aimee Cartwright RAND Corporation Editing and Design Editing and graphic design by Angela Brammer Photography by Christopher Davidson (pp. 12, 27, 38, 95); Tiina Folley (pp. 32, 44, 68—9, 84); Dr. Kenneth G. Sexton (pp. 61, 80); Dr. William Vizuete (pp. 50, 72); and ©iStockphoto.com/deveritt (p. 5) 104 ACGIH American Conference of Governmental Industrial Hygienists ADACI Abu Dhabi Air and Climate Institute ADFCA Abu Dhabi Food Control Authority ADNOC Abu Dhabi National Oil Company ADPD Abu Dhabi Police Department ADWEA Abu Dhabi Water and Electricity Authority AGEDI Abu Dhabi Global Environmental Data Initiative CCS carbon capture and sequestration CWM Center of Waste Management Abu Dhabi DED Dubai Municipality Environment Department DFG German Research Foundation (Deutsche Forschungsgemeinschaft) DHA Dubai Health Authority DOT Department of Transport (Abu Dhabi) EAD Environment Agency—Abu Dhabi EHSMS Environment, Health and Safety Management System (Abu Dhabi) EPA Environmental Protection Agency (U.S.) ESMA Emirates Authority for Standardization and Metrology FAO Food and Agriculture Organization of the United Nations FEWA Federal Electricity and Water Authority (UAE) GAP Good Agricultural Practices GDP gross domestic product GHG greenhouse gas GMO genetically modified organism HAAD Health Authority—Abu Dhabi ISO International Organization for Standardization KPI key performance indicator MHESR Ministry of Higher Education and Scientific Research (UAE) MOE Ministry of Education (UAE) MOEcon Ministry of Economy (UAE) MOEW Ministry of Environment and Water (UAE) MOF Ministry of Finance (UAE) MOH Ministry of Health (UAE) MOI Ministry of Interior (UAE) MOL Ministry of Labor (UAE) NILU Norwegian Institute for Air Research NRF National Research Foundation (UAE) NTA National Transport Authority (UAE) OHS occupational health and safety PM particulate matter ppm parts per million RAND RAND Corporation RFF Resources for the Future RSB Regulation and Supervision Bureau for the water, wastewater, and electricity sectors in Abu Dhabi emirate SDI Spatial Data Infrastructure database VOC volatile organic compound UAEU UAE University UNC University of North Carolina—Chapel Hill UNFCCC United Nations Framework Convention on Climate Change UPC Urban Planning Council (Abu Dhabi) WHO World Health Organization Appendix C Key to Common Acronyms