The [[DPSEEA framework]] was developed by the WHO to understand the linkages between environment and health, to support decision-making. The framework has been widely used in European and international health assessments (Corvalán et al. 2000). Figure 2.3 shows the framework. The range of causes that should be specified include the more immediate causes (exposures to environmental hazards) to more upstream causes of environmental hazards (such as environmental pressures caused by, e.g., economic or population growth). The immediate causes are termed proximal and the upstream causes distal. ^ea3c65 • Driving forces or ‘drivers’ are the social, demographic and economic developments in societies (e.g., economic growth, urbanization) and the corresponding changes in lifestyle factors, overall levels of consumption and production patterns. Drivers function through human activities which may intentionally or unintentionally exert pressures on the environment. • The pressures exerted by society may lead to unintentional or intentional changes in the state of the environment, such as levels of pollution in the water, air or soil. • Factors such as human behaviour and lifestyle choice will influence individual exposure to environmental hazards. These exposures lead to effects on human health which include mortality and morbidity outcomes. • Action can be taken by decision-makers at any stage along this causal chain. An illustration of the DPSEEA framework as applied to a) outdoor air pollution and b) indoor air pollution is given in Table 2.5. ![[DPSEEA framework to air pollution.png]]