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_____________________________________________________________________

IMPACT THE INTERNATIONAL HEALTH IMPACT ASSESSMENT

CONSORTIUM _____________________________________________________________________

A Prospective Rapid Health Impact Assessment of the Replacement Waste Disposal Facility in

the States of Jersey

Stage 1

March 2007

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Acknowledgements This report is the work of IMPACT, the International Health Impact Assessment Consortium, including Debbie Abrahams, Hilary Dreaves and Andy Pennington. Alex Scott-Samuel was the Technical Director. As associate consultants, Anthea Cooke (Inukshuk) led the stakeholder workshop and Kate Ralls (Arup) contributed to the health profile and impact analysis. Our thanks go to Steve Smith, Will Gardiner and Stephen Othen for their guidance and comments and to Lyn Hougez for her assistance in organising the stakeholder workshop. In addition our thanks to the Steering Group members for their information, advice, support and critique. We would very much like to thank those community and organisational stakeholders who generously gave their time to inform us and Fran, Anne and Chris for all their administrative support, especially over the Christmas period.

IMPACT Division of Public Health

Whelan Building University of Liverpool

Liverpool L69 3GB

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Table of Contents

Acknowledgements...............................................................................................1 Table of Contents..................................................................................................2 List of Figures .......................................................................................................4 List of Tables.........................................................................................................5 Executive Summary ..............................................................................................6

Introduction........................................................................................................6 Energy for Waste Incinerator Proposal..............................................................6 HIA Methodology...............................................................................................7 Findings.............................................................................................................9 Recommendations to the HIA Steering Group ................................................11

1 Introduction ..................................................................................................13 2 Summary of the Energy from Waste Incinerator Proposal ...........................14

2.1 Introduction...........................................................................................14 2.2 The Proposal ........................................................................................14

3 Methodology ................................................................................................15 3.1 Introduction...........................................................................................15 3.2 Methods and procedures ......................................................................15 3.3 Limitations ............................................................................................18

4 Policy Analysis.............................................................................................19 4.1 Introduction...........................................................................................19 4.2 Analysis of the Rationale and Context of the EfW facility proposal.......19 4.3 Analysis of the development of the EfW proposal ................................21 4.4 Analysis of the EfW proposal and the non-health care policy environment.....................................................................................................21 4.5 Conclusion............................................................................................22

5 Health Profile ...............................................................................................23 5.1 Introduction...........................................................................................23 5.2 Population.............................................................................................24 5.3 Population Characteristics ....................................................................25 5.4 Ethnocultural Structure .........................................................................26 5.5 Economic and Employment Activity......................................................27 5.6 Education..............................................................................................28 5.7 Social Security......................................................................................29 5.8 Health Status ........................................................................................29 5.9 Births and Deaths .................................................................................29 5.10 Morbidity and Disability.........................................................................32 5.11 Health and Lifestyle ..............................................................................32 5.12 Life Expectancy ....................................................................................32 5.13 Health Services ....................................................................................33 5.14 Public Services .....................................................................................35 5.15 Transport ..............................................................................................35 5.16 Tourism.................................................................................................36 5.17 Energy ..................................................................................................37

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5.18 Waste Management..............................................................................38 5.19 Background Air Quality/Pollution ..........................................................38

6 Evidence from the Literature........................................................................43 6.1 Introduction...........................................................................................43 6.2 Air Quality and Pollution .......................................................................43 6.3 Incineration ...........................................................................................46 6.4 Perceived health risk ............................................................................47 6.5 Analysis of HIAs of similar proposals....................................................47

7 Evidence from Stakeholders ........................................................................49 7.1 Introduction...........................................................................................49 7.2 Workshop Format .................................................................................49 7.3 Findings from Focus Groups ................................................................51 7.4 Potential health impacts........................................................................53 7.5 Summary of main health impacts identified: .........................................61 7.6 Recommendations................................................................................61 7.7 Evaluation.............................................................................................62

8 Impact Analysis............................................................................................63 8.1 Introduction...........................................................................................63 8.2 Air Quality .............................................................................................63 8.3 Traffic....................................................................................................63 8.4 Perceived Risk......................................................................................64 8.5 Environment .........................................................................................64 8.6 Health and Safety .................................................................................64 8.7 Engagement .........................................................................................64

9 Conclusion and Recommendations .............................................................66 9.1 Conclusion............................................................................................66 9.2 Recommendations to the HIA Steering Group......................................66

10 Evaluation ................................................................................................69 11 Bibliography .............................................................................................70 12 Appendices ..............................................................................................74

12.1 Appendix A Additional Profile Data and Data Requested .....................75 12.2 Appendix B Stakeholder Workshop Invitations .....................................90 12.3 Appendix C Workshop Model and Programme.....................................96 12.4 Appendix D Stakeholder Workshop “Graffiti Wall” Tables ....................98 12.5 Appendix E Stakeholder Workshop Evaluation ..................................102

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List of Figures Figure 1 A Generic Model of HIA ..........................................................................8 Figure 2. La Collette Industrial Zone ...................................................................14 Figure 3. A Generic Model of HIA ......................................................................15 Figure 4. A Social Model of Health......................................................................16 Figure 5. Health Profile Indicator Categories ......................................................23 Figure 6. Change in Employment by Sector (1996 – 2005) ................................28 Figure 7. Expenditure on Social Benefits, 2004 (£million)...................................29 Figure 8. Principal Cause of Death, Annual Average (2001 – 2004)...................31 Figure 9. Major Causes of Years of Life Lost*.....................................................31 Figure 10. Average Age at Death (1955 – 2004) ................................................33 Figure 11. Total Number of Vehicles Registered in Jersey (1970 – 2005)..........35 Figure 12. Number of Staying Leisure and Day Visitor (1990 – 2004) ...............37 Figure 13. Jersey’s Total Final Energy Consumption by Fuel Type (2004).........37 Figure 14. Percentage of Private Households Overcrowded ..............................77 Figure 15. Planning and Building Control Applications (1998 – 2004) ................77 Figure 16. Principal Cause of Death, Annual Average (2001 – 2004).................81 Figure 17. Infant Mortality ...................................................................................81 Figure 18. Percentage of Population in Each Body Mass Index (BMI) Group.....82 Figure 19. Number of Periods of Organised or Independent Physical Activity greater than 30 Minutes per Week (Percentages) ..............................................82 Figure 20. Number of Practitioners per Thousand Population (2001) .................83 Figure 21. Frequency of Travel by Mode ............................................................84 Figure 22. Total Electricity Supply* and Imports (1991 – 2004) ..........................85 Figure 23. Energy Related Carbon Emissions ....................................................85

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List of Tables Table 1. Population Density of Jersey, England and the UK...............................25 Table 2. Broad Population Structure, 1996 - 2001..............................................26 Table 3: Population by Languages Spoken .......................................................27 Table 4. Crude Birth rate (CBR) and Crude Death Rate (CDR)..........................30 Table 5. Frequency of Visits to a Doctor in the Last 12 Months by Age (Percentages) .....................................................................................................34 Table 6. Average Weekly Household expenditure on Health Services by Sector34 Table 7. Waste Arisings and Treatment at Bellozane (1990 – 2005) ..................38 Table 8. Source and Emissions Data* ................................................................40 Table 9. Emissions from the Jersey Electricity Company Power Station ............42 Table 10. Air Pollution and Health.......................................................................45 Table 11. Traffic ..................................................................................................54 Table 12. Environment........................................................................................56 Table 13. Community Involvement – Mental Health and Wellbeing ....................58 Table 14. Health and Safety ...............................................................................59 Table 15. Total Resident Population, 1981 - 2004..............................................75 Table 16. Parish Population and Density ............................................................75 Table 17. Economic Activity for All Adults in Jersey: 1991-2001........................78 Table 18. Employment Status by Gender of the Economically Active and Inactive for Adults of Working Age ...................................................................................78 Table 19. Public and Private Sector Employment by Occupational group (percentages)......................................................................................................79 Table 20. Highest Level of Educational Attainment by Place of Birth (Percentage of the Working Age Population) ..........................................................................79 Table 21. Highest Level of Educational Attainment by Gender...........................80 Table 22. Self Reported Health Status by Age....................................................80 Table 23: Public Rating of Selected Public Services...........................................83 Table 24. Travel to Work by Mode by Parish (Percentages)...............................84 Table 25. Waste Recycled or Composted...........................................................86 Table 26. Source and Emissions Data* ..............................................................86 Table 27. Additional Data and Levels of Data Requested...................................87 Table 28. Workshop Invitees...............................................................................90 Table 29. Graffiti Wall Tables..............................................................................98

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Executive Summary

Introduction This Executive Summary of the rapid Health Impact Assessment (HIA) of the proposal for a new Energy for Waste (EfW) facility on the island of Jersey summarises the Health Impact Assessment methodology used, the potential health impacts of the EfW proposal and recommendations to enhance the positive and reduce the negative impacts. The HIA was undertaken by a team of consultants from IMPACT, the International Health Impact Assessment Consortium at the University of Liverpool. HIA is a policy tool concerned with improving health and reducing health inequalities. It is a systematic process which aims to identify what the health effects of new policy, strategy or project proposals on a defined group of people might be. It considers which key health determinants, such as air quality, transport and economic factors will be affected by the proposals and how these in turn will affect the health and wellbeing of the population, as well as the differential distribution of these impacts. By providing evidence of these potential heath impacts to policy makers, it helps to inform their decisions. The aim of the stage 1 EfW facility HIA was to undertake an initial assessment of the health effects of the EfW proposal using a validated generic HIA methodology; should outline planning permission be granted, a stage 2 HIA will build on this assessment and describe the distribution of effects across the population.

Energy for Waste Incinerator Proposal The States of Jersey approved a Solid Waste Strategy in 2005. A key part of the implementation of the strategy is the replacement of the existing Energy from Waste (EfW) incinerator, located at Bellozanne with a modern, cleaner waste disposal facility. The decision to locate the new facility at La Collette, subject to planning approval, was made by the States of Jersey in June 2006. An outline planning application was submitted on 9 January 2007, based upon the Environmental Impact Statement (EIS) produced from an Environmental Impact Assessment on the site undertaken for the States of Jersey by Babtie Fichtner in 2006. As a statutory consultee on planning applications, the Public Health Department of the States of Jersey wish to respond to the outline planning application, following an investigation of the potential health impacts of the proposal. This will be mindful of the Planning Departments comments on the robustness of the EfW EIS.To this end, two prospective rapid HIAs of both the outline planning

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application (Stage 1) and subject to planning approval, the detailed planning application (Stage 2) have been commissioned. The focus of the outline planning application and EIS Report is the site of La Collette 2 in St Helier.

HIA Methodology The HIA methods and procedure used were based on a validated generic HIA methodology (Figure 1). The process was undertaken between January and mid February 2007. The scope of this Stage 1 HIA was defined by the HIA Steering Group in January. This HIA is described as a rapid HIA, reflecting the depth of assessment. In this HIA new data were collected at a stakeholder workshop; predominantly existing, accessible data were defined and analysed. From this, the evidence was identified and impacts defined. The policy analysis (section 4) involved the collection and analysis of a range of policy documents to determine the context of the EfW facility proposal. Relevant secondary data were identified and retrieved from the EIS Report (vol2) and other sources to develop a profile of the island (section 5). Evidence from the literature was also gathered and distilled (section 6). Qualitative information and experiences were collected by discussions with organisational stakeholders, and at a participatory workshop (section 7). Finally, evidence from all data sources was aggregated and the key health impacts of the EfW facility proposal were characterised in the impact analysis (section 8). There were challenges with the limited availability and accessibility of population health and other data which imposed limits on the health profile, and lack of established ‘public participation in decision-making’ processes.

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Figure 1 A Generic Model of HIA

Qualitative and quantitative data collection

Impact analysis

Establish priority impacts

Recommendations developed

Profiling of communities

Policy analysis

Process evaluation

Scoping

Conduct assessment

Report on health impacts and policy options

Impact and outcome evaluation

Monitoring

Screening

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Findings The Impact Analysis brought together the evidence from all the data collected from different sources and using different methods. It identifies and characterises the potential impacts of the EfW facility describing: • Health impacts – the health determinants affected and the subsequent effect

on health outcomes; • Direction of change – health gain (+) or health loss (-); • Scale – the severity (mortality, morbidity and wellbeing) • Likelihood of impact – definite, probable, possible or speculative based on

the strength of the evidence and the number of sources; For clarity throughout the report the potential impacts are in bold and the likelihood of an impact is underlined. Definitions of likelihood are as follows: Speculative = may or may not happen; no direct evidence to support; Possible = more likely to happen than not; direct evidence but from

limited sources; Probable = very likely to happen; direct strong evidence from a range

of data sources collected using different methods; Definite = will happen; overwhelming, strong evidence from a range of

data sources collected using different methods. The HIA makes a number of assumptions concerning the implementation of the EfW facility proposal, e.g. that the facility will be in the ownership and control of the States of Jersey and that as a consequence, it can institute measures for monitoring implementation of HIA recommendations into the future and measure operational performance. The proposal defines the timeframe for delivery and completion of the new facility as 2010 and describes the likely context for the period till then, e.g. target achievement for recycling and composting, traffic and transport infrastructure. The level of analysis was defined as island-wide. Based on the available evidence, the EfW proposal will have both positive and negative impacts. The most significant positive impact in the longer term will potentially result from reductions in emissions from the development of an EU compliant EfW facility, using a technology yet to be agreed, probably contributing to improved air quality from stack emissions. In the absence of a causal relationship, it is not possible to directly attribute any apparent reduction in adverse health outcomes to the new EfW facility alone. It can only be speculated then that sensitive individuals and vulnerable groups will potentially benefit most from the improvements in air quality. There is potential for greater population health gains with improved control of emissions from vehicular traffic and in conjunction with other public health interventions, such as the recent smoking ban.

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The main negative impacts are concerned with perceived risk from waste incineration, visual impact on the skyline and thus potentially tourism, of the building housing the facility and concerns regarding traffic flows and congestion. A number of factors described in the literature as “fright factors” for increasing worry about perceived risks to public health are broadly applicable to the EfW facility proposal. It is therefore possible that there will be an adverse effect on the wellbeing of the population, particularly in the vicinity and for workers during the decision-making process. It is speculated that there will be negative impacts on some staff potentially affected by the proposal, e.g. changing the location and possible nature of employment. Although it has not been possible to assess the impacts on the workforce, evidence from other studies has shown that negative health impacts are associated with perceived “job insecurity”, particularly with changes in the nature of the job, e.g. new or different skills required. However, it is possible to mitigate against these factors by addressing key mediators of these effects, e.g., decision latitude and participation. While it has not been possible to make an assessment of the potential impacts on the local economy, it is speculated that there may be both positive and negative effects, in that there may in the distant future be an opportunity to profit from utilising spare capacity at the facility, while in the short term, construction could provide local jobs, but also potentially affect property prices, access and journey times for people living and working in the immediate area.

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Recommendations to the HIA Steering Group Data • Complete and extend the health profile data set. There are specific indicators

identified in the report and Appendix A that should be included in the stage 2 HIA Health Profile. Based on the assumption that the data has already been collected, this will need to be extended to include, for example, traffic distribution and transportation, baseline air quality results and relevant morbidity data.

• Data on construction and post construction impact on traffic, noise and air quality should be collected

• Having regard to data protection legislation, should it be enacted in Jersey, all health data should be captured at parish level wherever possible.

• Data quality improvement, in line with the Public Health Report 2006 and this report, is needed to strengthen the monitoring of future HIA work, in stage 2 HIA and beyond. This would include data by social class, ethnicity and population subgroup.

• Evidence from a wider range of stakeholders and key informants should be gathered during the stage 2 HIA.

Public Engagement • Further stakeholder participation, whether in workshops or by using other

community development methods to be agreed and appropriately resourced, will be undertaken in the stage 2 HIA.

• There should be evidence of the participation in stage 2 HIA of vulnerable population subgroups e.g., non English speakers, people living and working in the vicinity of the plant, those with cardiovascular and respiratory disease.

Development Phase • The health impacts of the construction/development phase of the proposed

development have not been considered in this report and will be assessed in the Stage 2 HIA.

• Agreed actions are needed to mitigate the potential negative health effects of the proposal on the current workforce during transition.

• There should be clear evidence of the participation of potentially affected population subgroups, such as construction workers, staff at the current facility and other vulnerable groups in stage 2 HIA.

Traffic • Further investigation regarding the impacts of this proposal on traffic in the

area adjacent to La Collette is needed. • Road traffic accidents should be included within the scope of the stage 2 HIA,

in anticipation of data availability • The impact of using older refuse collection vehicles, in light of potentially

higher levels of emissions should be addressed.

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Communication • The existing communications strategy should be developed to maximise

outreach opportunities to engage communities and raise awareness about the proposal and target vulnerable groups, using appropriate media. This should be linked to promotion of recycling and composting.

• There should be a clear and explicit procedure that allows the public to monitor and complain about the operation of the new facility, in order to foster a sense of control, likely to improve their mental health and wellbeing.

• Consideration should be given to Department of Health guidance on communicating risk.

Physical Environment • Make explicit arrangements for monitoring and maintaining the physical

environment, including interventions to mitigate the visual impact of the site, specifically the height of the building.

Future Work • Clear reporting pathways for this report, stage 2 and monitoring of the

implementation of the proposal should be made explicit in the stage 2 HIA.

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1 Introduction IMPACT, the International Health Impact Assessment Consortium at the University of Liverpool was commissioned in late December 2006 by the Public Health Department of the States of Jersey to undertake a prospective rapid Health Impact Assessment (HIA) of the proposed replacement Energy from Waste (EfW) waste disposal facility in the States of Jersey. This proposal was submitted as an outline planning application on 9th January 2007 and was being consulted upon between January and March 2007. Should outline planning permission be granted for the facility at the agreed site (La Collette), a Stage 2 HIA will be undertaken on the detailed planning application. HIA is concerned with improving health and reducing health inequalities. It is a systematic process, which aims to identify what the health effects of a new policy, strategy or project proposal, such as the EfW facility proposal, might be on a particular group of people. HIA can be done at a national, regional, city or even ward level. It considers which key health determinants, such as air quality, transport and economic factors will be affected by the proposals and how these will in turn impact on the health and wellbeing of the population. By providing evidence to policy makers on the potential health effects of these proposals it helps to inform their decisions. The stage 1 HIA is a rapid assessment. It aims to assess the health effects of the EfW facility proposal using a generic HIA methodology. Should outline planning permission be granted, the Stage 2 HIA will consider the detailed planning application, the differential distribution of impacts of this across the population, including workers and the impacts by geographical area. It will be informed by the Stage 1 HIA. This report will describe the scope of the assessment, including the methods and process, the data collected and the evidence defined from these data. The potential health impacts emerging from the analysis of this evidence will then be defined in broad, qualitative terms. Finally, conclusions and recommendations for the Department of Public Health will be presented.

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2 Summary of the Energy from Waste Incinerator Proposal

2.1 Introduction This section describes the EfW facility proposal.

2.2 The Proposal The proposed facility, located on the reclamation area of La Collette Industrial Zone Phase 2 is an enclosed EfW facility to recover energy from residual solid waste (including dried sewage sludge), with an adjoining bulky waste facility to recycle or shred bulky waste for energy recovery. Energy recovery is achieved by incinerating waste to generate steam, which would be piped across to a neighbouring Jersey Electricity Company (JEC) facility where it will power turbines for energy production. It is anticipated that the new facility will share the chimney (negating the need to have its own chimney) and other facilities with JEC. Should planning approval be granted, construction is anticipated to commence in early 2008, for a period of thirty months, with the new facility coming into full use by mid-2010. There will be an increase in staff during the construction phase with planned training and transfers of staff to the new facility, followed by decommissioning of the incinerator at Bellozanne. To the east of the site is the fuel farm, operated and leased by a number of utility and petrochemical companies. The JEC power station lies immediately to the north of the site, with the States Bus Depot to the east of the fuel farm. There are sealed storage pits for ash from Bellozanne in mounds south east of the power station. The EfW facility will be between the Bus Depot, ash mounds, power station and coastal embankment. Figure 2. La Collette Industrial Zone

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3 Methodology

3.1 Introduction This section describes firstly the methods used to carry out this rapid HIA and secondly the limitations of the work.

3.2 Methods and procedures The assessment was conducted using a generic HIA methodology. Figure 3. A Generic Model of HIA

Source: Abrahams et al (2004) EPHIA Guide. www.ihia.org.uk HIA uses a broad social model of health, described by Dahlgren and Whitehead (1991) showing the main determinants of health as layers of influence. It demonstrates that health is affected by a range of factors, not all of which are readily quantifiable.

Qualitative and quantitative data collection

Impact analysis

Establish priority impacts

Recommendations developed

Profiling of communities

Policy analysis

Process evaluation

Screening

Scoping

Conduct assessment

Report on health impacts and policy options

Impact and outcome evaluation

Monitoring

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Figure 4. A Social Model of Health

Dahlgren and Whitehead (1991). Policies and strategies to promote social equity in health. Stockholm: Institute of Future

Studies A Rapid HIA is the most usual form of an HIA. Existing information and evidence are appraised in a desk-top process and usually supplemented with a half or day long workshop to enable stakeholder views and experiences to be collected. A word of caution is that the word Rapid can be misleading – a Rapid HIA can be an extremely intensive process over only a relatively short time span, say twelve weeks. The aim of the HIA was to identify the potential health effects of the waste disposal facility proposals, including their differential distribution, on the population of Jersey by undertaking a two stage prospective HIA on the outline and detailed planning applications. This report presents only the work undertaken in stage 1, relative to the outline planning application and does not include the development and construction of the EfW facility. The stage 2 HIA will build on the findings of stage 1 and include development and construction phases. A capacity building and scoping workshop was facilitated with the HIA Steering Group on 4th January 2007. This helped to define the boundaries of the HIA including stakeholder groups to be engaged. At this workshop it was agreed to focus on health effects at an island level. Policy analysis of the OPA/Environmental Impact Statement (EIS) and associated policy documents of the States of Jersey was undertaken in order to identify the context of the proposal. All were accessed via www.gov.je and www.health.gov.je

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An indicator set for the health profile for this HIA was defined. Existing data from externally commissioned survey reports were reviewed and requests made for further data, for example, time-series health, transport, access and lifestyles data. Using these sources and data from other sources, the profile was prepared. Some of the data that would ideally appear in this health profile is not yet collected for Jersey (Medical Officer of Health 2006). In addition, little time-series and parish level data is available. Access to the following data was not possible:

• Standardised Mortality Ratios • Employment rates by ethnicity • Economic activity rates by age • Limiting Long Term Illness or disability (numbers or rates) • Working days lost to ill health (number and proportion of working days) • Accidents in the workplace (rates/numbers) • Road traffic accidents

It is hoped that these data will be accessible in the stage 2 HIA. A brief review of relevant evidence from the published and unpublished literature on the potential relationship between incineration of municipal solid waste and health was undertaken. Not all data provides strong evidence. The quality and strength of evidence are dependent on the research design of the study; this applies to qualitative and quantitative research. The strongest evidence however is derived from ‘reviews of reviews’ followed by systematic reviews. Quantification is not the end point of a health impact assessment (FPHM 2000) and new quantitative data is not generally generated in a rapid HIA (Abrahams et al, 2004). Primary qualitative data was gathered using a qualitative participatory approach, the purpose of which is to gather evidence from the experience, knowledge, opinions and perceptions of populations affected by the policy (stakeholders) and people with expert knowledge (key informants). This evidence: • provides a more in-depth picture of the range of health determinants affected

by the policy; • provides a detailed understanding of how they think this impacts on health

outcomes and why; • contributes to prioritisation of impacts; • provides a perspective on health inequalities. Wherever possible, representatives of potentially affected population groups should be involved (Abrahams et al, 2004). The scope of this HIA included a stakeholder workshop for community participants and representatives of Jersey organisations (section 7). Purposive sampling methods were used to generate the initial stakeholder database, from a sample frame defined using the Association of Jersey Charities database. This was followed by additional mapping of stakeholders (in this case, organisational stakeholders and Steering Group members) using a snowballing approach. The database contained a total

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of 250 contacts all of whom were invited to the workshop. Purposive sampling is a non-random sampling method, which aims to sample a group of people with a particular characteristic, for example, people involved in the development and implementation of a proposal. Snowball sampling involves an initial group of respondents (that is organisational stakeholders and key informants) to identify others they know have a similar characteristic (that is an involvement or interest in the proposal (Abrahams et al, 2004). Further community stakeholder participation, based on an expanded sample frame, using workshop and other qualitative and community development methods will be undertaken in the stage 2 HIA, should the OPA be approved. Impact analysis was based on the evidence available at the time of writing. It identified evidence of impacts from the data collated and characterised the potential health impacts from these in terms of health determinants affected and the potential effects on health outcomes and health services. Practical recommendations, where possible evidence based, are made founded on the information available at the time of writing.

3.3 Limitations The limitations of the assessment were the challenges associated with the access and availability to data, lack of experience of this and other forms of public participation in Jersey and the relatively short timetabling of the HIA. There is always a necessary compromise between brevity and rigour in any study, and examination of primary data, a more comprehensive health profile and the opportunity to engage with a larger number of community stakeholders would have added rigour to the work. Data issues made analysis, including the level of analysis, over time challenging. Consistent, comparable data formats will be important for monitoring purposes and in order to assess any changes in the distribution of the impacts on health. Formal consultation processes with the States of Jersey are relatively new (2005) and based on written submissions in English. While recognising this is not ideal, there appears as yet to be little documentation (and websites) published in languages other than English and formats other than written to inform the population, of which there are non-English speaking groups, such as the Portuguese . HIA methodology allows stakeholders the opportunity not just to raise issues and identify potential health impacts, but consider how best to enhance or mitigate the impacts these might have on the determinants of their health, prioritise those that are of greatest relevance to them and make appropriate recommendations to decision makers. Should outline planning permission be granted, a HIA on the detailed planning application will allow for wider community stakeholder participation and analysis of the distributional effects.

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4 Policy Analysis

4.1 Introduction This section presents a brief analysis of the proposal for a new Energy from Waste (EfW) facility at La Collette on the island of Jersey and associated policy documents. The analysis examines the rationale and context of the EfW facility proposal, as described in the Environmental Impact Statement (EIS) central to the outline planning application; the synergy of the proposal with national and international policies for waste management and the relationship of the proposal to non-health care policies and strategies, such as transport, environment and tourism.

4.2 Analysis of the Rationale and Context of the EfW facility proposal

4.2.1 Planning As described in section 2, the EfW facility proposal describes the nature of the buildings and facilities proposed for the La Collette site and their potential impacts upon the environment. Fundamentally, this means constructing new EU compliant enclosed facilities for handling bulky waste and incineration of non-inert waste (including dried sewage sludge) on the existing La Collette site prior to the demolition of the old waste facility at Bellozanne. The rationale driving these proposals is described in the States of Jersey ‘Solid Waste Strategy’ (2005), the Environment Report (2005) and the island’s ‘Strategic Plan 2006-11’ (States of Jersey, undated). The issues being addressed include: • Increasingly high levels of waste generated by a growing population • Exhaustion of existing availability for landfill on the island • Non-compliance with current EU best practice and legislation at the aged

Bellozanne incinerator • Developments in waste management practices and pollution and emissions

control technologies that will increase generation of electricity and significantly improve air quality

• A desire to manage waste sustainably, “in island”, into the future in line with the International Waste Hierarchy

• Policy drivers, such as EU Directives on packaging, landfill, specific products, waste incineration, pollution prevention and control and UK strategies, such as the animal by-products regulations and national waste strategy, against which Jersey would wish to benchmark its activities.

The Solid Waste Strategy is underpinned by the internationally agreed Waste Hierarchy and is contextualised by their 1996 Environmental Charter commitment to follow best European practice and comply with key European legislation, detailed in the strategy. The EfW proposal for the La Collette site, as described in the outline planning application submitted on 9th January 2007, is detailed in an externally

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commissioned EIS. The policy context described in the EIS indicates that the proposal has been developed in accordance with local planning policy and EU and UK policy drivers.

4.2.2 Health The Strategic Plan 2006-11 acknowledges that while Jersey offers an excellent quality of life for most people, the island does have inequalities and wishes to address social inequalities, public engagement, transport, public housing and roads, anti-social behaviour and costs and prices, all of which are determinants of health. As an example of this, there is a forthcoming law introducing low income support on the island, replacing means tested grant arrangements. There is a new focus on population health, founded on the socioenvironmental model of health, in Jersey, with recommendations for developing a health strategy; promoting strategic development and integration of health care; a modern public health function (including information to monitor population health improvement); health protection (including disease surveillance and notification); population based services (for health improvement and screening) and partnership working to promote public health messages and services. From a limited search and discussions with Steering Group members, there is an apparent and palpable drive to develop public health policy, improve health, public health infrastructure and healthcare systems in Jersey, not least evidenced by the commitment to HIA, but it is early days. It is acknowledged that data and information systems are not yet sufficiently established to link with the organisational will to deliver it, if it is to be meaningful in fostering a cultural change in the understanding of the health of Jersey. From our current knowledge, healthcare infrastructure in Jersey differs very significantly from that in the UK, in that there is no NHS, with services provided either privately, or through social insurance connected to employment. Community services are provided through States funded charities, or charitable groups, either local or linked to UK national charities. The Health and Social Services Business Plan (2006) clearly commits to system redesign in order to deliver improved health and social wellbeing for islanders, necessarily focussing at this point on “health and social care services”, providing direction until new strategies are forthcoming. However, healthcare services (and access to them) are only one small part of the living and working conditions that shape the physical environment in which a community lives and cannot alone improve health or reduce inequalities.

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4.3 Analysis of the development of the EfW proposal Against a background of increasing waste generation, an old and inefficient EfW plant at Bellozanne whose levels of emissions fall below current European standards and the exhaustion of landfill site availability on the island, the States of Jersey implemented a Waste Management Law in 2005, together with a comprehensive Solid Waste Strategy. The Strategy, which covers recycling targets and composting initiatives, identified two possible sites for a replacement EfW facility, at Bellozanne (which was the preferred option, as then identified in the Island Plan) and La Collette, with a commitment to undertake HIA on the preferred site as a means of assessing potential impacts on public health. The decision to locate the new EfW facility at La Collette, subject to planning approval, was made in June 2006.

4.4 Analysis of the EfW proposal and the non-health care policy environment

Given the relative position of this HIA to the development of public health and health infrastructure on the island, at the time of writing there is more demonstrable cohesion between the EfW facility proposal and non-health policy, particularly planning and environmental policy, than there is associated with health policy. As an example of good, but not yet joined up, practice, the Draft Integrated Travel and Transport Plan (States of Jersey, undated) recognises increased cycling, walking, use of buses and reduced pollution from vehicles as contributing to healthier lifestyles, but makes little reference to the relocation of the EfW facility from Bellozanne to La Collette and the possible implications for travellers and transport providers and users. Assessment of traffic and transportation forms a section of the EfW proposal, with nuisance, network congestion and increased pollution identified as potential impacts. The EfW plant developer cannot control the traffic routes taken by refuse collection vehicles, which are owned and operated by the Parishes or commercial operators. The traffic assessment considered the ability of the relevant junctions to handle the limited additional traffic proposed. Work was commissioned to model baseline and new scenarios, but in terms of the vehicle flow accessing and leaving the site, rather than the journey time element for local residents and businesses and bus service providers. There is little evidence of public participation in this work, although the bus company were engaged in consultations to develop the proposal. The importance of maintaining and improving public transport across the island, including for access to the General Hospital, was identified in the Tourism Strategy (2004), but similarly, this seems not to have been brought forward in a cohesive way.

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The commitment to tackling inequalities in the Strategic Report augers well for the future, but there are challenges, not just in the integration of health care services and the adoption of a population approach to health, but in the legislative infrastructure, that go beyond the scope of the HIA. For example, immigration has been constrained by requirements of three years residency to gain a vote and generally thirteen years residency in order to purchase a property. Such constraints may run counter to the drive to encourage social inclusion and public engagement and ultimately reduce inequalities, particularly for those who contribute (or have contributed) to the prosperity of the island, but are less able to overcome disadvantage (section 5). There is evidence (WHO 2006) that participation alone is insufficient to empower socially excluded populations and that empowerment strategies that build on authentic participation are needed.

4.5 Conclusion There is general coherence between the EfW facility proposal and local, UK and European waste management and planning policy. There is also some cohesion with the States’ Environment Review (2005) and Planning and Environment Business Plan (2006). It is less clear if there is cohesion with other environmental strategies, such as the Air Quality Strategy and forthcoming Energy Strategy. Stage 2 HIA policy analysis would consider this. While there is a clear strategic commitment to population health and public health development, health policy development appears not as yet sufficiently progressed to provide a foundation from which it is possible to embed healthy public policy development across all sectors in Jersey. The use of HIA methodology is a positive step towards this. The outline planning application, including the EIS properly focuses on the La Collete site and also looks “beyond the fence” but only in so far as is necessary to develop systems, such as road access and traffic, for the efficient operation of the site and facility itself, with reliance in some instances on assumptions that modelled scenarios will be the reality in the absence of local data. The constraints in the geographical scope of an EIS are recognised, however, impacts on human health are not limited to specific geographical boundaries.

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5 Health Profile

5.1 Introduction The purpose of the health profile is to give a picture of the health and socio-demographic context of the proposal in order to better understand its potential health impacts and the particular population groups that may be affected. The profiling has involved collecting and analysing secondary (existing) data on a number of indicators that relate to the content and context of the proposal, and its possible impacts on health or health determinants. Indicators are measurable variables that reflect the state of a community or of persons or groups in a community. It should be noted that some data contained in this profile have been drawn from the Environmental Impact Assessment data. It is recognised that the Jersey Government’s Regulatory bodies may not accept these. The development of a Health Profile for Jersey is a new initiative. Some of the public health data that would appear in a health profile is not yet collected for Jersey (Medical Officer of Health, 2006). The profile would ideally consist of trend (time series) data and local level data. Trend data illustrates changes over time, and local data illustrates local variations in health/health determinants and the inequalities that exist at local levels. Data relating to some indicators and also trend and local level data were not available for inclusion within the stage 1 HIA health profile. However, trend and local level data will be sought for inclusion within the stage 2 HIA health profile, together with data on the additional indicators. Appendix A (Section 12.1) contains a list of the additional data and levels of data that have been requested from the States of Jersey. The figure below shows the categories of indicators that are typically included within a health profile. These are not discrete categories and some indicators fall into more than one category. Figure 5. Health Profile Indicator Categories

Broad Indicator Categories

Population Health Status Health Determinants

Living and working conditions Economic/employment

conditions

Lifestyle factors

Biological factors (see population)

Ethnocultural structure

Population structure

Population change (births, deaths & migration)

Social and cultural indicators

General Health

Births & deaths

Cause of death

Morbidity and disability

Life expectancy

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5.2 Population Population levels, structure and characteristics are important determinants of the health of people in Jersey. Changes to factors such as migration have particularly significant implications on any small island where resources (e.g. land/housing) are at a premium. Small changes in natural population growth and ethnocultural structure may have a relatively greater impact amongst the small population. Population levels in Jersey have a direct relationship to the levels of waste produced on the island. Population growth leads to higher levels of consumption and higher levels of waste and energy usage. The predicted capacity of the proposed EfW facility is based partly on predictions of population growth.

5.2.1 Total Population The total resident population of Jersey in 2004 was estimated at 87,700, which is an increase of approximately 100 on December 2003. The net increase was a combination of an increase of 220 due to natural growth and a decrease of 120 due to net outward migration (Jersey in Figures, 2005). Historical (1981-2004) population data is contained within Appendix A.

5.2.2 Population change Natural population growth has been relatively steady over the period 1990 to 2004 as a result of a combination of a decrease in birth rates coupled with a decrease in death rates. During the period 2000-2002 Jersey experienced small net inward migration of less than 100 persons per year, this is likely to be a reflection of the stability of the labour market during this period. In 2003 however, Jersey experienced a net outward migration of over 200 persons. This coincides with a fall in private sector employment at this time. Net outward migration was again experienced in 2004, although levels fell to nearer 100 persons. This excludes seasonal workers that are present on the island for less than one year, although, the 2001 Census estimates that seasonal workers are in the order of 4,000 persons per year in each direction (Census 2001 Jersey). Transient residents also contribute to the population of Jersey and the 2001 Census estimates that 2,500 transient residents enter Jersey each year and leave after one to five years. The construction stage of the EfW facility, together with the decommissioning of the old facility, may attract temporary or transient workers as a result of employment opportunities.

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5.3 Population Characteristics

5.3.1 Population Density Table 1. Population Density of Jersey, England and the UK

Population figures for the UK are taken from the corresponding 2001 Census.

*if the 2 km2 of the St Helier (La Collette) land reclamation site are included in the total area of Jersey, the population

density is 740 per km2 (Source: Jersey in Figures, 2005) On an Island of only 116km2 and with a population of 87,700, population densities are relatively high at 760 persons per km2. This is more than three times the population density of the United Kingdom; this places land at a premium in Jersey and results in high costs of land and property.

5.3.2 Populations The EfW facilities proposed location in St Helier places it within the most populated Parish on the island of Jersey, with almost a third (32%) of the island’s population concentrated in the parish at the time of the 2001 census. The population of St Helier is more than the populations of the second and third largest parishes combined. Population densities are also highest in St Helier at 3,292 per km2, compared with the average population density of 750 per km2 for the island as a whole. Both the existing and the proposed EfW facilities are located within St Helier. Further data on Parish populations and population densities can be found in Appendix A.

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5.3.3 Broad Population Structure Sixty-five percent of the population of Jersey is of working age and the total working age population has increased by some 800 persons over the last five years. The relative proportion of the working age population to the non-working age population has implications to the burden placed on workers/taxpayers. Table 2. Broad Population Structure, 1996 - 2001

1996 2001

Under 16 years 15,005 15,664Working age1 56,207 57,015Above working age 13,938 14,507 Total Population 85,150 87,186

(Source: Census 2001 Jersey) Women accounted for 51.3% of the total population of Jersey in 2001, a change of 0.1% from 51.4% in 1991. Women predominate in the higher age group groups (70+), but are at a ratio of approximately 50% within the working age categories (Census 2001 Jersey).

5.4 Ethnocultural Structure Figures on cultural and ethnic background for Jersey indicate that there are low levels of ethnic diversity on the Island compared to the UK. 98.9% of the island’s population in the 2001 census were classified as ‘white’ (of varying origins) compared to the UK 2001 Census in which 92.1% were classified as ‘white’. A relatively small 1.1% of people were classified as either black or Asian (of varying origin) in the 2001 Jersey Census, compared to 6% in the UK. The majority (51.1%) of the island’s population are of Jersey nationality, closely followed by 34.8% of the population that are of British origin. Together, these two groups account for 85.9% of the island’s total population.

5.4.1 Languages The main and secondary languages spoken by the population are represented in Table 3. This table shows that 94% of the population speak English as their main language. Of the population that don’t speak English as their main language, 71% speak it as a secondary language (4.26% of the total population). Portuguese was the second main language spoken by residents, with 5%

1 Due to the school leaving age being changed in 1992, from 15 to 16 years of age, it is not possible to directly compare 1991with 1996 and 2001.

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speaking this as their main language. The table also indicates that more than a quarter (27%) of the population of Jersey speak more than one language. Table 3: Population by Languages Spoken

Mainlanguage

Secondarylanguage

Totalspeakers

English 82,349 3,443 85,792Portuguese 4,002 3,303 7,305French 338 14,776 15,114Jersey French 113 2,761 2,874Other languages 384 4,496 4,880

(Source: Census 2001 Jersey)

5.5 Economic and Employment Activity

5.5.1 Adult Economic Activity rates Economic activity rates in Jersey appear to be relatively high. At the time of the 2001 census, 82% of the working age population of Jersey were in employment, compared with an average of 78% for the UK. Jersey’s standardised ILO (International Labour Organisation) unemployment rate for adults aged 16 and over was 2.1%, substantially lower than that of the UK (5.1%), the United States (4.0%) and any other E.U. Country (E.U. average is 7.7%). However, although the numbers of people of working age, in employment, have remained relatively constant over the period 1991 to 2001; as a proportion of the total population, there has been a decrease in the number of economically active people. Further data on economic activity can be found within Appendix A.

5.5.2 Employment Status Of the 82% of the population that were economically active on the island at the time of the 2001 Census, the majority (75%) were working full-time for an employer. A further 11% worked on a part-time basis for an employer, and 11% were self-employed. Further data on employment status can be found be found in Appendix A.

5.5.3 Public and Private Sector Employment Jersey’s workforce is dominated by the private sector, with only 13% employed within the public sector. The majority of the public sector is dominated by personal service occupations, associate professional and technical, and professional occupations. Very few of those employed as process, plant and machine operatives are employed within the public sector; 97% of this group are employed within the private sector. Workers within the current EfW facility are State employees. Private sector jobs are more evenly distributed across a range

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of occupations. Further data on public and private sector employment by occupational sector can be found within Appendix A.

5.5.4 Change in Employment by Sector In recent years, employment in Jersey has changed towards a more service-orientated economy. Employment in manufacturing, agriculture and fishing, electricity, gas and water have all seen declines. However, the most significant decline has taken place within part of the tourism sector (hotels, restaurants and bars); this is a sector that may be affected by the construction and operation of the EfW facility, together with the sectors containing construction and energy industries. Figures show that the numbers employed in the electricity, gas and water sector have fallen by 120 over the period 1996-2005, and are now at only 500 (Source: Jersey in Figures, 2005). Figure 6. Change in Employment by Sector (1996 – 2005)

(Source: Jersey in Figures, 2005)

5.6 Education

5.6.1 Educational Attainment Educational attainment would appear to be comparable with the British Isles at both GCSE and A-level stage, with those obtaining 5+ O-levels/CSE/GCSE matching levels of attainment with the rest of the British Isles at 22%, and numbers obtaining 2+A Levels or 4+ AS Levels matching British Isles figures at 9%. However, beyond A-Level, a different pattern emerges and Jersey begins to fall behind the rest of the British Isles in terms of academic attainment. Only 3% of the working age population in Jersey possess a first degree compared with the British Isles average of 9%. People of Portuguese/Madeiran origin have relatively low levels of educational attainment and a high proportion of people with no formal qualifications (88%). Further data can be found within Appendix A.

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5.7 Social Security The figure below shows that the majority of expenditure on social benefits is on pensions (36% or £76 million), followed by housing benefit (12%), survivors benefit (10%) and invalidity benefit (9%). Expenditure on GP visits is £6million (or 3%). Figure 7. Expenditure on Social Benefits, 2004 (£million)


5.8 Health Status

5.8.1 General Health The majority of people in Jersey (93%) reported their health status as either ‘good’ (70%) or ‘fairly good’ (23%); 7%, of the population rate their health status as ‘not good’. Reported health status varies significantly with age. Of those 7% who rated their health as ‘not good’ nearly half were aged 65+. The majority of those who rated their health as ‘good’ were in the 25-44 age group. Among people of working age (16-64), the majority report their health as either good or fairly good. Appendix A contains further data on ‘self reported health status by age.

5.9 Births and Deaths

5.9.1 Birth and Death Rates During the period 1991 to 2004 birth rates have continued to remain around 2-3% higher than death rates. Over the same period, both birth and death rates have seen a decline of around 1-2%, with death rates experiencing a slighter greater decline.

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Table 4. Crude Birth rate (CBR) and Crude Death Rate (CDR)

Figures for CBR and CDR are per 1000 residents per annum

(Source: Jersey in Figures, 2005) Data and analysis on infant mortality is contained within Appendix A.

5.9.2 Causes of Death and life Years Lost Circulatory disease is the greatest cause of death in Jersey for both men and women, followed by cancer (see Appendix A). Cancer is also the most significant cause of major years of life lost. Heart attacks, strokes and other circulatory diseases are also responsible for the greatest proportion of deaths in the UK and the EU (Census 2001 UK, Eurostat 2006). However, in the UK, the EU (EU 15) and each member state of the EU 15 male death rates from circulatory disease are significantly higher than those for females; in the UK 300 per 100,000 males and 190 per 100,000 females died from circulatory disease in 2003 (Europa, 2000; National Statistics, 2003). From Jersey in Figures data (2005) it would appear that Jersey death rates for men are higher than the UK and, a much greater proportion of women in Jersey die from circulatory disease than in the UK and the EU 15 (Appendix A). However, data recently published (Jersey Annual Social Survey 2006) suggests that comparability of data requires further clarity. Despite this, men lose proportionally more years of life through all the major causes of death than women.

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Figure 8. Principal Cause of Death, Annual Average (2001 – 2004)


External causes such as accidents and suicides make a relatively small contribution to cause of death, but are more significant in terms of years of life lost. Men are more than twice as likely as women to experience a loss of years as a result of external causes. It is also notable that Jersey has a higher suicide rate than UK (Health & Social Services Business Plan, 2006). Other measures such as quality of life indicators will be collected in the Stage 2 HIA to get a better picture of mental wellbeing in Jersey. Figure 9. Major Causes of Years of Life Lost*

*Years of life lost is expressed as the total number of years of all those people dying before the age of 75 years

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5.10 Morbidity and Disability

5.10.1 Limiting Long-term Illness and Disability Additional data on limiting long term illness and disability has been requested from the States of Jersey, this data will be incorporated within the stage 2 HIA health profile.

5.10.2 Occupational Health and Safety Additional data on occupational health and safety will be collected in the Stage 2 HIA.

5.11 Health and Lifestyle The majority of the population of Jersey do not smoke. 25% of the population are smokers, with19% of the population smoking on a daily basis. 25% of the population of Great Britain were also smokers in 2004.

5.11.1 Weight and Obesity Although 70% of the population claim to eat more than 5 portions of fruit and vegetables a day, obesity is still a problem on the Island, with 47% of the population falling into the category of overweight or obese (see Appendix A for further information). Obesity rates in Jersey are 10% lower than those for the UK, which stand at 24% (Our Island, Our Health, 2006). Obesity has however been identified as a growing problem on the Island, and a significant contributory factor to increasing levels of heart disease, cancer and diabetes.

5.11.2 Physical Activity 30% of the population report that they take 6 or more periods of physical activity greater than 30 minutes per week. Approximately 37% only take between 1 and 4 periods of such exercise a week, and a further 13% undertake no exercise in a given week. 52% of St Helier residents walk to work (Jersey Annual Social Survey). Further data on physical activity is contained within Appendix A. This is particularly relevant to this HIA as air quality is a factor determining participation in outdoor activity such as cycling.

5.12 Life Expectancy Life expectancy has seen a steady increase over the period 1955 – 2004. Life expectancy for women has risen by 8 years to 79 years of age and for men by 6 years to 72 (Jersey in Figures, 2005). However, life expectancy still falls short of the average for the UK as a whole which is 81.0 years for women and 76.6 years for men (ONS Data for 2003-05).

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Figure 10. Average Age at Death (1955 – 2004)


5.13 Health Services Healthcare infrastructure in Jersey differs very significantly from that in the UK, in that there is no NHS, with services provided either privately, or through social insurance connected to employment.

5.13.1 Number of General Practitioners Provision of doctors on the Island, at 2.1 per thousand population is low when compared with the rest of Europe, where figures range from 3.0 - 4.2 per thousand population. However, Jersey compares favourably with the UK where provision is at 1.7 per thousand. Details of the roles and function of these doctors was not available, so further details will be sought for inclusion within the stage 2 HIA health profile.

5.13.2 Visits to Doctors The table below shows that 23% of the population of Jersey had visited the doctor twice in the previous 12 months (2005 data). The older age groups (65+) tend to be the most frequent visitors to the doctor. Data on children was not available.

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Table 5. Frequency of Visits to a Doctor in the Last 12 Months by Age (Percentages)

(Source: Jersey Annual Social Survey, 2005)

5.13.3 Expenditure on health services Health services in Jersey are predominantly private. Therefore, data on household expenditure on health services provides an indication of the true economic costs to households of health services and the distribution of expenditure between sub-sectors of the health service. As a percentage of total household expenditure total weekly expenditure on health services is at around 2.3% (£14.70). It also indicates that the majority of expenditure is on dentists, followed by pharmacy and other medicines. Data on household expenditure by population subgroups, such as ethnic group and social class, would provide an indication of inequalities that exist within these groups; this data will therefore be sought for inclusion within the stage 2 HIA health profile. Table 6. Average Weekly Household expenditure on Health Services by Sector Expenditure Amount in pounds Percentage of weekly

household expenditure

Pharmacy & other medicines

£3.60 0.57%

Doctors £3.00 0.48%Dentists £5.20 0.83%opticians £1.80 0.29%Other medical related services (inc. hospital)

£1.10

Total Expenditure Weekly on Health

£14.70 2.3%

(Source: Jersey Household Expenditure Survey 2004/2005)

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5.14 Public Services

5.14.1 Public Perception of Public Services Public perceptions of the amenity of public services on the Island are relatively good with the majority of services rated as ‘good’ (for the selected services below). The Bellozane Waste facilities in St Helier, appear to have a good public perception and are rated as ‘good’ or ‘very good’ by nearly 60% of the public. The Green Waste Facilities at La Collette also received the same good/very good rating of 60%. However, the majority of people rated the management of road works as either poor or very poor (63%) and the provision of island-wide recycling bins as poor or very poor (56%) The public rating of the condition of roads in Jersey was relatively balanced with 53% rating the condition as poor or very poor. Appendix A contains further data on public ratings of public services in Jersey.

5.15 Transport The proposed EfW facility has the potential to affect both the volume and profile of transport in St Helier. Changes to the uses of the two sites of the existing and future EfW facility (Bellozane and La Collette 2) may redistribute public and commercial traffic between the locations and other changes may result from alterations to capacity/usage; the construction and decommissioning stages of the two sites may also affect transport. The available baseline data on transport in Jersey is presented below; additional transport data will be requested for inclusion in the stage 2 HIA health profile.

5.15.1 Number of Vehicles The total number of vehicles registered in Jersey has continued to grow since 1975, and is still continuing to grow in 2005. Figure 11. Total Number of Vehicles Registered in Jersey (1970 – 2005)


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5.15.2 Number of Vehicles per Household The average number of cars per household stood at 1.42 in 2005 and appears to have increased since the 2001 census. The average number of vans was 0.12, bicycles 0.71 and motorbikes 0.18 (Jersey Annual Social Survey, 2005).

5.15.3 Mode of Travel to Work by Parish According to the latest data for 2005, 51% of all economically active adults in Jersey travel to work by private car, and do so without anyone else in the vehicle. However, for the Parish of St Helier this percentage drops to only 32%. In fact the most popular mode of travel for St Helier residents is to walk to work, and 52% use this mode of travel. Walking to work makes a significant contribution to levels of physical activity and the number of periods of activity greater than 30 minutes per week that people take. Changes to the location of the EfW facility may affect workers journeys to work/mode of transport. Further data on mode of travel to work by Parish is contained within Appendix A.

5.15.4 Sea Transport The proposed EfW facility is located next to St Helier harbour; this harbour has a mix of uses including the arrival and departure point for ferry passengers. Travel by sea transport has changed little in terms of numbers, during the period 2000-2005, generally fluctuating between about 850-900 thousand passengers a year. Purpose of journey has also remained relatively constant. The majority of journeys in all years have been to France (60% in 2005) followed by journeys to the UK (24% in 2005).

5.16 Tourism The proposed EfW facility is located near to an area for tourism that includes St Helier Harbour. The La Collette site is therefore potentially one of the first areas of Jersey that ferry passengers, including tourists, will see.

5.16.1 Visitors to Jersey Although a popular holiday destination, the number of visitors coming to stay for leisure purposes in Jersey has declined significantly between 1990 and 2004, figures have nearly halved over the period. Whilst the popularity of Jersey for long stay leisure visits has declined, the number of day trippers has seen a slight increase, rising by 20,000 visitors over the period, although the most recent figure for 2004 is 34,000 down on 2002 when day tripper levels peaked at 194,000 visitors. The average age of visitors to Jersey is currently 55 years (Tourism Strategy, 2004).

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Figure 12. Number of Staying Leisure and Day Visitor (1990 – 2004)


5.17 Energy

5.17.1 Jersey’s Energy Consumption The majority of energy consumed in Jersey is in the form of petroleum products; over 65% comes from this fuel type. The second most popular source of energy is electricity, and this accounts for 28% of energy consumption. It is notable from the figure below that there is no mention of the consumption of energy from renewable sources or energy from waste, although it is possible/likely that ‘electricity’ may be produced from such sources. Figure 13. Jersey’s Total Final Energy Consumption by Fuel Type (2004)


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5.17.2 Electricity Total electricity supply has increased in a relatively linear pattern over the period 1991 -2004, increasing at an average rate of 15,385MWh per year. The percentage of that supply that is imported has also increased over time, from a low of approximately 150,000MWh in 1992 to a peak of around 625,000MWh in 2003 (Jersey in Figures, 2005); see Appendix A for further information. Data on contribution of the existing and proposed EfW facility will be sought for inclusion within the stage 2 HIA. Data on energy related carbon emissions is contained within Appendix A.

5.18 Waste Management

5.18.1 Waste Treatment at Bellozane The current energy from waste plant at Bellozane receives over 70,000 tonnes of refuse for converting into energy a year. The amount of refuse received increased steadily until 2003, but since then quantities have started to decline significantly year on year. Table 7. Waste Arisings and Treatment at Bellozane (1990 – 2005)


Data on waste recycling and composting in Jersey is contained within Appendix A.

5.19 Background Air Quality/Pollution Data and description of air quality, including any information on methodology is taken directly from the EfW facility proposal Environmental Impact Statement, 2006. However, the robustness of this data has not been validated.

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5.19.1 Nitrogen Dioxide Survey Data Nitrogen dioxide (NO2) surveys were carried out in Jersey using diffusion tubes in 2004. These give monthly average readings at a number of locations, mainly in St. Helier. Average readings outside St. Helier were generally between 5 and 20 µg/m3. Average readings in St. Helier are generally between 20 and 36 µg/m3, with a few exceptions. The Air Quality Strategy for England, Scotland, Wales and Northern Ireland (DETR, 2000) set standards for NO2 concentration levels of 287 µg/m3 based on one hour mean measurements. NOx refers to oxides of nitrogen, NO and NO2, with NO being converted to NO2. Between 1990 and 1997 the predominant source of NOx was road transport (approximately half) followed by the electrical supply industry (20%) and industrial and commercial sectors (17%). As described in section 6, NO2 decreases lung function and increases the risk of respiratory symptoms, particularly in asthmatics for concentrations above 380 µg/m3 for 30 minute exposures; children are seen as especially vulnerable to NOx exposure (WHO, 2003). The convergence of energy and air quality policies has contributed to a reduction of NOx emissions of 58% (AEA Technology Environment, 2005). The setting of limit values and the implementation of policies to achieve these is estimated to have reduced the number of deaths brought forward and hospital admissions from NOx emissions, however, WHO (2004) are asserting that there are health effects associated with pollutant levels below current limit values indicating the need to lower these limits even further.

5.19.2 VOC Survey Data A Volatile Organic Compounds (VOC) survey was carried out at six sites in 2004, again measuring monthly averages. The six sites were Le Bas Centre, the Airport, Beresford Street, Handsford Lane, Roberts and Clos St Andre. The concentrations were measured at 2µg/m3 or lower at all tube locations except for the tube located at “Roberts”, where the average concentration was around 4.7µg/m3. (Energy from Waste and Bulky Waste Facilities, EIS, 2006)

5.19.3 Source and Emissions Data Data on source and emissions is available for the current Energy from Waste Plant at Bellozane and this data is detailed in the table below. This data provides information on the concentration of a number of pollutants at the chimney outlets of the plant.

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Table 8. Source and Emissions Data*

Item Unit Current (Bellozanne)

Proposed Facility (La Collette)

Chimney Height m 90 90

Effective Chimney Diameter m 1.732 1.768

Chimney Position (E, N) m, m 40862, 67139 41923, 64400

Flue Gas Exit Velocity m/s 13.1 14.9

Flue Gas Conditions at chimney outlet

Temperature °C 230 190

Oxygen % v/v, dry

7.1 7.1

Moisture Content % v/v 15.6 15.6

Nm3/s 19.7 25.3 Volume at reference conditions (dry) Nm3/h 70,807 91,037

Am3/s 30.93 36.6 Volume at discharge conditions

Am3/h 111,361 131,793

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Emissions Conc. (mg/m3)

Rate (g/s)

Conc. (mg/m3)

Rate (g/s)

Oxides of nitrogen (as NO2) 400 7.867 200 5.058

Sulphur dioxide 600 11.80 50 1.264

Carbon monoxide 100 1.967 50 1.264

Particulates (PM10) 50 0.983 10 0.253

Hydrogen Chloride 700 13.77 10 0.253

Hydrogen Fluoride 1.5 0.030 1 0.025

Ammonia - - 10 0.253

VOCs 10 0.197 10 0.253

Mercury 0.05 0.98 mg/s 0.05 1.3 mg/s

Cadmium and Thallium 0.3 5.90 mg/s 0.05 1.3 mg/s

Other Metals 5 0.098 0.5 12.6 mg/s

PAHs (as B[a]P) 0.0001 1.97 µg/s 0.0001 2.53

µg/s

Dioxins and Furans 12 ng/m3 236 ng/s 0.1

ng/m3 2.53 ng/s

Notes: Emission concentrations are for dry flue gas, at reference conditions of 11% oxygen, 273oK and 1 atmosphere to allow direct comparison between different facilities. For the new facility, concentrations are assumed to be at the limits of the Waste Incineration Directive, except for ammonia and PAHs, where no limits are stated. This will overestimate the impact of the emissions, as the facility will operate below these limits. For the current facility, concentrations are measured values where available. Emission rates are corrected to the actual flue gas conditions. “Other Metals” are Antimony, Arsenic, Chromium, Cobalt, Copper, Lead, Manganese, Nickel, Vanadium. A description of the units is given in the glossary in Section 18.2.

(Source: Energy from Waste and Bulky Waste Facilities, EIS, 2006)

The principal inputs to the dispersion model with respect to the releases to be modelled are shown within Appendix A.

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5.19.4 Emissions from the Jersey Electricity Company Power Station Figures taken from recent emissions testing at the Jersey Electricity Company power station at La Collette have provided the following results for emissions of oxides of nitrogen (NOx), Sulphur Dioxide (SO2) and Dust. Table 9. Emissions from the Jersey Electricity Company Power Station

Emissions to Atmosphere (mg/Nm3)

Exit Velocity

Flue Diameter

Equipment Operating Hours per year

NOx SO2 Dust Boiler 4 500 666 2,600 80 8.86 1.981

Boiler 8 500 800 2,600 30 14.00 2.743

12 MW Diesel

engines (x2)

1,500 152 169 - 19.15 1.981

5 MW Diesel

engines (x2)

1,500 152 169 - 8.71 1.981

(Source: Energy from Waste and Bulky Waste Facilities, EIS, 2006)

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6 Evidence from the Literature

6.1 Introduction This section presents evidence from a brief review of the secondary scientific literature and publications (e.g. literature reviews, guidelines, reports) concerning potential impacts upon health and wellbeing of modern waste management practices. The search strategy was limited to literature published in English within the last ten years, particularly since the EU Landfill Directive in 1999 and Waste Incineration Directive in 2000. In addition, evidence of health impacts of perceived health risk associated with waste management was examined. The review followed the methodology described by Mindell et al (2006). Priority was given to “reviews of reviews” and systematic reviews, which are regarded as the “gold standard” of the hierarchy of scientific evidence on which to base decisions. It should be noted that the limitations of the HIA, particularly the relatively short reporting requirements and relationship to the outline planning application (with no decision required at this stage on the choice of technology to be used) prohibited a comprehensive literature search. Following on from Steering Group comments and reflecting other HIA reports, it is worth emphasising that most literature about waste incineration relates to ”old type” facilities with significantly different emissions profiles. Newly constructed plants have to meet stricter controls and therefore are significantly cleaner. This does not mean that there are no health effects from “new type” waste incineration facilities, but that there is as yet, little robust evidence relating to them and the evidence at the moment cannot establish a causal relationship. This may be due to limitations in the data available, or the effects of confounding factors, such as exposure to other emissions (e.g. traffic), population, socio-economic and lifestyle factors. These issues apply also to other forms of literature, such as “grey literature”, whose appraisal goes beyond the scope of this HIA. For these reasons, in light of comments made, our views remain unchanged. Databases searched included Cochrane Collaboration, Campbell Collaboration, DARE (Database of Abstracts of Reviews of Effects), Health Evidence Bulletins, Wales and World Health Organisation Health Evidence Network, using the search terms incineration of municipal solid waste(MSW); incineration of solid waste; incineration of waste; waste; waste management; waste incineration; solid waste. References to clinical or healthcare waste incineration were excluded from the review.

6.2 Air Quality and Pollution There is an extensive literature on the health effects of air quality and pollution, including many diseases, an estimated reduction in life expectancy of a year or more for people living in European cities and increased infant mortality in highly polluted areas ((WHO 2004).

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Emissions from transport clearly, by sheer numbers, proportionally pollutes more than incineration; a single incinerator will emit more pollution than one car. This needs to be considered when viewing inventory information. The significant contribution of transport to air pollution in the UK and its effects on health were tabulated by Cave, Cooke and Benson (2004), for example, NOX 48% from road traffic and 20% from the electrical supply industry. Population subgroups with potentially higher vulnerability include those who are innately more susceptible, those who become more susceptible, or are simply exposed to unusually large amounts of air pollutants, such as unborn and very young children, the elderly, those who suffer from cardiorespiratory disease, the socially deprived and those with respiratory disorders, such as asthma or chronic bronchitis (WHO 2004).

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Table 10. Air Pollution and Health Pollutant Main sources % in UK from road

transport Effect on health

Benzene Combustion and distribution of petrol

67% Genotoxic carcinogen, causes leukemia

1,3- Butadiene Combustion of petrol

80% Genotoxic carcinogen, causes lymphomas and leukemia

Carbon monoxide

Incomplete combustion

91% Increased deaths and CVD hospital admissions

Nitrogen dioxide

Combustion in air: road transport, electrical supply industry, industry & commerce

46-61% Long-term: affects lung function, enhanced responses to allergens.

Acute: as particulates

Ozone Sunlight acting on NOx and VOCs, etc

Long distance pollutant

Deaths & Respiratory hospital admission. Respiratory symptoms & Lung function

Particles 1: combustion (road traffic),

2: chemical reactions in air.

Coarse: eg dust, soil, salt, pollen, tyres, construction

25% in cities and in

peak episodes

Acute: Shortens lives, increases hospital admissions from respiratory and CVD causes. Increased asthma symptoms & bronchodilator use

Sulphur dioxide Combustion of sulphur containing fuel

2% Respiratory & CVD deaths and respiratory hospital admissions brought forward. Constriction of airways

(Source: Adapted from Transport and health Study Group, 2000)

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The Committee on Medical Effects of Air Pollution (2006) has published new findings on cardiovascular disease and air pollution, with a likely association shown between outdoor air pollutants and increased deaths and hospital admissions for cardiovascular disease. Family history, smoking and hypertension remain more relevant factors. The mechanism is thought to relate to inhalation of particles, but is not yet exactly understood. They therefore advocate adoption of a precautionary principle in future planning and policy development. The by-products of the incineration process and emissions contribute to background pollution levels. Provided that solid ash residues and cooling water are handled and disposed of appropriately, atmospheric emissions remain the only significant route of exposure to humans (Health Protection Agency 2005). However, the evidence regarding waste incinerators relates to older generation significantly more polluting facilities operating before the EU Municipal Waste Incineration Directives 1989, EU Waste Incineration Directive 2000 and associated regulations were implemented. This is considered in section 6.3.

6.3 Incineration Despite the advantage of reducing the space required for landfill, incineration is highly controversial because of the perceived risk from air pollution, especially dioxins. Such fears are natural, given the bad practices of the past (Royal Society of Chemistry, 2002). Reviewing the literature relating to modern waste management practices, including incineration, Saffron, Giusti & Pheby (2003) found that the evidence linking adverse health outcomes with incineration, landfill or landspreading sewage sludge was insufficient to claim a causal relationship. They note the complexity of seeking to ascertain an association between individual sensitivity and resistance, confounders, proximity, exposure and increased incidence of any adverse health outcome, concluding that based on current research it is not possible to say which of any cases are directly attributable to the hazard in question. This was further supported in 2005 by the Health Protection Agency, who concluded that provided they comply with modern regulatory requirements, the pollutants emitted by [modern] incinerators should contribute little to the concentrations of monitored pollutants in ambient air. Their position statement noted that although there may be some data limitations and incomplete information in the epidemiological studies, indications are that emissions from such incinerators have little effect on health. They do, however, strongly support policies to further reduce exposure to persistent pollutants, such as dioxins. Roberts and Chen (2006) considered there to be seven aspects of incinerator development for which there was some evidence of a potential effect on health, six of which they deemed unquantifiable: anxiety, employment, background

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noise, occupational risk, road accidents and reduced use of landfill. In their quantitative study, only stack emissions, monitored over 25 years, were useful in deriving a risk figure that allowed comparison against risk of dying from other causes.

6.4 Perceived health risk There is clear evidence from the literature that the public perception of potential impacts on health is in itself an impact that affects the psychological health and wellbeing of a population (Centre for Public Health, JMU, 2006; Roberts and Chen, 2006; AERC for SE Wales Regional Waste Group 2003; Royal Society of Chemistry 2002). The DoH (1997) guidance on communicating about risks to public health considered firstly, the empirical research on reaction to risk, extending this to the wider context, such as the contribution of the role of the media in determining why some risks rather than others become major public “issues” and secondly, the decision process involved in risk communication. They note that if culture and structures inhibit good risk communication, the ideal of two-way communication, throughout the process, in order to enhance trust and guard against taking too narrow a view, will not be achieved, possibly resulting in cumulative damage to institutional credibility. From several existing analyses, they brought together a number of interdependent “Fright Factors”, the relevance of which is that what matters is how the risk is perceived, rather than any “real” risk. They describe risks as more worrying (and less acceptable) if they are perceived as: • Involuntary (e.g. exposure to pollution), rather than voluntary e.g. dangerous

sports or smoking) • Inequitably distributed (some benefit, others suffer the consequences) • Inescapable by taking personal precautions • Arise from an unfamiliar or novel source • Result from man-made, rather than natural sources • Cause hidden and irreversible damage e.g. illness many years after exposure • Particular danger to future generations e.g. small children or pregnant women • Threaten illness, injury or death, arousing dread • Damaging identifiable rather than anonymous victims • Be poorly understood by science • Subject to contrary statements from responsible sources (or worse, the same

source) There is guidance on reducing perceived risk which should be considered by the Steering Group (Department of Health 1997)

6.5 Analysis of HIAs of similar proposals There have been relatively few independent HIAs undertaken of EfW facility proposals as yet, although it is fast becoming good practice, relative to new

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planning guidance. The Welsh Assembly has moved somewhat closer to this in identifying HIA as a tool that must be used in [making] waste management decisions. In a risk assessment undertaken as part of an HIA for a planning application for a waste incinerator undertaken in 2006, Roberts and Chen noted that regardless of whether emissions have any direct effect on health, incineration is associated with considerable public concern which may have a significant harmful effect on the mental, physical and emotional health of local residents. The perceptions of potential health impacts of waste management operations, particularly among residents living near a facility, were recognised as leading to anxiety and real adverse health impacts in an HIA of the South East Wales Regional Waste Plan (2003) undertaken to address health issues raised during the public consultation process for the plan. A recent HIA (2006) undertaken as a result of public concerns expressed about a planning application submitted for a Resource Recovery Park, including a refuse derived fuel plant, examined the current scientific literature and found that present day practice for managing solid municipal waste has, at most, a minor effect on health. However, the HIA focussed on potential health impacts as perceived by the public and found that the qualitative evidence gathered through the assessment demonstrated that there were health impacts already occurring, likely to have an impact on the mental and social wellbeing of the community (defined as four Local Authorities, with a population of some 362,000). The EfW facility proposal focuses on the La Collette site alone. While there is some evidence that consideration has been given to issues likely to impact upon health e.g. noise and traffic, “beyond the fence”, this is not clearly defined. Together with an absence of prior public consultation and possible perceived health concerns among the public, there is evidence of a need for improved and possibly different forms of communication with the public.

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7 Evidence from Stakeholders

7.1 Introduction This section presents the process and findings from a Stakeholder Health Impact Assessment (HIA) workshop on the proposal to establish a new EfW facility in Jersey. The workshop was attended by representatives of public, private and voluntary organisations as well as local people’s representatives and was held in the Jersey Potteries. The information collected from the workshop will be used as part of the evidence being collected for the HIA being undertaken on the outline planning application. The HIA will consider various forms of evidence such as a rapid review of the health impacts of other waste management proposals and a review of published research papers or studies that have examined these potential impacts. This will all be assessed in order to identify potential impacts of the new waste disposal facility and to identify recommendations designed to maximise the possible positive benefits to health and wellbeing as well as ways to minimise potential negative impacts. The HIA report will inform the States of Jersey Public Health Department’s response to the Outline Planning Application for the waste facility.

7.2 Workshop Format The aim of this workshop was: To offer an opportunity for stakeholders to consider and share views and other forms of information on the potential impacts on health and wellbeing of the new waste disposal facility on communities. This was achieved by the following objectives: • Sharing information about what the main elements of the proposal are • Sharing what data and evidence has been collected so far • Considering what stakeholders think are the main communities that might be

affected • Considering what those effects might be on the health and wellbeing of those

communities • Considering how those effects could be managed to ensure that opportunities

to improve health and wellbeing are maximised, and how any potential risks to health and wellbeing could be minimised.

The HIA steering group recognised that it was important to invite a wide range of people to attend the workshop. This was in order to gather as many views and experiences about potential health impacts from various perspectives such as how the proposal could affect population groups defined by: • Age such as young children or older people • Particular residential areas such as local parishes • Commerce and industry such as local businesses • Publicly funded services such as health, schools • Advocacy groups such as particular health interests

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• Expert witnesses such as people with knowledge of the proposal or health issues

• Community or voluntary sectors such as Age Concern and Soroptimists International.

• Political representatives such as local government. Public consultation is in early stages in the States of Jersey which meant that there was not a well established database of people or organisations from which to draw up an invitation list. IMPACT, with the support of the HIA steering group suggested an invitation list drawing from the Association of Jersey Charities, plus additions brainstormed at a HIA Capacity Building Workshop held for steering group members. A total of 250 organisations, parishes or community groups were invited (Appendix B). A total of 15 people attended from a range of organisations and interests representing older people, young people, parents with young children, disabled health and safety, parishes such as Port of St Helier, community development and health promotion, medical condition interest group, as well as three ‘expert witnesses’ who have detailed knowledge of the EfW facility outline planning application, the Environmental Impact Assessment and Public Health. The programme for the workshop was modelled on tried and tested best practice for a one day HIA workshop (Appendix C, Section 12.3). The first part of the day included a welcome from the Head of Health Protection, Public Health Department of States of Jersey who have commissioned the HIA. It was emphasised this ‘inaugural’ HIA workshop was an important part of the HIA recognising that people living and working on the island have valid views and evidence to submit as well as this being an opportunity to share and listen to information that impacts on health. This was followed by presentations aimed to explain what HIA is all about, what is involved with the EfW facility outline planning application, and what the evidence of impact on health of modern waste incinerators suggests. This latter suggests: • Research of health impact of waste incineration is a growing area of work • Some evidence is available on air pollution that relates to the bi-products of

waste incineration, however, as yet, there is insufficient evidence to support a causal link with adverse health effects

• There is some evidence that public perception of risk can be an impact on mental wellbeing

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7.3 Findings from Focus Groups

7.3.1 Issues (otherwise known as determinants) that affect health HIA uses a broad social model of health based on the model shown in section 3 that shows the main determinants as layers of influence and demonstrates that health is affected by a range of factors (Dahlgren and Whitehead, 1991). Participants were invited to note down on post-its as many of their issues/concerns or factors about the EfW facility that they thought were a concern. They were asked to focus upon how the EfW facility might impact on their health and wellbeing, as well as that of the community they were representing. They were then invited to place them under the five headings, and to find themes: • Age, genetics and biological • Lifestyles • Social and community networks • Living and working conditions including services • Public policy, environment and economic situation. They were then invited to identify emerging themes by clustering the issues within each of the five headings and to give the clusters a name. From this they were able to identify four main themes. Full details of the issues are presented in Appendix D, Section 12.4.

7.3.2 Main health and wellbeing determinants identified: Traffic was identified as a concern of almost the entire group. The specific issues that were identified included:

• The volume of lorries that would be using the only access route into the EfW facility. It was perceived that this would generate congestion, ‘funnelling’ at the tunnel’, noise and air pollution from the dust and fumes

• An increase in the potential for road traffic accidents and safety for pedestrians

• Commercial traffic through residential areas • Distrust of the public on traffic flow assessments undertaken for the planning

application • Concern that the HIA is only focusing on the EfW facility – the intention is to

co-locate within the current industrial site with the Jersey Electricity Company and others to include in the Masterplan being developed by the Waterfront Enterprise Board – thus compounding traffic usage.

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Community involvement • Lack of awareness and involvement in the consultation for the planning

application of communities most likely to be affected such as older people, young people and others

• Lack of involvement due to consultation ‘fatigue’ or distrust that their views would be considered or likely to influence decisions – a feeling that decisions are being made behind closed doors

• Employment opportunities and risks due to the re-location of the EfW facility. Environment • Negative visual impact of the building needed to house the EfW facility –

some participants were not aware of the height required (higher than they thought). The impact of this might have an effect on tourism as the Havre des Pas area is of particular interest and ‘St Helier would be stigmatised as a dirty industrial parish’

• A few participants picked up that the eventual closure and demolition of the current waste incinerator at Bellozanne would mean an improvement in air quality for this area.

• Reasons were requested from the engineers why the new EfW facility could not to be contained within the valley of the Bellozanne area rather than impacting greatly on the coastline. It was confirmed it would be possible to construct the new EfW facility at La Collette before the demolition of the incinerator. In this case the air quality aspects would be realised. However the air quality (odour) problems associated with the sewage works situated at Bellozanne would remain.

• A few participants were unaware that the storage of household rubbish would continue at Bellozanne and that larger lorries would need to be obtained to transfer the household rubbish to La Collette.

• Issues raised about property prices might be reduced in the locality • Some properties might not have the space for re-cycling storage Health and risk • Perceived that there is already an increase in stress and anxiety levels for

some people about the proposal – perception that quality of life will be adversely affected. The distrust of the information and assessments supporting the planning application is resulting in people feeling angry and disempowered hence affecting their health and wellbeing

• Distrust that there are not likely to be negative impacts on health – what about the long term?

• Fears about the risks to health of fly ash and dust arising from the EfW facility and traffic

• Risk of a major industrial accident by its proximity to the fuel farm and other hazardous areas.

• Odours and pest control concerns • Separating out waste materials and composting health and safety concerns.

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7.4 Potential health impacts Having identified the four main health determinant themes that participants believed were priorities for the HIA to consider a more detailed assessment was undertaken. Participants self selected themes they wished to explore and two groups considered two themes in the morning and two in the afternoon (each person contributing to two themes). A rapid appraisal framework adapted from the Merseyside Guidelines for HIA (Scott-Samuel et al 1998) was used to record the discussions which were facilitated by members of IMPACT using three questions: • How might the health determinant change as a result of the proposal?

E.g. If the determinant is air quality and the activity is increased numbers of lorries – what does this mean for the determinant, and who are the population groups likely to be most affected?

• How might the expected changes affect the health and wellbeing of

those people – are there positive or adverse (negative) impacts? • What do you think should be recommended as a result of what we have

identified? The following tables present the discussions arising from these:

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Table 11. Traffic Health

determinant Activity Predicted health impacts Comments /

recommendations

TRAFFIC Positive

Negative

Changes in vehicle volumes Increased noise & safety concerns

• Energy from Waste (EfW)

• Refuse Handling Plant (RFP) commercial

• RHP public • Green waste • Transfer • Inert waste • Staff • La Collette • Night • Access & safety

Potential better traffic management

Reduced traffic at Bellozanne therefore improved noise and pollution levels

Increase in noise and air pollution Increased risk of traffic accidents Funnelling all traffic to one road – increase in congestion and subsequent concentration of negative health impacts such as reduced air quality: concerns over the single access/escape route during an accident involving the fuel depot

Reduction in traffic at Bellozanne Needs to be quantified to achieve a correct assessment. Slight increase over time at Bellozanne by other states departments utilising the area released by the demolition of the incinerator Increase in traffic means an increase in noise – sleep deprivation

Current HIA is focusing on the one road that is part of this planning application. Needs to be considered alongside all development in the area to get total picture of increase in traffic and health impact. A long term plan/Master plan is needed now and consideration of the health impacts of that plan is required Possibly look at alternative access routes as part of plan?

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(dis)Trust in traffic data assessment/information as part of planning assessment

Information in the public domain about the proposals

The public do not trust the information given to them about the potential traffic implications as they see the EfW as a ‘done deal’ and potential negative impact information is not shared and/or the assessments are in-accurate. Health impact of this is increase in stress and anxiety.

The public need to know about the Masterplan proposals for the area so they can consider how the EFW fits into this. Share information with the public that is easy to understand and accurate.

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Table 12. Environment Health


recommendations ENVIRONME

NT

Positive

Negative

Visual impact Height of the EFW building

Environmental protected area Havre des Pas Stress resulting from impaired visual impact due to height of building

Landscaping: • Trees that are

resistant to salt burn • Colour of building • Insulation to reduce

noise Communicate with public about size of the building

Operational capacity

Efficiency of EFW Increase in lorries

One chimney (if Jersey Electricity Company agree): • Improved air quality • Less movement of ash & less of

it • Additional power • Profitability • Opportunities for education If spare capacity (if recycle and composting works well) could offer potential profit from burning other peoples’ waste, but that is more long term, as the first thing to do would be to incinerate the stored waste from Bellozanne.

Health & safety regulations in Jersey for workers needs to be up to international standards – hence may be added risk Increase in lorries & bottle necks of traffic brings stress Spare waste from Bellozanne is too likely to fill up any spare capacity for a year or two

Trade off capacity around how big a plant is needed – if it was smaller, it wouldn’t possibly have spare capacity for profit, but the biggest might possibly –it could be a spur to encourage wasteful islanders to get recycling/composting in the hope of profiting from spare capacity.

Education Offices / facilities

Accessible for re-education of young people (links to Community involvement theme)

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Decision to base EFW at la Collette

How much of Bellozanne closes versus advantage of La Collette?

Wellbeing of Bellozanne residents – reduced stress

Height of building required ‘Sanguine’ because it’s an island and a cleaner incinerator than Bellozanne, some people may be either resigned to or less concerned i.e. sanguine about the proposal, whereas for others, this may not be the case… Do the advantages of La Collette outweigh the remaining things at Bellozanne? Reduced property values – stress RAMSAR - the environmental site on the coastal edge of La Collette. Is there any possible discharge to the sea affecting it?

Lack of awareness in the public arena re: height of the building –55M from sea to roof level. 34M from ground to roof level. Information needed about what is going to replace Bellozanne site Better explanation of balance / trade-off for members of the public to take a ‘wider view’ Possibility of solar panels? Better efforts to publicise recycling may be a positive trade-off.

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Table 13. Community Involvement – Mental Health and Wellbeing Health


recommendations

COMMUNITY INVOLVEMENT – Mental health and wellbeing

Positive

Negative

Lack of involvement of most affected Lack of understanding of issues

e.g. social housing areas next to La Collette include older people / Cheshire home

Improve engagement increases wellbeing / mental health, feeling of safety / supported in small groups Engage business and landlords Increased citizenship

Likely negative impact Target locals – go to them Identify an advocate within, via States Housing Tenants Support Officer Personalise / appropriate language Timing / crèche = incentivise

Transient population

E.g. nurses, financial services employees and temporary Eastern European residents

landlords not giving their tenants the correct information re voting, services etc

Language / translation Pastoral Centre, St Thomas’, Welcome, via uniform etc

Young people Young People Council

Employment Uncertainty re losing jobs / re-deployment

Improved environment Develop skills

Promote opportunities e.g. additional training, jobs for locals in construction un + skilled

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Table 14. Health and Safety Health


recommendations HEALTH & SAFETY

Positive

Negative

Emissions

Closure of Bellozanne

very clean discharge non breach of standards Bellozanne closure

Adding to any existing pollution problems C02 emissions

Compliance with International standards, Baseline studies of local air quality

Working conditions

Treatment etc of fly - ash

Less risk of accidents to workers

Accidents Contamination

Adopt safe working Maintain monitoring of effects on workers & environment Publicise results

Road safety A: Bellozane B: La Collette

A: Decrease of traffic at Bellozanne (reduction in traffic pollution and accidents) Needs to be quantified because of the transfer of household rubbish to La Collette.

Increased traffic at La Collette

Havre des Pas / Route Du Fort – accidents Tourist traffic (Vehicle emissions)

Refuse storage

Reduction in existing storage implications

Potential combustion catastrophe (increase in traffic pollution and accidents) Odour / pest control / ground waste pollution leading to: Odour – infiltration to properties / pest infestation / private water supplies Potential combustion catastrophe Odour / pest control / ground waste pollution

Odour – infiltration to properties / pest infestation / private water supplies Bailing in sealed bales Ensure a recognised method of disposal / re-use

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Health determinant

Activity Predicted health impacts Comments / recommendations

HEALTH & SAFETY

cont.

7.4.1 Positive

Negative

Use of ash as a building material - fear - health effect Handling hazardous waste

Proximity to fuel farm Separation from waste Blowing tubes concerns

Modern technology will reduce the contact of workers with harmful ash at Bellozane

Stress Anxiety Ash as a pollutant? How will it happen / will it happen? Waste now has to be handled

Final plant choice / design Care in sorting Separate out prior to collection Promote separation / recycling programme to reduce the presence of hazardous substances in waste being incinerated and the subsequent contamination of ash Provide public information on the risks associated with the use of ash in building materials Provide public information to prevent concerns over blowing tubes

This framework is derived from Scott-Samuel A, Birley M and Ardern K (1998). The Merseyside guidelines for health impact assessment. Liverpool: Merseyside Health Impact Assessment Steering Group.

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7.5 Summary of main health impacts identified: • There are some potential positive impacts of the EfW facility proposal.

These relate to improved air quality resulting from the closure of the Bellozanne incinerator facility and the performance of new technology that the new facility will have to comply with. There may be opportunities for employment, training and education which have the potential to have a positive impact on health.

• Drawing from the available evidence collected and assessed to date, there does not appear to be much significant health risk from the EfW facility itself other than health and safety concerns for workers, and the potential risk from combustion or industrial accident.

• However, there are concerns identified that have implications for health risk arising from the suspicion that the resulting heavy lorry traffic that will be generated by the EfW facility, coupled with the restricted access they will have through residential areas could result in respiratory related conditions, and increased stress and sleep deprivation due to noise.

• In addition, mental health and wellbeing could be adversely affected, in the short term, by a feeling of scepticism about the information being published about the proposal, a general public feeling that the decision has already been made, apathy by the public to get involved with discussions about the proposal. Anxiety and stress levels are likely to be increased.

There was also some suggestion that the visual impact of the new building could have an impact for local residents on their wellbeing and pride in the Havre des Pas / St Helier location, as well as for those visiting Jersey.

7.6 Recommendations A number of draft recommendations, designed to maximise potential positive impacts and mitigate against potential negatives on health were discussed and supported by participants, and have been considered as part of the Rapid HIA: • Communication – promote the positive health impacts such as air quality

improvements. Develop a Communications Strategy for Phase 2 that includes site visits for schools and parents and other interested groups, as well as maximises outreach opportunities such as working with community development workers.

• Traffic – this Rapid HIA is focusing on the one road that is part of this planning application. The impact of traffic implications for the EfW facility needs to be considered alongside all development in the area to get a total picture of increase in traffic and its consequent health impact

• Health & Safety for workers – promote high standards, as well as how members of the public can monitor and complain about the running of the new facility – mental wellbeing is likely to improved if people feel they have a sense of some control

• Promote environmental interventions designed to improve the visual impact of the site – specifically the height of the building

• Promote and support re-cycling and composting opportunities.

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7.7 Evaluation All participants were encouraged to complete an evaluation form at the end of the session – 13 of the 15 did so. Details of the evaluation are in Appendix E, Section 12.5. The majority (9 of the 13) stated they had found the day to be very or quite useful. Comments and words used to describe the day included: “I learnt a lot”, “Good to have information on project” “Too little too late”, many stated it had been informative and interesting, thought provoking, challenging, interactive. The workshop helped to develop participants’ understanding of HIA and, for some, a consolidation of experience and theory. Suggestions for future HIA included providing material beforehand, simplifying the presentations and language, trying to involve more people, more central location, although most people felt the venue and refreshments to be of a high standard. The majority of people stated that the quality of the facilitation and presentations to be good quality although there were some comments about the presentations being too technical and over running. The participative yet directed nature of the workshop was appreciated. Some people stated that they would be able to share the information with others and to advocate for HIA early in planning processes.

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8 Impact Analysis

8.1 Introduction This section brings together the evidence from all the data collected from different sources and using different methods. It identifies and characterises the potential impacts of the EfW facility describing: • Health impacts – the health determinants affected and the subsequent

effect on health outcomes; • Direction of change – health gain (+) or health loss (-); • Scale – the severity (mortality, morbidity and wellbeing) • Likelihood of impact – definite, probable, possible or speculative based on

the strength of the evidence and the number of sources; For clarity, the potential impacts are in bold and the likelihood of an impact is underlined. Definitions of likelihood are as follows: Speculative = may or may not happen; no direct evidence to support; Possible = more likely to happen than not; direct evidence but from

limited sources; Probable = very likely to happen; direct strong evidence from a range

of data sources collected using different methods; Definite = will happen; overwhelming, strong evidence from a range of

data sources collected using different methods.

8.2 Air Quality It is probable that replacement of the current EfW incinerator with an EU compliant EfW facility will contribute to improvements in air quality in Jersey. There is evidence in section 5 and 6 that a new EfW facility, complying with EU legislation and air pollution controls, will significantly reduce levels of potentially harmful emissions. Vulnerable groups, such as workers, children, older people and those suffering from chronic respiratory illnesses and cardiovascular disease will potentially benefit most from air quality improvements. However, as there is insufficient evidence to confirm a causal relationship between emissions from waste incinerators and adverse health effects (section 6), it is not possible to directly attribute health gains to the operation of the new facility.

8.3 Traffic It is possible that there will be direct impacts upon traffic in the area due to re-distribution of public and commercial traffic between the locations. This will also impact on air quality. Although mitigation of traffic impacts, with regard to the La Collete site alone, has been a consideration in the EIS, there is evidence (section 7) that a broader view of the traffic and transport impacts in the area beyond the La Collette site is needed to understand fully the traffic implications of the proposal. This will also contribute to an assessment of the

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net impact on air quality. Poor air quality may also affect outdoor activity levels, e.g. walking to work (section 5) It is speculated that changes in the nature and volume of vehicular traffic may result in positive or negative impacts with regard to numbers of road traffic accidents, evidenced in section 7.

8.4 Perceived Risk It is possible that there will be an adverse effect on the wellbeing of the population during the decision-making process. There is evidence (section 6) that public perception of potential impacts on health can affect the psychological wellbeing of the population and manifests itself during the consultation phase for planning applications to build similar EfW facilities. Evidence from stakeholders (section 7) supports this.

8.5 Environment It is possible that there will be some negative visual impact as a consequence of the enclosure of the incinerator in a single building. There is evidence (section 7) related to this, despite substantial efforts to mitigate these effects in the EIS in line with local planning guidance. It is unclear if this may impact on the local economy through tourism. Community stakeholders speculated that there may be a negative impact on property prices adjacent to La Collette in the short term (section 7).

8.6 Health and Safety Community stakeholders speculated that co-location at La Collette with other potential ignition sources (notably the fuel farm) will increased the risk of major industrial accident. There is evidence (section 7) of such a perceived risk, although this has been addressed in the EIS. It is possible, based on evidence in sections 6 and 7, that the health of the workers in the new facility will improve due to improved working conditions and ways of working. This should include their ability to access the new facility. This will be assessed in more detail in the Stage 2 HIA. There may be opportunities for increased employment during the construction of La Collette and the decommissioning of the Bellozanne incinerator. It is speculated that this could be both positive and negative, requiring further investigation in stage 2 HIA.

8.7 Engagement With the proposed access to shared office facilities with JEC and a wider understanding of modern EfW incineration processes, it is speculated that the implementation of the Solid Waste Strategy overall may more easily be achieved in the short to medium term. There is some evidence (section 7) that

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the opportunity for educational visits and promotion of the benefits of new technology could engage young islanders in particular, with a view to improving public participation in the long term, and indirectly wellbeing. The health profile demonstrates that there is a large minority of non-English speaking residents in Jersey. It is speculated that a communications strategy using other languages and media will improve understanding of the proposal and therefore mitigate potential adverse effects, such as perceived risk.

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9 Conclusion and Recommendations

9.1 Conclusion Rapid assessments involve collecting and analysing mainly existing, accessible data with the impacts described in broad, qualitative terms: the limitations of these assessments reflect the necessary trade off between brevity and rigour. The assessment was largely reliant on what data were already available of appropriate quality and comparability. Key impacts have been defined, however, in Stage 1, it has not been possible to assess distributional effects, the size of the population affected, or the latency of these impacts. The focus of this HIA was the outline planning application for the La Collette location for the EfW facility. Stakeholders raised issues concerning overall development in this part of St Helier. Participation of community stakeholders was sought by the commissioners, but the timing of the assessment and the historical lack of engagement of communities in decision-making precluded contributions from key stakeholders and allowed limited data collection and analysis. However, it is clear that the proposal will have both positive and negative health impacts on the population of Jersey. The most significant positive impact will potentially result from reductions in emissions from the development of an EU compliant EfW facility, using a technology to be agreed, contributing to improved air quality where the technology and operation of the facility meet the required standards. However, the net impacts, concerning changes in traffic and transportation associated with the new EfW facility, and their impact on air quality, need to be explored in more detail. Similarly the impacts on road traffic accidents and potential injuries, as well as outdoor activity such as walking and cycling also needs to be assessed in Stage 2. The main negative impacts are likely to relate to perceived risk regarding such facilities, possibly exacerbated by some distrust regarding open communication and only a recent history of public engagement.

9.2 Recommendations to the HIA Steering Group

9.2.1 Data • Complete and extend the health profile data set. There are specific

indicators identified in the report and Appendix A that should be included in the stage 2 HIA Health Profile. Based on the assumption that the data has already been collected, this will need to be extended to include, for example, traffic distribution and transportation, baseline air quality results and relevant morbidity data.

• Data on construction and post construction impact on traffic, noise and air quality should be collected

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• Having regard to data protection legislation, should it be enacted in Jersey, all health data should be captured at parish level wherever possible.

• Data quality improvement, in line with the Public Health Report 2006 and this report, is needed to strengthen the monitoring of future HIA work, in stage 2 HIA and beyond. This would include data by social class, ethnicity and population subgroup.

• Evidence from a wider range of stakeholders and key informants should be gathered during the stage 2 HIA.

9.2.2 Public Engagement • Further stakeholder participation, whether in workshops or by using other

community development methods to be agreed and appropriately resourced, will be undertaken in the stage 2 HIA.

• There should be evidence of the participation in stage 2 HIA of vulnerable population subgroups e.g., non English speakers, people living and working in the vicinity of the plant, those with cardiovascular and respiratory disease.

9.2.3 Development Phase • The health impacts of the construction/development phase of the proposed

development have not been considered in this report and will be assessed in the Stage 2 HIA.

• Agreed actions are needed to mitigate the potential negative health effects of the proposal on the current workforce during transition.

• There should be clear evidence of the participation of potentially affected population subgroups, such as construction workers, staff at the current facility and other vulnerable groups in stage 2 HIA.

9.2.4 Traffic • Further investigation regarding the impacts of this proposal on traffic in the

area adjacent to La Collette is needed. • Road traffic accidents should be included within the scope of the stage 2

HIA, in anticipation of data availability • The impact of using older refuse collection vehicles, in light of potentially

higher levels of emissions should be addressed.

9.2.5 Communication • The existing communications strategy should be developed to maximise

outreach opportunities to engage communities and raise awareness about the proposal and target vulnerable groups, using appropriate media. This should be linked to promotion of recycling and composting.

• There should be a clear and explicit procedure that allows the public to monitor and complain about the operation of the new facility, in order to foster a sense of control, likely to improve their mental health and wellbeing.

• Consideration should be given to Department of Health guidance on communicating risk.

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9.2.6 Physical Environment • Make explicit arrangements for monitoring and maintaining the physical

environment, including interventions to mitigate the visual impact of the site, specifically the height of the building.

9.2.7 Future Work • Clear reporting pathways for this report, stage 2 and monitoring of the

implementation of the proposal should be made explicit in the stage 2 HIA.

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10 Evaluation Evaluation is an important part of Health Impact Assessment, both of the assessment process and the report recommendations. Process evaluation of the HIA assessment, for those undertaking the assessment and engaged in it, is essential for lessons to be learned that can improve efficiency and also contribute further to the robustness of the methodology. Timely process evaluation of this report will be undertaken, following delivery of the report, using a mutually agreed method. For commissioners, it is essential that a clear pathway for the evaluation of the HIA report be developed. In addition an impact evaluation will be undertaken; this is important in mapping out which recommendations have been taken up and monitored (by when and by whom).

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11 Bibliography Abrahams D et al (2004) European Policy Health Impact Assessment (EPHIA) A Guide. IMPACT, University of Liverpool, Liverpool. www.ihia.org.uk Abrahams D (2006) A Desk-Based Health Impact Assessment of the North West Regional Economic Strategy. IMPACT, University of Liverpool, Liverpool. www.ihia.org.uk Applied Environmental Research Centre Ltd (2003) South East Wales Regional Waste Plan. Health Impact Assessment. South East Wales Regional Waste Group. www.sewaleswasteplan.org Babtie Fichtner Ltd (2006) Energy from Waste and Bulk Waste Facilities. Environmental Impact Statement Vol 2. States of Jersey. www.gov.je Cave B, Cooke A, Benson K (2004) Urban Renaissance Lewisham. Health and Social Impact Assessment. www.seahorseia.com Department of Health (1994) An Oral Health Strategy for England. Department of Health, London. www.doh.gov.uk Department of Health (1997) Communicating about risks to Public Health: Pointers to Good Practice. Department of Health, London. www.doh.gov.uk/Policy and Guidance/Health and Social Care Topics/ Department of Health (2006) Cardiovascular Disease and Air Pollution. A Report by the Committee on Medical Effects of Air Pollutants. Department of Health, London. www.doh.gov.uk Environment and Public Services Committee (2005) Solid Waste Strategy. Changing the Way We Look at Waste. States of Jersey. www.gov.je Environment Department (2005) The State of Jersey - A Report on the condition of Jersey’s environment. States of Jersey. www.gov.je Environmental Health Team, Centre for Public Health (2006) Rapid Health Impact Assessment of the proposed Ince Resource Recovery Park. Liverpool John Moores University, Liverpool. www.cph.org.uk Europa (2000) Bulletin EU 9-2000, http://europa.eu/bulletin/en/200009/p103008.htm. Accessed 25/01/2007. Eurostat (2006) Statistics in focus - Population and Social Conditions - Causes of Death in the EU. http://tinyurl.com/2msmy5. Accessed 25/01/2007. Health and Social Services Department (2006) Business Plan 2006. States of Jersey. www.gov.je

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Health and Social Services Department (undated) Health and Social Care Strategic Summary. States of Jersey. www.gov.je Health Protection Agency (2005) Municipal Waste Incineration. Health Protection Agency, London. www.hpa.org.uk HM Government (2005) One Future – Different Paths. The UK’s shared framework for sustainable development. Department for Environment, Food and Rural Affairs. www.defra.gov.uk Hu S-W, Shy C M (2001) Health Effects of Waste Incineration: A Review of Epidemiological Studies. Journal of the Air& Waste Management Association. 51:1100-1109 Jersey Tourism Report (2004) Making a Difference – A strategy for revitalising Tourism in Jersey. Jersey Tourism, St Helier. www.lho.org.uk Joffe M, Mindell J (2006) Complex Causal Process Diagrams for Analysing the Health Impacts of Policy Interventions. Opportunities and Demands in Public Health Systems. American Journal of Public Health, vol 96, no3. London Health Commission and Environment Committee of the Assembly (undated) Health Impact assessment – The Mayor’s draft Municipal Waste Management Strategy. www.lho.org.uk Medical Officer of Health (2006) Our Island Our Health – Annual Report of the Medical Officer of Health. States of Jersey. www.health.gov.je Mindell J, Biddulph J P, Boaz A, Boltong, Curtis S, Joffe M, Lock K, Taylor L (2006) A guide to Reviewing Published evidence for use in Health Impact Assessment. London Health Observatory, London. www.lho.org.uk Office of National Statistics (2003) Mortality - Circulatory diseases. http://tinyurl.com/2u76w3. Accessed 25/01/2007. Pitts N B, Boyles J, Nugent Z J, Thomas N, Pine C M (2005) BASCOD Survey Report 2003/2004. British Society for the Study of Community Dentistry. www.bascd.org Planning and Environment Department (2006) Business Plan 2006. States of Jersey. www.gov.je Policy and Resources Committee (2005) States of Jersey Code of Practice on Written Consultations. States of Jersey. www.gov.je Rabl A, Spadaro J V (2002) Health Impacts of Waste Incineration. Environmental and Health Impact of Solid Waste Management Activities. Issues in Environmental Science and Technology, No.18. The Royal Society of Chemistry

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Roberts R, Chen M (2006) Waste Incineration – how big is the health risk ? A quantitative method to allow comparison with other health risks. Journal of Public Health, Vol 28, no3, pp261-266. Saffron L, Giusti L, Pheby D (2003) The Human Health Impact of Waste Management Practices. A Review of the literature and an evaluation of the evidence. Management of Environmental Quality: An International Journal Vol 14, no2, pp191-213 Sandover Associates (undated) Draft Supplementary Planning Guidance on Tall Buildings for the St Helier Waterfront. www.gov.je Scott-Samuel A, Birley A, Ardern K (2001) The Merseyside Guidelines for Health Impact Assessment. 2nd Edition. IMPACT, University of Liverpool, Liverpool. www.ihia.org.uk Secretary of State for the Environment, Transport and the Regions (2000) Waste Strategy 2000 for England and Wales. Parts One and Two. www.detr.gov.uk States of Jersey (2001) Report on the 2001 Census Jersey. States of Jersey Statistics Unit, St Helier. www.gov.je States of Jersey (2005a) Jersey in Figures 2005. States of Jersey Statistics Unit, St Helier. www.gov.je States of Jersey (2005b) Report on the Jersey Annual Social Survey 2005. States of Jersey Statistics Unit, St Helier. www.gov.je States of Jersey (2005C) Report on the Jersey Household Expenditure Survey 2004 / 2005. States of Jersey Statistics Unit, St Helier. www.gov.je States of Jersey (2006) Jersey Labour Market Report 2006. States of Jersey Statistics Unit, St Helier. www.gov.je States of Jersey (undated) Strategic Plan 2006 – 2011. Chief Minister’s Department, States of Jersey. www.gov.je Transport and Health Study Group (2000) Carrying Out a Health Impact Assessment of a Transport Policy – Guidance. Faculty of Public Health Medicine, London. www.fphm.org.uk and www.nhs.uk/transportandhealth Transport and Technical Services Department (undated) Draft Integrated Travel and Transport Plan for Jersey – Action Plan 2007 – 2001. Transport and Technical Services Department, States of Jersey. www.gov.je UK National Air Quality Archive: Air Quality Standards. www.airquality.co.uk/archive/standards.php. Accessed 24/01/07

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US Environmental Protection Agency. National Agriculture Compliance Assistance Center - Air. www.epa.gov/oecaagct/tair. Accessed 26/01/07 Wallerstein N (2006) What is the evidence on effectiveness of empowerment to improve health ? Copenhagen, WHO Regional Office for Europe (health Evidence Network Report; www.euro.who.int/Document/E88086. Accessed 26/01/07 World Health Organisation Europe (2004) Health Aspects of Air Pollution - Results from the WHO Project “Systematic Review of Health Aspects of Air Pollution in Europe”. WHO European regional Office Denmark. www.euro.who.int World Health Organisation Health Evidence Network (2007) How large a risk to health is air pollution in the European region and is there evidence indicating effective measures to reduce it? Summary of HEN network members’ report. www.euro.who.int/HEN?Syntheses World Health Organisation Health Evidence Network (2007) What are the effects on health of transport-related air pollution? Summary of Health effects of transport-related air pollution (2005). www.euro.who.int/HEN/Syntheses

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12 Appendices

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12.1 Appendix A Additional Profile Data and Data Requested

12.1.1 Additional Profile Data

12.1.2 Total Population Table 15. Total Resident Population, 1981 - 2004


12.1.3 Parish Population and Density Table 16. Parish Population and Density

Parish Population

2001 Census

Percent of total

Area(km2)

Population Density

(persons per km2)

St Helier 28,310 32 *8.6 3,292St Saviour 12,491 14 9.3 1,343St Brelade 10,134 12 12.8 792St Clement 8,196 9 4.2 1,951Grouville 4,702 5 7.8 603St Lawrence 4,702 5 9.5 495St Peter 4,293 5 11.6 370St Ouen 3,803 4 15.0 254St Martin 3,628 4 9.9 366Trinity 2,718 3 12.3 221St John 2,618 3 8.7 301St Mary 1,591 2 6.5 245 JERSEY 87,186 100 116.2 750


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12.1.4 Explanations for the Changes to Age Structure in Jersey The ‘Report on the 2001 Census’, provides some explanation for the changes presented in section 5.2.2, and includes the following:

• ‘An 8% increase was recorded between 1991 and 2001 in the number of children under 10 years of age, and an 11% increase in the 10-19 year age group. The former increase occurred entirely in the first part of the 1990’s and the latter increase in the late 1990’s as the younger cohort aged. Both increases were due principally to the baby-boom generation of the 1960’s having their own children, and also to immigrants of young working age who arrived in the island during the 1980’s, remaining and having children;

• the small reduction in the number of young children (0-9 years) between 1996-2001 is a result of the tailing off of the abovementioned effects, and is also a reflection of the declining crude birth rate;

• the large decline in the 20-29 age group is primarily due to the aging of the young immigrant population of the 1980’s;

• the increase in the population aged 70 and over is a result of the continued increase in life expectancy;

• the decrease recorded for the group aged 80-89 years is a result of falling birth rates and higher death rates during and immediately after the First World War’.

12.1.5 Overcrowding A household is considered to be overcrowded if the number of persons per room is 1.5 or greater. At the time of the 2001 Census, 1,007 households in Jersey were overcrowded according to this definition, that is 2.8% of the total number of private households. A total of 2,684 people were living in these overcrowded households. A more specific measure of the level of overcrowding in the Island is the proportion of two-person households living in one room; there were 616 such households recorded by the 2001 Census, constituting 4.8% of all two-person private households (Census 2001 Jersey). Figure 14 below illustrates historical overcrowding in Jersey in terms of both indicators.

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Figure 14. Percentage of Private Households Overcrowded


Data contained within the ‘Report on the 2001 Census’ (2002) indicates that St Helier has the highest ratio of persons per room out of all Parishes on the Island, at 0.54 persons per room. In fact this ratio was 17% greater than that of the remaining eleven parishes combined, which was 0.46 persons per room. St Helier also accounted for 56% of all overcrowded households on the Island and 57% of overcrowded two-person households.

12.1.6 Planning and Building Control Applications in Jersey Following a peak in planning and building control applications in 2000, the number of applications has experienced a steady decline falling to a low of 3,490 in 2004. Figure 15. Planning and Building Control Applications (1998 – 2004)


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12.1.7 Economic Activity Table 17. Economic Activity for All Adults in Jersey: 1991-2001

1991 1996 2001Economically Active

Men 27,018 26,017 25,983Women 20,529 20,975 22,121

Total 47,547 46,992 48,104

of whom ILO unemployed 1,581 1,549 1,022% ILO unemployed 3.3% 3.3% 2.1%

% of the total population who were

economically active56.5% 55.2% 55.2%

Ratio of wholly retired to economically active 1: 4.9

4.3 4.1

(Source: Census 2001 Jersey) Table 18. Employment Status by Gender of the Economically Active and Inactive for Adults of Working Age

Aged 16 and over Working age, 16-59/64 yrs Men Women Total Men Women Total

Economically active Working for an employer: full-time 20,250 15,280 35,530 20,125 14,975 35,105 Working for an employer: part-time 725 5,220 5,945 550 4,720 5,270 Self employed, employing others 2,305 490 2,795 2,180 440 2,620 Self employed, not employing others 2,115 695 2,810 1,975 615 2,585 Unemployed: looking for or waiting to take up a job

590 435 1,020 585 425 1,010

Total active 25,985 22,120 48,105 25,415 21,175 46,590

Economically inactive Retired 5,370 6,305 11,675 815 360 1,175 Looking after the home 145 5,875 6,020 100 3,695 3,800 In full-time education 1,475 1,640 3,115 1,470 1,640 3,115 Unable to work: sickness or disability 1,190 930 2,120 1,135 795 1,925 Other: e.g. temporarily absent 245 245 495 225 190 415

Total inactive 8,420 15,000 23,420 3,745 6,680 10,425

Overall totals 34,405 37,120 71,520 29,160 27,855 57,015

Figures are rounded to the nearest 5


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12.1.8 Public and Private Sector Employment by Occupational Group Table 19. Public and Private Sector Employment by Occupational group (percentages)

OCCUPATION Publicsector

Private sector

Managers & Senior Officials 5 95 Professional Occupations 31 69 Associate Professional & Technical 30 70 Administrative & Secretarial 8 92 Skilled Trades Occupations 2 98 Personal Service Occupations 46 54 Sales & Customer Service Occupations <1 >99 Process, Plant & Machine Operatives 3 97 Elementary Occupations 9 91

All occupations 13 87 (Source: Census 2001 Jersey)

12.1.9 Educational Attainment Table 20. Highest Level of Educational Attainment by Place of Birth (Percentage of the Working Age Population)

Highest Qualification Jersey Irish

Republic

Elsewherein British

Isles

Portugal/

Madeira France

Other EU/EE

A

Else-wher

e Higher degree 3 4 6 + 8 8 10 First degree 6 6 9 + 7 9 16 NVQ level 4-5, HNC, HND

1 1 2 + 1 1 1

2+ A levels, 4+ AS levels, Higher School Certificate

9 16 9 1 8 11 12

NVQ level 3, adv. GNVQ 2 1 1 + 1 + 1 1+ A level/AS level 3 3 4 1 3 4 4 5+ O levels/CSE/GSCE (higher pass), Sch. Cert. 22 16 22 3 9 12 14

NVQ level 2, int. GNVQ 1 1 1 1 1 + 1 NVQ level 1, fnd. GNVQ 1 1 1 1 1 1 + 1+ O level/CSE/GCSE (any grade) 15 5 14 2 6 6 5

Other qualification 5 12 6 2 14 10 8 No formal qualifications 32 34 25 88 42 37 28 100 100 100 100 100 100 100


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Table 21. Highest Level of Educational Attainment by Gender Highest Qualification Men Women Total % men % women

Higher degree 1,248 1,089 2,337 53 47

First degree 2,132 1,909 4,041 53 47

NVQ level 4-5, HNC, HND 531 291 822 65 35

2+ A levels, 4+ AS levels, Higher School Certificate 2,245 2,540 4,785 47 53

NVQ level 3, adv. GNVQ 337 471 808 42 58

1+ A level/AS level 901 1,141 2,042 44 56

5+ O levels/CSE/GSCE (higher pass), Sch. Cert. 4,772 6,423 11,195 43 57

NVQ level 2, int. GNVQ 242 399 641 38 62

NVQ level 1, fnd. GNVQ 300 321 621 48 52

1+ O level/CSE/GCSE (any grade) 3,418 3,702 7,120 48 52

Other qualification 1,994 1,196 3,190 63 37

No formal qualifications 11,040 8,373 19,413 57 43

Total 29,160 27,855 57,015 51 49


12.1.10 General Health Table 22. Self Reported Health Status by Age


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12.1.11 Cause of Death Figure 16. Principal Cause of Death, Annual Average (2001 – 2004)


12.1.12 Infant Mortality Infant mortality data for Jersey indicates that rates have fluctuated significantly over the period 1994 – 2004, peaking at highs of 6.3 and 6.2 in 1995 and 1998 respectively, and reaching lows of 1.8 and 2.0 in the years 1994 and 2000 respectively. In 2004, infant mortality rates were relatively low at around 3.0. This fluctuating pattern contrasts with death rates for the total population which have experienced a steady decline over this period. Figure 17. Infant Mortality


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12.1.13 BMI Figure 18. Percentage of Population in Each Body Mass Index (BMI) Group


12.1.14 Physical Activity Figure 19. Number of Periods of Organised or Independent Physical Activity greater than 30 Minutes per Week (Percentages)


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12.1.15 Health Services Figure 20. Number of Practitioners per Thousand Population (2001)


Table 23: Public Rating of Selected Public Services Very good Good Poor Very poor Don’t

know La Collette green waste facility

12 47 10 3 27

Bellozane waste facilities

12 47 10 3 27

Management of road works

1 25 41 22 10

Number of pedestrian crossings in town

8 68 13 3 9

Cleanliness of pavements and roads

19 58 18 3 1

Condition of roads

5 42 39 14 1

Adequacy of road signs

10 65 16 2 7

Island-wide recycling bins

6 28 38 18 10


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Table 24. Travel to Work by Mode by Parish (Percentages)


12.1.16 Frequency of Travel by Mode of Transport According to the Jersey Annual Social Survey from 2005, ‘most adults travelled by car either every day or several times a week, with a similar proportion (85%) walking for more than 10 minutes with such frequency. In contrast, almost half of all adults (48%) never cycled, and about two-fifths (42%) never travelled by bus’. Figure 21. Frequency of Travel by Mode


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Figure 22. Total Electricity Supply* and Imports (1991 – 2004)


*Public electricity supply only, excludes own generation and use at Bellozane

12.1.17 Energy Related Carbon Emissions Overall provisional energy related carbon emissions in Jersey have fallen sharply, by around 30%, between 1991 and 2004, from 139,000 tonnes to 96,000 tonnes. The cause of this reduction is the switch from on-island electricity generation to importing energy from France’ (Source: Jersey in Figures, 2005). It is noted that carbon emissions from waste burning / electricity generation at Bellozane are not included within these figures. Figure 23. Energy Related Carbon Emissions


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12.1.18 Waste Recycling/Composting The amount of waste that is either recycled or composted has decreased over the period from 1995 to 2005 by approximately 10,000 tonnes. Significant reductions have occurred since 2000 in the amount of agricultural and green waste that is recycled or composted. Aggregates have also seen a decline over the period. However, glass and textiles have seen an increase in the amount that is recycled, with textile recycling nearly tripling over the period. Table 25. Waste Recycled or Composted


12.1.19 Emissions Table 26. Source and Emissions Data* Item

Current (Bellozanne)

Emissions

Conc. (mg/m3) Rate (g/s)

Oxides of nitrogen (as NO2) 400 7.867 Sulphur dioxide 600 11.80 Carbon monoxide 100 1.967 Particulates (PM10) 50 0.983 Hydrogen Chloride 700 13.77 Hydrogen Fluoride 1.5 0.030 Ammonia - - VOCs 10 0.197 Mercury 0.05 0.98 mg/s Cadmium and Thallium 0.3 5.90 mg/s Other Metals 5 0.098 PAHs (as B[a]P) 0.0001 1.97 µg/s Dioxins and Furans 12 ng/m3 236 ng/s

(Source: Energy from Waste and Bulky Waste Facilities, EIS,2006 ) *Notes:

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• Emission concentrations are for dry flue gas, at reference conditions of 11% oxygen, 273oK and 1 atmosphere to allow direct comparison between different facilities. For the new facility, concentrations are assumed to be at the limits of the Waste Incineration Directive, except for ammonia and PAHs, where no limits are stated. This will overestimate the impact of the emissions, as the facility will operate below these limits. For the current facility, concentrations are measured values where available.

• Emission rates are corrected to the actual flue gas conditions. • “Other Metals” are Antimony, Arsenic, Chromium, Cobalt, Copper, Lead, Manganese,

Nickel, Vanadium (EIS, 2006).

12.1.20 Additional Data and Levels of Data Requested Table 27. Additional Data and Levels of Data Requested

Indicator Requested at Island level

Requested at parish level

Population Age structure X Population by gender

X

Population projections

X

Cultural/ethnic background

X

Languages X Persons per household

X

Population density X ECONOMIC AND EMPLOYMENT ACTIVITY

Employment X Unemployment X Part- time employment

X

Employment type (industrial sector)

X

Economic activity rate by gender

X

Economic activity by age

X X

Employment rate by ethnicity

X X

Occupation X Change in employment sector

X

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EDUCATION Highest level of educational attainment BY PLACE OF BIRTH

X

Highest level of educational attainment by gender

X

Professional qualifications

X

SOCIAL SECURITY

Expenditure X HEALTH Perceived health X Crude birth rate (CBR)

X

Crude death rate (CDR)

X

SMR X X Infant mortality rate X Life expectancy X Cause of death (Respiratory disease)

X

Cause of death (Cancers)

X

Cause of death (Circulatory)

X

Cause of death (External causes)

X

Cause of death (Digestive disorders)

X

Causes of years life lost (Respiratory disease)

X

Causes of years life lost (Cancers)

X

Causes of years life lost (Circulatory)

X

Causes of years life lost (External causes)

X

Causes of years life lost (Digestive disorders)

X

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Limiting Long Term Illness or disability

X X

Working days lost to ill health

X X

Accidents in the workplace

X X

Mental Health Suicide Rates by age and gender

X

Benzodiazepine prescribing rates

X

Psychiatric re-admission rates

X

HEALTH SERVICES

Number of Doctors X Visits to Drs by age X Expenditure on health services by social class and ethnic groups (as percentage of total household expenditure)

X

TRANSPORT Number of Road Traffic Accidents (RTAs)

X X

TOURISM Visitors Visitors arriving by ferry

X

ENERGY Facilities contribution to total energy supply in Jersey (Bellozane EFW facility and proposed La Collette 2 EFW facility)

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12.2 Appendix B Stakeholder Workshop Invitations Sample frame defined from Association of Jersey Charities list, with additions obtained using a snowball approach. Some are abbreviated for ease of handling the original spreadsheet. All were invited, by e-mail or letter, to attend the Stakeholder Workshop. Numbers were restricted to the capacity of the venue at Jersey Potteries. Parishes are shown as an indication of coverage only. Some groups gave no details or only an e-mail contact, so do not show a parish. Table 28. Workshop Invitees

AJC Reg No Organisation Parish

266 7 Overseas ATC St Brelade 197 Ace of Clubs St Helier 254 ACET St Saviour 254 ACET Portuguese St Saviour 225 After Breast Cancer Support St Helier 158 Age Concern St Helier 139 Alzheimers Society St Helier 181 Amnesty International 238 Art in the Frame Grouville

41 Arthritis Care St Clement

49 Arthritis& Rhue Coun Res

178 Arts in Health Care Trust St Helier 268 Autism Jersey St Saviour 166 Aviemore Childrens Centre St Martin 281 Breakthrough Breast Cancer

55 Brig-y-don Childrens Home St Clement 191 Brook Centre St Helier 239 Brook Hospital for Animals Grouville 271 Bukit Lawang Trust St Lawrence

35 Caesarian MD Welfare Society St Helier 12 Cancer Research UK Grouville

129 Cancer Back Up St Brelade, 280 CAT Action Trust 1977 St Lawrence

182 Causeway Association St. Helier

207 Chernobyl Child Lifeline 88 Christians Together St Clement

156 Citizens Advice Bureau St. Helier 292 Citizens Advice Bureau St. Helier

43 CLIC Sargent Cancer Care Children 100 Communicare St. Brelade 211 Community Charitable Trust St. Helier 177 DBP Surgical Trust 258 Diabetes Action St Martin

97 Duke of Edinburgh Award Scheme St. Saviour 69 Durrell Wildlife Conservation Trust Trinity

120 Eastern Good Companions St Clement 215 Eating Disorders Support Group St. Saviour

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115 Family Nursing and Home Care St. Helier 277 Fete des Arts St. Saviour 295 Fort Regent Users Group St Martin 267 Friends of Esparado Childrens Haven St Helier 175 Friends of Issue 167 Friends of Maritime Museum St Helier 286 Friends of the Bridge St Saviour 252 Gerard le Claire Environmental Trust Trinity 155 Girl Guiding St Clement

96 Glanville Home for Infirm and Aged Women St Saviour 111 Good Companions Club St Helier 249 GOSH Jersey Appeal 278 Greyhound Rescue St Brelade

21 Guide Dogs for the Blind Association St Ouen 247 Haut de la Garenne Trust St John 206 Headway Brain Injuries Association St Helier 190 Hearing Resource Centre St Helier 274 Help a Jersey Child St Helier

205 Help an African Schoolchild Trust St. Helier 282 Help from the Rock St John 261 Hikkaduwa Community Charitable Trust 201 International Dendrology Society St Helier 118 International Medical relief St Lawrence 273 Island Aid for World Children St Helier 263 Island Friends Together St Helier 237 Jersey SANDS 203 JABS J Assoc Bereavement Support CYP St Saviour 272 Jersey ADHD Support Group St Saviour 138 Jersey Across Group St Helier 230 Jersey Aid for Europe Foundation St Lawrence 260 Jersey Art & Therapy Group St Saviour

78 Jersey Arts Centre St Helier 202 Jersey Assoc Cancer Nurses St Helier 183 Jersey Assoc of Carers Inc St Helier

25 Jersey Assoc Spina Bifida & Hydrocephalus St Ouen 10 Jersey Assoc Youth & Friendship St Helier

221 Jersey Asthma Society St Peter 109 Jersey Blind Society St Helier 232 Jersey Cancer Help Centre

11 Jersey Cancer Relief St Helier

168 Jersey Catholic Pastoral Services St Helier 290 Jersey Chamber of Commerce St Helier 208 Jersey Charitable Trust Commonwealth Students

60 Jersey Cheshire Home St Helier 241 Jersey Childcare Trust St Saviour

85 Jersey Christmas Appeal St Helier 140 Jersey Clinic St John 127 Jersey Concern and Action Group

3 Jersey Council on Alcoholism St Helier 53 Jersey Diabetic Assoc St Helier 79 Jersey Dips Swimming Club St Helier

145 Jersey Disabled Holiday group Grouville

92

64 Jersey Dyslexia Assoc St Brelade 218 Jersey Eisteddfod St Helier

71 Jersey Epilepsy Assoc St John 285 Jersey Fair-trade Island Group 226 Jersey Family Mediation Service St Helier

27 Jersey Focus on Mental Health 240 Jersey Foster Carers Assoc St Saviour 184 Jersey Friends of Anthony Nolan Trust St Ouen

162 Jersey Friends of Childline St Lawrence 148 Jersey Friends of the Earth St Saviour 217 Jersey Gambia Schools Trust St Peter 121 Jersey Glaucoma Society St Lawrence 276 Jersey Greyhound Supporters

38 Jersey Haemophilia Group St Helier 242 Jersey Healthcare Foundation 233 Jersey Hedgehog Preservation Society St Helier 161 Jersey Heritage Trust st Helier 209 Jersey Homeless Outreach Group St Helier

75 Jersey Hospice Care St Helier 195 Jersey Humane Society

77 Jersey Hyperbaric Treatment Centre 291 Jersey Institute of Directors St Clement 128 Jersey Junior Chamber St Peter 220 Jersey Junior Dog Handlers Assoc St Saviour

131 Jersey Kidney Patients Assoc St Brelade 294 Jersey Lions Club St Helier

13 Jersey Mencap Trinity 7 Jersey Multiple Sclerosis Society St Saviour

152 Jersey Ostomy Society St Helier 1 Jersey Oxfam Shop St Helier

143 Jersey Parkinson's Disease Society St Saviour 81 Jersey Relief for the Needy Trust 15 Jersey Round Table St Brelade

293 Jersey Round Table St Helier 122 Jersey Scout Association St Ouen 265 Jersey Sea Cadet Corps St Helier

4 Jersey Society for Deaf & Hard of Hearing People St Helier 33 Jersey Society for Deaf Children & Young Adults St Lawrence

5 Jersey Society for the Disabled St Helier 87 Jersey Society for the Prevention of Cruelty to Animals St Helier

132 Jersey Sports Association for the Disabled St Helier 154 Jersey Stroke Club St Helier 229 Jersey Symphony Orchestra 270 Jersey Tsunami Relief for North East Sri Lanka Grouville 214 Jersey Variety Sailing Trust 112 Jersey Women's Refuge St Helier 212 Jersey Youth Trust St Helier

99 Jubilee Sailing Trust St Saviour 245 Kids's Club

2 Knights of St Columba St Saviour 192 La Ronde Concert Band of Jersey St John 146 Lady Taverners Grouville

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82 League of Friends for the Jersey Group of Hospitals St Saviour 113 Les Amis St Saviour

62 Leukaemia Research Fund St Clement 24 Lions Club of Jersey Grouville 18 Little Sisters of the Poor St Helier

9 Maison des Landes Trust Jersey St Ouen 244 Meals on Wheels St Helier 137 Methodist Homes for the Aged (Jersey)Ltd St Helier 107 Mission to Seafarers (Jersey Branch) St Clement 149 Motor Neurone Disease Association St Clement 227 Mustard Seed (Jersey) St Peter

54 National Association for the Welfare of Children in Hospital St Helier 199 National Autistic Society (Jersey Branch) St Helier

63 National Childbirth Trust (Jersey Branch) 204 National Meningitis (Jersey) Trust St Brelade 193 Network to Prevent Abuse and Violence in the Home St Helier 224 Nippers 179 NSPCC Jersey St Peter 114 Occupational Centres Ltd 216 Parents Against Drug Abuse St Helier 287 Peter Ward Memorial Midwinterwalk 117 Pisces Trust St Brelade

94 Pre-School Learning Alliance (Jersey) St Helier 185 Quality of Life Animal Sanctuary St Helier

68 Radio Lions Hospital Broadcasting Association St Helier 46 Red Cross St Helier 73 Relate (Jersey Marriage Guidance) St Helier 45 Riding for the Disabled St John

124 RNLI Jersey Lifeboat Guild St Martin 52 Roseneath Trust for the Homeless St Helier

8 Royal Antediluvian Order of Buffaloes - RAOB St Helier 6 Samaritans St Helier

29 Save the Children Fund St Lawrence 19 Scope (was Jersey Spastics Society) St Helier

279 Scott Gibaut Homes Trust St Ouen 228 Sea Shores of East Africa Charitable trust 269 Shopmobility St Helier St Helier 196 Silkworth Lodge St Helier

98 Silverstar Community Playgroup Association St Mary 288 SOBS - Survivors of Bereavement by Suicide St Helier 250 Societe Jersiaise St Helier

16 Soroptimist International of Jersey Grouville 76 St John Ambulance Council of the Order of St John St Helier 56 St Lawrence Youth Club St Lawrence

164 St Ouen Youth and Community Centre St Ouen 248 St Peter's School Parent/teacher Association St Brelade 253 Supporting African Schools St Helier 223 The Band of the Island of Jersey Grouville 116 The Boys Brigade St John 102 The Caesarean Association St Helier 257 The Glass Rainbow Trust St Helier 283 The Inclusion Project 135 The Jersey Association of Men of the Trees St Ouen 255 The Jersey Community Relations Trust St Helier

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219 The Jersey Donkey Home St Helier 157 The Jersey Employment Trust St. Saviour 284 The Jersey Herpetology Society Grouville 259 The Jersey Rebuild Sri Lanka Fund St Brelade 264 The Jersey Youth Council St Helier 256 The Kenyan Widows and Orphans Trust 246 The National Trust for Jersey St Mary 101 The Royal British Legion St Helier 176 The Salvation Army St Helier

72 The Shelter Trust St Helier 235 Tommy's - the baby charity St Helier 189 Tools for Self Reliance St Helier 170 TOP - Triumph over Phobia St Saviour 147 Trinity Youth Centre Trust Trinity 141 UNICEF (Jersey Branch) St Helier 275 Universal Healing Group St Brelade

14 Variety Club of Jersey (Channel Islands) St Saviour 236 Victim Support Jersey St Helier 262 Victoria Cottage Homes Residents Association St Saviour 231 Wanangwe School and Orphanage Trust St Helier

61 Wellbeing St Saviour 136 Wessex Medical Trust (Jersey) 150 Women's Royal Voluntary Service St Helier 296 Jersey Harbours St Helier 297 Channel Island Welding St Helier 298 La Collettee Cold Store St Helier

Newey & Eyre St Helier Mercury Distribution St Helier Port Fairline CI St Helier Top Nosh St Helier Rosden Glass Fibre St Helier Freeport Marine Ltd St Helier GT Marine St Helier Ashley & Co St Helier Pioneer Coaches St Helier RR Whittingham & Co St Helier Sonnic Cleaning St Helier Sunseeker Workshops St Helier Jersey Hospitality Association St Helier Jersey Hoteliers Association St Helier WEB St Helier JEC Jersey Gas Troys Huelin Renouf Condor Logistics St. Helier Port Services Ferry Speed Condor Ferries

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15th January 2007 Dear Sir or Madam, Proposals for a new Waste Disposal Facility: Health Impact Assessmworkshop, 31st January 2007, 9.30 a.m. to 3.00 p.m., at Jersey Potter

The States of Jersey’s Public Health department has commissioned IMPACT tHealth Impact Assessment (HIA) on the planning proposals for the new Wastein Jersey. HIA is a recognised methodology that aims to inform and influence dThe Waste Project HIA will feed into Public Health’s response to the planning As part of the HIA process we would like to invite you to a Stakeholder Workshheld on 31st January. This will provide you with the opportunity to discuss the pon health and wellbeing of the new waste disposal facility. Numbers are restricreturn the slip below or alternatively telephone or email by 25th January to Lyn……………... Yours faithfully, Debbie Abrahams Director, IMPACT +, International Health Impact Assessment Consortium

------------------------------------------------------------------------------------------------------------I am able/not able to attend the HIA stakeholder workshop on 31st January (pappropriate) Name:……………………………………………………………………………………Organisation (if appropriate):…………………………………………………………Contact details:………………………………………………………………………………………………………………………………………………………………………Telephone no./email address:………………………………………………………… Dietary requirements:…………………………………………………………………Crèche facility requirements:…………………………………………………………Access requirements:…………………………………………………………………

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12.3 Appendix C Workshop Model and Programme

Proposals for a new Waste Disposal Facility Health Impact Assessment Stakeholder Workshop

31st January 2007, 9.30 a.m. to 3.00 p.m. VENUE: JERSEY POTTERIES

Target audience This workshop is open to anyone who represents organisations including local government, health, commerce, community and voluntary sector, as well as communities of interest and members of the public of the States of Jersey. We particularly wish to hear from people who can share views and other forms of information on how they perceive the proposals for Jersey’s new waste disposal facility might impact on the health and wellbeing of local people. Hereafter referred to as ‘stakeholders’. Aim of the workshop We will offer an opportunity for stakeholders to consider and share views and other forms of information on the potential impacts on health and wellbeing of the new waste disposal facility on communities. This will be achieved by: • Sharing information about what the main elements of the proposal are • Sharing what data and evidence has been collected so far • Considering what stakeholders think are the main communities that might be

affected • Considering what those effects might be on the health and wellbeing of

those communities • Considering how those effects could be managed to ensure that

opportunities to improve health and wellbeing are maximised, and how any potential risks to health and wellbeing could be minimised.

What is this for? This information will be used as part of the evidence being collected for the Health Impact Assessment (HIA) being undertaken on the planning application. The HIA will consider various forms of evidence such as a rapid review of the health impacts of other waste management proposals and a review of published research papers or studies that have examined these potential impacts. This will all be assessed in order to identify potential impacts of the new waste disposal facility and to identify recommendations designed to maximise the possible positive benefits to health and wellbeing as well as ways to minimise potential negative impacts. The HIA report will feed into the States’ Public Health Department’s response to the Outline Planning Application for the waste facility.

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Programme 9.30 Registration and coffee 10.00 Welcome and purpose of the day

Steve Smith, Head of Health Protection, Public Health Department, Anthea Cooke, Lead Facilitator for IMPACT

10.15 What is Health Impact Assessment all about? Hilary Dreaves, Senior Researcher, IMPACT+, University of Liverpool 10.30 Overview of the outline planning application of the new waste

facility Will Gardiner, Director, Technical and Transport Services, the States of Jersey

Government 10.45 What do we know so far? A summary of the evidence Hilary Dreaves 10.55 Questions and answers 11.10 Introduction to group work

Anthea Cooke 11.30 Workshops session 1 Facilitated groups

12.30 Lunch 1.15 Workshops session 2 Facilitated groups 2.15 Workshop feedback and plenary discussion including next steps Anthea Cooke 2.50 Evaluation of the day

Anthea Cooke

2.55 Closing remarks and thank you Steve Smith

3.00 Ends

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12.4 Appendix D Stakeholder Workshop “Graffiti Wall” Tables HEALTH & WELLBEING DETERMINANTS Health wellbeing issues identified by participants (please note the views and experiences reflected here are the words of the participants) Table 29. Graffiti Wall Tables

Category of health determinant

Issues

Age, genetics and biological

Young People Have the young people come have their say

Younger people have no time to recycle –too busy with work/children

Education

Access Insufficient accessibility through central point of delivery for elderly or disabled

Lifestyles

Traffic / noise Noise x 3

Air quality from site & traffic x 2

Safety

Amenity

The future??

Location Loss of viewing re: activities in the area (older people)

Benefit – good in industrial area & away from housing

Composting needs a garden space

Re-cycling Achieving re-cycling targets

Air quality Noise and dust a problem for local residents

Pollution -= air quality – e.g. dioxins, PCBs

Health continued… Stress and anxiety as more coverage hits media / local grapevine!

Perceived health problems & impact on residents & workers

Children living within 5km of incinerator are 2x likely to die of cancer (5km = 20% of Jersey) 2

No scientific evidence to show that incineration impacts on health? The island is currently looking at impact on health from telephone masts – we are hearing conflicting opinions yes and no. How can we be sure?

Given paucity of evidence – could we be creating health issues

2 Please note this comment was made by a participant. We believe this refers to a study by Knox (Knox EG. Childhood cancers, birthplaces, incinerators and landfill sites. Int J Epidemiology 2000; 29 (3): 391-7). This is one of a series of studies carried out by Knox on a dataset of birth addresses and death addresses of around 22,000 children who died of cancer in the UK between 1953 and 1980. Knox considered migration patterns of children relative to the locations of incinerators. This was before improved emission control equipment had to be introduced in 1996, with a further upgrade in 2005.

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Health Impact on health of babies

Residents wellbeing of Havre des Pas

Those working in the area

that will not materialise until some 10/20 years down the line? Long term health impacts? What monitoring will we do?

Re-use of ash for building materials – public fear of use in homes

Proximity to gas /fuel storage facility

Social and community networks

Quality of Environment Environment impact review Visual impact Impact of plant on the visual aspect of the area of particular tourist and residential importance Population growth –will it cope? Additional fuel emissions from heavy lorries St. Helier stigmatised as a dirty industrial parish Play areas around site for families would it be less healthy? Living around the site Job Losses Potential job losses through new technology

Use of sites Future use of Bellozanne A decision has already been taken to replace the incinerator at Bellozanne. Will our deliberation change this? Other long term uses of La Collette – conflicts of interest Involvement of Community Fully informed decision making

Exclusion from decision

The people who it might impact on most will not have chance to fully state concerns & influence plans

People being expected to be involved in project which is not considering the full picture re. La Collette –adds to cynicism around public involvement

Living and working conditions including services

Traffic Impact Noise impact through traffic & plant

Parking control – workers/visitors

Recycling uses more energy –

Waste / location Groups will be affected – elderly and young Excessive cost of EFW plant in relation to pure

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taking items to collection points

Traffic impact on roads infrastructure –quality of life

Traffic especially through tunnel

Traffic impact on air quality

Traffic weight (numbers) & control

Traffic

Increase congestion

Increase in heavy traffic –safety for pedestrians

Waste / location Two areas of waste

Site

Support of local employment (increase) training

Impact to those visiting Jason? Prov???

Plans to use bottom ash or fly ash as a building material is inherently as dangerous as dumping –long term effects

Most suitable location in terms of health not ££

Amenity (Havre Les Pas - walk & Bathing Pool & vening area & Howard Davis Park & St Lukes School

incinerator re. long term financial health of residents

People need their “rubbish” collected

Are all the modelling assumptions right? How will we know? Safety Higher recycling resulting in longer storage at homes which are not designed for adequate ??

Proximity to fuel farm

Smell from deliveries to plant –also storage of refuge

Disposal of ash

fire risk

Noise from plant

Vermin being attracted to the area

Fire – breakdown of pollution –need to use chimney for JEC

Smells/odours & impact on Havre des Pas residents

Risk attached to siting plant in an adjacent location to fuel farm i.e. gas/oil/petrol

General Socio-Economic Conditions, Legislation, Environment

Pollution Traffic if you don’t know what else is going down there? Planning

Traffic Worried about pollution from lorries etc. coming from all over the island converging on St. Helier Traffic flow increases-pollution Air quality Noise

Risk cont. Incineration next to fuel farm –risk of explosion

Danger all eggs in one basket

Visual Impact Visual effect –Gateway to Jersey

Visual impact of facility –blot on landscape

Size –projected further

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Commercial traffic levels through nearby residential areas Fumes toxic etc. flowing over densely populated area incl. St. Helier businesses

Property Impact on property prices & resultant impact on health

Not all houses have space to separate to recycle

Other businesses around the site

Separate section no title ?public access –if so, when?

Location is at odds with environmental agency guidelines

Is EFW v. Plain incineration a more toxic exercise?

Will this lead to further taxation?

Risk Waste from plant disposal containment

recycling and eliminate need for such a large plant

Blighting of area for future development

Jersey’s character

Concerns of size of plant: is it future proof?

Visual impact

Visual impact of site on health & wellbeing

Coast

Loss of coastline

Visual blight

Visually disappointing

Benefits Jobs

Location??

Recycling

Island improvement with closure of Bellozanne

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12.5 Appendix E Stakeholder Workshop Evaluation

** Workshop Evaluation Form** January 31st 2007

All participants were encouraged to complete an evaluation form – 13 of the 15 did so.

1a. How useful was this workshop for you?

Very Useful

x 4

Quite Useful

X6

OK

X2

Some Use

X1

Little Use

Comments: “Good to have information on project “ “I learnt a lot” “Some areas were too technical – I felt early input could be on community involvement” “It was a partial repetition of the previous workshop – though I understand why this had to be!” “Very useful but too many have anti-views on site – not helpful” “Too little too late I feel” “Exceeded my expectations”

2a. What three words would you use to describe the workshop? Informative x 6, Constructive, well run, really very interesting, involving, educational x 2, thought-provoking, interesting x 4, enlightening, technical x 2, clarifying, challenging, specialist, inclusive, relaxed, helpful, interactive, good information, the unknown area behind the workshop, engaging

3a. How did the workshop contribute to your understanding of health

impact assessment? • Very good • A great deal • Not much more than the steering group meeting • Considerably • Seeing the theory begin to take shape in a practical manner gave an

insight into how an HIA is compiled • Clarified many points • Consolidated previous workshop • Clear • Gave me a clearer understanding of the breadth of the study • Made me think • Very well in enabling a focus on many of the issues & widening the

individual concerns into a collective approach • Better understanding about impact • Fully

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4a. What suggestions do you have to make future workshops on HIA more useful?

• No comment • Give out handouts beforehand, some pre-meeting preparation • More active generation of participants • Get more members of the ‘general’ public to attend via other organisations –

Rotary, Women’s Institute etc • Trim the presentations • Plain English presentations even for professional groups, I think some of it

was too complicated • Simplify and target separate audiences appropriately • Half day sessions would be better • Make a concerted effort – perhaps through personal contact – to encourage

more people to attend • More people in perhaps a more central location • Smaller groups to enable greater participation

5a. What comments would you like to make about the venue and refreshments?

• Excellent x 2 • OK x 2 • Good • Very good but out of town • Fine, plenty of parking space • Very good x 3 • Pleasant environment • Venue ideal for the number attending. Refreshments adequate.

6. What comments would you like to make about the presentations and facilitation?

• Excellent • A bit laboured at first • Good • Fine • Whilst very concise and efficient more time could have helped although I

recognise how fatigue can set in • Good – just need to simplify / shorten presentations. Facilitation fine other

than that • Good quality • Shame presentations over-ran • Well done, well prepared • Very good – nice and easy but focused & directed when required • I think the workshop groups should be smaller – say 6 people in each – each

with a facilitator / leader

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7. What is one thing that you will tell people in your organisation about HIA?

• Facilitated exchange of information in a very professional manner • Use it in part as early as possible in the selection process • “If Livingstone uses it – don’t” • Useful process to inform considering planning applications • A useful tool x 2 • Feedback on some of the points raised to allay concerns • Speak out if you have concerns. It is too late once decisions have been

made • A good interactive tool • It was an interesting and informative consultation exercise

a prospective rapid health impact assessment of the ... · health impacts of the efw proposal and...

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