title: Participatory health impact assessment used to support decision-making in waste management planning: A replicable experience from Italy.
abstract: The lack of participatory tools in Health Impact Assessment (HIA) to support decision-makers is a critical factor that negatively affects the impacts of waste policies. This study describes the participatory HIA used in deciding on the possible doubling of the municipal solid waste incinerating plant located near the city of Arezzo, Italy. Within the framework of the new waste management plan, a methodology for the democratic participation of stakeholders was designed adopting the Local Agenda 21 methodology. Communication and participation events with the stakeholders were set up from the plan's development to its implementation. Eleven different categories of stakeholders including individual citizens were involved in 21 local events, reaching over 500 participants in three years. Actions were performed to build the commitment and ownership of the local administrators. Then, together with the environment and health agencies and a representative from the local committees, the local administrators collaborated with scientists and technicians in the knowledge-building and scoping stages. Focus groups of voluntary citizens worked together with the researchers to provide qualitative and quantitative evidence in the assessment stage. Periodic public forums were held to discuss processes, methods and findings. The local government authority considered the HIA results in the final decision and a new waste strategy was adopted both in the short term (increased curbside collection, waste sustainability program) and in the long term (limited repowering of the incinerator, new targets for separate collection). In conclusion, an effective participatory HIA was carried out at the municipal level to support decision makers in the waste management plan. The HIA21 study contributed to evidence-based decisions and to make a broadly participatory experience. The authors are confident that these achievements may improve the governance of the waste cycle and the trust in the public administration.
authors.affiliation: Institute of Clinical Physiology, National Council of Research, Via Moruzzi, 1, 65124 Pisa, Italy. Electronic address: linunzia@ifc.cnr.it.
authors.forename: Nunzia
authors.initials: N
authors.lastname: Linzalone
authors.affiliation: Institute of Clinical Physiology, National Council of Research, Via Moruzzi, 1, 65124 Pisa, Italy. Electronic address: acoi@ifc.cnr.it.
authors.forename: Alessio
authors.initials: A
authors.lastname: Coi
authors.affiliation: Regional Agency for Environmental Protection Emilia-Romagna, Via Begarelli, 13, 41100 Modena, Italy. Electronic address: plauriola@arpa.emr.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Lauriola
authors.affiliation: Local Agenda 21, Via Sarpi, 2, 35138 Padova, Italy. Electronic address: luised@comune.padova.it.
authors.forename: Daniela
authors.initials: D
authors.lastname: Luise
authors.affiliation: Centro Formazione e Ricerca Socio-Sanitario ed Ambientale Francesco Redi, Via della Fioraia, 17/19, 52100 Arezzo, Italy. Electronic address: spedone64@gmail.com.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Pedone
authors.affiliation: International Society of Doctors for the Environment, Via della Fioraia, 17/19, 52100 Arezzo, Italy. Electronic address: isde@ats.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Romizi
authors.affiliation: Department of Prevention, AUSL 8, Via P. Nenni, 20, 52100 Arezzo, Italy. Electronic address: d.sallese@usl8.toscan.
authors.forename: Domenico
authors.initials: D
authors.lastname: Sallese
authors.affiliation: Institute of Clinical Physiology, National Council of Research, Via Moruzzi, 1, 65124 Pisa, Italy. Electronic address: fabrizio.bianchi@ifc.cnr.it.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Bianchi
mesh_terms: D055812:Community-Based Participatory Research; D003657:Decision Making; D004777:Environment; D062489:Health Impact Assessment / Q000379:methods*; D006304:Health Status; D006801:Humans; D017745:Incineration; D007558:Italy; D015397:Program Evaluation; D011639:Public Opinion; D011640:Public Policy; D012923:Social Class; D018505:Waste Management / Q000379:methods*
keywords: Democratic participation; Health impact assessment; Integrated approach; Public health; Stakeholder engagement; Waste policy