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OMANI GUIDELINES ON

ENVIRONMENTAL AND HEALTH IMPACT ASSESSMENT OF

DEVELOPMENT PROJECTS

by

Dr. Salim Said Al-Wahaibi MPH (Johns Hopkins, USA), COHP (Johns Hopkins, USA), DFE (KSU/KSA), M.D. (Arabian Gulf University, Bahrain)

B. Med.Sc. (Arabian Gulf University, Bahrain)

Director, Environmental & Occupational Health

Ministry of Health Sultanate of Oman

§ § § § §

Mr. Abdullah Rashid Al-Mandhry

MSC Industrial & Occupational Hygiene (LSHTM, London, UK) BSC Environmental Health (USA)

QHSE Manager, UBS, Oman Weatherford, c/o OOISS P.O. Box 510, P.C. 112

Ruwi, Sultanate of Oman

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TABLE OF CONTENTS

Topics Page

INTRODUCTION - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

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CHAPTER 1: HIA in existing EIA - - - - -

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CHAPTER 2: A brief introduction to HIA - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

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CHAPTER 3: Types of development and their specific health aspects CHAPTER 4: The initial screening process CHAPTER 5: Terms of Reference and the HIA methodology CHAPTER 6: Appraisal CHAPTER 7: Monitoring of health and compliance CHAPTER 8: Social Impact Assessment Approaches in EIA Protocols: A Social Science Perspective

ANNEX A - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 66

ANNEX B - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ANNEX C - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

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INTRODUCTION The Royal Decree 10/82 and its amendments entitled “The Law on Conservation of the Environment and Prevention of Pollution” has no doubt been the pillar of environmental protection and conservation in Oman. Yet, the human health dimension of the Environmental Impact Assessment procedures that have their roots in this decree remains ambiguous, lacks comprehensive coverage of health issues and fails to foster a strategic alliance between the environmental and public health authorities. The present guidelines aim to stimulate progress in the area of Environmental and Health Impact Assessment at a time when development in Oman is accelerating. There are growing concerns over the immediate and long-term impacts of the many development projects taking place: industrialization (e.g. construction, petro-chemical and pharmaceutical industries), seaport development, rapid urbanization, and the development of transport infrastructure, of the tourist industry and of agricultural production systems, implying, for example, irrigation extension and increased use of pesticides. All these development activities and others not mentioned here aim at improving the living conditions and quality of life of the Omani population. Yet there is growing evidence that a lack of early-planning stage consideration of impacts on the environment and human health and a failure to incorporate effective environmental and health safeguards do in fact result in a reduced health status of vulnerable communities. The cement factory in XXX is one example with its adverse effect on respiratory disease incidence. Social determinants, including development-related migration of workers, carry the hazards of the re-introduction of communicable diseases. Yet, on the positive side, there is also evidence from Al Batinah that a shift from surface to drip irrigation not only saved scarce fresh water resources but also contributed to the interruption of malaria transmission. Health Impact Assessment (HIA) has a distinct profile in the procedures constituting the planning of development. It is a decision-making tool that helps prevent the transfer of hidden costs to the health sector, contributes to the early detection of cost-effective preventive measures and ensures that the human resource supporting the development is in good health. Environmental determinants of health are critical, hence the strong ties between environmental and health impact assessment. Yet, an exclusive focus on the environmental determinants of health would overlook the important role of social changes induced by development and their impact on health. Development in Oman is still mainly project-oriented, and impact assessment procedures should therefore fit in with the project cycle. Yet, an evolution to stronger policy directives setting the development framework is on the horizon and will call for impact assessment to move upstream. The current mode of

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environmental and health impact assessments will have to give way to strategic impact assessments. These guidelines will therefore need updating when that happens, but for the time being they are based on the more conventional model. There are a great number of players in environment, health and development in Oman. EIA and HIA require regulators in the ministries of environment and health who can ensure the procedures are followed correctly. They are the main target audience of these guidelines. In the private sector, planners and managers become proponents of new development projects. They have to comply with the impact assessment procedures and with the outcome: safeguards and mitigating measures to be incorporated in their project design and operations. The current legislation does not cover, apparently, development activities initiated by the public sector. A large percentage of all development projects is, nevertheless, proposed by different ministries or other state bodies. Even the medical services part of the health ministry itself could be subject to an EHIA requirement, for example in relation to the particular risks of hospital waste posed by the construction of a new hospital or clinic. Therefore the overall target audience of these guidelines is quite wide and varied, and they try to avoid using unnecessary technical terminology or jargon. Instead, they aim at clarifying procedures, their purpose and those who are responsible for the different E & HIA stages. These guidelines build on the existing EIA guidelines, issued by the Directorate General of Environmental Affairs “Guidelines for obtaining environmental permits”. Those guidelines provide a mere listing of good practice and some standards to adhere to. The present guidelines want to go further and focus on the step-by-step procedures and the institutional arrangements, and also on the actions required once an EIA and/or HIA has been approved by the relevant authorities and its recommendations need to be implemented. For a lot of these procedures, the administrative infrastructure does not yet exist in Oman. There are great capacity building needs to get HIA off the ground. The guidance given here is based on experiences from other countries that have had to handle similar problems. With method and procedure at the core, the guidelines also indirectly point to the kind of administrative infrastructure and policy framework that needs to be build, without being prescriptive. Ultimately, it will be for the Omani authorities to decide how they want to accommodate effective impact assessment exercises in their own governance structure. The guidelines are structured as follows: in chapter 1 an analysis is made of the existing Guidelines for Obtaining Environmental Permits as the basis for EIA in Oman and the place of health in these guidelines. Chapter 2 serves as an introduction to Health Impact Assessment and provides a brief explanation of the various steps in the HIA process. Chapter 3 addresses the subject from the development angle and considers the potential health impacts of

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different types of development in Oman, with information that will be helpful to the initial screening process. In Chapter 4 screening of development projects and in Chapter 5 the formulation of HIA Terms of Reference in discussed, and this expands into the core of the HIA methodology, reviewing hazards and risks of particular importance in Oman. Chapter 6 focuses on the appraisal of the HIA report and the subsequent development of a Health Management Plan. Chapter 7 focuses on the monitoring responsibilities during the construction and operational phase. In the final chapter, Chapter 8, the specific characteristics of social impact assessment are discussed, complementing the information given earlier in the text.

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CHAPTER ONE: HIA IN EXISTING EIA Royal Decree 10/82 shows that the Sultanate’s commitment and seriousness on the subject of environmental protection and conservation dates back as far back as 1982. The Law on Conservation of the Environment and Prevention of Pollution stipulates the need for private development initiatives to obtain an Environmental Permit. It requires that an Environmental Impact Statement (EIS) for development projects be submitted with the application for a license. This EIS is reviewed by the Ministry of Regional Municipalities, Environment and Water Resources (MORMEWR) and before the development can go ahead, a No Environmental Objection (NOE) decision must be issued by the Ministry. According to the Law, the decision has to be made within 60 days of submission of the EIS and in order to issue its approval, the Ministry will need to be satisfied that the environmental impacts, which are described in the EIS, are acceptable. The preparation of an EIS, and its review, implementation and monitoring make up a tedious exercise that requires trained, skilled, and experienced professionals in both the private and government sector if it is to be done effectively. In fact, the different aspects of the process require different areas of expertise for its effective implementation. To help make the process more effective, the Directorate General of Environmental Affairs, MORMEWR has issued guidelines under the title of “Guidelines for obtaining Environmental Permits”. These guidelines are not true Environmental Impact Assessment guidelines in that they do not give directions for an EIA process or for the administrative structures to support it. Rather, it is a normative document that lists the general and specific requirements a development project should meet with respect to environmental issues in order to obtain an Environmental Permit. The present HIA guidelines want to go beyond these normative directives, setting an initial, tentative framework that will allow essential HIA functions to be carried out, but leaving flexibility to further adapt structures and procedures once experience with HIA has been gained. The Guidelines produced by MORMEWR classify development projects in Oman into eight (8) groups “according to the technical aspects of their construction and operation phase” (1). The classifications are as follows: GROUP CLASSIFICATION EXAMPLES One Industrial Projects Chemical Petrochemical, Oil & Gas, Power

Generation, Organic Fertilizers, Textile, Metal Smelting and Refining etc.

Two Mining Projects Quarries, Crushers, Gypsum production, Marble & Ceramic, Extraction Minerals, Cement and Brick Factories, etc.

Three Agricultural Poultry Farms, Livestock Pens, Slaughterhouses,

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Projects Agricultural Products and Animal Fodder, Pesticide Storage, etc.

Four Food Projects Dairy Production, Bakeries, Food Production & Packing, Flour Mills, Fish Wrapping, etc.

Five Service Projects Roads, Water Supply Systems, Commercial & Residential Complexes, Dams, Hospitals & Health Centers, Permanent & Temporary Camps, Wastewater Treatment Plants, etc.

Six Marine & Coastal Projects

Commercial Ports & Fishing Harbours, Marine Bridges, Marinas, Clubs, Aquaculture, Artificial Lakes, etc.

Seven Tourism Projects Hotels, Temporary Tourist Camps, Tourist Resorts & Villages, etc.

Eight Light Industries Small Brick Factories, Gas Cylinders Storage & Sale, Carpentry, Smithy and Metal Workshops, Carwash, Oil Change & Car Repair Workshops, etc.

In the following section of this Chapter, the requirements specified in this normative guideline of the MORMEWR are analyzed for the adequacy to address the health issues that cut across development projects. The detailed guidelines are provided in Annex A, for easy reference. Analysis of the Guidelines for obtaining Environmental Permits The existing guidelines can be appraised for their generic value to the Environmental Impact Assessment process in Oman, and for their specific value with respect to the health dimensions of such an assessment. These issues are addressed by applying the following, systematic series of questions to the contents of the document. 1. Do the guidelines provide clear guidance on how to successfully carry out an EIA procedure from start to finish ? For each of the eight groups listed, the guidelines list a number of general requirements applying to all types of projects in the group. Moreover, they also list technical conditions to be complied with for each project within a given group. The guidelines present a list of requirements and conditions without linking them, necessarily, in a sequential procedure. The overall rationale of the exercise is lacking, as are the inputs and outputs associated with each step. Basically, these are simple checklists of items, many of which require an action that could be fitted into a logical sequence of a flow chart of activities. 2. Are the criteria proposed for the decision-making on impact assessment issues sound and unambiguous? At various junctures in the General Requirements, the decision-making criteria are vague. For example:

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“…….. The applicant should submit a completed application form for the environment permit and, if necessary, attach an Environmental Impact Assessment Study (EIA).”

or “……….If applicable, the applicant should apply to the Chemicals

Department in the Ministry of Regional Municipalities, Environment and Water Resources for a permit for dealing with chemicals …”

In neither of these two examples is there a proper definition of what “if necessary” or “if applicable” mean – is there a criterion that the guideline user can apply in a specific case, or is the applicant supposed to apply his/her own judgment. In the first example, this basically implies that there is no accountability for the decision whether or not an EIA should be done. From examples from other countries it is known that this decision is best left to the authority of the Environment Ministry (or in the case of Health Impact Assessment: the Ministry of Health) through an initial screening process. 3. Is there a clear and consistent reference to the administrative structures and responsibilities that support the impact assessment procedures? Throughout the checklists references are made to departments, directorates and ministries from where certain permits and clearance can be obtained. Most of these need to be obtained prior to the start of the project. There is no reference, however, to any process of monitoring compliance, quality control and fines for non-compliance. Carrying out an EIA would require a series of activities supervised by the environment authorities, as well as an administrative structure to ensure effective implementation of he recommendations that emerged from the assessment. Throughout this process responsibilities may shift from strictly regulatory to operational. Admittedly, the administrative structure to support EIA and HIA activities in Oman is not complete. Based on experiences in other countries, these guidelines makes suggestions how these structures could be created through internal re-profiling of the relevant Directorates in the MORMEWR and the MOH. 4. Is the scope of the guidelines sufficiently comprehensive? The guidelines provide a broad framework of different types of development projects, and for each of these detailed standards and norms are listed. The application of the guidelines seems, however, to be restricted to private sector initiatives, and not to development projects undertaken by other public sectors such as agriculture, industry or transport. On the impact side, the scope is meager, in fact the possible impacts (and the preventative or mitigating measures) are not mentioned at all. From a perspective of the impact assessment procedures, the guidelines lift out one part, which deals with the regulatory part of obtaining a permit. No coverage is given of the initial

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screening and scoping process, the formulation of Terms of Reference, the appraisal of impact assessment reports or the follow up of approved impact assessment recommendations. 5. Do the guidelines provide usable indicators to ensure independent quality control of the procedure and method? This aspect of EIA is completely lacking from the MORMEWR guidelines. 6. Is health adequately covered by the guidelines? Few direct references are made to health issues directly, and where they are made they are of a particularly general nature, such as in the general requirements:

“The applicant must ensure full compliance with the health, security and safety requirements at the construction and operation stages of the project”

Only for projects perceived to have a direct impact on health, such as the Group Four projects (Food Projects), approval from the health authorities is required prior to project implementation, but only as the municipality level. For example, under the technical conditions for Dairy and Food Production and Packing Industries it is stipulated that:

“The applicant should submit an approval from a health department of the concerned Municipality” (2)

Clearly, there is little understanding of the impacts development-induced change in environmental and social determinants of human health may cause. This omission of the MOH is of definite concern in the approval stage since the expertise available with the health authorities at the level of the concerned Municipalities relates to inspection and not to Health Impact Assessment. Will the application of the guidelines result in an effective Health management Plan? From the outset, the MORMEWR guidelines are clearly about requirements and conditions to be met for a “No Environmental Objection” clearance to be issued. It is left to the judgment of the project proponent to decided whether something as structured as an Environmental Management Plan or a Health Management Plan be developed and implemented as part of project development, and there is no indication that formal mechanisms are in place to verify the compliance with the necessary environmental and health safeguards. In conclusion The implementation of an adequate and effective Environmental Impact Assessment in Oman is in no way guaranteed by the current MORMEWR guidelines. They have their roots in the initial period of environmental

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protection, when the submission of and Environmental Impact Statement was the key mechanism to obtain approval from the environmental authorities to move ahead with a project. Impact assessment has evolved considerably since then and numerous technical and managerial aspects of it have been developed to ensure that prevention has become the key goal of the exercise, and that development options are considered from the environmental and health perspective at the earliest stages. Therefore, the EIA process as it is currently documented in the Sultanate of Oman not only is deficient to allow for acceptable EIAs, but it also leaves a gap in the potential application of appropriate Health Impact Assessment of projects. At the current pace of development in Oman, this, in turn, may lead to adverse health and social impacts of immense magnitude. This is precisely the gap that the present guidelines aim to bridge.

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CHAPTER TWO: A BRIEF INTRODUCTION TO HIA

The World Health Organization defines Health Impact Assessment as a combination of procedures, methods, and tools by which a policy, programme or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population. From this definition, a number of characteristics can be immediately derived: (1) HIA is a prospective activity, in other words, it aims to predict the health consequences of planned policies, programmes and projects (2) to carry out HIA properly, a number of assessment tools have to be applied in a methodological way, following a certain set of procedures. (3) HIA does not look at the average health effects in a large populations, but aims to identify vulnerable groups that may suffer from disproportionate adverse health impacts s a result of development-induced change. (4) HIA is not a static evaluation of the current health status of a population that will be affected by change, but it is an assessment of the change itself, and the likely health outcome that can be expected to result from it. Health Impact Assessment recognizes that the health sector, through the delivery of preventive and curative health services, has an important role to play in people’s health status. Yet, other sectors, public and private, in dealing with development, influence that health status on a daily basis through their decision-making that changes the environmental and social determinants of health. It should not be overlooked that all these other sectors combined govern resources that are orders of magnitude greater than the resources allocated to the health sector, in Oman some 3% of the GDP. Health Impact Assessment is closely related to the better known Environmental Impact Assessment (EIA). Both are modern planning tools to allow for a better-informed decision making on development issues, and their procedures and methodology are by and large similar. By carrying them out in parallel during the early planning stages of a project, the health and environment authorities can take advantage of the various synergies between the two assessments, in data collection and analysis for example. Together with other forms of impact assessment, HIA fits in a larger framework of good planning practice. At a strategic level, it can contribute to the choices between different development options; at the project level it will facilitate the early identification of adverse health effects of a selected development option, and, thus, the design of effective mitigating measures. EIA & HIA also help focus on involuntary risk exposure of vulnerable communities and provide a basis for well-founded compensations when needed.

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The rationale for HIA is multiple, but the most convincing argument for decision-makers outside the health sector is that carrying out an HIA constitutes sound economics. Whereas development without HIA may create health problems requiring costly solutions from the side of the health authorities, a proper HIA will prevent the transfer of such hidden cost to the health sector. Moreover, health safeguards and mitigating measures that can be incorporated in a project’s early design and operational phases are often more cost-effective than remedial health sector interventions afterwards. Finally, any development project will have to rely on the inputs of human resources and a healthy workforce will be essential for its success and sustainability. The second argument in this rationale for HIA relates to the equity principle. An HIA that is properly implemented helps identify vulnerable groups. Development aims at bringing benefits to society at large, but it may overlook adverse impacts on specific vulnerable groups. Well-known examples include dams which provide essential energy for remote urban centres, yet may affect the health status of local communities adversely; or large airports that play a key role in trade, transport and employment of a country, but that will also cause health risks to those living under the flight paths of landing planes. In these situations simple trade-offs are unacceptable: HIA provides the basis for effective health protection measures for such communities. The third argument in favour of HIA relates to the opportunities to promote health in the development context. The word impact has gained a negative connotation over the years, and it must therefore be stressed that HIA is about risks and opportunities. Any assessment will consider both positive and negative impacts. It therefore helps to identify the opportunities for health promotion, and seizing such opportunities adds value and, again, makes economic sense. Methodologically, any Health Impact Assessment is made up of a number of distinct actions that must always be carried out and that lead to a final conclusion concerning specific hazards and the probability that under the influences of the development process they will cause changes in the health status of a specific community. These actions are the following: • Screening and scoping to determine need, focus and boundaries

Impact assessments require resources to carry them out and complete them. It is therefore important, from a perspective of economics, to carry out a rapid screening of all development projects, with the prime objective to decide whether a full HIA is required. As a secondary objective, screening helps to identify relevant hazards and vulnerable communities. This information, in turn, serves as a basis for the formulation of the Terms of Reference for the HIA.

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Figure 1: An Overview of the Health Impact Assessment (HIA) Process ACTION INFORMATION OUTPUT

Types of health hazard

Definition of project type and location

Long list of hazards

Retrieval of project experience

Screening: health hazard identification

Scoping: initial health examination to set boundaries

Short list of hazards with potentially significant

health risks and list of vulnerable communities

Initial Health No Examination Sufficient for IEE Yes

No further action

Consult Bank health specialist

Need for

HIA?

Scope

TOR formulation for HIA

Health Impact Assessment Report

Health Impact Assessment

Approved

Appraisal HIA Report and negotiations

Recommendations and intersectoral Health Management Plan

Health Risk Management

Health Monitoring Data Compliance reports

Project benefit Monitoring and Evaluation

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Screening and scoping are desk exercises and in Oman the responsibility should be with the Department of Environmental & Occupational Health of the Ministry of Health. The two tasks should be carried out in close consultation with the counterpart department in the Ministry of Regional Municipalities, Environment and Water Resources responsible for EIA screening. Institutionalizing of HIA screening and scoping would be supported by including, in the Guidelines for obtaining Environmental Permits, under General Requirements:

The project proponent should submit the proposal for Health Impact Assessment screening and scoping to the Department of Environmental & Occupational Health in Ministry of Health (DE&OH) and abide by the Department’s recommendations concerning the desirability of a full HIA to be carried out.

Eventually, this requirement should also be included, as appropriate, in the environmental and public health legislation. More details on the screening procedure are given in Chapter 4. • Translation of hazards into risks This is the core of the actual impact assessment: identified hazards are considered in the light of the expected changes instigated by a development project and the level of risk associated with the hazard once the project is completed is estimated, assuming no specific health measures are taken. Three groups of risk factors are considered: community risk factors, environmental risk factors and institutional risk factors. The outcome of the individual hazard/risk assessments are synthesized into an overall, comprehensive Health Impact Assessment. In this process, a number of issues are crucial: the HIA should include transparent public consultations of communities that will be affected, the evidence base should be broad and not restricted to scientific evidence only and objectivity and procedural rigour must, at all times, be verifiable. Chapter five gives further details. • Design of a Health Management Plan Based on the outcome of the Health Impact Assessment, recommendations for health safeguards, mitigating measures and strengthening of health services are formulated. These recommendations should be technically sound, socially acceptable and economically realistic and feasible. They are combined in a comprehensive and intersectoral Health Management Plan with a clear time frame and a detailed budget. Both these tasks will be the responsibility of independent consultants who work under Terms of Reference given to them by the Department of Environmental & Occupational Health of the Ministry of Health. • Implementation of the Health management Plan. Once the HIA report and the Health Management Plan have been submitted by the consultants, a number of steps are needed to arrive at the successful implementation of the recommended health measures. First, the HIA report has to be subjected to a rigorous appraisal as a matter of quality control (Chapter 6) next the resources for the Health Management Plan have to be secured in negotiations with the Ministry of Finance (these negotiations

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should be part of the broader negotiations about the project at large) and institutional arrangements need to be established for the Plan’s activities to be carried out. Finally, both compliance with the proposed measures as well as the health status of the affected communities need monitoring (Chapter 7). The Department of Environmental & Occupational Health of the Ministry of Health takes responsibility for all these steps, in close consultation with MORMEWR. For some steps, such as the HIA appraisal, an ad-hoc working group of independent experts may be created, drawing relevant professionals from University institutions. Depending on the size and location of the development project, the monitoring functions may be delegated to the Regional counterparts of the MOH/DEH&MA In order to apply the HIA methods, a standard set of procedures needs to be followed. These procedures ensure that the HIA activities are carried out in a logical sequence, whereby the output of on step provides the inputs into the next. They also ensure that HIA can be anchored in the broader sequence of events of the project cycle, so that screening takes place at the design and pre-feasibility stages, the impact assessment at the same time as the feasibility studies (which are, in fact, economic assessments) and appraisal prepares for the negotiations phase. The HIA regulatory body, in Oman the Department of Environmental & Occupational Health, makes sure the procedures are followed correctly. The standard HIA procedures, set in motion following project identification, include: screening: focus on key disease issues and vulnerable groups scoping: setting boundaries in time and space TOR: drawing up Terms of Reference for the HIA Appraisal: verification of compliance with TOR, quality of the HIA

Report and soundness of recommendations Negotiations: ensure resource allocations for health measures MoU: creating a framework for intersectoral action Implementation: monitoring health and verification of compliance Evaluation : have resources have been disbursed correctly ? In summary, there are a number of essential functions in the performance of HIA that will be the direct responsibility of the Ministry of Health, and these include:

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• Assistance in the screening and scoping of project options • Drawing up the HIA Terms of Reference • Appraising the HIA report • Approving an intersectoral Health management Plan • Setting up a framework for intersectoral action (e.g. MoU) • Preparing a solid evidence-based position for negotiations • Verification of compliance with the recommended measures • Monitoring the health status of local communities The project proponent, whether it be private enterprise or a public sector institution, will have to ensure the HIA work is properly done, while the essential functions of the MOH are strictly regulatory, until the monitoring phase.

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CHAPTER THREE: TYPES OF DEVELOPMENT AND THEIR SPECIFIC HEALTH ASPECTS

This chapter introduces a number of health hazards that are relevant in the context of Oman and provides a brief explanation of the environmental and social determinants of the level of risk such hazards may pose. It continues to list types of development projects that have taken place in Oman in the past, or that are included in the country’s 7th Five Year Development Plan (2006-2010), with an indication of the risks specifically associated with each type of project. 3.1 Health perspectives At the start of this review of health issues, it is important to clearly define the terminology: A health hazard is an agent that may cause harm to the human being A health risk is a measure of likelihood that an identified hazard causes harm to a particular group of people at a particular time and place A health impact is a change of health risk associated with a project Commonly, five distinct health hazards are recognized: 1. agents of communicable diseases 2. agents/causes of non-communicable diseases 3. causes of malnutrition 4. causes of injury 5. causes of psychosocial disorders Key among the development related health hazards in Oman are: • Excessive concentrations of toxic or carcinogenic chemicals that will be

found mostly the mining or in the industrial environment, but also in certain handicraft cottage industries. Eventually, such chemicals will find their way into consumer goods.

• Agents of infectious diseases, whose transmission pathways may vary from being fecal-oral, through vector-borne to sexually-transmitted. A range of environmental and social determinants will play a role in these pathways.

• The main endangered life-sustaining media will be underground and surface

freshwater resources, but the lost of good agricultural lands or of fisheries, may also have major detrimental impacts on the nutritional status of human population.

Any increase of wet areas has the potential to enhance the growth of water-related vectors of systemic parasitic diseases. Any uncontrolled discharges of raw sewage or human excreta, will increase the transmission risks of enteric infections through water or food. The arrival of a foreign workforce may introduce new pathogens into local communities, including HIV and various parasitic/bacterial or viral pathogens.

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Epidemiological screening at the start of the HIA procedures in Oman should consider the following significant health impacts with clear environmental determinants: Systemic parasitic disease hazards: Four parasitic diseases had a significant prevalence in some parts of Oman in the past, and there continues to be a real risk of their re-introduction through migrant workers from endemic parts of the world: malaria, schistosomiasis, leishmaniasis and lymphatic filariasis. Environmental receptivity to the transmission of these diseases is enhanced by:

Any changes in the local hydrology, including the introduction, extension or intensification of agricultural irrigation schemes, the construction of dams, and the creation of impoundments and reservoirs. Depending on the water quality and other ecological conditions, they may increase the populations densities of anopheline and/or culicine mosquitoes. This, in turn, may increase the transmission risk of transmission of malaria and/or filariasis, depending of the mosquito species in question. Globally, malaria is actually the main systemic parasitic health problem in most tropical countries, and highly prevalent in the several of the South-Asian countries from where a large part of Oman’s workforce originates.

In connection with changes in land use patterns, caused by agricultural

development, urbanization, roads, or changing habits of traditionally nomadic peoples like the Bedouins, the vegetation characteristics of an area may evolve. In other parts of the WHO Eastern Mediterranean Region it has been observed that the enhanced growth of shrubs on which certain rodents feed can lead to an increased risk of leishmaniasis transmission, where these rodents serve as the reservoir of the Leishmania parasite.

In the urban setting, the creation of ponds of stagnant sewage or ditches

of dirty water, or certain facilities for waste water treatment may facilitate the growth of mosquitoes, vectors of lymphatic filariasis, that breed in organically polluted waters. As a result, the environmental receptivity to filariaris transmission to neighboring human population may be increased

In Oman, the risk areas for malaria, schistosomiasis-and leishmaniasis are well known to the national health authorities. As universal screening for these parasitic diseases of all Asian migrant workers coming to Oman is in practice not feasible, many development projects, particularly those entailing major construction works have the implied risk of re-introduction of these diseases. A proper HIA, with health risk mitigation through a reduction of environmental receptivity and effective monitoring is the optimal response to this problem. Hazards of enteric infections: Infections by water- or food-borne pathogens are not uncommon in Oman. In the rural areas the risk is mainly linked to contaminated drinking water, while throughout the country there is an infection risk from food eaten raw that is contaminated by sewage or by human excreta. The germs causing enteric infections may be viruses, protozoa or bacteria. The two major viral enteric diseases are hepatitis A and poliomyelitis. Fortunately in Oman, most of the

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population develop a strong naturally acquired immunity against hepatitis A, and children’s vaccination coverage against poliomyelitis is high. Therefore the actual risks related to these viral hazard are limited. The two major protozoal enteric infections in Oman are giardiasis and amoebiasis. Giardiasis is relatively common in Oman, and amoebiasis is wide-spread and usually transmitted through the consumption of raw vegetables, that have been grown on fields irrigated with waste water. Bacterial enteric infections are numerous, ranging from salmonellosis and shigellosis (both transmitted mostly through contaminated food), to typhoid fever and cholera (transmitted mostly through contaminated drinking water). The urban population usually use tap water which is chlorinated, but rural populations tend to get their drinking water from shallow wells or springs, which are very sensitive to contamination by sewage or human excreta. Clearly, any proposed irrigation projects using waste water need to be studied for the possibilities of incorporating health safeguards for agricultural workers and for consumers; any development project in the rural areas should seize the opportunity to include the improvement of access to safe drinking water and basic sanitation. Hazards of respiratory infections In Oman, acute respiratory infections are a significant cause of child morbidity. Environmental risk factors for those ARI include poor housing, overcrowding of dwellings, as well as indoor and outdoor air pollution. The same environmental factors plus malnutrition also facilitate the spread of tuberculosis. Increasingly of public health concern are the respiratory infections that affect mostly middle aged people and the elderly, and that are transmitted through aerosols and droplets coming out of poorly maintained air conditioning systems. Hazards of chronic respiratory diseases Chronic respiratory diseases are linked to indoor and outdoor air pollution. Chronic respiratory diseases such as pneumoconiosis, silicosis or fibrosis, are commonly found among miners and industrial workers. The genesis of these diseases needs high levels of human exposure, which are found among unprotected workers in mines, quarries and specific industries; but usually not among the general population. However, an increased risk for communities living nearby certain industries such as cement factories has been observed in Oman. Sexually-transmitted infections including HIV/AIDS: In all parts of the world where extensive infrastructure works are carried out by a largely imported workforce, there is an elevated risk of sexually-transmitted diseases, including HIV/AIDS. Even in countries like Oman, where the initial hazards are low, the pathogens may be imported with the workforce. Screening can only partially prevent the disease from entering the country. A proper HIA will automatically highlight this issue, and provide the authorities an opportunity to select from a number of possible preventative actions.

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Chemical hazards Acute chemical poisoning may occur at home as a result of mishandling of chemical consumer products such as cleaning media, cosmetics, pharmaceutical products, household pesticides, and so on. It may also happen among workers in industry and in handicraft workshops. Unprotected agricultural workers may be exposed to pesticide poisoning, but pesticide use in Oman is relatively limited and for 80% confined to applications for treating soils in greenhouses. The actual levels of air water and soil pollution by toxic inorganic chemicals, organic chemicals and their residues are not sufficiently high in Oman to pose an acute health risk to the human population; however, in the case of major industrial accidents, the exposure of neighboring populations may reach a level where a serious risk to human health arises. Hazards for carcinogenicity: An increased incidence of neoplasms (cancers) and their precursors may occur as a result of long-term exposure to relatively small doses of carcinogenic chemicals or radiation. In Oman, cancer is not yet a major cause of morbidity in the general population, but it is an important cause of hospital patients’ mortality, and therefore the general population should be protected against excessive exposure to carcinogens. Those carcinogens may be consumer products such as tobacco, but they may also be chemicals emitted by industrial processes, which find their way into urban air, drinking water or food. Oman is a signatory to the Stockholm Convention on POPs which is an international, legally binding instrument aimed at reducing and eliminating the production and use of twelve compounds labeled as Persistent Organic Pollutants – eight of these are first generation residual pesticides and the treaty also covers PCBs, and dioxins and furans. Natural resources and health

The health of the Omani people is closely linked to the quality of the natural resources in its territory. While Oman is rich in mineral resources, its wealth in other natural resources is comparatively less, in particular fresh water resources and soils. It is, on the other hand, rich in marine resources. Conservation of natural resources, especially those in short supply, is crucial to the health status of the Omani people. Basic needs ultimately rely on the availability of good quality fresh water resources and good soils to achieve food security. It is in this area that the environment and health authorities in Oman have there greatest common interest, and where effective co-operation can enhance the capacity to achieve results. The depletion of good quality fresh water resources in Oman is a major cause for concern, even if currently the high-tech solution of de-salinization of seawater can provide large volumes of good quality drinking water. Water resources being scarce in most of Oman, any wastage of good quality fresh water, does not only represent an economic loss, but also a threat to

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human health, as human life depends on water availability for drinking and hygiene. Existing fresh water resources are jeopardized through pollution of aquifers, or through salinization resulting from excessive pumping of underground waters. The prevention of pollution and the replenishment of underground water resources should be a top priority in the Sultanate of Oman. Another source of concern is the loss of good agricultural lands and the depletion of marine fish stocks Major loss of agricultural land increases the country’s reliance on outside sources of food and ultimately it may endanger the food security and the nutritional status of the population. Agricultural land may be lost through unplanned urbanization, construction of major reservoirs, or of major transportation infrastructures. In Oman, fisheries contribute significantly to the protein component of the daily diet, and is therefore crucial for nutrition. Coastal and seawater pollution may have detrimental effects on fish nurseries and may drastically cut down fish stocks. 3.2. Main environmental health impacts of selected projects Large size reservoirs Dam, reservoir and impoundment projects have a positive impact because they store water and increase water availability. This is, of course, particularly relevant in a country like Oman, where water resources are scarce. If poorly planned, however, they may have a number of negative impacts:

Loss of a considerable surface of good agricultural land; Loss of fresh water resources through excessive evaporation; Loss of water quality through eutrophication and algal blooms; Propagation of mosquito populations, with the risk of malaria outbreaks

and the transmission of other mosquito-borne diseases; Increased human-water contact, with the risk of schistosomiasis

transmission if the parasite is introduced in the area. Sedimentation, trapped behind the dam and prevented from fertilizing

down stream lands.

Major agricultural irrigation schemes Agricultural development enhances food security and helps the Omani economy to be less reliant on food imports. Irrigation is an important component of a strategy to expand and intensify agricultural production. Poorly designed agricultural irrigation schemes may result, however, in a massive loss of good agricultural lands though salinization, particularly if drainage is inadequate. Its most direct adverse impact is the possible increase of mosquito and snail populations, with its consequences for the incidence of malaria and schistosomiasis cases. Oman has a strong track record of promoting modern forms of irrigation, such as sprinkler, bubble and drip irrigation, where such risks are minimized. Technical design handbooks are available on proper design of

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agricultural irrigation schemes, one of them edited by the USAID, another one by the joint UNEP/FAO/WHO Panel of Experts on Environmental Management for Vector Control (PEEM). Treated sewage reuse for irrigated agriculture Oman and other countries in the region increasingly rely on waste water for agriculture. Depending on the level of treatment, there are a number of health risks to consider. The main impact may be the micro-biological contamination of unconfined aquifers and, therefore, of the shallow wells from which rural population take their drinking water. Another well-documented impact is the possible micro-biological contamination of vegetables and fruits grown on these lands and eaten raw. A third, minor impact may be infection of agricultural workers in case of exposure to the larvae of intestinal helminthes or of accidental ingestion of irrigation waters. Cement plants and quarries To support the major infrastructure works planned or underway in Oman, the construction industry itself is likely to expand considerably. The main health impacts of quarries consists of injuries among workers, and of chronic respiratory diseases resulting from workers excessive exposition to mineral dust. Quarries have little health impacts outside the work environment. Cement plants produce large emissions of dust on the down-wind surroundings. Populations living in the areas below the plume of the plant stack, breathe high concentrations of dust, and are therefore at an increased risk of chronic respiratory diseases. Dusty air also increase the susceptibility to and seriousness of infectious respiratory diseases, as well as the seriousness of eye diseases. Oil production, oil refineries and petrochemical industries The natural oil and gas reserves in the region form the mainstay of the local economy, including the economy of Oman. The oil industry is a major polluter. The drilling of wells uses lubricant sludge which is a compound including many offensive chemicals. Around wells there is leakage of this sludge, and also leakage of oil. This leakage may pollute soils, destroying its agricultural capacity; if oil fields are located in the desert, this is a negligible impact, however. The transport of oil is another source of leakage, which may pollute freshwater, agricultural lands or range lands, coastal areas and the sea. Coastal pollution of a closed sea, such as the Arab Gulf, may have a detrimental impact on fish nurseries and then on the nutrition of fishing populations. This problem is perhaps less acute for Oman, as it faces the open Indian Ocean, but fishermen continue to rely on fish stocks in the coastal areas. The pollution of tourist beach resorts not only has economic but also health dimensions. From production to transport and to refinery, oil industry is at risk of fires and explosions. Its direct health impact are therefore injuries and burns among workers and the neighboring population; its indirect health impact results from loss of good quality freshwater and of food production assets.

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In addition, oil refineries and the petrochemical industry are emitting significant quantities of toxic chemicals in air, water and soil. Through inhalation or ingestion, those chemicals may be absorbed by the populations living around the plants, not speaking of unprotected workers inside the plant. Among those chemicals it is worth to quote poly-cyclic aromatic hydrocarbons (PAH), which are all more or less carcinogenic, the most aggressive being “benzo-a-pyrene”. Usually PAH are accounted for their toxicity measured as equivalent benzo-a-pyrene. The PAH content varies with different blends of oil from different regions; for example, the so-called Arabian light has a relatively low content. Excessive and continued exposure of the surrounding populations to PAH emissions creates a risk of increased cancer incidence. Chemical Industries The oil industry is only one branch among the large family of chemical industries, the most common in Oman being manufacture of fertilizers, pesticides, paints and dyes. All chemical industries are subject to accidents and explosions, and, in case of large scale industrial explosion the neighboring population may suffer badly. This is why chemical industries must be located far from human settlements, inside especially engineered industrial plants, and illegal urbanization around the plants must be prevented. In addition, all chemical industries are, to a greater or lesser extent, potential sources of toxic chemical emissions in air, water and soil. Among the chemical industries, pesticide manufacturing is especially hazardous, as they deal with products that affect basic biological mechanisms. Steel works and other metallurgical industries Inside those industries workers are exposed to high injury risk, to excessive noise and heat, and to various toxic chemicals and heavy metals, in case those industries are not isolated in especially designed industrial parks, the surrounding population may also be at risk. Actually steelworks do not emit large amount of toxic metals, but no-ferrous metal industries do emit such toxic particulates. Lead smelting emits lead dust, zinc smelting emits cadmium, aluminum smelting emits fluorine. Galvanic industries release cyanide in wastewater. Those emissions do have an impact on surrounding populations among which intoxication cases may eventually be diagnosed. Seawater desalination plants In order to meet its freshwater needs, sea water desalination is an essential activity in Oman. There are two different processes to desalinate sea water, either flash-distillation which is a thermal process and for which energy consumption is related to the amount of salt removed, but not to the amount of water treated. Reverse osmosis is the most efficient process to treat brackish water, but flash-distillation is preferred to treat seawater with high salt content as this is the case for the Red Sea, or the Arab Gulf waters.

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The by-product of both processes is a large amount of brine, which has to be disposed of and is generally discharged into the sea. Another problem is associated with the anti-fouling products that are used to protect pipes from excessive invasion of marine organisms, and from paints which are used to protect those pipes against corrosion. Brine discharge as well as anti-fouling and anti-corrosive product leakage may have a detrimental impact on marine life, and especially on fish nurseries. Therefore poorly planned seawater desalination plants may have an adverse impact on fishery resources, on the livelihood of fishermen and on the general nutritional status of people. Phosphate mining and other mines There are two ways to exploit mineral resources, either through digging in open air, or through underground burrows. The main impacts are injuries among miners, followed by chronic respiratory diseases due to inhalation of dust, and sometime lung cancer due to radon if underground mining take place, as a small amount of uranium is often included among phosphate rock layers. If mining is performed in open air, neighboring populations are exposed to mineral dust and eventually to particles loaded with heavy metals. Lead will come from lead mining, cadmium from zinc mining, and mercury emissions may come from the use of mercury to extract some precious metals such as gold or silver. However if mining is performed underground, exposure levels of the neighboring population is significantly lower. If the mine is located inside a narrow mountain valley, due to lack of atmospheric dispersion dust concentration in the mine neighborhood will be significantly higher than in a plain setting. Phosphate mining take place usually in open air and is a major dust producer, creating a risk of chronic respiratory diseases and also a risk of eye diseases; but the main problems come from two by-products often found inside phosphate deposit, they are fluorine and uranium. High prevalence of fluorosis is seen among populations living around phosphate mines, but so far no significant increase of cancer such as leukemia has been reported despite detectable levels of uranium inside the phosphate deposit. Fossil-fuel fired power plants The main impact of thermal power plants comes from air pollution by SO2, NOx, and particulate matter. This pollution has negative impacts on the lung function of the population living in the polluted area. Another impact of thermal power production is thermal pollution of the water body used for cooling. With no large rivers in Oman, power plants are sited on the coast and use seawater for cooling purpose. An excessive increase of coastal water temperatures may be detrimental to marine life and may result in a drastic reduction of fish stocks. Major transportation infrastructure, airports and highways When located inside agricultural lands, these infrastructures may spoil large amounts of already scarce agricultural lands, and reduce the national capacity to produce food. Transportation infrastructures may also be sources of noise and air pollution, however the negative impacts of those nuisances on human beings are significant only in nearby urban areas.

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Other than noise and chemical pollution, the main health impact of transportation infrastructures results from their capacity to facilitate importation of pathogenic organisms from abroad, often to areas where the local population may not have natural immunity against those pathogens. Liquid or solid waste disposal facilities As the population of Oman expands, so will the amount of solid and liquid waste it produces and there will, therefore, be a need to develop more waste management and disposal facilities. The building of waste disposal facilities is basically an asset for public health as it aims to reduce pollution of land and waters. However, some inadequately planned facilities may have negative impacts overriding their positive ones. For example, a waste incinerator located inside an urban area may be a major source of air pollution for this area. A poorly operated composting plant is a major source of unpleasant smell. A sanitary landfill located too close to an urban area, may be a source of infections and nuisances, it will attract scavengers, who will be exposed to the worst possible occupational conditions, unsafe and unhealthy. Wastewater treatment plants may create health risk, when the treatment is inefficient, or when unsafe reuse of the effluent take place. Industrial wastewater contains toxic compounds and should not be discharged in municipal sewers without prior chemical neutralization. In some occasions, industrial wastewater is stored in large ponds. In such cases, the pond should be effectively fenced, as accidents have occurred, involving the death of children who swam in such ponds. 3.3. Some basic notes on infection risks Human pathogens (disease-causing organisms) are biologically designed to survive inside human body or in an environment resembling the human body. Usually, they will not survive for a long time under conditions of extreme temperatures or total lack of water. However, a number of human pathogens can survive, and sometimes reproduce, in the body of other animals; these are referred to as animal reservoirs of human pathogens. Systemic human parasites may need to spend a part of their biological cycle in the body of another organisms. If this organism plays a passive role in hosting the parasite, it is called an intermediate host (example: the snail intermediate hosts of the Schistosoma parasite); if the organism plays an active role in pathogen transmission through biting (usually biting insects), it is called a vector. Humans get infected through inhalation of pathogens fixed on aerosols, or through ingestion of contaminated food or drinks, or through bites of animals or insects. The infective dose is the minimum amount of pathogen that has to enter the human body to cause clinical illness, and this is specific for each pathogen. In their childhood, human beings naturally acquire immunity against the most common pathogens (the typical childhood diseases) Vaccination is an effective, artificial way to boost an individual’s immunity against specific pathogens,

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usually viruses or bacteria. Immunity against human pathogens gradually weakens among old or sick persons. Young children are also especially sensitive to infections. A population is vulnerable to infection and an epidemic may develop if immunity at the community level is lacking against a specific infection. The vulnerability of a population also depends on the effectiveness of the health services, and other public services with an impact on health. Vigilance of the health services, through effective monitoring and surveillance, is the first line of defence against epidemic outbreaks. The capacity of the health services is an important measurable component in Health Impact Assessment, and needs considering from the perspective of the new health situation that will arise once a development project is operational. Pathogens includes viruses, bacteria, and two kinds of parasites: protozoa and worms. Viruses cannot survive outside a cell or a bacteria, they are not sensitive to antibiotics, but vaccines are available against the most common of them. There are many kinds of pathogenic bacteria, among them mycobacteria are the more difficult to control. Parasites have a complex life cycle, involving sometimes transits through several different animal species. The malaria pathogen is a protozoa of the genus Plasmodium. It takes on various anatomic forms during the stages of its life cycle. Sexual reproduction takes places, obligatory, inside mosquitoes of the genus Anopheles, the vector. Four species of Plasmodium exists, all at one time present in Oman. Anopheles larvae develop in clean bodies of water; the female Anopheles needs a blood meal prior to laying its eggs. The mosquito gets infected through biting infected individuals, and then the parasite undergoes sexual reproduction and physiological changes to end up inside the mosquito glands from where it is injected into another human at the next bite. This cycle takes 8-10 days. areas in Oman are at a lesser risk of malaria transmission. Schistosomiasis (also known as bilhariazis) is caused by trematode worms of the genus Schistosoma, whose adults live and lay eggs inside human blood vessels. The eggs are excreted by infected persons with urine and hatch in water. The first stage larvae infest the bodies of aquatic snails and develop inside the snail into second stage free swimming larvae called cercariae. These penetrate the skin of humans in touch with he water. Control can consist of improved sanitation and hygiene, snail control and case detection/drug treatment. In many water resources development projects, particularly irrigation schemes, design and water management measures can be included to minimize human/water contact and snail propagation. The Leishmania parasite is a flagellate protozoa and causes leishmaniasis, in Oman in its cutaneous form known as ??? Reservoir hosts of the parasite are rural wild rodents of several species, and its vector is the sand-fly of the genus Phlebotomus, which transmits the infection from rodent to humans and between humans. Any environmental change, which create conditions favorable to the propagation of rodents or of sand-flies increases the risk of Leishmania transmission. Those three parasitic diseases are mainly found in rural areas.

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3.4. Chemicals behaviour in the environment Industries and other activities generate pollutants, which are discharged in the environment as atmospheric emissions, and liquid or solid waste discharges. Human beings may absorb pollutants which are included in air they breathe, the water they drink, or the food they eat. , Some pollutants may even cross the skin barrier. According to their physical characteristics, chemicals will concentrate preferably in specific media with which they have links. For example volatile chemicals will disperse in the air, water-soluble chemicals will concentrate in any water they may reach, chemicals with high capacity of adsorption will concentrate in soils, and more specifically in the soil’s organic matter. After having reached their favorite media, chemicals may undergo two kinds of processes: transformation and/or concentration. Through biochemical transformations a chemical will be changed in two or several metabolites, usually less offensive, but sometime more offensive than the original chemical Physical concentration take place in accordance to respective density and solubility. For example, heavy particulates from an atmospheric emission will sediment quickly on the soil and accumulate with time; water-soluble products will concentrate in water bodies. Fat-soluble chemicals eventually fall down on pasture, may be recycled by animals feeding on those pasture, and then they will concentrate in fatty tissues as they pass through the food-chain. When significant emissions of a specific toxic chemical are identified, there is a need to characterize this chemical for its health risks. For this purposes, WHO produces the “chemical safety sheets”, available from IRPTC (International Registry of Potentially Toxic Chemicals in the WHO Programme of Chemical Safety . According to the physical characteristic of the chemicals and its potential for transformation, which are recorded on the chemical safety sheet, the HIA consultant will know to what extent chemical emissions of a proposed project will constitute a health hazard/risk. Once it is has been recognized that there is a risk of chemical pollution of water or food for human consumption, the absorbed doses may be computed on the basis of the potential concentration of pollutant, multiplied by the quantity of drink or food absorbed daily. The WHO/FAO “Codex Alimentarius” lists, for the most commonly used chemicals, the maximum daily intake that does not affect human health. If those levels are trespassed detrimental impacts on the health of sensitive individuals may be observed, and those ill-health impacts will grow with the growth of the average absorbed doses. When only toxicity is involved, i.e. when the chemical is a poison, toxicologists recognize that there is non–effect level below which no ill-health impacts will take place. But when the chemical is a carcinogen, there is no non-effect level, as the risk will be proportional to the cumulatively absorbed dose. The same proportionality to the cumulatively absorbed dose applies to exposure to ionizing radiation.

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Contrarily to biological pathogens, toxic chemicals do not multiply, they may only be transformed or concentrated. Therefore it should be easier to keep them under control. There is no such thing as human immunity against hazardous, toxic or carcinogenous chemicals.

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CHAPTER FOUR: THE INITIAL SCREENING PROCESS In the Sultanate of Oman, development projects are proposed on a daily basis. The initiative may be with private enterprise or with one of the public sector institutions. Many projects are proposed at the national level, many more at the regional or local level. A Health Impact Assessment procedure should, ideally, capture all proposals, and the regulatory authority should decide which proposals need a full HIA. The purpose of initial screening is to make an informed decision, applying criteria that have been agreed on, about the need to make a given project proposal subject of an full HIA. Screening is a desk exercise, and screening with a view to a possible HIA is the responsibility of the Ministry of Health. It should, however, be carried out in close consultation with the environmental authorities, who screen projects with a view to a possible EIA. The timing of screening is important: in the context of the project cycle, it should be done during the design and pre-feasibility stage The criteria used in the screening exercise relate to the characteristics of the proposed project’s outcome in terms of environmental conditions and social structure. Similar criteria are used for EIA screening and those currently applied in Oman for that purpose are listed in the table below. The HIA screening criteria may overlap with the EIA criteria, but there may also be differences. The EIA criteria will focus on the protection of natural resources and of sensitive ecosystems, especially those with threatened wild life and rare plant species. Water resources and soils of good quality are certainly of importance to the communities whose livelihood depend on them, and biodiverse ecosystems provide goods and services that are of direct or indirect importance to health. The nutritional dimension is closely associated to these criteria. HIA screening criteria will, however, first and foremost consider environmental conditions under which disease causing organisms (pathogens) and, possibly, their vectors will thrive. The social conditions that are conducive to the transmission of these and other communicable diseases will also be contained in the present guidelines, as will be those conducive to psycho-social disorders. Major infrastructure projects should be earmarked for their possible risks of accidents and injuries, in particular if these risks are new and not properly covered under any existing occupational health legislation. The areas where EIA and HIA screening criteria probably have the greatest overlap are those of industrial development, energy, transport and mining, i.e. all those projects where there is an increased risk of release of and exposure to hazardous chemicals. This tends to be a strong focus in all impact assessment screening and reflects the industrialized-country origin of the exercise.

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Table 1: Screening criteria in the GCC Guidelines – Projects Requiring Detailed Study on Environmental Impacts 1. Projects with potential considerable adverse impacts on the social or natural

environment or those, which have impacts on an area larger than the site. 2. Large projects with major capital investment or manpower or projects which

cover large extensive areas. 3. Projects, which include the use of large quantities of chemicals, hazardous

substances or operations or the activities, which might cause health hazards. 4. Projects with potential adverse impacts on natural, cultural, social, historical

heritable, esthetic, scenic or industrial resources. Without prejudice to the above mentioned, in general, the following development projects and activities require detailed “Environmental Impact Assessment” (E.I.A.). An “Environmental Impact Statement” (E.I.S.) can be submitted as an executive summary for the detailed study. a) First List Specified Projects 1) Large projects which have an actual impact on the quality of the ambient air.

They include:

(i) Cement industry, factories which use clay containing materials and lime materials to produce (clinker) cement, and the works of grinding (clinker) cement.

(ii) Potteries which produce annually produce more than 2000 tons of concrete

products, by mixing sand, gravel, water and cement. (iii) Concrete factories which annually produce more than 2000 tons of concrete

products, by mixing sand, gravel, water and cement. (iv) Factories producing ferrous and non-ferrous substances. They are factories

which melt metals for moulding or plating. (v) Mixing asphalt works: They are the works which include grinding rock to mix

with asphalt.

(vi) Grinding rocks, raw materials, metals and chemicals or grain products which are carried out by grinding or separating into different sizes by screening or purifying by aerification or any other method.

(vii) Oil refineries: The installations in which crude oil is refined.

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Table 1 (continued):

Screening criteria in the GCC Guidelines – Projects Requiring Detailed Study on Environmental Impacts

(viii) Storing and manufacturing oil products: The work of storing oil products in

tanks of more than 2000 cubic meters capacity or the work of purifying used oil or manufacturing grease.

(ix) Mining industries where raw materials are melted to extract minerals or

metals. (x) Factories of metal recovery from scrap: They are factories in which metal

scrap is treated by any equipment operating by fuel or the ones using electric power.

(xi) Any facility using one equipment or more, operating by fuel and consuming,

or which may consume, separately or collectively, more than 300kg of fuel per hour.

(xii) Any facility for producing fungicide, insecticide and herbicide or any other

chemicals.

(xiii) Any facility for manufacturing or treating paper.

(xiv) Any facility emitting more than 100 tons of air pollutants per year, in the absence of control equipment, which might have an adverse impact on air quality by itself or together with other similar facilities.

2) Projects which may affect water quality. They include the following projects

which require treatment: Projects which must treat pollutants before discharging to the environment. Projects which store waste and may subsequently treat and discharge them

to the environment.

3) Projects and operations which are big enough to affect the soil. They include the following: Projects and operations which might generate tangible pollution to the soil

such as the pollution resulting from harmful substances or compounds discharged into the soil or from the overuse of fertilizers and pesticides.

Projects and operations which might lead to tangible deterioration of the soil

or its dispersion (by water or air) such as agriculture in marginal areas and the intensive use of forests, pastures, in addition to the main engineering projects which might lead to the natural liberation of water.

4) The activities which include the following: Slaughtering and skinning animals and handling meat. Establishing jetties and buildings at the coast. Mining Extraction industries

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Table 1 (continued):

Screening criteria in the GCC Guidelines – Projects Requiring Detailed Study on Environmental Impacts

Any construction works accompanied by dredging the sea bed and soil, and

filling beaches, bays, shallow lakes and wet lands. Landfills of solid, hazardous and harmful waste Exploitation of forests and scarce natural resources.

Any of the above listed projects shall be exempted if the applicant is capable of convincing the concerned authority, in a clear way, that his project represents a minor change or a minor addition to an existing project while the impacts shall not exceed the standards stated regarding the conservation of environment.

b) Second List

Development Activities with Environmental Impacts 1) Projects which might affect areas of high environmental value, from the point of

view of the conservation of environment. These areas include mountainous areas, wetland areas, forests, pastureland, valleys, coastal areas, coral reefs, shallow bays, and the areas containing unique and important flora and fauna.

2) Projects which might cause damage to archaeological and historical areas of scientific and educational or aesthetic value.

3) Projects which include exploitation ad use of natural resources particularly if they

are scarce or non-renewable. 4) Projects including allocating specific areas with special patterns of development

such as towns (regions), industrial services and new suburbs. 5) The main engineering works such as:

Electric, telephone ad pipelines Transportation facilities such as main roads, ports, railways and airports.

6) Works with tangible impact on the nature and formation of wadis or dams, aquifer

or irrigation and drainage systems and their water content. 7) Projects including the establishment of factories or performing operations which

might lead to air, water or ground pollution. This includes chemical, biological, thermal and radiological pollution, or lead to noise or any other potential pollution. If the project proposed is not certain that his project, which is classified under the aforementioned classification, requires an E.I.A. he has to submit a preliminary report for the concerned authority, according to guidelines presented by the concerned authority. The decision of the concerned authority shall be final.

Many of the above categories have explicit reference to health issues and others do implicitly so. In addition to the above, the following criteria are proposed specifically for the screening of proposed projects in relation to Health Impact Assessment. In the

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application of these criteria, documented evidence from other, similar projects provides additional guidance and arguments. I. Water resources development I.1 Reservoirs and impoundments with a surface area of over xx hectares at

less than yy km from human settlements, or foreseen to have human settlements established within the perimeter of yy km I.2 Irrigation schemes using surface irrigation or including night storage tanks of over xx hectares with human settlements in their perimeter. The presence of hydraulic structures where standing water collects is also an important criterion. I.3 Waste water treatment plants with human settlements within a perimeter of xx km, in particular plants using stabilization ponds. I.4 Projects for the use of waste water in agriculture and aquaculture. I.5 Small dams projects with a density of >xx small dams per km2 with human settlements within a perimeter of yy km I.6 All the above project types if they entail the resettlement of local populations from the dam, reservoir, impoundment, irrigation system or pond sites.

II. Energy production II.1 Thermal energy generating plants within xx km from human settlements. II.2 High-voltage power lines if there are human settlements within the xx m

wide corridor along them II.3 Fuel depots with a capacity greater than xx liters with human settlements within a perimeter of yy km II.4 Gas stations with fuel depots greater than xx liters with human settlements within a perimeter of yy m

III Industrial development, including petro-chemical and other chemical

industries <<This section will have to derive criteria from the EIA criteria listed in table

1 and it should be checked to what extent these criteria need to be sharpened for HIA applications>>

IV Transport IV.1 Road construction involving use of arable land or land already used for

agricultural production, requiring the resettlement of local communities or,

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through its infra-structure, cutting off communities from access to their land/to the sea on which they depend for their livelihood. IV.2 Extension of sea port facilities to increase the country’s capacity to receive sea-going cargo vessels IV.3 Construction of new airports or extension of existing ones, to increase the country’s capacity to receive air traffic, in particular those developments implying new flight paths for take off and landing over human settlements IV.4. The construction of major infrastructural elements: bridges, fly-overs, tunnels etc

V. Tourist industry V.1 Construction of hotels, pensions, motels and other lodging facilities with

more than xx rooms V.2 Land-scaping or re-landscaping of hotel grounds, in particular the use of ponds and other aquatic features V.3. Creation of major day-tripper sites, for pick-nicks, barbecues etc

VI. Agricultural development VI.1 Schemes for irrigated agriculture using surface irrigation, entailing

impoundments or night storage tanks, and hydraulic structures where standing water is permanently collected. VI.2 Agricultural development schemes entailing crops requiring important chemical inputs (pesticides, herbicides, fertilizer), including rice, sugar cane and cotton. VI.3 Cattle and other livestock projects involving animals that can serve as intermediate hosts or reservoirs for organisms causing disease in humans. VI.4 Agriculture and aquaculture schemes using treated or un-treated waste Water VI.5 Mechanization projects introducing heavy machinery for agricultural production.

VII. Urban development VII.1 Development of residential areas for more than xx people VII.2 Major urban infrastructure projects (drinking water supply, sewage,

storm drains) VII.3 Urban solid waste management projects

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VII.4 Hospital waste management projects VIII. Mining <<insufficient information>> IX. Others (???) The screening process assigns projects to one of three categories, and this assignment de facto implies the final decision on the need for an HIA. This decision should be made known to the project proponent within 30 days after submission of the proposal to the Department of Environmental & Occupational Health of the Ministry of Health, with the option of a one-time 30 day delay for complex cases. The categories are:

A. No Health Impact Assessment required, permit to proceed granted B. Rapid, partial Health Impact Assessment required before permit to proceed can be granted C. Full Health Impact Assessment required before permit to proceed can be granted

The screening exercise also serves a first inventory of the health hazards and risks that will need specific attention in the HIA, and it will help define some of he vulnerable communities affected by the proposed project. By no means, however, should this information restrict the work of the consultants on the more in-depth HIA. Their work should consider all options and cover the possible health issues in the most comprehensive way. For any project proposal that has been earmarked as either category B or C, the health authorities next carry out a scoping, in close consultation with the environment authorities. Scoping sets the boundaries in time and space within which the HIA has to be carried out. Depending on the predominant health hazards associated with a particular project, the health impacts may occur immediately, or they may appear on the medium or longer term. As a general rule, most communicable diseases will show up fairly rapidly, although for some, like schistosomiasis, it may take many years before serious morbidity becomes apparent. Accidents and injuries are also short term impacts. Non-communicable diseases, on the other hand, will take a long time to mark a significant difference in the local epidemiology, especially those that are linked to a chronic exposure to certain toxic chemicals. In addition to the health impact horizon of different types of projects and their specific hazards, the temporal scoping should also, for all practical purposes, take into account the actual expected lifespan of the project itself, until its rehabilitation or its possible de-commissioning. For the spatial boundaries of an HIA, clearly communities in the immediate vicinity of the project area need to be considered in the assessment. For the environmental determinants of health, the boundaries are most likely to coincide with those of EIA.

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For social determinants of health, however, the boundaries may be wider, especially when the project causes migration of workers and service providers. In Ethiopia, irrigation development is suspected to have led to the spread of schistosomiasis over hundreds of kilometers, because of the periodic migration of agricultural workers linked to the harvest season. The outcome of screening and scoping includes a notice to the project proponent indicating the decision concerning the need for a partial or full Health Impact Assessment. It also provides basic information for the formulation of Terms of Reference for the HIA, including the main hazards and risks to be considered, a first indication of vulnerable communities and the spatial and temporal boundaries for the exercise. The details concerning the rationale, contents and use of the Terms of reference are covered in the next chapter.

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CHAPTER FIVE: TERMS OF REFERENCE AND THE HIA METHODOLOGY Terms of Reference (TOR) for Health Impact Assessment are the backbone of the HIA exercise. They serve as binding instructions for the consultants on what their minimum performance should be. As such, they must an integral part of the contract under which the HIA is commissioned. The TOR also serve as the reference point for the subsequent appraisal of the HIA report. The first step in any appraisal is to check whether the HIA has been carried out in conformity to the TOR. The TOR are formulated on the basis of the outcome of the screening and scoping process, with any other relevant information added as appropriate. Formulation of the TOR takes place at the end of the pre-feasibility phase, to ensure that the HIA process is in line with the other feasibility studies and assessments. The Ministry of Health (Department for Environmental & Occupational Health) is responsible for formulating the TOR. This should be done, however, in close consultation with the EIA staff in the MORMEWR and other institutions involved in the planning process. The TOR sets out minimum requirements, and the consultants should be encouraged to broaden their scope should they discover the need to do so in the process of carrying out the HIA. The TOR also set a strict time frame for completion of the HIA and submission of the HIA report. Adherence to this time frame is essential for the health sector to remain a partner in the overall planning process. The specifics of the TOR will differ from one HIA to another. In the section below a generic TOR is presented with a brief outline and the summary contents of the various sections. Generic Terms of Reference for Health Impact Assessment The Generic Terms of Reference for Health Impact Assessment comprise the following components. Introduction

This states the purpose of the Terms of Reference, the type of project to be assessed, with a brief description and the geographic location and area involved in the project. It also describes the institutional set-up and the implementing arrangements for the health impact assessment, and it identifies relevant institutions and the type of information that may be available from them.. Background information

This provides a brief history of the proposed project and its development with the objectives, the status and timetable, and it identifies the project proponent. Related projects within the region must also be identified.

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Objectives

This states the general as well as specific objectives of the health impact assessment in relation to the project preparatory activities such as feasibility studies (planning, design and execution) and as part of environmental impact assessment. Three points need clear elaboration: an assessment must be carried out that considers health hazards, risks and opportunities; recommended safeguards, mitigating measures and health promotional activities need to be listed as an outcome of the assessment; solid evidence must be provided that the recommendations are technically sound and adequate, socially acceptable and economically feasible. Environmental Requirements

This section identifies regulations and guidelines, which will govern the assessment. The requirement for health impact studies in Oman is currently partly included in the EIA regulations; the Ministry of Health is considering to bring specific HIA regulations into effect. Study Area and time frame

This section specifies the boundaries of the study area for the assessment. Wherever applicable, it should include the human communities downstream and downwind of the project. It also specifies the time horizon of the HIA. Scope of work

The health hazards and vulnerable communities that require particular attention are listed based on the initial screening. The consultant(s) will be asked to refine the scope of work for contracting agency review and approval. Health Risk Assessment

At the start, the consultant(s) will study and review the available literature (both peer-reviewed scientific literature and grey literature). The consultant(s) will also arrange for a series of meetings with relevant authorities from different sectors and from different administrative levels. Arrangements will also be made for effective community consultation and public hearings. The consultant(s) will assess the health risk associated with each identified health hazard at each project phase. The assessment will include the following considerations:

o Community vulnerability Identify each vulnerable community to be affected by the project and assess the nature, magnitude and likelihood of transmission or exposure. Estimate the expected risk levels for each hazard in each vulnerable community based on existing health sector records and/or special surveys, and taking into consideration the changes induced by the project.

o Environmental risk factors

Consider the environmental factors that may contribute to an increase in health risk As a result of the development project. For all factors give qualitative estimates of

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the health consequences, and where possible, also provide a quantitative estimate within a reasonable range.

o Institutional risk factors

Establish in more detail the capacity and capabilities of existing protection agencies, such as the environmental and health agencies, which have jurisdiction over the project site. The consultant(s) should assess the limitations of existing data and recommend how to strengthen the health information system in support of health risk management. Health risk management

This section outlines the structure and contents of the Health Management Plan. Prepare recommendations for health safeguards and mitigating measures to address the elevated health risks identified, and health promotional activities to address health opportunities. Consider different options for their technical soundness, social acceptability and economic feasibility. Formulate a Health Management Plan made up of these recommendations, including monitoring during the construction and operational stages, which covers: a description of the work tasks, skills/tests/interviews, frequency, institutional and financial arrangements, justification/use of the monitoring data. Consultant requirements

This section presents the kinds of expertise and experience required for the HIA. The Consultant(s) must have previous experience of assessing the health impacts of development projects. The Consultant must have broad specialist knowledge of the most significant health risks. If diverse health risks are identified then additional consultants may be required with specialist knowledge of each. This section should furthermore describe the ideal profile of the consultant(s): background, experience and skills. Reports, duration and schedule

This will specify the total period of the study, staff-months of experts, dates for consultation, periodic reports, date of submission of the final report and other target dates. Other information

This will provide the consultant(s) with preliminary information on data sources, background reports and studies, and other relevant publications.

How to assess health impact The actual Health Impact Assessment is the responsibility of consultants and as such falls outside of the scope of these guidelines. A brief overview of the methods that can be used in an HIA is presented here for completeness sake. Systematic literature review A search of the scientific literature using a number of key words should yield the relevant information about health issues in the project area as well as

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health issues elsewhere in the country related to the type of project proposed. It will also yield available information on types of interventions and their relative success in preventing and/or controlling situations of ill-health. Review of Ministry of Health reports Health sector reports, produced at the central level, will give an insight into the health status and trends in the project area. They will also help gain a better idea about the capacity of the health sector in terms of monitoring and surveillance, and its epidemiological capabilities. Review of the project documentation Only a full review of the project documentation will give sufficient knowledge about the nature and magnitude of the project, and its design and construction details. This will also inform the consultants about the environmental and social changes that will result once the project becomes operational, and this is critical for the assessment. Possible site visits to similar projects A visit to a similar project in the country will strengthen the image of what the proposed project will eventually look like, and provides an opportunity to get first-hand information of the health situation as it evolved in the project from local authorities and members of the local community. Mapping It is important to obtain or develop detailed maps of the project area with all the relevant features presented and backed up by geo-referenced datasets. In a GIS health datasets can be entered for overlay with other datasets and modeling can be done of the changes that will be introduced by the project and their possible health risk dimension. Hazard identification The hazards mentioned in the TOR on the basis of the screening procedure should be checked for their robustness, and additional hazards should be considered. Conclusions on additional hazards can be drawn from the above mentioned reviews of the literature and project documentation, as well as from the site visits to other projects. A final check consists of a site visit to the project area itself. Identification of vulnerable communities The initial screening will have produced a first list of communities with an elevated level of vulnerability to health risks resulting from the project. Through the mapping exercise there will be a clear picture of the communities in the project area, and based on the project documentation communities that will move into the area, either temporarily (construction workers) or permanently (re-settled communities, additional work force for the project). Based on environmental and social indicators, the vulnerable communities need to be re-affirmed or identified, and within communities, specific vulnerable groups also need identification.

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At this stage, there should also be one or more consultations with affected communities and public hearings. Assessing the risks For each health hazard the probability that the risk associated with it changes or remains the same must be estimated, and this for each phase in the project. This is the actual assessment exercise. It considers community risk factors, environmental risk factors and institutional risk factors. The estimations are at least qualitative (the risk will be higher, lower or remains the same) but in some cases attempts can be made for (semi-)quantitative estimates. For example, in the case of a dust producing industry an estimate can be made on the resulting increase in acute respiratory diseases, extrapolating from existing projects, and taking into account the location of communities with respect to the industry and the prevailing winds. If time permits, the evidence base can be strengthened by carrying out environmental epidemiology studies in areas where similar projects exist, and for future monitoring purposes, also baseline data in the project area can be collected. Usually, however, the estimates have to be restricted to extrapolations from already available data, because of time limitations. For the institutional risk factors it is critical to have a comprehensive insight into the structure and functioning of the health system and the role of non-health sector institutions in health protection and promotion The outcome of this is documented in tables for the different vulnerable communities at different phases of the project. Identification of health opportunities Special attention must be given to a review of potential health promotional components that can be fitted into the project. These include such obvious ones as extending access to safe drinking water and sanitation to communities affected by the project. Large projects for which a temporary work force settles in the project site usually create a health services infrastructure for that work force, offering the opportunity to create facilities that can continue to be used by the local community once the temporary work force has moved out. Synthesis of the assessment Once all hazards for all vulnerable groups at all project phases have been considered and assessed, the information is synthesized in one table. At this stage it is important to check whether there are issues that cancel each other out or re-enforce one another, or whether there are apparent contradictions between some of the estimates made. Also, once the synthesis nears its completion, some type of ranking needs to be applied to single out the truly crucial health risks that must be addressed.

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Figure 2 Health Impact Assessment Summary Table Project type

Project phase

Location

Community HEALTH HAZARD HEALTH RISK

Agents of Communicable Disease

Agents/causes of Non-communicable Disease

Causes of Malnutrition

Causes of accidents and Injuries

Causes of psycho-social disorder

Design of safeguards, mitigating measures and health promotional measures Based on this synthesis assessment, on the information collected on interventions elsewhere and in line with the overall design of the project, now measures must be developed that either prevent or at least minimize any expected adverse health impacts. Also, health promotional measures must be designed in response to the health opportunities identified. For those adverse health effects remaining, a clear outlook of the expected health problems must be drawn up with recommendations how the health sector institutions can best prepare to respond to them. All recommended measures must be evidence based, and should meet criteria for social acceptability, technical soundness and economic feasibility.

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Development of a Health management Plan The recommended measures are compiled in a health management plan which designates the institutions responsible for specific actions, puts the package in a time frame and attaches a detailed, realistic budget to the activities. HIA report Finally, a report of the HIA is made, outlining the information collected and generated, presenting the assessment and the Health Management Plan and discussing the obstacles met and lessons learned for future reference, and this report is submitted on the target date stipulated in the TOR.

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CHAPTER SIX: APPRAISAL The appraisal of a Health Impact Assessment report is probably the most critical step in the entire procedure, because it constitutes the independent quality control of the work that has been done by the HIA consultants. At the same time, it provides the basis for the completion of the Health Management Plan and the development of a strategy and the arguments for negotiating that plan. While the assessment itself is a predictive judgment, the appraisal is a structured, retrospective evaluation, which measures the HIA report against the original TOR and against a number of other important criteria. As is true for the other steps in HIA, timing is of the essence. The appraisal has to be done as soon as the final HIA report is available, and with ample time to ensure that the Health Management Plan and its supporting evidence and arguments are available well ahead of the negotiations with the Ministry of Finance. Consultation with the authorities appraising the feasibility study and the EIA is also important. As the regulatory body, the Department of Environmental & Occupational Health of the Ministry of Health is responsible for performing the appraisal properly. For simple and straightforward HIA reports, the task can be carried out by staff of the Department, but more complex projects (and therefore perhaps less straightforward HIA reports) will require the establishment of an ad-hoc task force of independent experts, preferably nationals. University departments will be the best sources for such experts, but in some cases foreign experts from the Region may need to be designated. The World Health Organization can provide advice on possible regional experts. For projects that have a major impact on the livelihood or social cohesion of communities, a representative of those communities may also be appointed as a member of the task force. Care has to be taken in appointing members of the ad-hoc task force so that no conflict of interest can arise. Task force members should be asked to sign a declaration of “no conflict of interest”. They are generally not remunerated for their work as a member of the task force, but their expenditures are covered and the institution/department to which the expert is affiliated may receive a salary replacement compensation for the time spent by its staff member in the task force. All members of the ad hoc task force are designated in their personal capacity. Objectives The objective of the appraisal is to maintain optimal quality standards in Health Impact Assessment. There are four possible outcomes of an appraisal of an HIA report:

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• The HIA report is rejected as inadequate • The HIA report is not rejected but deemed to require major improvements • The HIA report is accepted with minor corrections • The HIA report is accepted as it stands The appraisal is a two-step procedure. First the actual assessment procedure and the HIA conclusions are appraised. If found to be satisfactory, then the recommended measures for health risk management and for health promotion are appraised. The assessment procedure The starting point of the appraisal consists of re-visiting the TOR. During the assessment new facts may have come to light that make it necessary to re-consider the adequacy of the TOR. For example, for a major sea port extension, the feasibility study may have led to certain infrastructural elements at the port entry that will cause shifts in the coastal currents. This point may not have been considered in the original TOR, yet it may have become clear that the new currents may take polluted water to a nearby tourist beach. If this issue has not been addressed in the HIA report, this omission can not be attributed to the consultants; rather the original TOR were inadequate. If necessary, adjustments can be made to the TOR that will then need to be taken into account during the remainder of the appraisal. The next critical step is to ensure that the HIA is in conformity with the TOR given to the consultants. If available, the HIA report is also compared to the EIA report and the reports are checked for any blatant contradictions. Based on this initial appraisal step, a conclusion can be drawn as to whether the HIA has been carried out in full conformity with the TOR provided. The two main elements of the assessment procedure that need appraising are the report’s objectivity and the procedural rigour. For the objectivity the following points need considering: The consultants’ possible conflict of interest To investigate this, the arrangements for commissioning the HIA need to be clarified. If the consultants were directly contracted by the project proponent, then the sensitive issue of the client/consultant relationship may have had an influence over the HIA outcome. Consultants depend on their clients for future assignments and may therefore be less than critical in their HIA work. The risk of a potential conflict of interest is reduced if consultants are contracted indirectly, through the Ministry of Health or, under a joint arrangement for HIA and EIA, through the Ministry of Regional Municipalities, Environment and Water Resources. Such an arrangement implies that the

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project proponent will have to transfer the funds required for the assessment(s) to one or the other ministry. Clearly, any links that may exist between the consultants and the firm(s) that may be involved in the construction or operation of the project (if different from the proponent) may also affect the objectivity of the report adversely. Timing There are a number of aspects related to timing that require checking at the appraisal phase. First, the timing of field work as part of the HIA will, for certain health issues, needs to be properly selected; there is little value in making direct observations about malaria transmission outside of the transmission season. Baseline data collection for any of the infectious diseases should always be done over a minimum period of twelve months, and preferably over two twelve month cycles. Yet, only very large projects will have preparatory periods allowing for such longitudinal studies. More frequently, consultants will have to base themselves on the monitoring and surveillance data that are available from the Ministry of Health. Field visits to check on the feasibility of certain environmental management interventions as part of the project are, of course, also best done during the transmission season. Secondly, the parallel processes of feasibility studies, EIA and HIA should have been planned in such a way that timing of the three allows for optimal synergies between them. It is still most frequently observed that HIA is added as an after thought – as a result the consultants work in a vacuum and have no access to their colleagues working in the other areas. The time spent on HIA is also indicative for the quality of the HIA report. For HIAs commissioned at the end of the feasibility stage, often extremely limited windows of opportunities exist, of no more than three weeks. This puts a serious constraint on preparing a quality HIA. For this part of the appraisal it is useful to prepare a project calendar with bar-charted activities, to put the time spent on HIA into perspective. Budget The objectivity of the HIA report may be severely impaired if the financial resources allocated to the HIA were insufficient. There are no clear guidelines concerning the exact percentage of an overall project budget that should be set aside for HIA, but as a rule of thumb anywhere between 1 and 5% of the budget for project planning would be a fair contribution. A similar percentage range also applies to the health component in the final project implementation, to cover health safeguards, mitigating measures and health promotion.

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If calculations point out the budget for HIA was below the 1% threshold of planning costs, then it can be assumed that the objectivity of the report has been adversely affected. Access to information An HIA report has to present information that is accurate, comprehensive and credible. Access to information is key to achieving that. It is possible that consultants have not been able to obtain adequate access to information. There are several possible reasons for this. First of all, informants from the different ministries may have been reluctant to share reports and data with the consultants; in fact, it is even possible that they have met with obstacles when trying to access information from other departments within the Ministry of Health itself. The search for health statistics and data on health services can be facilitated by the issuance of a formal instruction by the Minister of Health to all departmental directors to provide full collaboration with the consultants. To facilitate access to information from other ministries, at least a letter of introduction from the Minister of Health should help open doors, and for projects of a considerable size arrangements with other ministries could be agreed at Cabinet level. Part of the information will have to be retrieved from the affected communities themselves. Obstacles to comprehensive information retrieval in communications with community members may include gender or racial prejudices, or language barriers. An all-male team sent out to survey the health status of a community, or to investigate their attitude or opinion may miss out on important perspectives of female members of that community. The use of foreign consultants carries the risk that communications with tribal groups through interpreters do not yield the full information. Members of the ad-hoc task force should add from their own experience and knowledge in cases where they perceive the collection of information for the HIA has been sub-optimal. Procedural Rigour It is important to distill from the report whether the HIA procedures have been followed in good order. The report should reflect that the consultants have: • identified all critical health hazards that are relevant in the context of the

proposed project, within the boundaries agreed on during the scoping • identified all vulnerable communities whose health may be particularly

affected by the proposed project

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• considered all the community risk factors linked to the identified hazards, both from the perspective of environmental and social change expected to be induced by the proposed project

• considered all environmental risk factors linked to the identified hazards,

including the indirect consequences of environmental change on social determinants of health

• considered all institutional risk factors, including the capacity, capability

and jurisdiction of the institution responsible for health protection and promotion

• ensured that in their impact assessment activities they put sufficient

emphasis on public hearings and other ways of consulting the vulnerable communities that might be affected by the proposed project

• prepared a synthesis of the risk findings into a prioritized and strategic

impact assessment • formulated recommended measures for health risk management and for

health promotion, and combined these in a Health Management Plan. Conclusions The final conclusions of an HIA report should acknowledge the different risks for different communities and community groups, it should sum up the risks and rank them for priority, using disease burden as the main criterion. In the conclusion, all risk factors identified should be well-justified and based on solid evidence; the same is true for the process of synthesis of the risk factors. All vital statistics should be cross checked, and any assumptions made in the assessment should be clearly stated for the ad-hoc task force to judge. Having completed the first part of the appraisal in this way, an intermediate balance can be made up and the ad-hoc Panel can decide, if necessary, to first return the report to the consultants for greater or lesser improvements, before moving on to the second step in the appraisal. If the conclusions are rejected outright, there is no need to consider the recommendations; the HIA will then have to be fully redone. Recommendations There are a number of types of recommendations that can result from an HIA, and these include: • Health safeguards that divert the risk entirely and prevent a negative

health impact from occurring. • Mitigating measures that minimize, to the extent possible, any predicted

adverse health effects

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• Health promotional measures that add value to a project by making use of

the health opportunities it offers. In order to implement HIA recommendations, they may be incorporated into the technical design or operational features of a project; they may become part of a regulatory framework; they may come to expression through economic tools (subsidies, taxes, incentives, sanctions); and/or they may be part of the overall strengthening of health services. A systematic review of recommendations lists all recommendations with an indication in what category each one falls (safeguard, mitigating measure, promotional measure), the health problem as well as the community it addresses and the project stage when it should be implemented. Each recommendation should then be checked against three sets of criteria: technical adequacy and soundness, social acceptability and economic feasibility. These three groups of criteria are considered in detail in the following section. Technical adequacy and soundness The design of the measures proposed, especially if they are measures of an infrastructural or engineering nature, is the first critical point to consider. The design of sedimentation ponds, for example, in a waste water use scheme, for example, will be decisive for the level of health risks associated with the scheme. The design of irrigation schemes may or may not include hydraulic structures that are self-draining, to avoid stagnant water where vectors can breed. On a larger scale, in urban planning, measures to create open spaces can focus on parks or on sports facilities, effective health promotional settings depending on the population composition of the people for whom the settlement extension is intended. Operation and maintenance is a next issue for consideration when appraising the recommended health measures for their technical adequacy and soundness. Including highly sophisticated drinking water supply in a development project in a remote rural area may be technical sound, but from a perspective of operation and maintenance it is definitely not adequate. Finally, the geo-physical setting, climate condition and the local availability of materials are also important considerations in this part of the appraisal. Social acceptability The characteristics of the community for which the measures are intended are a critical determinant of their potential success. The promotion of insecticide treated nets in an area where water resources development is taking place and vector-borne disease transmission risks on the rise may be acceptable in one community, but totally unacceptable in another; similarly, indoor residual spraying has suffered considerably from a decreasing social acceptance. Moving a community away from a site of industrial development may meet

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with fierce resistance that can only be overcome by providing acceptable levels of compensation. The use of data from a Knowledge, Attitude, Practice and Believe study in support of formulating the recommendations is a good indicator of whether or not the consultants have taken social acceptability into account. Another indicator is linked to the level of public consultation in the development of the recommended measures, and the possible role the local community will be able to play in their implementation. Economic evaluation Investing in development is done on the premise that the economic returns will be positive. Even if the environmental and health issues are considered as externalities in the overall economic picture, the measures recommended will still need to be justified on the grounds of their relative cost-effectiveness and their overall affordability. There should therefore be clear evidence in the recommendations section of the HIA report, that the selected options for safeguards, mitigating measures and health promotion represent the most efficient solutions to the problems identified. Very often, by placing these health issues in the broader context of development, there will be opportunities for economies of scale and synergies. Design improvements can at times be made at no extra cost at all. For each major measure proposed there should be a cost-effectiveness analysis comparing it to other options for interventions. These may also include after the fact interventions. Measures of an infrastructural nature are often capital intensive and this raises the question of affordability in the context of the overall project budget. This requires careful weighting of the advantages of capital investment for a long-lasting improvement versus recurrent costs at smaller amounts extended over a long period of time. The prevailing discount rate established by the Central Bank of Oman is a critical determinant in this connection. There are a great deal of other technical issues involved in checking the recommended measures for their economic feasibility, and it is therefore best to engage a health economist at this stage, as a co-opted member of the ad-hoc task force, to be sure this part of the appraisal is dealt with adequately and satisfactorily. Final outcome of the appraisal At the end of the appraisal, the members of the ad-hoc task force once again visit the TOR to reflect on lessons learned, and then make the final decision concerning the HIA report: rejection, partial or full acceptance. This decision

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is communicated to the authorities who inform the consultants and the project proponent. The endorsed recommendations are assembled into a Health management Plan for which a realistic schedule and an adequate budget are developed, and this plan is used as the basis for negotiations with the Ministry of Finance.

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CHAPTER SEVEN: MONITORING

This brief but crucial chapter looks beyond the strict assessment exercise. All too often in the past, environmental or health impact assessments have ended the moment the assessment report was submitted. Project proponents assumed that they had fulfilled their regulatory obligations for the planning procedures, but saw no need to actually implement the recommended measures comprehensively. Many impact assessment reports have thus ended on the shelves without ever being opened again. The key to an appropriate follow-up is the establishment of an effective monitoring system. Several issues will need monitoring once the construction phase of a project starts, and they need to be monitored simultaneously. In principle, the Department of Environmental & Occupational Health of the Ministry of Health should be leading this effort; in practice, the distinct monitoring activities had best been delegated to the MOH Regional Directorate-General of the Region where the project is located. One part of the monitoring commitments concern the verification of compliance by other sectors/entities to implement the recommended measures they are responsible for according to agreed specifications. Based on the Health Management Plan, the number of measures will have to be implemented by the proponent, by institutions dealing with infrastructure and engineering, or by third parties. Institutional arrangements (for example: a memorandum of understanding MoU) will need to be agreed to spell out responsibilities and resource flows. These arrangements will also spell out the verification process. It is most appropriate to establish an ad-hoc monitoring body within the Ministry of Health structure to perform the verification that will be operational for the period project construction is underway. Any residual functions that spill over into the operational phase of the project can then be transferred to the permanent monitoring body of the Ministry of Health. Verification involves the following activities: • Reporting on compliance with agreed measures, standards and

specifications • Evaluation of the effectiveness of the recommended measures • Consultation with the relevant parties to address technical problems as

they arise and remedy unforeseen health impacts • Periodic review of the adequacy of the institutional arrangements,

resources and cash flows for the most cost-effective implementation of the measures

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• Review of operational plans and suggestions for the adjustment of

legislation as necessary. The other area requiring enhanced monitoring is that of the health status of the affected communities. HIA is mainly a qualitative procedure and therefore leaves a lot of uncertainty. This means that the health status of the affected communities requires monitoring not only for the risks that have been identified, but rather a more comprehensive monitoring. The health authorities in the region therefore will need strengthening of their monitoring capacities and capabilities well in advance of the start of the project. In addition to verifying whether the health impacts predicted are developing in accordance with expectations, taking into account that safeguards and mitigating measures are implemented, there is also the need to carry out surveillance for health issues that were not predicted and may arise unexpectedly: the introduction of new infectious diseases, or peculiar accidents that are link to new technologies being used in the project. Monitoring the changes in health status involves measuring: • Health indicators (such as infant and child mortality, incidence of

communicable diseases, nutritional status) • Environmental indicators (such as disease vector densities, concentration

of chemical pollutants, access to adequate sanitation) • Socio-economic indicators (such as income levels) which will provide

information on the affordability of health services for vulnerable groups. Regular reporting on the results of monitoring and regular consultation on the monitoring results between all parties concerned will ensure that the resources invested in HIA will also lead to maximum health benefits for affected communities.

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CHAPTER EIGHT: SOCIAL IMPACT ASSESSMENT

This chapter reviews Social Impact Assessment from the perspective of its possible contributions to Health Impact Assessment and it also lists some of the deficiencies of SIA from the health perspective. INTRODUCTION In the context of EIAs, the advisory role of health professionals is often to make sure that negative health effects are evaluated when possible, that adequate mitigation measures and monitoring programmes are suggested and that negative impacts are balanced with potential induced positive health impacts such as a greater infrastructure for emergency (search and rescue) operations, additional health care facilities, economic spin-offs and the reduction of transfer payments, an increase of the healthy labour-market active population and a greater spending power for the workers, translating in greater access to health care. However, to maximize the input, health professionals must be able to participate early in all phases of environmental assessments, from the writing up of the Terms of Reference for the environmental studies to the appraisal of the environmental impact assessments once they are completed. Because in the conventional set up social impact assessments are one of the main sources of health data in environmental impact assessment reports, the objective of this section is to provide a realistic overview of what a SIA usually consists of, and of which methods are typically used by social science consultants when estimating impacts of development projects. It is hoped that this will help health professionals understand the usefulness and limits of SIAs, facilitate their interpretation of the data covered and, ultimately, deal better with the social determinants of health in a Health Impact Assessment. What exactly is a social impact assessment, what data can be found and what should not be expected of an SIA? This chapter first discusses the purpose of SIAs, the types of questions addressed and the strategies used to address the questions and to get the appropriate information. The is followed by a discussion of the usual elements found in SIAs as well as the type of expertise necessary, and potential health considerations that should be kept in mind by health practitioners who are likely to be involved in the environmental impact assessment process as their reviewers or collaborators. Which Elements are Described in Social Impact Assessments Unless formally required in the environmental impact directive, the following elements can usually be found described or referred to in SIA (cf. Branch et al. 1984, Finterbush 1985, Bowles 1991). Physical environment

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In regard to the physical environment, the three fundamental elements to be considered in view of potential disturbances and the need to develop preservation or mitigation measures are archaeological and historical sites, important landmarks, and land use, land tenure and occupancy patterns. Archeological and historical sites: Surveys are usually undertaken by archeologists. Their objective is to identify archeological or historical sites, remains or artifacts that may be subject to disturbances due to the proposed project activities. Once they have identified and officially catalogued these sites, safeguard measures or exploratory as well as salvage excavations can be undertaken in accordance with provincial or state regulations. Through their essential input on historical land use and occupancy patterns, social scientists can help pinpoint areas of interest and document types of past activities associated with these areas, values attributed to these places of interest, and community feelings regarding the need to protect the sties or even correct disturbances due to past development activities. There are usually few health aspects directly related to his work, most community concerns and issues being of socio-cultural nature (e.g. values, equity and empowerment issues, etc.) however, if important value-laden sites are not well identified and disturbed by the project, in some contexts popular hindsight associations might be made later on between taboo breaches, for instance, and apparent or perceived illness episodes. In cases where it is inevitable that ancestral lands or structures of a spiritual value will be affected by the project, inadequate handling of the issue can result in important psychosocial disorders. Delicate consultations with the local community should aim at an agreement on the performance of rituals that help it to come to terms with the change. Important Landmarks: The most often examined landscape parameters are visual impacts and transportation infrastructure. These are usually assessed by either geographers, landscape planners or urban planners. When they are called upon, most of their work, however, is usually centered around designing mitigation and compensation measures. Also because some landmark of specific interest might need to be preserved, a highlight of the main features of the impacted areas is usually undertaken in an EIA. As for noise levels or odor emissions, these elements are rarely extensively discussed in SIAs, unless they are described as potential threats during pre-assessment scoping procedures. When they are mentioned in SIAs, it is most often because the impacted communities have expressed some concerns over these issues. Because of their academic background and of their knowledge of local communities, social scientists can help identify valued landmarks and the perceived limits to developing or altering existing landmarks or transportation routes. Through community consultations, they can also help design mitigation measures that are socially better acceptable.

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Some areas might hold invaluable resources for local use in traditional medicine. Although knowledge on collection, preparation and use methods are seldom shared with outsiders, if queried local experts will often mention the need to preserve these resources and those areas of interest. Noise and odor pollution can lead to different physical health problems or induce psychosocial reactions. Estimating the extent of these potential problems is however difficult and usually not mentioned in SIAs. If experts are asked too provide likely noise or odor estimates and evaluate potential impacts for the EIA, then these analyses are usually published in a report separate form the SIA. If extensive modifications are also undertaken around the worksite, the this is part of the monitoring process and not included in the SIA. There are, nevertheless, WHO standards for noise pollution that should be consulted and applied. Different disturbances can also lead to injury or accidents. This is the case, for example, with sudden noises (such as caused by low flying surveillance aircraft, or blasting) or inadequate signalization where traditional transportation routes or corridors can be disturbed by the project developments and activities. Land use, land tenure and occupancy patterns: Often done by social scientists, land use, land tenure and occupancy surveys essentially serve to identify those who use the lands and the resources potentially affected by the proposed project, to clarify and identity environmental stewardship and ownership issues concerning these lands, as well as to document the different types and intensities of resource use. Typically, these studies provide a historical perspective of the evolution of land use and occupancy in the area. This is essentially a descriptive part of the SIA, but different data expressed herein serve directly to evaluate health effects related to the proposed project components, such as impacts on nutrition or recreation. Essentially, this can be calculated from the perspective of diminished access to resources and lands as well as resource depletion. The relations between land owners and those who do not own land creates situations in development projects that may have repercussions for the health status of individuals and groups. Social and Community Indicators With regard to the human environment, the main indicators assessed relate to social organization, public services and utilities, sociodemographic characteristics of the impacted communities, economy and health. However, headings and internal organization of the SIA reports vary in detail from one assessment to the other. Demography: Ideally, describing and analyzing demographic data should be done by demographers who have the ability and knowledge necessary to prepare simulations which can be useful when predicting long terms impacts

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of development projects. However, is SIAs demographic descriptions are often static and done either by a social scientist or, frequently, by economists because they also need these data to model their economic simulations, Tracing official census data can in principle be done by anybody, and when non-professionals are used for this part of the assessment, very little insight is provided in the SIA on what a demographer would have, otherwise, suggested. The most important demographic data to look for in the context of an SIA are sex ratios, age pyramids, and in- and out-migration mobility patterns. These data are used to simulate economic impacts, to define the characteristics of the potential local workforce, and to evaluate some impacts of a transient or new in-migration workforce. The main health issues to keep in mind are the possible pressure of in-migration on public utilities as well as on access to health services available in neighboring communities. Improved transportation infrastructures to isolated communities can also, in some cases, lead to out-migration of local residents. With new migration patterns new pathogens may be introduced into an area. Temporary in-migration of construction workers will also affect the social fabric and has been linked in most parts of the world with sexually transmitted infections, in particular HIV/AIDS Transportation and safety issues must be kept in mind when examining changes to local transportation infrastructure. Public hygiene should also be taken into account in regard to the carrying capacity of existing utilities and to potential impacts on basic resources such as access to safe drinking water and adequate sanitation. Polity: This is usually a domain of the social sciences. Polity refers to public administration and community infrastructures, including formal and informal organizations, community services, housing, transportation, utilities, and so on. The objective of the SIA with regard to polity is to assess the strain a proposed project may exert on local access to community services, for instance because of demographic pressure from migrant workers on the availability of housing, community services and equipment, and store supplies. SIAs also seek to predict the capacity of the public administration to adequately deal with social friction that might arise between the project staff and local inhabitants. Economy: Definitely the grounds of economists, economic impact assessment is very often integrated in the SIA reports. Economic evaluations in SIA do not cover the profitability of the project, but rather its potential effects on the general local economy (jobs created, taxes paid, services and goods delivered, and so on). The main elements described with regard to impacted communities are employment and human resources, activity sectors, businesses, income and expenditures. In the impact assessment section per se, the direct and indirect economic benefits of the projects are often well described. However, negative economic impacts on neighboring

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communities are either overlooked or are given considerably less space. This is an important aspect of economic valuations which are based on the premise that the projects being essentially driven by economic imperatives, impacts are necessarily positive. Moreover, economists rarely have direct access to knowledge on local dynamics and thus are often unable to identify local economic resistance or promotion factors. In some SIAs, indirect economic impacts will be calculated, on property value for instance, as will other direct impacts, such as on local purchasing power and spending patterns, but this is usually done once the economists can secure input from the social scientists. There is a fundamental difference between the evaluation of economic spin-offs and cost-benefit studies. Economic spin-offs are always considered positive when undertaken in SIAs because the level of economic activity is increased every time money is spent whether to build a factory, to clean-up river bank or to hire workers. As for cost-benefits or cost-efficiency comparisons between options, the focus is rather on evaluating the distribution of impacts, i.e. who wins versus who loses. Concerning employment, social scientists will often generate data on equity considerations in the labour recruitment process for the project, or potential personnel turnover rate problems by considering local expectancies, needs, qualifications, education levels and customs. They might also bring up other related issues such as potential “skimming effects” of jobs offered by the project (i.e. new development projects often drain some of the leaders and some of the most qualified workers from neighboring communities, thus generating indirect social impacts). Because they are more likely than economists have to access to local data concerning informal economy, social scientists can help document project-related externalities, such as revenue losses incurred by diminished resources or reduced access, and can pinpoint those groups at risk of having to bear these losses. Increased spending power or diminished access to natural resources can impact positively or negatively quality of life indicators or generate nutritional changes. Education: Education data are compiled by social scientists or economists essentially to determine the potential labour basin and skilled personnel locally available. These data are used to evaluate potential employment creation benefits and to determine the need or possibility of setting-up specific training programmes. There are usually few health aspects directly related to this part of the SIAs, as increased training and education are usually viewed positively when equitable. Health: Birley and Peralta (1995) group health hazards of development projects into five categories: communicable diseases, non-communicable diseases, malnutrition, injuries and accidents, and psycho-social (mental) disorders. Although all these can sometimes be found described in EIAs,

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health hazards or health risks are typically analyzed in a number of different ways. Usually, the source of risk defines where specific health effects are discussed and evaluated. For instance, toxicological analyses regarding potential contamination through drinking water, airborne gases of particles or contamination of the food chain can be found in the biophysical impact assessment reports. In turn, impacts that are related to human efforts, interactions, choice, values or orientations can be found in the SIAs. In SIAs, descriptions of health issues calls upon a number of indicators, depending on which can be found detailing data specific to the affected communities. The description of health data can be useful to health professionals to put the impact assessments in context or to propose, when possible, adequate safeguards, mitigating measures or monitoring systems. This is possibly the most underdeveloped element of EIAs in regard to health issues. Most often, the only measures taken are those that relate to toxicological impacts. However, because of the various potential repercussions of some projects, a number of indicators of psychosocial stress or social morbidity could be added to monitoring procedures such as mental pathologies, substance abuse, depression, suicides and so on. In the case of physical health, it should be possible to follow the pattern of accidents related to changing land use configurations and transportation corridors, and certain pathologies indicative of physical or social stress directly related to the projects (e.g. STIs). Ideally, in the case of psychosocial disorders, assessors should ideally be psychologists or social workers, and medical experts (e.g. medical anthropologists, sociologists or geographers). In many SIAs, health effects are not identified as such and can be found under a number of headings (nutrition, land use and occupancy, polity, social control, etc.) and can be referred to simply as either social or psychosocial impacts. Different elements associated with a development project can generate psychosocial stress and problems in the community, for instance because:

• The appeal of the new jobs offered can have a skimming effect on community leadership and authority;

• Clan or political affiliations might create unequal access to employment;

• Absence of local workers from home, increased worker substance abuse or inordinate gambling and spending patterns generate household tensions;

• Social or cultural misunderstandings and tensions can arise during interactions between the workforce and neighboring communities.

The above elements can sometimes be found described in SIAs. However, two other potentially important problems that can arise are less seldom mentioned. First, inadequate environmental communications by the promoter can induce undue fears and generate risk-related anxiety that the land can be

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affected by the proposed project, which can foster a feeling of loss of control in terms of environmental health issues (cf. Grondin and Brunueu 1994). In social sciences literature, various psychosocial impacts have been associated with perceived environmental degradation and change, in particular: phobic reactions, adaptation problems, distress, disruption of interpersonal relations and a diminished capacity of individuals or groups to function adequately. These impacts often translate as impressions of loss of control over health, loss of trust in organizations, calling upon various rules of thumb to explain the etiology and perceived consequences for health, and so on. Various standardized questionnaires (e.g. Social Adjustment Scale, Hopkins Symptom Checklist (90 items), GHQ-2,) based on auto-evaluation have been developed to address the quantification of these problems (e.g. Foulks et McLellan 1992, Dunn et al.1994, Taylor et al. 1991). However, the main difficulties in using methods such as these lie in that they are time consuming, and in the fact that they might be considerably more useful as monitoring measures than as predictive tools for impact assessment. Other health issues not usually discussed in SIAs Occupational Health: Discussions in SIAs typically avoid mentioning occupational health. On the other hand, no mention is usually made of the costs related to additional medical evacuations or regular support to the project’s nursing staff by local nursing stations or hospitals, nor of direct costs of increased pressure on social services if psychosocial problems increase in affected communities. More often than not, potential impacts concerning occupational exposure, hazards and health are not considered in EIAs, essentially because this is understood as being either covered by official occupational health and safety protocols or a management’s responsibility. In some cases, this is most unfortunate because many employee integration problems and related costs could be avoided if due diligence were applied before project implementation. For example, some of the potential problems not usually covered by occupational health and safety protocols are:

•accident rates due to the absence of training programmes specifically tailored to enhance worker safety in view of unfamiliar work environments and equipment; •psychosocial stress and adaptation problems due to:

•long periods of absence from home because of commuting operations, with effects on both the workers (inactivity, estrangement from support workers, loss of family control) and their families; •cross-cultural adjustment problems between workers and staff or between co-workers aggravated by differing training backgrounds, cultural misunderstandings, religion, language and communication barriers, etc.;

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•high worker turnover in relation to a lack of incentives, of positive discrimination or of industrial time and space adjustment strategies;

•physical fatigue from:

long work periods (in commuting operations, work schedules are often

12 hours a day, seven days a week for a duration of the time on site);

lack of adequate leisure and sport facilities;

worker circadian rhythm maladjustment (sleep cycle perturbed, tension and stress);

nutritional problems (diet quantity and/or quality imbalances) as well as

lifestyle changes (e.g. increased smoking or substance abuse) in long distance commuting operations.

Nutrition: The objective of describing nutritional behaviour (particularly local food consumption) in affected communities lies in the need to assess potential impacts in terms of the natural resources that contribute to the local diet and that can be affected by the proposed project. Very few or no new data are usually generated in this part of the assessment. In brief, most of the work is simply the collection of dietary surveys available or, at the very least, a summary description of prevailing hunting, fishing and trapping activities, to provide estimates of important foodstuffs. This can also sometimes be complemented by interviews focusing on local food values or preferences. For these reasons, plus the fact that nutrition surveys are rarely undertaken and that funding is typically limited, the work is usually done by social scientists. Nutritional changes can be due not only to direct impacts on the natural resources but also because of indirect social and economic repercussions such as:

reduced access to local food because of the loss of providers who are working for the proposed project;

land use pattern changes due to indirect environmental disturbances (such as noise, runoffs or increased circulation on the land or waterways);

changes in local consumption and spending patterns (i.e. increased access to imported goods and foodstuffs).

Social control and deviation: Though data on public safety (such as crime rates) are sometimes provided in the descriptive part of the SIA, it is often integrated in the analysis or impact assessment part of the SIA because of conflicting ideologies. For instance, if consultant charged with the assessment has indications that the proposed project might increase public unrest, the project promoter can counter that this may not happen because jobs will be offered, spending power will be increased, and everybody will be happier. This is thus a subject where ideologies often clash. While it is true

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that these changes are difficult to predict, were they taken more seriously, monitoring measures could be designed to adequately follow some of the project’s effects, and make adjustments according to these with mitigation measures when possible. The possible increase in the incidence of social pathologies and morbidity related to problems such as prostitution, STIs, substance abuse, violence and so on should be taken seriously in some context, and for some proposed projects. Increased cultural sensitivity training for workers, or development of adequate leisure and sport facilities for the workforce can sometimes be simple mitigation measures that can help canalize and curb some potential problems. However, in regard to this type of effect, there might be some debate about social responsibility between the stakeholders: in the final analysis, who is accountable for potential social problems, the project proponent or the communities? Ideology: Not often especially labeled in SIAs, community concerns, norms, values, beliefs, and attitudes are all elements that social scientists document in relation to local social structures (identify, family, community, education, bureaucracy and politics, youth and elders, work and leisure, gender relations, power, social change and development), to land use and occupancy patterns, and to the proposed project. These can – and should – typically be found disseminated throughout SIAs because they provide valuable insight on project acceptance, potential social impacts and the fundamental community perspective. Ideology is a fundamental determinant of illness, disease, sickness and health (e.g. Eisenberg and Kleinman 1981, Fabrega 1974, Zimmerman 1980). Sensitivity to local concerns, norms, values, beliefs, and attitudes provides a certain measures of the SIAs ability to adequately predict potential effects. However, because of the limits of SIAs (in terms of resources available) very little should be expected as to the possible quantification of these impacts.

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ANNEX A Omani Guidelines for Obtaining Environmental Permits This list of requirements and conditions is taken from the existing guidelines. However, in bold items have been added that are suggested for insertion in these lists to boost the focus on Health Impact Assessment

GROUP ONE INDUSTRIAL PROJECTS

This group includes the following projects: a) Chemical and petrochemical projects b) Oil and gas projects c) Water purification and desalination plants d) Power generation stations e) Organic fertilizers f) Textile projects g) Tanning and leather manufacturing projects h) Metals smelting and refining, and i) Other projects as determined by the Ministry 2.1.1 General Requirements that apply to all the projects listed within this group:

1. The applicant should submit a completed application form for the environmental permit and if necessary attach an Environmental Impact Assessment study (EIA).

2. The applicant should obtained the Term Of Reference(TOR) for

Environmental Health Impact Assessment study (EHIA) from Department of Environmental & Occupational Health in Ministry of Health (DE&OH).

3. The applicant should attach documents describing the location of the

project such as Krooki and maps, and technical information specifying production process such as machinery catalogues, floor plans and production processes flow diagrams.

4. The applicant should attach a deed or lease agreement, and copies of

all other permits and licenses issued by the concerned government authorities.

5. The applicant is fully financially and legally responsible for any

environmental damage resulting from the project and restoration of the environment.

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6. If applicable, the applicant should apply to Air and Noise Pollution Section of the Ministry for a permit to use radioactive materials or equipment containing radioactive materials.

7. The applicant should ensure that noise levels do not exceed the levels

determined in the Ministry’s noise pollution control regulations.

8. The applicant must not commence construction before obtaining the necessary approvals.

9. If applicable, the applicant should apply to Chemical Department in

this Ministry for a permit for dealing with chemicals (import, production, processing, sale, purchase, distribution, storage and disposal).

10. The applicant must ensure full compliance with the health, security and

safety requirements at the construction and operation stage of the project.

11. The applicant must ensure that no waste materials will be disposed of

into the surrounding environment without a written permit from the Ministry.

12. The applicant should submit to the Ministry an Environmental

Management Plan.

13. The applicant should provide the designated Ministry’s staff with unrestricted access to the project site to ensure that all relevant environmental impacts of the projects are being considered.

14. The applicant/owner is fully legally and financially responsible for

environmental impacts during construction, operation and post-closure phase of the project, including cost of mitigation measures, created by the actions or lack of action of its employees, contractors, subcontractors, payment of compensation, settlement of claims, etc.

15. The applicant should provide a list of all substances used in the project

including their quantities and copies of Material Safety Data Sheet (MSDS) for each material.

16. The applicant should provide a copy of permit to store chemicals

issued by Directorate General of Civil Defense.

17. Based on the nature of the project and its location the Ministry may have additional requirements.

2.1.2 Technical Conditions a) Chemical and petrochemical projects

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1. The company shall provide adequate training to personnel handling hazardous chemicals.

2. The company shall monitor gaseous emissions resulting from the

project and periodically report to the Ministry.

3. The company shall control solvent fumes.

4. The company shall control emissions generated during handling, storing and processing of materials.

5. The company shall utilize closed system to reduce emissions from

material mixing and melting.

6. The company shall reuse and discharge treated liquid effluent in accordance with the Ministry’s regulation.

7. The company shall develop a hazardous and non-hazardous waste

management plan taking into consideration principles of waste reduction, recycling and use of clean technologies.

8. Hazardous chemicals shall be transported in sealed containers.

9. The company shall provide emergency mobile containers to contain

and facilitate removal of leaking chemicals.

10. Based on the nature of the project and its location the Ministry may include additional requirements.

11. Provide information on risks, safety precautions use, emergency

measures in the event of an accident, on labels or safety data sheets and proper disposal.

b) Oil and gas projects

1. The company shall refrain from damaging or cutting of vegetation. 2. The company shall spray water to control dust generated during site

preparation and leveling.

3. The company shall dispose collected non-hazardous waste at a licensed site and by a method approved by the Ministry.

4. The company shall ensure that gaseous emissions are within the limits

specified by the Ministry.

5. Collection tanks shall be lined by reinforced concrete to prevent seepage of pollutants into the soil.

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6. The company shall ensure that industrial liquid waste and wastewater are treated and discharged in accordance with the Ministry’s regulations.

7. The national and/or international specifications of pipes, production

stations, transportation and distribution of oil and gas shall be adhered to.

8. The company shall report immediately all incidents of spills to the

concern Department of this Ministry.

9. If applicable, the company shall notify Air and Noise Pollution Section of the Ministry about intention to use explosives.

10. The company shall notify the Ministry stating amount of gas if possible,

of any emergency discharge of gas into atmosphere.

11. Prior to discharging, the company shall submit a pipe-test water management plan that shall include among others information about any water treatment chemicals.

12. Care should be taken to recover hydrocarbon gas residues retained in

control valves.

13. The company shall submit a plan form management of oil and gas production water that was approved by the Ministry of Water Resources. The plan should include but not be limited to quantity, quality and methods of disposal of the production water.

14. Evaporation ponds that are used for the disposal of drilling mud shall

be lined with an impermeable liner and surrounded with wire fence.

15. The company shall back fill dry unused evaporation ponds and reinstate the surrounding area.

16. The company shall submit periodical reports on volume and

concentration of gaseous emissions at the project site.

17. The company shall ensure that fuel is stored in specially designed mobile containers or impermeable lined sites.

18. The company shall submit for review and approval technical

information necessary to determine the required height of stacks of power generating stations (number of turbines, capacity of turbines, type and amount of fuel used).

19. Based on the nature of the project and its location the Ministry may

include additional requirements.

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c) Water purification and desalination plants:

1. The company shall register the proposed plant with Ministry of Electricity and Water.

2. The company shall obtain a separate approval of Ministry Water

Resources Saline for construction of line evaporation ponds for disposal of saline cooling water.

3. The company, if applicable, shall submit for review and approval

technical information necessary to determine the required height of smoke stacks.

4. The company shall implement necessary measures to control

emissions of chemicals used for water sterilization (chlorine and ozone).

5. Based on the nature of the project and its location the Ministry may

include additional requirements. d) Power stations

1. The company shall place fuel storage tanks on impervious bases lined with reinforced concrete and surrounded by bunting walls.

2. The company shall collect, store and dispose of hazardous waste in

accordance with the Ministry’s regulation.

3. The company shall not use transformers and other electrical equipment containing Polychlorinated Biphenyls (PCB) oils.

4. The company shall submit for review and approval technical

information necessary to determine the required height of smoke stacks (number of turbines, capacity of turbines, type and amount of fuel used).

5. The company shall ensure that cooling water discharges to the sea

adhere to the appropriate Ministry standards and regulations.

6. The company shall obtain a separate approval of this Ministry for discharge of cooling water into the marine environment.

7. Based on the nature of the project and its location the Ministry may

include additional requirements. e) Organic fertilizers

1. Complete information on the type of crude / raw materials used in the manufacturing process, shall be submitted to this Ministry.

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2. The company shall place fermentation and storage tanks on impervious bases lined with reinforced concrete and surrounded by bunting walls.

3. The company shall reuse and discharge treated liquid effluent and

storm water discharges in accordance with the Ministry’s regulations.

4. The company shall submit for review and approval a detailed proposal to treat and dispose of contaminated wastewater.

5. The company shall develop and implement an odour control

programme.

6. The company shall submit for review and approval technical information necessary to determine the required height of smoke stacks (number of turbines, capacity of turbines, type and amount of fuel used).

7. Based on the nature of the project and its location the Ministry may

include additional requirements. f) Textile projects

1. Industrial waste-water shall be separated from domestic wastewater.

2. The company shall ensure that industrial effluent is treated and discharged in accordance with the Ministry’s regulation.

3. The company shall ensure that prior to discharge to public sewer,

industrial wastewater should undergo preliminary treatment and meet the Ministry’s standards and regulations.

4. The company shall ensure that domestic wastewater is treated and

discharged in accordance with the Ministry’s regulations.

5. The company shall ensure that wastewater treatment sludge is treated and disposed of in accordance with the Ministry’s regulations.

6. Based on the nature of the project and its location the Ministry may

include additional requirements. f) Tannery and leather manufacturing projects

1. The project shall be established in a suitable site for industries with potential environmental effects as designated by this Ministry in coordination with other government authorities.

2. Every possible effort shall be made to reuse the chemicals used in the

manufacturing process.

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3. The company shall ensure that prior to discharge to public sewer, industrial wastewater should undergo preliminary treatment and meet the Ministry’s standards and regulations.

4. The company shall develop and implement an odour control

programme.

5. The company shall ensure that domestic wastewater is treated and discharged in accordance with the Ministry’s regulations.

6. The company shall ensure that wastewater treatment sludge is treated

and disposed of in accordance with the Ministry’s regulations.

7. The company shall manage non-hazardous and hazardous solid wastes in accordance to the Ministry’s regulations and standards.

8. The company shall ensure that the site is clean and free of waste and

litter in order to avoid generation of vermin and vectors.

9. Based on the nature of the project and its location the Ministry may include additional requirements.

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GROUP TWO

MINING PROJECTS This group includes the following projects: a) Quarries b) Crushers c) Gypsum production (decoration and ornamental sheets) d) Marble, floor tiles production and ceramic factories e) Extraction of minerals f) Cement and brick factories, and g) Other projects as determined by the Ministry. 2.2.1 General requirements that apply to all the projects listed within this group. 1. The applicant should submit an approval from Department of Mines and

Quarries of the Ministry of Commerce and Industry that would indicate the area of the proposed quarry/mine and map with the project coordinates.

2. The applicant should obtained the Term Of Reference(TOR) for

Environmental Health Impact Assessment study (EHIA) from Department of Environmental & Occupational Health in Ministry of Health (DE&OH).

3. The applicant should submit a completed application form for the

environmental permit and if necessary attach an Environmental Impact Assessment study (EIA).

4. If possible, the proposed quarry/mining site should be located outside the

protected areas. 5. The applicant is fully financially and legally responsible for any

environmental damage resulting from the project restoration of the environment.

6. The site of the quarry or crusher shall be located far from populated,

archeological, tourism and agricultural areas, as well as tarmac roads. The topography and hydrology of the area shall be taken into consideration and shall be as per the ministerial decisions issued in this respect.

7. If applicable, the company shall notify Air and Noise Pollution Section of

the Ministry about intention to use explosives. 8. The applicant should provide the designated Ministry’s staff with

unrestricted access to the project site to ensure that all relevant environmental impacts of the projects are being considered.

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9. The applicant for a quarry/crusher project is required to provide a bank

guarantee of OR5000.- valid for the period of approval. 10. The applicant shall not commence operations before obtaining the

necessary approvals. 11. If necessary, the applicant should apply to Chemicals Department in this

Ministry for a permit for dealing with chemicals (import, production, processing, sale, purchase, distribution, storage and disposal).

12. The applicant should attach technical information describing production

processes such as machinery catalogues, floor plans and production process flow diagrams.

13. If applicable, the applicant should apply to Air and Noise Pollution Section

of the Ministry for a permit to use radioactive materials or equipment containing radioactive materials.

14. Based on the nature of the project and its location the Ministry may have

additional requirement. 2.2.2 Technical Conditions a) Quarries

1. The company shall ensure that its excavation activities shall not exceed one and half (1.5) meters below grade and shall not change the course of wadis and tributaries.

2. The company shall not cut trees and remove or disturb the soil from

within five (5) meters of the base of a tree. 3. The company shall control dust generated during the loading and

transporting of soil and stores by water spray or other method approved by the Ministry.

4. After mining of material in borrow pits is completed, the company shall

restore the site by demolition and removal of buildings, temporary roads, waste litter and grading the site.

5. The company shall place fuel storage tanks on impervious bases lined

with reinforced concrete and surrounded by bunting walls. 6. The company shall collect spent oil in sealed drums and store them in

concrete lined sites. 7. The company shall dispose collected non-hazardous waste at a

licensed site and by a method approved by the Ministry.

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8. Based on the nature of the project and its locations the Ministry may include additional requirements.

b) Crushes

1. The company shall utilize bag filters or water sprayers, or a combination of both systems to control dust generated from the gravel crushing and sorting processes.

2. The company shall ensure that hoppers are closed from all sides

except material loading and water spray is used to control dust. 3. The company shall cover conveyor belts and install water sprayers at

all falling points and crusher floor. 4. The company shall ensure that dust control equipment is used when

necessary and maintained in good order.

5. The company shall control road dust with water spraying or other method approved by the Ministry. It is preferable that the trucks and vehicles use roads far from residential areas.

6. The company shall place fuel storage tanks on impervious bases lined

with reinforced concrete and surrounded by bunting walls. 7. The company shall collect spent oil in sealed drums and store them in

concrete lined sites. 8. The company shall disposed collected non-hazardous waste at a

licensed site and by method approved by the Ministry.

Based on the nature of the project and its location the Ministry may include additional requirements.

c) Gypsum production (decoration and ornamental sheets)

1. The company shall implement efficient duct control measures. 2. The company shall ensure that collected marble dust is reused or

disposed of at a licensed site and by a method approved by the Ministry.

3. The company shall ensure that industrial effluent is treated, reused or

discharged in accordance with the Ministry’s regulations. 4. The company shall dispose collected non-hazardous waste at a

licensed site and by a method approved by the Ministry

5. Based on the nature of the project and its location this Ministry may include additional requirements.

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d) Marble production and ceramic tiles factories

1. The company shall ensure that collected marble dust is reused or disposed of at a licensed site and by a method approved by the Ministry.

2. The company shall ensure that industrial effluent is treated,

reused or discharged in accordance with the Ministry’s regulations.

3. The company shall ensure that production floors are cleaned regularly to prevent emission of marble powder into the atmosphere.

4. Based on the nature of the project and its location the Ministry may

include additional requirements. e) Extraction of minerals

1. The company shall submit for review and approval a detailed solid non-hazardous and hazardous waste management plan that should include but not be limited to proposed handling, storage, disposal methods and monitoring and reporting procedures.

2. The company shall submit for review and approval detailed liquid waste

management plan that should include but not be limited to proposed handling, storage, disposal methods and monitoring and reporting procedures.

3. The company shall submit for review and approval a detailed dust,

noise, particulates and gaseous emissions control that should include but not be limited to proposed control methods and monitoring and reporting procedures.

4. Based on the nature of the project and its location the Ministry may

include additional requirements.

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GROUP THREE

AGRICULTURAL PROJECTS This group includes the following projects: a) Poultry farms (poultry, broilers and chicken rearing) b) Livestock pens c) Slaughterhouses d) Agricultural products and animal fodder, and e) Other projects as determined by the Ministry. 2.3.1 General requirements that apply to all the projects listed within this group. 1. The applicant should submit a completed application form for the

environmental permit and if necessary attach an Environmental Impact Assessment study (EIA).

2. The applicant should obtained the Term Of Reference(TOR) for

Environmental Health Impact Assessment study (EHIA) from Department of Environmental & Occupational Health in Ministry of Health (DE&OH).

3. The proposed project should be located in the area designated

“agricultural”. The applicant should attach a deed or lead agreement. 4. The applicant should submit an approval from Ministry of Agriculture and

Fisheries, Department of Mines and Quarries of the Ministry of Commerce and Industry that would indicate the location and production capacity of the project.

5. The project shall be located far from residential areas and main roads at a

suitable distance to be determined by this Ministry. 6. The applicant is fully financially and legally responsible for any

environmental damage resulting from the project and restoration of the environment.

7. The applicant should provide the designated Ministry’s staff with

unrestricted access to the project site to ensure that all relevant environmental impacts of the projects are being considered.

8. The applicant shall not commence construction of the project before

obtaining the necessary approvals. 9. Based on the nature of the project and its location the Ministry may have

additional requirements.

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2.3.1 Technical Conditions a) Poultry farms

1. The company shall tile poultry-houses with cement or similar impervious material. The company shall ensure that the poultry-houses are always kept clean.

2. The company shall dispose collected dead chicken at a licensed site

and by a method approved by the Ministry. Unauthorized incineration of dead chicken is prohibited.

3. The company shall not dry or store chicken manure at the site without

approval by the Ministry. Chicken manure shall be disposed of promptly.

4. The company shall not locate poultry houses near water well at a

distance closer than fifty (50) metres.

5. The company shall handle wastewater according to Ministry’s regulation.

b) Livestock pens

1. The company shall tile livestock pens with cement or similar impervious material.

2. The company shall not dry or store manure at the site without approval

by the Ministry. Manure shall be sold or disposed of promptly. 3. The company shall ensure that livestock pens are always kept clean. 4. Based on the nature of the project and its location the Ministry may

include additional requirements. c) Slaughter-houses

1. The company shall tile livestock pens with cement or similar impervious material.

2. Slaughter-houses shall be designed in accordance with the health

standards defined by the concerned authorities. 3. The company shall submit for review and approval a detailed liquid

waste management plan that should include information about method(s) of treatment and disposal.

4. Treatment of solid waste generated by slaughter-houses for the

production of organic fertilizers and animal feed.

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5. In case solid waste is not re-used, then it shall be collected and disposed of immediately at the designated sites.

6. Based on the nature of the project and its location the Ministry may

include additional requirements. d) Agricultural products and animal fodder

1. The company shall store raw materials and products in specially designated sties lined with cement.

2. Plant materials and animal waste used in production shall be collected

and stored in enclosed sites. 3. All production processes shall be carried out in enclosed buildings. 4. The company shall store raw materials (especially dried fish) and

products in sealed, specially designated containers.

5. The company shall not dry fish at the production site without prior permission from this Ministry.

6. The company shall not install boilers or other heating equipment

without prior permission from this Ministry. 7. Based on the nature of the project and its location the Ministry may

include additional requirements.

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GROUP FOUR

FOOD PROJECTS This group includes the following projects: a) Dairy production b) Bakeries c) Food production and packaging d) Flour mills e) Fish wrappings, and f) Other projects as determined by the Ministry 2.4.1 General requirements that apply to all the projects listed within the group: 1. The applicant should submit a completed application form for the

environmental permit and if necessary attach an Environmental Impact Assessment study (EIA).

2. The applicant should obtained the Term Of Reference(TOR) for

Environmental Health Impact Assessment study (EHIA) from Department of Environmental & Occupational Health in Ministry of Health (DE&OH).

3. The applicant should submit an approval from Ministry of Commerce and

Industry that would indicate production capacity of the project. 4. The proposed project should be located in the area designated “industrial”

or “commercial”. The applicant should attach a deed or lease agreement. 5. The applicant is fully financially and legally responsible for any

environmental damage resulting from the project and restoration of the environment.

6. The applicant should attach technical information describing production

processes such as machinery catalogues, floor plans and production process flow diagrams.

7. The applicant should provide the designated Ministry’s staff with

unrestricted access to the project site to ensure that relevant environmental impacts of the projects are being considered.

8. The company shall collect solid non-hazardous waste and dispose at a

site approved by the local Municipality. 9. If applicable, the company shall submit for review and approval technical

information necessary to determine the required height of smoke stacks (type of fuel, boiler, etc.)

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10. Industrial wastewater shall be discharged into a septic tank annexed to a

holding tank. 11. Non-hazardous solid waste shall be collected from the site and disposed

immediately in the designated sites in coordination with the concerned Municipality.

12. Sewage waste shall be discharged into septic tanks annexed to holding

tank in case of non-existence of sewerage system. 13. Based on the nature of the project and its location the Ministry may have

additional requirements. 2.4.2 Technical Conditions a) Dairy production

1. The applicant should submit an approval from a health department of the concerned Municipality as well as department of environmental health in Ministry of Health.

2. The company shall not incinerate waste without permission from this

Ministry. 3. The company shall submit periodical reports on stack emissions. 4. Should there be cattle pens attached to the factory, then the project

shall be established in an area designated “agricultural” and comply with the terms for cattle pens operations.

5. Based on the nature of the project and its location the Ministry may

include additional requirements. b) Bakeries

1. The company shall ensure that only electricity or natural gas is utilized as furnace fuel.

2. The company shall ensure that the height of the stack shall not be less

than three (3) meters above the apex (roof) of the bakery building and the nearby buildings.

3. Based on the nature of the project and its location the Ministry may

include additional requirements. c) Food Production and packaging

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1. Products shall be kept in stores equipped according to the standard food hygiene specifications provided that the stores shall be clad with reinforced concrete to prevent seepage of any pollutants.

2. The company shall submit periodical reports on stack emissions.

3. If the project is associated with agricultural products from local farms, it is preferable to be established on agricultural land provided with the approval of the Ministry of Transport and Housing.

4. The applicant should submit an approval from a health department of the concerned Municipality department of environmental health in Ministry of Health..

5. Based on the nature of the project and its location the Ministry may

include additional requirements. d) Flour mills

1. The company shall implement dust control measures, and install and maintain appropriate dust filters.

2. The company shall install covers over conveyor belts and install and

hoppers. 3. The company shall submit periodical reports on stack emissions. 4. The company shall ensure that noise levels do not exceed the levels

determined in the Ministry’s noise pollution and regulations. 5. Based on the nature of the project and its location the Ministry may

include additional requirements. e) Fish wrapping

1. Products shall be kept in stores equipped according to the standard food hygiene specifications.

2. The company shall conduct drying, washing, cutting, and wrapping

inside of enclosed buildings. 3. Based on the nature of the project and its location the Ministry may

include additional requirements.

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GROUP FIVE SERVICE PROJECTS

This group includes the following projects: a) Roads b) Water supply systems c) Commercial and residential complexes d) Storage and recharge dams e) Hospitals and health centres f) Electric supplies and telephones g) Permanent and temporary camps h) Wastewater treatment plants, and i) Other projects specified by the Ministry. 2.5.1 General requirements that apply to all the projects listed within this group 2. The applicant should submit the completed application form for

environmental permit and if necessary attach an Environmental Impact Assessment study (EIA).

3. The applicant should obtained the Term Of Reference(TOR) for

Environmental Health Impact Assessment study (EHIA) from Department of Environmental & Occupational Health in Ministry of Health (DE&OH).

4. A letter from the project owner shall be submitted. 5. The project designs shall be submitted. 6. The applicant/owner is fully legally and financially responsible for

environmental impact during construction, operation and post-closure phase of the project, including cost of mitigation measures, created by the actions or lack of action of its employees, contractors, subcontractors, payment of compensation, settlement of claims, etc.

7. If possible, the company should avoid locating project in areas of dense

vegetation. 8. If applicable, the company shall notify Air and Noise Pollution Section of

the Ministry about intention to use explosives. 9. The company should ensure that the proposed location comply with

coastal set backs specified in the Ministry’s regulations. 10. The applicant should provide the designated Ministry’s staff with

unrestricted access to the project site to ensure that all relevant environmental impacts of the projects are being considered.

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11. The company shall collect solid waste and dispose at a site approved by the local Municipality.

12. The applicant should ensure that domestic wastewater is treated and

discharged in accordance with the Ministry’s regulations. 13. Based on the nature of the project and its location the Ministry may have

additional requirements. 2.5.2 Technical Conditions a) Roads

1. The company shall collect removed asphalt and dispose it at a site approved by the local Municipality.

2. The company shall submit to the Ministry for review and approval

designs of road crossing through wadis, tributaries and aflaj. 3. The company shall obtain a separate approval for establishing borrow

pits, quarries, crushers or any other similar permanent of temporary, projects and facilities connected with construction and operation of the project.

4. Care should be taken during construction of bridges across the khawrs

to avoid damage to the trees and disturbance to surrounding areas.

5. The company shall obtain a separate approval for establishing labour camps or any other permanent or temporary, manned or unmanned, projects and facilities connected with construction and operation of the project.

6. The company shall control road dust with water spraying or other

method approved by the Ministry. 7. Based on the nature of the project and its location the Ministry may

include additional requirement. b) Water supply systems

1. Should the Ministry approve abandoning of an old pipeline in the ground, the company shall plug all openings of the old pipes to prevent spreading vermin and vectors.

2. The company should remove all temporary structures, waste and

reinstate excavated areas. 3. The national or international technical specification concerning the

pipes and valves of the system shall be considered.

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4. Based on the nature of the project and its location the Ministry may include additional requirements.

c) Commercial and recharge dams

1. The company shall control dust with water spraying or other method approved by the Ministry.

2. The company shall ensure that sewage effluent is treated and

discharged in accordance with the Ministry’s regulations. 3. Based on the nature of the project and its location the Ministry may

include additional requirements. d) Storage and recharge dams

1. The company shall restore the area adjacent to the dam by demolition and removal of temporary buildings, temporary roads, waste litter and grading excavated sites.

2. The company shall control dust with water spraying or other method

approved by the Ministry. 3. The company should ensure that the proposed design provide outlets

for sand and gravel movement down a wadi towards the coast. 4. Based on the nature of the project and its location the Ministry may

include additional requirements. d) Hospitals and health complexes

1. The company shall ensure that sewage effluent is treated and discharge in accordance with the Ministry’s regulations.

2. Should the company decide to install a biomedical waste incinerator, it

shall submit for review and approval the technical information necessary to determine the height and smoke stacks (type of fuel, boiler, etc.).

3. The company shall ensure that hazardous medical waste is managed

and disposed off in accordance to the Ministry’s regulations. 4. Based on the nature of the project and its location the Ministry may

include additional requirements.

e) Power and telephone lines

1. Taking the required precautions to protect the electric lines in the areas of wadis and mountain passes.

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2. The company shall control dust with water spraying or other method approved by the Ministry.

3. The company shall ensure that the electric power line right-of-way has

sufficient setbacks from residential housing, as recommended by the Ministry.

4. If possible, the company should provide the Ministry with the

information about the force of the electro-magnetic field generated b the electric current.

5. Based on the nature of the project, and its location the Ministry may

include additional requirements. f) Permanent and temporary workers camps

1. The company shall not establish any temporary or permanent workers camps without prior approval by Ministry

2. Should the camp house more than (150) one hundred and fifty persons

a sewage treatment plant shall be installed otherwise the company may use holding tank or septic tank approved by the Ministry.

3. The company shall ensure that all car wash and repair workshops are

built and operated in accordance to the Ministry’s regulation.

4. Based on the nature of the project and its location the Ministry may include additional requirements.

g) Waste water treatment plants

1. Prior to designing and constructing any temporary or permanent wastewater treatment plant the company shall obtain from the Ministry the necessary Permit to Discharge.

2. All technical data concerning the plant design, shall be provided to the

Ministry.

3. The treatment effluent resulting from the plant shall comply with the specification stated in the related regulations.

4. A monthly report illustrating the result of the analysis of the quality of

effluent resulting from the plant shall be submitted.

5. A monthly report illustrating the analysis of the quality of sludge resulting from the plant shall be submitted.

6. Based on the nature of the project and its location the Ministry may

include additional requirements.

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GROUP SIX

MARINE AND COASTAL PROJECTS This group includes the following projects: a) Commercial ports and fishing harbours b) Marine bridges, marinas and clubs c) Aquiculture d) Artificial lakes, and e) Other projects specified by the Ministry. 2.6.1 General requirements that apply to all projects listed within this group.

1. The applicant should submit the completed application form for environmental permit and if necessary attach the Environmental Impact Assessment study (EIA).

2. The applicant should obtained the Term Of Reference(TOR) for Environmental Health Impact Assessment study (EHIA) from Department of Environmental & Occupational Health in Ministry of Health (DE&OH).

3. Submitting letter from the project owner.

4. Submitting the project designs (all concerned government approvals

shall be incorporated along with the application.

5. The applicant/owner is fully legally and financially responsible for environmental impacts during construction, operation and post-closure phase of the project, including cost of mitigation measures, created by the actions or lack of action of its employees, contractors, subcontractors, payment of compensation, settlement of claims, etc.

6. If possible, the company should avoid locating the project in areas of

dense vegetation.

7. If applicable, the company shall notify Air and Noise Pollution Section of the Ministry about intention to use explosives.

8. The company should ensure that the proposed location comply with the

coastal setbacks specified in the Ministry’s regulations.

9. The applicant should provide the designated Ministry’s staff with unrestricted access to the project site to ensure that all relevant environmental impacts of the projects are being considered.

10. The company shall collect solid waste and dispose at a site approved

by the local Municipality.

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11. The company shall ensure that domestic wastewater is treated and discharged in accordance with the Ministry’s regulations.

12. The company shall submit for review and approval a monitoring

reporting program that should include but not be limited to relevant environmental statistics, information about spills, progress of the project and implementation of mitigation measures.

13. The company shall control construction dust with water spraying or

other method approved by the Ministry.

14. The company shall collect spent oil in sealed drums and store them in concrete lined sites.

15. Based on the nature of the project and its location in the Ministry may

include additional requirements. 2.6.2 Technical Conditions

a) Commercial ports and fishing harbours

1. Prior to the beginning of the operation phase, the company shall establish a waste reception facility that will provide services to ships using the port.

2. The company shall obtain a separate approval for disposal of dredging

waste into the sea. 3. The company shall ensure that disposal of oil and oily waste from

boats and ships does not take place. 4. Based on the nature of the project and its location the Ministry may

include additional requirements. b) Marine clubs, marinas and bridges

1. The company shall ensure that there is no disposal into the sea of oil and oily waste from boats and ships.

2. Care shall be taken to protect vulnerable coastal areas such as

mangroves and coral reefs.

3. The proposed location shall be far from the areas affected by coastal erosion.

4. Based on the nature of the project and its location the Ministry may

include additional requirements.

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c) Fish aquiculture

1. If applicable, the company shall utilize in its breeding programme only fish that are indigenous to Oman.

2. If applicable, the company shall submit a certificate stating that

imported fish species are free from any diseases.

3. The company shall not dispose to the sea any fish waste without prior approval of this Ministry.

4. Fish aquaculture projects shall not be established in Khawrs, mangrove

area, coral reefs and the other environmentally vulnerable areas.

5. Nature feeders shall be used as much as possible.

6. Based on the nature of the project and its location the Ministry may include additional requirements.

c) Artificial lakes

1. The company shall control construction dust with water spraying or other method approved by Ministry.

2. State of the art technology shall be used in lake waters filtration.

3. Artificial lakes shall not be established in Khawrs, areas of marine

birds, natural reserves and wadis stream.

4. Based on the nature of the project and its location the Ministry may include additional requirements.

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GROUP SEVEN TOURISM PROJECTS

This group includes the following projects: a) Hotels b) Temporary tourist camps c) Tourist resorts and villages, d) Tourist boats, and e) Other projects specified by the Ministry 2.7.1 General requirements that apply to all projects listed within this group. 1. The applicant should submit an approval from the Directorate General of

Tourism, Ministry of Commerce and Industry. 2. The applicant should obtained the Term Of Reference(TOR) for

Environmental Health Impact Assessment study (EHIA) from Department of Environmental & Occupational Health in Ministry of Health (DE&OH).

3. The applicant should submit the completed application form for

environmental permit and if necessary attaches an Environmental Impact Assessment study (EIA).

4. The proposed project should be located in area designated “tourism” or

“commercial”. 5. Submitting the project designs. 6. Care should be taken during construction to avoid damage to the roads

and creating traffic jams. 7. The applicant/owner is fully legally and financially responsible for

environmental impacts during construction, operation and post-closure phase of the project, including cost of mitigation measures, created by the actions or lack of action of its employees, contractors, subcontractors, payment of compensation, settlement of claims, etc.

8. The company should ensure that the proposed location complies with

coastal set backs specified in the Ministry’s regulations. 9. The company shall control construction dues with water spraying or other

method approved by the Ministry. 10. The applicant should provide the designated Ministry’s staff with

unrestricted access to the project site to ensure that all relevant environmental impacts of the projects are being considered.

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11. The company shall ensure that domestic wastewater is treated and discharged in accordance with the Ministry’s regulations.

12. The company shall collect solid waste and dispose at a site approved by

the local Municipality. 13. Based on the nature of the project and its location the Ministry may include

additional requirements. 2.7.2 Technical Conditions a) Hotels

1. The company shall obtain a separate approval for establishing any marine activity associated with the project.

2. The company shall ensure that exterior design and colour schemes

match local architecture and surrounding landscape.

3. Based on the nature of the project and its location the Ministry may include additional requirements.

b) Temporary tourist camps

1. The company should ensure that the proposed location is far away from residential areas.

2. Care should be taken to avoid damage to trees and disturbance to

surrounding areas.

3. The company shall not dispose any wastes to the sea.

4. The company shall not establish any permanent structure at the site.

5. Based on the nature of the project and its location the Ministry may include additional requirements.

c) Tourist resorts and villages

1. If applicable, the company should inform the Ministry about intended use of pleasure crafts and recreational vehicles.

2. The company shall ensure that the exterior design and colour schemes

of the structures match local architecture and surrounding landscape.

3. Based on the nature of the project and its location the ministry may include additional requirements.

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d) Tourist boats

1. The boat owner/operator shall not discharge/dispose of untreated liquid and solid waste to the sea.

2. The owner/operator of a vessel longer than seventy (70) feel shall

submit for review and approval a detailed waste management plan.

3. The boat owner/operator shall not dispose of plastic waste to the sea.

4. The boat owner/operator of a vessel less than 7 feet long shall post signboards stating “Disposal of waste to the sea is prohibited”.

5. Based on the nature of the project and its location the Ministry may

include additional requirements.

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GROUP EIGHT

LIGHT INDUSTRIES This group includes the following projects: a) Small brick factories b) Gas cylinders storage and sale c) Carpentry, smithy and metal workshops d) Car wash, oil change and car repair workshops, and e) Other projects specified by the Ministry of Health. 2.8.1 General requirements that apply to all projects listed within this group. 1. The applicant should submit an approval of the Ministry of Commerce and

Industry. 2. The applicant should obtained the Term Of Reference(TOR) for

Environmental Health Impact Assessment study (EHIA) from Department of Environmental & Occupational Health in Ministry of Health (DE&OH).

3. If possible, the proposed project should be located in areas designate

“industrial”. 4. The applicant should submit a copy of lease or the site ownership. 5. The applicant should submit the completed application form for

environmental permit and if necessary attach an Environmental Impact Assessment study (EIA).

6. The applicant should ensure that noise levels do not exceed the levels

determined in the Ministry’s noise pollution control regulations. 7. The applicant should provide the designated Ministry’s staff with

unrestricted access to the project site to ensure that all relevant environmental impacts of the projects are being considered.

8. For small non-polluting projects, should there be no available municipal

sewerage system, wastewater should be discharge into a holding tank. 9. The company shall collect solid waste and dispose at a site approved by

the local Municipality. 10. The company shall ensure that no work is carried out during the late night

hours and rest days. 11. Based on the nature of the project and its location the Ministry may include

additional requirements.

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2.8.2 Technical Conditions a) Brick factories

1. The company shall line the production areas with concrete to prevent seepage of pollutants into the soil.

2. The project shall be located far from residential areas and main roads

at a suitable distance to be determined by this Ministry.

3. The company shall implement dust control measures to control dust from cement mixing.

4. Based on the nature of the project and its location the Ministry may

have additional requirements. b) Gas cylinders storage and sale

1. The company shall obtain an approval of the Directorate General of Standards and Specifications of the Ministry of Commerce and Industry.

2. The company shall obtain an approval for the proposed storage

location from the Civil Defense Department of the Royal Oman Police (R.O.P.)

3. The company shall ensure that all stored gas cylinders are tightly

closed and there is no gas leakage.

4. The company shall ensure that the site is equipped with fire extinguishers.

5. Based on the nature of the project and its location the Ministry may

have additional requirements. c) Carpentry, smithy and metal workshops

1. The company shall implement necessary measures to collect and dispose of sawdust and/or metal filings to prevent them from spreading.

2. Painting operations shall only take place in designated closed painting

rooms. Painting booths shall be equipped with filters or water curtains.

3. The company shall ensure that dyes and adhesives used in the shop do not contain lead or PCBs.

4. Based on the nature of the project and its location the Ministry may

have additional requirements.

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d) Car wash, oil change and car repair workshops

1. Used oil and filters shall be collected in special containers and placed on cement-lined floor. Disposal of such waste shall be in accordance with the Ministry’s regulations.

2. The workshop floor shall be lined with cement to prevent the seepage

of pollutants into the ground.

3. Painting operations shall only take place in designated closed painting rooms. Painting booths shall be equipped with filters or water-curtains.

4. The company shall ensure that dyes and adhesives used in the shop

do not contain lead or PCBs.

5. The company shall ensure that no work is carried out during the late night hours and rest days.

6. Based on the nature of the project and its location the Ministry may

have additional requirements.

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ANNEX B

Minimum content coverage of EIA/EHIA The following conditions listed below under specific industries shall be minimum coverage of the EIA/EHIA presented to the Ministry for review. LIST A: Basic conditions for all projects Having a sewage pipe and connecting it to the sewerage system. In cases where there is no sewerage system, a regular bore-hole some area should be established and cleaned regularly. Applying occupational safety measures. Providing necessary ventilation. Regular and frequent removal of solid wastes. Preservation of the green areas. If a stack is needed, it should be 3 to 5 meters higher than the highest building around. LIST A1 Conditions specific to the project’s physical establishment and sub-sector. Metal Industries 1. Raising the stacks of the smelting furnaces to 3-5 meters above the

highest point of adjacent buildings. 2. Covering tanks, which contain metals. 3. Establishing sedimentary tanks for the effluent before it is discharged into

sewers. These tanks should be cleaned regularly. 4. Closing and ventilation of coating basins. 5. Providing special stacks for aluminum smelting furnaces. 6. Providing boilers with stacks of appropriate height and ensuring that

residues of furnace are properly disposed of. Food Industries 1. Raising the stacks of ovens to 3-5 meters higher than the highest point in

adjacent buildings. 2. Providing the establishment with a tank for the separation of oil from the

water, which will be discharged into the sewerage system. Craft Industries 1. Raising the height of stacks to 3 meters higher than the highest point of

adjacent building. 2. Locating the industrial establishment 500 meters away from residential

areas in order to avoid noise.

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Chemical Industries 1. Providing the establishment with an oil-water separation tanks and getting

rid of the fat and oily products regularly. 2. Setting the height of the stack to a suitable level. 3. Ensuring that the establishment’s floor is impermeable. 4. Providing a tank for the separation of oils. 5. Providing a sedimentary tank for effluents before they are released into the

sewerage system. 6. Providing the establishment with ultra violet lamps for disinfection. 7. Providing special filters for the stacks of furnaces. 8. Providing the establishment with a chemical laboratory in order to monitor

the products and the raw materials used. 9. Providing LPG storage units with all safety facilities (pressure control, fire

extinguishers with thermal sensors). 10. Providing facilities for chemical neutralization of effluents, prior to their

discharge. Plastics Industries 1. Raising stacks to 3-5 meters higher than the highest point in adjacent

buildings. 2. Setting a suitable ventilator to prevent the inhalation of released gases.

Paper Industries 1. Raising stacks to a suitable height (i.e. 3 meters above the highest point in

adjacent buildings). Quarry Industries 1. Establishing a special borehole for collecting water and cleaning this hole

regularly. 2. Establishing sedimentation holes. These holes should be set in a series

and should be cleaned frequently. The sludge resulting from the cleaning should be disposed of frequently in an engineered land-fill.

3. Providing filters to clean the air inside the establishment. 4. Coordinating with the governorate in order to identify landfill sties for

wastes. 5. Locating the establishment outside planned residential areas. 6. Not locating the establishment in agricultural lands. LIST A2 Conditions specific to the projects inputs and outputs and sub-sector. Textile Industries 1. Providing and using good storages for raw materials. 2. Treating effluents before releasing them into the sewerage system.

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Metal Industries 1. Neutralizing effluents. 2. Submitting a written pledge to the licensing authorities that no refrigerating

gases will be used. 3. Providing and using good and legal storage for raw materials. 4. Not using cyanide – the use of cyanide is, in many countries prohibited by

law. 5. Coordinating with the governorate to get rid of the waste resulting from the

industry. Liquid effluents must be chemically neutralized before discharge. 6. Taking into account the Ministry of Health terms of reference in case the

product is to be used to hold food products. Paper Industries 1. Providing and using good storage for raw materials and products. 2. Neutralizing effluents. 3. Complying with product standards provided by the Ministry of Health. 4. The product has tom be used for the approved purpose only. It should not

be used in packaging drugs, food or for producing children’s toys. Craft Industries 1. Providing and using good storage for raw materials. Quarry Industries 1. Obtaining the raw materials from legal quarries. The owner of the

establishment should restore the vegetation on site. 2. Providing and using good and legal storage for the project’s materials in

such a way that they are not exposed to wind. 3. Safety measures to be implemented when using explosive stuff. Food Industries 1. Providing and using good storage for raw materials. 2. Complying with the instructions of Ministry of Agriculture regarding the

product. 3. Performing microbiological and chemical analysis for the water used in

industry. 4. Complying with the criteria set by the 5. Adding the required allowed percentages of iodine to the product 6. Neutralizing effluents. 7. Complying with legal conditions set the Ministry of Health when preserving

products in cans. 8. Constructing special landfills for waste that result from the industry. 9. Submitting a written pledge to the licensing authorities that no prohibited

refrigerating gases will be used. These gases are mentioned in Vienna Convention and Montreal Protocol for the protection of the ozone layer.

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Plastics Industries 1. Using new plastic for preserving food. 2. Applying the conditions and criteria set by the Ministry of Health on plastic,

which is to be used in contact with medical materials. 3. Storing raw materials in a suitable way in order to protect them from

rodents. 4. Submitting a written pledge to the licensing authorities that gases, which

were prohibited by Montreal Convention, will be replaced when a substitute is found in the future.

5. Using only permitted additives and dyes in plastic, which is intended to be used in direct contact with food.

6. Putting a label stating “suitable for preserving food” on the products intended to be used in direct contact with food.

7. Complying with international standards, which identify the percentage of phenyl chloride monomer, allowed to be added to plastic intended for preserving food. This has to be done since this substance has a carcinogenic effect.

8. Complying with the standards set by Ministry of Chemical Industries 1. Neutralizing effluents before they are discharged into the sewerage

network and complying with the industrial standards for wastewater effluents.

2. Good, safe and legal storage of liquid substances used in the industrial process.

3. Providing and using good storage for the product. 4. Complying with the instructions of both the Ministry of Health and the

Ministry of _____ regarding the product. 5. Complying with national standards for pollutants and raw material which

maybe added. Now heavy metals should be added. This is required in order to protect health.

6. Adding the required percentage of iodine to the product. 7. Conducting periodic analysis of the water used in the production process

in order to assure its safety. 8. Complying with the conditions set by the ________ regarding the

characteristics of the product. 9. Storing the project’s materials in legal places so that they are not affected

by wind. 10. The product should only be used in the specified purposes. It should not

be used at all in preserving food or drugs or in producing children’s toys. A written pledge should be submitted for this purpose.

11. Complying with the conditions of the Ministry of Health regarding the packaging of the product.

12. Coordinating with the local authority to dispose of waste from sedimentation tanks and to choose a suitable landfill site.

13. Submitting a written statement to the licensing authority stating in it that no prohibited refrigerating gases will be used. These gases are identified in

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Vienna Convention and Montreal Protocol for the protection of the ozone layer.

14. Disinfecting potable water and analyzing it periodically 15. Complying with the national standards for air quality when they are issued. 16. Labeling product’s container(s) with a clear notice stating that it should be

kept away from heat sources. LIST A3 Conditions specific to the project’s production process and sub-sector Textile industries 1. Reducing noise 2. Adding air-exhaust system to remove dust and fibres. Metal Industries 1. reducing noise 2. Providing a ventilator for the smelting process Chemical Industries 1. Melting metals within legal conditions 2. Completing the packaging process in a closed environment 3. Achieving a safe mixing level for pesticides in containers or order to

protect public health Food Industries 1. Ensuring hygienic conditions during the production process 2. Conducting re-crystallization of salts. 3. Following new technology in the process of breaking salt blocks. Plastic Industries 1. Supplying production machines with devices for siphoning fumes which

results from the production process. LIST A4 Conditions specific to project’s workers and work environment and sub-sector. Metal industries 1. Using should for protection against high temperatures of melting furnaces. 2. Reducing the noise level 3. Complying with the labour law concerning prohibiting work for children

under 16 years old. Actually child labour must be prohibited in all hazardous industries.

4. Working within the identified working hours in order not to cause nuisance to the neighborhood

5. Providing workers with meals containing egg and milk.

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Chemical Industries 1. Compelling workers to wear clothing protective against welding as well as

gloves and masks. 2. Taking precautionary measures against fire. 3. Providing workers with regular meals containing eggs and milk. 4. Working within the identified working hours in order not to cause a

nuisance to the neighborhood. 5. Ensuring hygienic conditions. 6. Compelling the workers who are dealing with raw materials and active

ingredients to wear gloves and protective glasses. Food Industries 1. Conducting periodic checks of workers to ensure that they do not have

communicable diseases. 2. Reducing noise levels. 3. Working within specified working hours in order not to cause a nuisance to

the neighborhood.

Quarry Industries 1. Hosing down with water on a regular basis in order to prevent dust from

spreading 2. Increasing health awareness among workers and providing them with

suitable masks to protect them from dust and compelling them to wear them.

Paper Industries 1. Complying with the labour law that no children under 16 years old are

allowed to work. 2. Providing workers with meals, which contain milk and eggs. 3. Working within the identified working hours in order not to cause a

nuisance to the neighborhood. Craft Industries 1. Reducing noise levels. 2. Working within the specified working hours in order not to cause a

nuisance to the neighborhood. LIST B Non-standard projects Gold/Jewelry design and making 1. List A conditions only.

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Ceramics and design industries 1. List A conditions only. Ice Industries 1. Reducing the level of noise. 2. Undertaking a periodic check of workers t ensure that they do not have

any communicable diseases. 3. Undertaking a chemical and bacteriological analysis of the water used. Sports Centres 1. Providing the necessary ventilation. 2. Providing hygienic conditions for the establishment, especially in

bathrooms. Storage and refrigeration 1. Submitting a written pledge to the licensing authorities stating in it that no

refrigerating and inspected gases will be in use. These gases were identified in Vienna Convention and Montreal Protocol for the protection of the ozone layer.

2. Proper disposal of solid wastes. Maintenance of domestic equipment 1. List A conditions only. Fuel stations 1. Constructing a basin for the separation of oils and fats (in case of oiling

cars). 2. Undertaking safety precaution against fire accidents such as explosions in

the fuel tanks. Concrete walls have to be built around the tanks. 3. Compelling the owner of the establishment to get rid of the sludge

precipitated in the tanks by transporting it to one of the oil refineries in the country where it is treated or transporting it to a special hole designated by the authorities.

Vehicle spare parts warehouse and sale 1. Good storage of the materials used and keeping them away from rodents. Workshops for car washing and oiling 1. Constructing a basin for oil-water separation. 2. Undertaking safety precautions in relation to accidents Selling gas cylinders

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1. Take precautions against fires and explosions Pressing coal 1. the product should not be sold in the country unless a check is undertaken

to measure sulphur oxides that result from burning the product or from the fuel used in the industry. Sulphur oxide concentration should comply with the national standards.

2. In case there are not national standards for any of the by-products resulting from using coal, the authorities concerned can set the appropriate standards to be followed.

Food oil Industry 1. Establishing an oil-water separation basin in order to get rid of the water

content in oil before disposing of it. 2. The owner of the establishment has to ensure that the sludge precipitated

in the tanks is transported to one of the oil refineries in the country where it is treated or it is transported to a special hole designated by the authorities.

3. Providing workers with rubber gloves in order to protect their skin from mineral oils and providing them with suitable masks.

Sheep abattoir 1. Maintenance of equipment and ventilators, which are present in the

abattoir in order to prevent bad odours. 2. Disposing of liquid wastes in a sedimentary pond before they are

discharged into the sewage system. This should be done in order to prevent pollution in the area. The pond should be cleaned regularly and the wastes that result from cleaning should be transported to official landfills for incineration.

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ANNEX C

Minimum Coverage of Health Impact Assessment of EIA EIA Sections requiring Ministry of Health active participation in review of Health Impact Assessment Sections, include the following: Results of analysis of the health component Analysis if the health component, of all EIA responses to environmental permit applications examined, for recording purposes was done by classifying mitigation measures related to health into three broad categories: occupational safety and health, consumer safety and health, and environmental health. This was done for each to project sector. An account of results is given below. Food Industries Occupational safety and health 1) Conducting periodic clinical tests for workers to ensure that they are free

from communicable diseases. 2) Reducing noise levels. 3) Ensuring hygienic conditions during the production process. Consumer safety and health This mainly concerns product safety from a health point of view. The conditions mentioned to ensure the safety to products were: 1) Conducting microbiological and chemical analysis of the water used in the

industry. 2) Complying with the conditions set by both the Ministry of Health and the

Ministry of ______ regarding the product. 3) Packaging and storing within the standard concisions set by the Ministry of

Health. Environmental Health 1) Constructing landfills for the solid wastes of the establishment. 2) Submitting a written pledge that not refrigerating gases will be use. These

gases are identified in Vienna Convention and Montreal Protocol for the protection of ozone layer.

Quarry Industries Occupational safety and health 1) Reducing dust levels by hosing down with water on a regular basis.

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2) Providing the workers with masks to protect them from dust ad compelling them to use them.

3) Providing filters to clean the air inside the establishment. Environmental health 1) Coordinating with the local authority to identify landfill sites for disposal of

waste. 2) Not locating the establishment in agricultural land and residential areas. 3) Obtaining raw materials from legal quarries. Metal Industries Occupational safety and health 1) Using protective measures against the high temperatures of the melting

furnaces. 2) Reducing noise levels. 3) Providing workers with meals containing eggs and milk. Consumer safety 1) Complying wit the conditions set by the Ministry of Health regarding the

characteristics of the product if it will be used for preserving food products. Environmental health 1) Neutralizing effluents. 2) Submitting a written pledge to the licensing authorities that no prohibited

refrigeration gases will be used. These gases are identified in Vienna Convention and Montreal Protocol for the protection of the ozone layer.

Plastics Industry Occupational safety and health 1) Providing workers with suitable masks to prevent inhalation of fumes

resulting from the production process. 2) Providing local exhaust ventilators to prevent inhalation of releases gases. 3) Reducing noise levels. 4) Providing workers with meals containing egg and milk. Consumer safety 1) Using new (not re-used) plastic for containing food. 2) Complying with the Ministry of Health standards and conditions for plastic,

which should be in direct contact with medical materials. 3) The product should not be used in preserving food and drugs in producing

children’s toys. 4) Using only permitted additives and dyes in plastic, which is intended to be

used in direct contact with food. 5) Complying with international standards, which identify the percentage of

phenyl chloride monomer, which is allowed to be added in the plastic used

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for preserving food. This has to be done because the previous substance has carcinogenic effects.

Environmental health 1) Compliance with the national standards for air quality where they have

been finalized. 2) Submitting a written pledge to the licensing authorities that no prohibited

refrigeration gases will be used. These gases are mentioned in the Vienna convention and the Montreal Protocol for the protection of the ozone layer.

Chemical Industries Occupational safety and health 1) Compelling workers to wear protective devices to protect them from

welding and also to wear protective gloves and masks. 2) Reducing noise levels. 3) Undertaking safety precautions against fires. 4) Providing the establishment with ultra violet lamps for disinfection. 5) Disinfecting potable water and analyzing it periodically. Consumer safety and health 1) Complying with conditions set by the Ministry of Health when packaging

the product. 2) Conducting periodic tests or analysis of the water used in the production

process to ensure its safety. 3) Complying with the conditions for quality assurance regarding products’

specifications and standards. 4) Labeling the product container(s) with a label clearly stating that it

should be kept away from heat sources. Environmental health 1) Chemical neutralization of effluents before they are disposed of. 2) Submitting a written pledge to the licensing authorities that no prohibited

refrigeration gases will be used. These gases are mentioned in the Vienna Convention and the Montreal Protocol for the protection of the ozone layer.