GCRI · Health Nexus

Environmental health

Environmental hazards reach health through the air people breathe, the water they drink, the heat their bodies must shed and the chemicals that accumulate over years. Their effects are often diffuse, delayed and shared with other causes, which makes them easy to overlook and hard to attribute. This page sets out how environmental exposure becomes disease, how exposure and effect are measured, and what the evidence serves for health and environment authorities.

02The question

Environmental health: how the risk develops.

Water, air, heat, pollution and health. The dossier below sets out how the risk develops, what is measured, where the data come from, how it is modelled and who decides.

Mechanism

Exposure becomes dose

Ambient concentrations become personal exposure through where people live, work and spend their time, then dose through breathing rate, water intake and duration. Indoor sources such as household combustion of solid fuels can outweigh outdoor levels.

Mechanism

Heat stresses body and system

Heat raises risk for older people, outdoor workers, infants and people with chronic illness. Heatwaves increase hospital demand while reducing staff capacity and straining power for cooling, so bodies and services are stressed together.

Mechanism

Water carries pathogens and chemicals

Floods and failing sanitation spread faecal pathogens; drought concentrates contaminants and pushes people to unsafe sources. Arsenic, fluoride, nitrate and lead cause chronic harm that appears only after long exposure.

Mechanism

Exposures combine

Heat raises ground-level ozone, wildfire smoke adds fine particles, and drought and dust compound both. Combined exposures act on the same organ systems, so effects estimated one hazard at a time can understate the joint burden.

03Geography

Environmental exposure in Africa.

Population density, daytime surface heat and haze over Africa, from NASA GIBS. Each layer carries its own date.

The interactive map needs JavaScript; the layer list and sources are below.

Layers 3

Environmental exposure, for this page

About this layer
Evidence
Estimated
Source
Gridded Population of the World v4.11 (NASA SEDAC (CIESIN, Columbia University))
Provider
NASA SEDAC (CIESIN, Columbia University)
Licence
CC BY 4.0
Vintage
null; Census-based estimate, static (2020)
Resolution
about 1 km grid
Uncertainty
Census-based estimate of people per square kilometre in 2020, shown as exposure context; not a count of people affected by any hazard.
Reached through
gibs.earthdata.nasa.gov, only after you allow the live map
About this layer
Evidence
Observed (persistent cloud still leaves gaps)
Source
VIIRS NOAA-20 Level 3, 8-day (NASA LANCE)
Provider
NASA LANCE
Licence
NASA open data
Vintage
8-day; Satellite 8-day composite; persistent cloud still leaves gaps
Newest at build
2026-09-14
Resolution
about 1 km grid
Uncertainty
Satellite skin temperature of the ground over the 8 days ending on the date shown, a heat exposure indicator; not air temperature, heat index or a heat warning.
Reached through
gibs.earthdata.nasa.gov, only after you allow the live map
About this layer
Evidence
Observed (clouds leave gaps)
Source
VIIRS NOAA-20 Deep Blue AOD (NASA LANCE)
Provider
NASA LANCE
Licence
NASA open data
Vintage
daily; Satellite retrieval; clouds leave gaps
Newest at build
2026-10-14
Resolution
about 2 km grid
Uncertainty
Satellite measure of haze, smoke and dust through the whole air column on the day shown; an exposure indicator, not ground-level PM2.5, an air quality index or a health warning.
Reached through
gibs.earthdata.nasa.gov, only after you allow the live map
About this layer
Evidence
Observed
Source
VIIRS NOAA-20 corrected reflectance (NASA LANCE)
Provider
NASA LANCE
Licence
NASA open data
Vintage
daily; Satellite image
Newest at build
2026-10-14
Resolution
about 250 m grid
Uncertainty
Satellite image. Satellite or model raster as the provider publishes it. Clouds, swath gaps and retrieval error leave gaps and noise; values are indicators, not measurements at a place.
Reached through
gibs.earthdata.nasa.gov, only after you allow the live map
About this layer
Evidence
Observed (clouds leave gaps)
Source
OMI Aura (NASA GES DISC)
Provider
NASA GES DISC
Licence
NASA open data
Vintage
daily; Satellite retrieval; clouds leave gaps
Newest at build
2026-10-10
Resolution
about 2 km grid
Uncertainty
Satellite column of nitrogen dioxide in the lower atmosphere on the day shown, mostly from combustion; not a ground-level concentration or a health warning.
Reached through
gibs.earthdata.nasa.gov, only after you allow the live map
About this layer
Evidence
Modelled (latest year GIBS publishes)
Source
MODIS Terra and Aqua land cover (MCD12Q1) (NASA LP DAAC)
Provider
NASA LP DAAC
Licence
NASA open data
Vintage
yearly; Satellite classification; latest year GIBS publishes
Newest at build
2024-01-01
Resolution
about 500 m grid
Uncertainty
Satellite land cover classes for the year shown, including croplands; a classification with known errors, not a farm register.
Reached through
gibs.earthdata.nasa.gov, only after you allow the live map

Latest available

NASA GIBS / EOSDIS · ASTER GDEM (METI, NASA) · Blue Marble (NASA) · © OpenStreetMap contributors (ODbL) · Natural Earth

Loading the latest NASA imagery.

Drag to move. Ctrl or ⌘ and scroll, pinch or the buttons to zoom; hover for the values under the pointer; reset returns to the region.

Environmental exposure, framed on Africa.Satellite and model products as NASA publishes them, each with its own date. They are indicators, not assessments of any place.

Data: NASA GIBS · ASTER GDEM · Blue Marble · © OpenStreetMap contributors · Natural Earth · NASA EONET · ESA Copernicus Sentinel-5P TROPOMI · NASA JPL OPERA DIST-ALERTSources and licences

  • We acknowledge the use of imagery provided by services from NASA’s Global Imagery Browse Services (GIBS), part of NASA’s Earth Science Data and Information System (ESDIS). Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
  • We acknowledge the use of imagery provided by services from NASA’s Global Imagery Browse Services (GIBS), part of NASA’s Earth Science Data and Information System (ESDIS). Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
  • Center for International Earth Science Information Network (CIESIN), Columbia University. 2018. Gridded Population of the World, Version 4 (GPWv4): Population Density, Revision 11. NASA Socioeconomic Data and Applications Center (SEDAC). Licensed under CC BY 4.0. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). doi:10.7927/H49C6VHW. CC BY 4.0
  • VIIRS near-real-time products (flood, land surface temperature, snow cover, corrected reflectance), NASA LANCE; imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
  • MODIS and VIIRS atmosphere products, NASA LANCE and LAADS DAAC; imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
  • OMI nitrogen dioxide (Aura) and OMPS aerosol index (Suomi NPP), NASA; distributed by the NASA GES DISC; imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
  • MODIS land products (vegetation indices, gross primary production, land cover), NASA LP DAAC and LANCE; imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
  • ASTER GDEM is a product of METI and NASA (ASTER Global Digital Elevation Model V003, NASA LP DAAC); imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). Cite as: NASA/METI/AIST/Japan Spacesystems and U.S./Japan ASTER Science Team (2019). ASTER Global Digital Elevation Model V003. doi:10.5067/ASTER/ASTGTM.003. NASA open data
  • Made with Natural Earth. Free vector and raster map data @ naturalearthdata.com. Public domain
  • © OpenStreetMap contributors (ODbL), via NASA GIBS (coastlines, boundaries, roads and place names). Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). ODbL
  • Blue Marble, NASA Earth Observatory; imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
  • Context on the globe and flat map: coastlines, boundaries, roads and place names from NASA GIBS reference layers (OpenStreetMap data, ODbL, © OpenStreetMap contributors); Blue Marble imagery as an optional base; 3D terrain and the elevation read-out from the ASTER GDEM elevation colour index (5 m to 200 m classes, exaggerated for legibility). Boundaries are drawn as published and imply no position on any territory.
  • Live events: NASA Earth Observatory Natural Event Tracker (EONET); events are indicative and keep their original source links.
  • Live: NASA EONET Events are indicative, not authority warnings.
  • Observed (EO): ESA Copernicus Sentinel-5P TROPOMI (contains modified Copernicus Sentinel data 2026). We acknowledge the use of imagery provided by services from NASA’s Global Imagery Browse Services (GIBS), part of NASA’s Earth Science Data and Information System (ESDIS).
  • Observed (EO): NASA JPL OPERA DIST-ALERT (contains modified Copernicus Sentinel data 2026). We acknowledge the use of imagery provided by services from NASA’s Global Imagery Browse Services (GIBS), part of NASA’s Earth Science Data and Information System (ESDIS).
  • NASA GIBS: We acknowledge the use of imagery provided by services from NASA’s Global Imagery Browse Services (GIBS), part of NASA’s Earth Science Data and Information System (ESDIS).
  • Air quality forecast, 5 days, PM2.5 (CAMS via Open-Meteo): Contains modified Copernicus Atmosphere Monitoring Service information 2026.
  • Past year, daily temperature (ERA5 via Open-Meteo): Contains modified Copernicus Climate Change Service information 2026.
  • Weather data by Open-Meteo.com (https://open-meteo.com/), licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/).
  • Optional layers (14 sources in the layer list: live, forecast, observed and context) print their provider credit on the map and here when switched on; forecasts are model output and derived indices are estimates.

Layers and dates

  • Population density, 2020: Population: CIESIN, Columbia University, Gridded Population of the World v4.11 (2018), NASA SEDAC, CC BY 4.0 · static
  • Land surface temperature, day, 8-day composite: VIIRS NOAA-20 Level 3, 8-day, NASA LANCE · 14 Sep 2026
  • Aerosol optical depth, daily: VIIRS NOAA-20 Deep Blue AOD, NASA LANCE · 13 Oct 2026
  • True colour: VIIRS NOAA-20 corrected reflectance, NASA LANCE · 13 Oct 2026
  • Nitrogen dioxide, lower atmosphere column: OMI Aura, NASA GES DISC · 10 Oct 2026
  • Land cover type (IGBP), yearly: MODIS Terra and Aqua land cover (MCD12Q1), NASA LP DAAC · 2024

04Couplings

Air, heat and water link the environment to illness.

DomainHow it couples hereWhat to watch
EnergyCombustion for power, transport and cooking is the main source of fine particulate pollution; heat stresses power systems. See heat and cooling.Fine particulate concentration in micrograms per cubic metre
WaterContaminated water carries chemical and microbial hazards. See drinking water and sanitation.Contaminant exceedances against WHO guideline values
FoodContaminants and residues enter diets; heat affects food safety.Residue monitoring results
BiodiversityUrban green space and trees reduce heat and filter air.Tree canopy cover by neighbourhood

The WHO global air quality guidelines (2021) set guideline values for fine and coarse particulate matter, ozone, nitrogen dioxide, sulphur dioxide and carbon monoxide, expressed in micrograms per cubic metre over stated averaging times. Heat-health warning systems follow WMO and WHO guidance (2015), which ties thresholds to local evidence of excess mortality.

05Monitor

Heat-health and equity watch.

The screen a team would use to follow this subject: its measures, states and decisions. Names are examples and values are illustrative.

Heat-health and equity watch

Environmental health · Summer season · District 4

Heat-health alert level 3GCRI · Health Nexus

Daily maximum temperature

Outreach to at-risk groups

People over 75 living alone104876Behind
Outdoor workers193245Behind
Care homes3999On track

Actions

  1. A-1Open cooling centres, district 4Civil protectiontoday
  2. A-2Adjust outdoor work hoursLabour inspectorate1 d
Heat-health and equity watch: the screen’s structure, terms and states for Environmental health.Example names and illustrative values; a design, not a record or a live system.
06Reports, standards and contributions

Environmental health evidence.

Exposure and heat-health analyses are designed for the Country Quarterly series. The Global Centre for Risk and Innovation (GCRI) sets no exposure limits and issues no heat warnings. Monitoring datasets would carry NS-3b metadata under the proposed Nexus Standards. Useful contributions: low-cost sensor data with co-location calibration, and heat-health outcome studies.

07Twin and cascade simulator

Model environmental health as a system. Run the cascade.

Assembled from the Nexus Standards area profile Health security and One Health: the hazards it names, the systems and sectors that carry the loss, the controls that dampen it and the data that observe it. Choose the components, pick an initiating hazard and step through the cascade. The Map view places the run on an example geography with open data. Every coupling weight is a stated assumption you can change. A teaching model, not a forecast, an assessment or a certification. To model a place of your own choosing, open the full System Builder.

Hazards

Controls

  • NS-0 Constitution and principles
  • NS-3 Risk record UNIs (grammar, legacy crosswalk, allocation authority)
  • NS-9 Contextual UNIs (deployments, instances, programme instances)
  • NS-10 Policies and clauses (machine-readable obligations: definition, binding, evaluation and enforcement)
  • NS-11 Verification and monitoring (evidence, attestations, zero-trust conformance observation)
  • NRS-H83 Hazard family: Health system capacity failure (NHS-1 health.system)
  • NRS-H42 Hazard family: Rare and persistent human infections (NHS-1 health.other-human)
  • NRS-H41 Hazard family: Animal-to-human spillover (NHS-1 health.zoonotic)
  • NRS-H43 Hazard family: Livestock and aquaculture epizootics (NHS-1 health.animal-health)
  • NRS-D3 Humanitarian response and resilient recovery
  • NRS-H46 Hazard family: Environmental and product harm to people (NHS-1 health.harm)

Observation

  • WHO Disease Outbreak News (listed for reference)
  • WAHIS animal health events (listed for reference)
  • WorldPop gridded population (listed for reference)
  • International Health Regulations capacity and health emergency preparedness
  • Percentage of bloodstream infections due to selected antimicrobial-resistant organisms

Example geography

  • West Africa: 59 hexagonal cells
  • Night lights tonight, outages (VIIRS Day/Night Band), NASA GIBS
  • Surface water through cloud, 30 m (OPERA DSWx-S1 radar), NASA GIBS
  • Rain rate, last half hour (IMERG), NASA GIBS
08Indicators

What is measured, and how well.

Each indicator carries its unit, its cadence, the kind of source behind it and the evidence label a value would carry. No values are shown: a programme supplies them under its own authority.

IndicatorUnitCadenceSource typeLabel
Annual mean fine particulate mattermicrograms per cubic metreannualGround monitors fused with satellite and model estimatesMODELLED
Population above the WHO air quality guidelinepersonsannualExposure surfaces on gridded populationESTIMATED
Heat stressuniversal thermal climate index, degrees CelsiusdailyReanalysis and weather forecastsMODELLED
Heatwave exposureperson-days of heatwave exposureseasonalTemperature records on gridded populationESTIMATED
Heat-related excess deathsdeaths above expectedseasonalVital registration against modelled baselinesESTIMATED
Reliance on polluting cooking fuelspercent of populationannualHousehold surveys, SDG indicator 7.1.2ESTIMATED
Drinking-water contaminant exceedancepercent of samples above the guideline valuemonthlyWater quality surveillanceOBSERVED
Blood lead concentrationmicrograms per decilitreper surveyBiomonitoring surveysOBSERVED
09Methods and evidence

How environmental health is modelled, measured and tested.

The model, its assumptions, its data and its uncertainty, in the form a scientist or engineer would check. Structures follow published methods. The values drawn are illustrative, not findings.

System model

The couplings between the systems in environmental health: signs of influence, a reinforcing and a balancing loop, and cross-links where stress jumps.

++−HealthCommunitiesEconomyR reinforcingB balancing
Causal loop diagram from the page’s systems; signs show the direction of influence. Illustrative structure for a system dynamics or network model, not estimated couplings.
FAIR guiding principles · GO FAIR and FORCE11W3C PROV · World Wide Web ConsortiumGuidance on consistent treatment of uncertainties · IPCCCEOS Analysis Ready Data · Committee on Earth Observation Satellites
10Sources

Where the evidence comes from.

Named public datasets and institutional records, each with its licence class. Sources by agreement are used only under their terms and never republished.

SourceWhat it givesLicence class
WHO Ambient Air Quality DatabaseAnnual mean particulate matter and nitrogen dioxide from city monitorsOpen, attribution, WHO terms of use
OpenAQHarmonised real-time and historical air quality measurementsOpen; licence per contributing source
Copernicus Atmosphere Monitoring ServiceReanalysis and forecasts of aerosols, ozone and wildfire smokeFree and open, attribution
ERA5 and ERA5-HEAT (Copernicus)Temperature and thermal stress indices, the universal thermal climate index includedFree and open, attribution
WHO and UNICEF Joint Monitoring ProgrammeDrinking water, sanitation and hygiene service levelsFree and open, attribution
IHME Global Burden of DiseaseModelled burden attributable to environmental risk factorsFree for non-commercial use, attribution
Lancet Countdown on health and climate changeIndicators of heat exposure, health impacts and adaptationPublished report and data, terms per indicator
11Decisions

Who decides, and what the evidence serves.

Health Nexus prepares evidence. The decisions below are taken by the authorities named, under their own rules, and never by the platform.

Who decidesThe questionEvidence this page serves
Ministries of health and environmentWhich pollutants and sources to regulate first, and which populations to protectExposure surfaces against guideline values; attributable burden with uncertainty
Municipal health and emergency authoritiesWhen to activate heat-health action plans and where to open cooling centresHeat stress forecasts with their skill; exposure of vulnerable groups by neighbourhood
Drinking-water regulators and suppliersWhich supplies need treatment, a source change or public advisoriesContaminant exceedance by supply; seasonal and flood-related contamination risk
Hospital systemsHow to prepare staffing, cooling and admissions for heat and smoke episodesSeasonal exposure outlooks; past admission patterns during episodes

Outputs this topic produces

  • Exposure surfaces for air, heat and water hazards with their error
  • Heat-health evidence for action plans and hospital preparedness
  • Attributable burden estimates with model assumptions stated
  • Combined-exposure profiles for districts and facilities
12Core questions

What experts ask.

Environmental health connects a measured exposure to a health outcome.

  • How do temperature extremes affect illness and death, and who is most sensitive?
  • What health burden comes from air pollution, including wildfire smoke?
  • When does flooding or drought compromise drinking water and sanitation?
  • Which chemical and pollutant exposures matter most, and at what levels?
  • How do exposures combine, for example heat with poor air quality?
13Mechanisms

Mechanisms and drivers.

Extreme heat strains the body’s ability to regulate temperature and places stress on the heart, kidneys and lungs. Older people, infants, outdoor workers, people with chronic illness and those without cooling are most at risk, and much of the harm occurs on hot nights when the body cannot recover. Cities amplify heat through the urban heat island effect.

Fine particulate air pollution penetrates deep into the lungs and bloodstream and is associated with respiratory and cardiovascular disease. Floods spread contamination and disrupt treatment works; drought concentrates pollutants and reduces water for hygiene. Many exposures act together, and their combined effect can exceed the sum of their parts.

14Methods and data

How it is studied, and where the methods stop.

Method or dataWhat it showsLimits
Time-series and case-crossover studiesShort-term associations between exposure and outcomesConfounding and exposure misclassification from fixed monitors
Cohort studiesLong-term effects of chronic exposureExpensive, slow and dependent on follow-up quality
Exposure modelling with monitors and satellite dataWhere and when people are exposedPersonal exposure differs from outdoor concentrations
Heat-health and air-quality early warning evaluationWhether warnings change outcomesHard to separate warning effects from weather variation
15Methods

How it is studied, and what the methods cannot say.

  1. Epidemiology and public health scienceSurveillance design and evaluation · Nowcasting under reporting delayApplied here
  2. Causal inference and impact evaluationEvaluating public health measures · Exposure-response for heat and airApplied here
  3. Probability and statisticsSurvey-weighted and small-area estimation · Expected baselines for excess mortalityApplied here
  4. Data engineering, interoperability and stewardshipLinking health information systems · Privacy-preserving publicationApplied here
  5. Complex systems and agent-based modellingContact and mobility networks · Cascades across health and infrastructureApplied here
16Where this page’s references

Where this page’s references lead.

The bodies and documents this page is read against. Status and editions change; each link goes to the issuing body.

17Questions

Questions and answers.

What is a WHO air quality guideline?
A health-based concentration of a pollutant, set by WHO from the evidence on health effects. It is not a legal limit; countries set their own standards, often with interim targets on the way to the guideline.
Can a death be attributed to heat or air pollution?
Rarely for an individual. Population methods compare observed deaths with those expected without the exposure, and the result is an estimate with uncertainty, not a count of named cases.
Why combine exposures instead of studying each one?
Because people experience heat, smoke, ozone and dust together, and the effects can add or interact. Studying each alone can miss part of the joint burden.
Where can I get advice about my own exposure?
From national and local health authorities and from health professionals. This page describes science and data, and it does not give personal or medical advice.
Why are heat deaths hard to count?
Heat rarely appears on death certificates. Its effect is usually estimated statistically by comparing deaths during hot periods with expected deaths, which is why estimates are reported with uncertainty.
Do warnings work?
Heat-health and air-quality warnings are widely used, but measuring their effect is difficult. Evaluation studies try to separate the effect of the warning from the weather itself.
Does Health Nexus set exposure limits?
No. Standards are set by competent regulators and health authorities. Health Nexus publishes evidence they may use.
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