BRE BR417 PDF

Scope of the review

Definitions

The World Health Organisation (WHO 1961) stated that health ‘is not merely the absence of disease or infirmity, but a state of complete physical, mental and social well-being'. Mant and Gray (1986) saw this as a philosophical statement of intent by WHO: the specific objectives set out in the same WHO document refer almost exclusively to ‘the eradication of specific disease states, the attainment of specific standards of nutrition and hygiene and the establishment of a basic structure of primary health services'.

This does not mean that the WHO definition of health can be ignored or is unimportant. Public health law in the UK specifically embraces this wider definition through the concept of ‘nuisance'. The legal concept of nuisance goes beyond medical definitions of ill-health and includes comfort and convenience; indeed decisions as to what constitutes nuisance are not made by doctors, or necessarily by reference to medical evidence, but by a jury working within the framework of common law. Thus, health can be said to be affected even when medical treatment or consultation does not occur. This report therefore covers the full range of the definition of health, but also seeks to evaluate the importance of the various health effects.

Under this definition of health, safety becomes an aspect of health promotion but, in this report, safety is interpreted separately to refer to the avoidance of unintentional injury or death (as distinct from the consequences of illness).

This report makes extensive use of terms related to risk assessment. Such terms are used with different meanings by different authors, and they are therefore defined here as they are used in this report.

• A hazard is a potential cause of harm to a person, for example low ambient temperature or high levels of carbon monoxide.

• A hazardous situation exists when a person is exposed to an ongoing hazard. 

• A hazardous event is a short-term exposure to a hazard. 

• A harm is the adverse health effect on the person which may rise from exposure to the hazard. A harm can range from trivial, such as brief discomfort, to extremely severe, including death.

• Risk is a function of (a) the probability that harm or harms will result from exposure to the hazard and (b) the severity of the harm or harms which may result.