Integrated environmental impact assessment: a Canadian
example
Roy E. Kwiatkowski1 & Maria Ooi2
Abstract The Canadian federal process for environmental impact assessment (EIA) integrates health, social, and environmental
aspects into either a screening, comprehensive study, or a review by a public panel, depending on the expected severity of potential
adverse environmental effects. In this example, a Public Review Panel considered a proposed diamond mining project in Canada’s
northern territories, where 50% of the population are Aboriginals. The Panel specifically instructed the project proposer to determine
how to incorporate traditional knowledge into the gathering of baseline information, preparing impact prediction, and planning
mitigation and monitoring. Traditional knowledge is defined as the knowledge, innovations and practices of indigenous and/or local
communities developed from experience gained over the centuries and adapted to local culture and environment. The mining company
was asked to consider in its EIA: health, demographics, social and cultural patterns; services and infrastructure; local, regional and
territorial economy; land and resource use; employment, education and training; government; and other matters. Cooperative efforts
between government, industry and the community led to a project that coordinated the concerns of all interested stakeholders and the
needs of present and future generations, thereby meeting the goals of sustainable development. The mitigation measures that were
implemented take into account: income and social status, social support networks, education, employment and working conditions,
physical environments, personal health practices and coping skills, and health services.
Keywords Environmental health; Environmental monitoring/methods; Risk assessment; Health status indicators; Mining; Diamond;
Socioeconomic factors; Culture; Aborigines; Knowledge, attitudes, practice; Intersectoral cooperation; Program evaluation; Canada
(source: MeSH, NLM).
Mots cle´s Hygie`ne environnement; Surveillance environnement/me´thodes; Evaluation risque; Indicateur e´tat sanitaire; Industrie
minie`re; Diamant; Facteur socio-e´conomique; Culture (Sociologie); Indige`ne; Connaissance, attitude, pratique; Coope´ration
intersectorielle; Evaluation programme; Canada (source: MeSH, INSERM).
Palabras clave Salud ambiental; Monitoreo del ambiente/me´todos; Medicio´n de riesgo; Indicadores de salud; Mineria; Diamante;
Factores socioecono´micos; Cultura; Aborı´genes; Conocimientos, actitudes y pra´ctica; Cooperacio´n intersectorial; Evaluacio´n de
programas; Canada´ (fuente: DeCS, BIREME ).
Bulletin of the World Health Organization 2003;81:434-438
Voir page 437 le re´sume´ en franc¸ais. En la pa´gina 438 figura un resumen en espan˜ol.
Introduction
There is a need for economic development in both
industrialized and developing countries in order for people
to improve their standard of living and reach their full human
potential. The challenge facing governments is to find ways to
support economic development that enhances health andwell-
being without adversely impacting the environment.
Canada’s north, made up of three territories (Yukon,
Northwest Territories and Nunavut) covers an area of
3 922 000 km2 characterized by a low population density
(1 person per 40 km2). Compared with Canada’s ten southern
provinces, the northern territories have a large proportion of
Aboriginals (50% vs 3%), high unemployment (13% vs 7%)
and a significant number of health and well-being problems.
People living in Canada’s northern provinces, in particular
Aboriginals, have a holistic view of the environment and link
their observations and appreciation of the physical world with
the cultural and social attitudes created and supported by close
interaction between the environment, health and lifestyle. The
federal and territorial governments are anxious to foster
development in the north that brings jobs but does not
significantly change the unique culture of northern commu-
nities or impact adversely on their health, well-being or
environment.
Historically, concerns raised by Aboriginals about
development projects in Canada’s territories include not only
those of the physical environment (air, water, food, soil, and
plant and animal species) but also a wide range of social,
economic, cultural and healthmatters. Specific health andwell-
being topics include: socioeconomic and sociocultural stress;
racism; assistance with finances and budgets (as the aboriginal
1 Chief, Office of Environmental Health Assessment, Health Canada, P.L. 6604M, Room C486, Tupper Building, Ottawa, Ontario K1A 0K9, Canada
(email: roy_kwiatkowski@hc-sc.gc.ca). Correspondence should be addressed to this author.
2 Regional Environmental Assessment Coordinator, Office of Environmental Health Assessment, Health Canada, Ottawa, Ontario, Canada.
Ref. No. 03-001370
Special Theme – Health Impact Assessment
434 Bulletin of the World Health Organization 2003, 81 (6)

economy is based on hunting and gathering); social diseases;
personal development; self-esteem and confidence; positive
mental health; and assistance to families left with one or no
parents as a result of employment opportunities outside the
community.
Environmental impact assessment (EIA) is a planning
process used by over 100 countries to predict, assess and
mitigate any significant adverse effects associated with a
proposed project, programme or policy. An integrated EIA,
which combines health, social, economic, cultural and
psychological well-being as well as the physical, biological
and geochemical environments, provides a holistic under-
standing of the complex interrelationships between the human
and natural environments that are key to human health. Under
the Canadian federal EIA process, the project proposer is
responsible for preparing the impact assessment report, while
the federal government is responsible for providing guidance
prior to the EIA report, reviewing the report, and deciding on
the fate of the project.
Approximately 6000 projects a year undergo an EIA
under the Canadian Environmental Assessment Act. The
general rule of thumb is that the level of effort ascribed to an
assessment should be comparable to the level of potential
adverse environmental effects of a project. There are thus three
types of EIAs that a project can undergo: screening,
comprehensive study and Public Panel Review. Screenings
account for over 95% of EIAs conducted and, generally, the
assessment is less intensive than for the other types.
Comprehensive studies are applied to large-scale projects that
have the potential to result in significant environmental effects,
and the assessment is usually more rigorous. A project may be
referred by the minister of the initiating department to a Public
Panel Review if initial self-assessment (screening or compre-
hensive study) reveals that a project is likely to cause significant
adverse environmental effects and cannot be justified in the
circumstances; if a degree of uncertainty remains regarding a
project’s potential adverse effects; or if public anxiety warrants
consideration of the project by a wider public review.
Assessment process for a diamond
mining project
In 1994, BHPDiamonds Inc. (part of BHP Billiton, one of the
world’s largest diversified resources companies) proposed to
develop Canada’s first diamond mine in the Northwest
Territories (NWT). As the mining industry in general — and,
specifically, the diamond industry — is one of the few bright
spots in an otherwise bleak NWT economy, the NWT
Diamonds Project proposal was of critical importance to the
territorial government as well as to the federal government. In
view of the uncertainty of the potential adverse environmental
effects and the level of public concern arising from the project,
theMinister of theDepartment of Indian Affairs andNorthern
Development (DIAND) decided to refer the project to the
Minister of the Environment for Public Panel Review.
TheMinister of the Environment appointed four people
to serve as Panelmembers to conduct the review of the project.
Panel members are selected according to their knowledge and
expertise relevant to the particular project under review, and
care is taken to ensure that there are no conflicts of interest
with members’ current employment to taint the independence
of the Panel. The Panel was chaired by a lawyer from Calgary
with considerable experience in dealing with northern,
aboriginal and environmental issues. The other three members
were: an adviser on aboriginal issues from Yellowknife, a
retired professor of geological services from the University of
Saskatchewan, and an economic policy consultant from
Yellowknife. The Panel is not a decision-making body, but
serves as an adviser with the mandate to review the
environmental consequences of a project, report on its
findings, and make recommendations to the Minister of the
Environment.
The Public Review Panel specifically instructed BHP
Diamonds Inc. to determine how to incorporate traditional
knowledge into the gathering of baseline information,
preparing impact prediction, and planning mitigation and
monitoring, and to include reference to the socioeconomic
environment in their environmental impact report. Tradi-
tional knowledge is defined as the knowledge, innovations
and practices of indigenous and/or local communities
developed from experience gained over the centuries and
adapted to local culture and environment. Traditional
knowledge is usually intensely local in its factual information
and draws on a very long-term information base (1). The
determinants of health (2) have become the cornerstone of
Canada’s approach to health and socioeconomic impact
assessment (3, 4). They provide the integrated impact
assessment framework detailed in the Canadian handbook on
health impact assessment (5), which gives national guidance on
the integration of health and socioeconomic impact assess-
ment within an EIA. All nine determinants of the assessment
framework (Fig. 1) do not warrant detailed review in all
projects, programmes and policies, but all of them should be
considered.
One of the first tasks of any Public Review Panel is to
consult technical experts and the general public to determine
the nature and scope of matters to be considered. All federal
departments with expertise pertinent to the project are also
invited. In March and April 1995, scoping meetings were held
in ten NWT communities likely to be affected by the project.
With the information obtained from 125 presenters, the Panel
developed guidelines for the preparation of the EIA report, in
which the proposer must deal with all the points outlined in the
guidelines to the satisfaction of the Panel. Failure to do so will
only serve to hinder the process, since the Panel can ask for
additional information to be provided in order to conform to
the guidelines. For this mining project, the guidelines made
specific reference to the health and socioeconomic environ-
ments. Under this umbrella, the company was asked to
consider: health, demographics, social and cultural patterns;
services and infrastructure; local, regional and territorial
economy; land and resource use; employment, education and
training; government; and other matters and concerns relevant
to the assessment of project effects.
Over a three-month period, BHP’s eight-volume EIA
report of more than 5000 pages (6) was then reviewed by the
Public Review Panel to determine its adequacy (i.e., whether it
provided the information required by the guidelines) and
completeness prior to the commencement of the public
hearings. Public hearings are not legal proceedings but serve to
allow the Panel to receive feedback from the public. In January
and February 1996, 18 days of public hearings were held in the
project area, so as to be accessible to the local communities that
stood to be most affected by the project.
435Bulletin of the World Health Organization 2003, 81 (6)
Integrated environmental impact assessment: a Canadian example

Once the public hearings were completed, the Panel
prepared a final report to the Minister of the Environment
containing its findings, conclusions and recommendations.
The report was made public shortly thereafter and the Panel
was disbanded, as unique review panels are created for every
project reaching this phase.
The Panel concluded that the environmental effects of
the NWT diamond mining project were largely predictable
and could be mitigated, and that those effects not predicted
could be monitored under the proponent’s environmental
management plan. It was the view of the Panel that the
project would be significantly beneficial to the northerners
and economically lucrative for the north, subject to certain
provisions. In total, the Panel made 29 recommendations
focusing on subjects such as land claims, aboriginal rights,
traditional knowledge, monitoring of the environmental and
socioeconomic programmes, environmental management
plans, mine site security, air quality, water quality, affected
wildlife, employment and compensation. The Minister of the
Environment and the Minister of the Department of Indian
Affairs and Northern Development then responded publicly
to the Panel’s recommendations. Final decision on the project
proposal was taken by Cabinet: all 29 recommendations were
accepted by the federal government, and Cabinet approved
the project. Upon approval of the project, BHP continued to
work with the community and government and has signed
Impact and Benefit Protocols with the Kitikmeot Inuit
Association and the Me´tis Nation-Northwest Territories
covering revenue sharing, environmental monitoring and
socioeconomic aspects, and has publicly stated its commit-
ment to sustainable development.
Mitigation measures and their
implementation
An overview of the application of seven of the determinants of
health in the diamond mine project framework is given below,
describing briefly how they were taken into account by the
mining company. In addition, prior to and independent of the
Public Panel Review process, the company made extensive
efforts to consult with community stakeholders to ensure that
environmental, health and socioeconomic issues were identi-
fied and that industry–community mitigation measures were
developed.
Income and social status
The NWT Diamonds Project created over 1000 construction
jobs and resulted in over 700 permanent jobs, making BHP the
largest private sector employer in the territory. Over 60% of
the jobs created were specifically staffed by northern residents,
half of them going to Aboriginals. The project has reduced
unemployment in the NWT by almost 3%.
Social support networks
Community meetings, open houses and cross-cultural training
workshops were held, in order to share cultural concerns and
to minimize any potential conflict between northern residents
and newly introduced workers from other parts of Canada.
Shift rotation of two weeks in and two weeks out (with
aboriginal employees flown from their home communities)
allowed aboriginal workers to stay within their communities.
Permanent roads were kept to a minimum to prevent a major
influx of new settlements and to preserve traditional
436 Bulletin of the World Health Organization 2003, 81 (6)
Special Theme – Health Impact Assessment

relationships with the land. Aboriginal elders were invited to
participate in archaeological field programmes to locate,
protect and avoid aboriginal burial sites. The elders also
participated in environmental workshops.
Education
A university undergraduate scholarship programme of
Canadian $ 5000 (approximately US$ 3500) per year per
student was established for aboriginal students to ensure a pool
of professional staff within the local area. Preferential hiring of
Aboriginals (including the relaxation of strict minimum
educational employment standards) and on-site job training
enhanced the skill sets and employability outside the mining
sector of local residents.
Employment and working conditions
The company put into place a progressive occupational health
and safety policy. Compliance with all applicable laws,
regulations, codes and standards relating to occupational
health and safety is an integral part of this policy. The policy
includes follow-up monitoring to establish trends and improve
the state of knowledge regarding health and worker safety.
Physical environments
An environmental management plan and adaptive manage-
ment strategy were developed, to ensure compliance with all
legislative and regulatory requirements. The plan focuses on:
the safe and permanent storage of process plant tailings and
mined-out pits; the management and proper disposal of
domestic and other wastes; construction and operation of the
project in such a manner as to minimize environmental
disturbance; and the development of a plan for appropriate site
reclamation, decommissioning and closure. Aerial and land
sightings of wildlife are logged and reported. Employees and
contractors are informed of the presence of wildlife in the
project area and informed of the animals’ seasonal habits, in
order to minimize human–animal interactions for the safety of
both.
Personal health practices and coping skills
Community-based committees were established by the mining
company to deal with drug and alcohol abuse, family violence,
sexually transmitted diseases and other social problems. A
policy mandating a drug-free and alcohol-free workplace was
created, and an HIV/AIDS policy for education and effective
handling of AIDS and HIV-related personnel issues was put in
place. An employee assistance programme was established to
provide advice and assistance for employees on an additional
range of issues including work-related stress management and
financial management as, traditionally, aboriginal communities
have not been a money-based society.
Health services
BHP has drawn on project revenues to invest in the social and
human resource capital of the NWT, and all employees were
incorporated into a health care plan. In addition, the company
has worked with aboriginal communities to ensure that their
traditional health care practices are respected and utilized as
part of the health care plan.
Conclusions
EIA must involve more than identifying, assessing and
mitigating the negative environmental impacts. It must also
identify and mitigate perceived concerns and enhance, where
possible, the positive aspects of a project. Environmental, health
and social consequences of development activities contribute
valuable information to each other and draw extensively on
comparable and closely interrelated data. The health of the
environment is clearly an important aspect of a community’s
health, but it is not the only determinant. How individuals,
families and communities are affected by development, and the
social consequences of that development, provide critical
information for health professionals. Similarly, knowledge of
the impacts on the quality of life and health of individuals,
families and communities is vital to social scientists.
Integration of health, social and environmental considera-
tions into a holistic impact assessment of projects, programmes
and policies would facilitate decision-making in an integrated
manner fully consistent with the recommendations made in
Agenda 21. Such assessment can be a cost-effective strategy:
when adverse effects on health and well-being can beminimized
or prevented from occurring, an additional burden on health
care services associated with the project is avoided.
By assessing the human dimensions, costly expenses for
mitigation, remedial action and compensation may be avoided.
This is accomplished by employing a more holistic approach:
by effectively soliciting and elucidating public concerns and
examining and evaluating potential changes to the human
environment, the consequences may be thoroughly deter-
mined. The costs of conducting an integrated impact
assessment are likely to be considerably less than those of
remedying health, social and environmental impacts were they
to occur unexpectedly.
A properly designed impact assessment that integrates
health, well-being, social and environmental considerations
generates a holistic assessment; it reduces duplication of data
and information resources, avoids potential inconsistencies,
and enhances financial efficiency, strengths, complementa-
rities and the value of health, social and environmental
sciences in proposed project, programme or policy decision-
making (7). n
Conflicts of interest: none declared.
Re´sume´
Evaluation inte´gre´e de l’impact sur l’environnement : un exemple canadien
Les me´thodes d’e´valuation de l’impact sur l’environnement (EIE)
utilise´es par le Gouvernement fe´de´ral canadien inte`grent des
aspects sanitaires, sociaux et environnementaux et consistent en
un examen pre´alable, une e´tude approfondie ou une « enqueˆte
d’utilite´ publique », tenant compte de la gravite´ escompte´e des
effets susceptibles de nuire a` l’environnement. L’enqueˆte d’utilite´
publique a e´tudie´ un projet d’extraction de diamants qu’il est
propose´ d’implanter dans les territoires du Nord du Canada, ou` la
moitie´ de la population est aborige`ne. Les experts ont enjoint
l’initiateur du projet de voir comment les connaissances
traditionnelles pourraient servir a` rassembler les donne´es de base,
a` e´tablir des pre´visions d’impact et a` pre´voir des mesures palliatives
437Bulletin of the World Health Organization 2003, 81 (6)
Integrated environmental impact assessment: a Canadian example

et de surveillance. On entend par connaissances traditionnelles les
connaissances, me´thodes novatrices et pratiques des communau-
te´s indige`nes et/ou locales accumule´es pendant des sie`cles et
adapte´es a` la culture et a` l’environnement local. La socie´te´
d’exploitation minie`re a e´te´ prie´e d’e´tudier dans le cadre de l’EIE les
e´le´ments suivants : sche´mas relatifs a` la situation sanitaire,
de´mographique et socioculturelle ; services et infrastructure ;
e´conomie locale, re´gionale et territoriale ; utilisation des sols et
des ressources ; emploi, e´ducation et formation ; gouvernement ; et
autres e´le´ments. Des efforts collectifs entre le Gouvernement,
l’industrie et les collectivite´s ont abouti a` un projet rassemblant les
pre´occupations de toutes les parties inte´resse´es et les besoins des
ge´ne´rations pre´sentes et futures, respectant ainsi les objectifs du
de´veloppement durable. Les mesures palliatives mises en œuvre
tiennent compte du revenu et du niveau social, des re´seaux d’appui
sociaux, de l’e´ducation, de l’emploi et des conditions de travail, de
l’environnement physique, de l’hygie`ne de vie, de la faculte´
d’adaptation et des services de sante´.
Resumen
Evaluacio´n integrada del impacto ambiental: un ejemplo del Canada´
Los procedimientos federales canadienses de evaluacio´n del impacto
ambiental (EIA) integran aspectos sanitarios, sociales y ambientales
y consisten en un ana´lisis, estudio detallado o revisio´n llevado a cabo
por un cuadro de expertos pu´blico, teniendo en cuenta la severidad
prevista de los posibles efectos ambientales adversos. El Cuadro de
Expertos Pu´blico examino´ un proyecto de extraccio´n de diamantes
propuesto en los territorios del norte del Canada´, donde el 50%de la
poblacio´n es aborigen. El cuadro de expertos instruyo´ especı´fica-
mente al proponente del proyecto para que determinase la manera
de incorporar los conocimientos tradicionales en la recopilacio´n de la
informacio´n de partida, la preparacio´n de la prediccio´n del impacto y
la planificacio´n de las medidas de mitigacio´n y monitoreo. Se define
como conocimientos tradicionales el conjunto de conocimientos,
innovaciones y pra´cticas de las comunidades indı´genas y/o locales
acumulado a lo largo de siglos y adaptado a la cultura y el medio
ambiente. Se pidio´ a la empresa minera que considerara en su EIA lo
siguiente: los perfiles de la situacio´n sanitaria, demogra´fica, social y
cultural; los servicios y la infraestructura; la economı´a local, regional
y territorial; el uso de la tierra y los recursos; el empleo, la educacio´n y
la capacitacio´n; el gobierno, y otros aspectos. Los esfuerzos de
cooperacio´n entre el gobierno, la industria y la comunidad
desembocaron en un proyecto que coordina las preocupaciones de
todos los interesados directos y las necesidades de las generaciones
presentes y futuras, respetando ası´ las metas de desarrollo
sostenible. Las medidas de mitigacio´n que se han implementado
tienen en cuenta los ingresos y la posicio´n social, las redes de apoyo
social, la educacio´n, el empleo y las condiciones de trabajo, los
entornos fı´sicos, las pra´cticas de salud personales y las aptitudes
individuales para hacer frente a situaciones difı´ciles, y los servicios de
salud.
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438 Bulletin of the World Health Organization 2003, 81 (6)
Special Theme – Health Impact Assessment