Environmental health

Introduction

Environmental risk factors are comprised of a broad range of physical, chemical, biological, cultural and ergonomic exposures that influence our health and wellbeing at home, in the outdoors and at work. They may be part of our natural or built environments and many exposures are the result of human activities, such as the burning of fossil fuels, contact with poisons or the use of plastics which can all contaminate our soil, air and water.

Environmental factors contribute to morbidity and mortality for several health conditions, and to health care expenditure.¹

• In 2024, air pollution accounted for 1.6% and occupational exposures and hazards accounted for 1.6% of the total burden of disease (DALY).
• Considered individually, the highest proportions of disease-specific burden attributable to air pollution were for type 2 diabetes mellitus (15.9% of type 2 diabetes mellitus) followed by lung cancer (9.5%) and coronary heart disease (9.0%).
• Considered individually, the highest proportions of disease-specific burden attributable to occupational exposures and hazards were for asbestosis, other pneumoconiosis and silicosis, each contributing 100% of the disease burden attributable occupational exposures and hazards.

In 2018–19, Australian health system spending attributable to those risk factors was $352 million and $551 million, respectively.²

Aboriginal and Torres Strait Islander Environmental Health Program

Queensland Health recognises the importance of environmental health in shaping the health and wellbeing of First Nations communities. As the lead government agency overseeing environmental health in Queensland, initiatives promoting health equity are a priority, aligning with national commitments in the National Agreement on Closing the Gap and the Queensland Health First Nations First Strategy 2032.

The Aboriginal and Torres Strait Islander Environmental Health Program (ATSIEHP) is focused on building environmental health capacity that supports environmental health and domestic animal management service delivery across 16 First Nations Local Government Areas and their 34 discrete First Nations communities. The ATSIEHP aims to mitigate the environmental health risks faced by remote First Nations communities by addressing local environmental health challenges through the employment of a local environmental health workforce. Local government service delivery areas include safe and healthy food, safe drinking water and wastewater, pest management including mosquito vectors, waste management, management of domestic animals, disaster and incident response, healthy and hygienic living environments and safeguarding recreational waters.

Healthy Housing Program

Queensland Health, the Department of Housing and Public Works and the Department of Energy and Climate (now part of Queensland Treasury) partnered to deliver the Healthy Housing Pilot Program (HHPP) in two remote First Nations communities. The HHPP was co-designed with Aboriginal and Torres Strait Islander Councils, local health services and other identified stakeholders, providing integrated and complementary services ensuring that homes support healthy living practices.

Since its commencement in 2022 until the end of January 2025, 199 households with over 1,140 residents across two communities have participated in the HHPP. At initial engagement, 37% of tenants did not know about acute rheumatic fever or rheumatic heart disease. All participants receive education regarding skin sores and skin sore prevention and treatment. To date, 9,952 health hardware related maintenance items such as lack of hot water, missing clothes lines and damaged or unsanitary food preparation surfaces, have been rectified under the HHPP. The program is now being extended to two additional communities during 2024–2026.

Among the participating communities, the HHPP has achieved several key outcomes (Figure 1):

• In partnership with a local health service, the HHPP delivered healthy skin lessons to 308 primary school students and distributed over 300 skin sore packs.
• The practice of hanging and drying towels increased by 34%, helping to reduce bacteria growth associated with skin infections.
• First aid availability in households improved by 53%.

Since the program's inception, overall skin-related presentations at the local health service have decreased by 8%.

Figure 1: Health Questions Survey (initial compared to final engagement), one participating community

Climate Risk and Sustainability

Human health depends on a healthy environment. Globally, the healthcare sector is estimated to contribute 4 to 5% of global greenhouse gas emissions.³ In Australia, it is estimated that the health system contributes 5.3% of national CO₂ emissions.⁴ Climate change also directly impacts health, particularly for vulnerable populations, including many First Nations peoples. Both climate change and severe weather events may trigger the spread of zoonotic diseases, the emergence of new health conditions, and disrupt the health system’s capacity to provide high-quality care.

Queensland Health is working to reduce its environmental impact with initiatives in place that incorporate both climate adaptation and mitigation strategies, including:

• establishing the Office of Hospital Sustainability (OHS) in 2020 to support energy efficiency, emissions reduction, and renewable energy initiatives across Queensland Health, including installation of solar power and energy saving upgrades to lighting, heating, ventilation and air conditioning and building management systems
• conducting type 2 energy audits at 50 health facilities across Queensland, providing over 150 energy conservation measures to reduce energy consumption, associated emissions and operational costs, potentially reducing carbon emissions by over 14,000 tonnes per year
• reducing emissions and improving air quality by continuing to transition to electric vehicles (EVs). By the end of January 2025, 825 Queensland Health fleet vehicles had been replaced with EVs (50% of the 2026 target of 1,642 vehicles)
• developing the Energy and Environmental Management System (EEMS) platform to provide a robust, scalable, and reliable data management solution integrating Queensland Health’s sustainability and environmental reporting
• establishing the Queensland Health Climate Resilience and Sustainability Taskforce executive leadership group to strategically lead and implement the Queensland Health Climate Action Plan 2025–2030, including system-wide climate resilience and sustainability strategies built upon the Queensland Health Climate Risk Strategy 2021–2026.

Queensland Health’s commitment to climate action will help ensure the ongoing provision of high-quality healthcare services, while minimising the environmental impacts of our operations.

Sewage spills

Waste material that is flushed down toilets, sinks and domestic drains is transferred via pipelines and pumps, thanks to community sewerage systems. From time to time, these systems can become overburdened and overflow in response to heavy rainfall or due to damage or failure of sewerage infrastructure. Larger spills, with greater potential to impact public health are less common, and their public health impacts can be difficult to measure.

Sewage spills can have adverse impacts on humans as well as the environment by:

• spreading harmful chemicals and microorganisms
• increasing the risk of direct contact between sewage and people, animals and plants
• potentially increasing levels of harmful bacteria and chemical contaminants, such as heavy metals, in seafood and making it unsuitable for human consumption.

In April 2024, Queensland Health was notified of a major sewage spill, thought to be the largest in Queensland’s history, into the Albert River on the Gold Coast. The Albert River, and nearby Logan River, are used for fishing and other recreational activities. Over three months, an estimated 450 megalitres (equivalent to 180 Olympic-sized swimming pools) of sewage was released before the fault was detected and repaired. Local businesses, such as prawn farms, were impacted and requested to not sell potentially contaminated food products until a public health risk assessment was completed.

To assess the impact of the spill on public health required a close partnership between:

• Queensland Health, including the Gold Coast Public Health Unit
• The Department of the Environment, Tourism, Science and Innovation
• Safe Food Production Queensland
• The City of Gold Coast.

Queensland Health tested and assessed test results of water, seafood from impacted prawn farms, and seafood from the Albert and Logan Rivers for chemical and microbial contamination. After the sewage leak was repaired, testing showed that:

• the Albert and Logan Rivers were suitable for the usual recreational water activities practised in the area
• seafood caught in the rivers or from local prawn farms did not contain levels of metal contaminants above the Australia New Zealand Food Standards Code or exceed health-based guidance values for per- and polyfluoroalkyl substances (PFAS)
• trace contaminant levels in fish were consistent with historical findings for fish caught in southeast Queensland estuaries.

Fortunately, despite the relatively high volumes of sewage released to the environment, no ongoing risks to public health were found. It is likely that water from upstream flows and tidal movements diluted and mitigated the spill’s impact. Mobile aquatic life, such as fish and prawns, were also probably able to move away from areas significantly impacted by the spill, avoiding any mass fish kills.

Additional information

Section technical notes

Health Questions Survey questions in Figure 1 have been modified for better display in a graphical format.

Figures on this page are interactive

To learn more about how to navigate interactive figures, dashboards, and visualisations see About this Report.