The extraction of coal seam gas (CSG) produces large volumes of potentially contaminated water. It has raised concerns about the environmental health impacts of the co-produced CSG water. In this paper, we review CSG water contaminants and their potential health effects in the context of exposure pathways in Queensland's CSG basins. The hazardous substances associated with CSG water in Queensland include fluoride, boron, lead and benzene. The exposure pathways for CSG water are (1) water used for municipal purposes; (2) recreational water activities in rivers; (3) occupational exposures; (4) water extracted from contaminated aquifers; and (5) indirect exposure through the food chain. We recommend mapping of exposure pathways into communities in CSG regions to determine the potentially exposed populations in Queensland. Future efforts to monitor chemicals of concern and consolidate them into a central database will build the necessary capability to undertake a much needed environmental health impact assessment.

Climate-related health indicators are potentially useful for tracking and predicting the adverse public health effects of climate change, identifying vulnerable populations, and monitoring interventions. However, there is a need to understand stakeholders’ perspectives on the identification, development, and utility of such indicators. A qualitative approach was used, comprising semi-structured interviews with key informants and service providers from government and non-government stakeholder organizations in South Australia. Stakeholders saw a need for indicators that could enable the monitoring of health impacts and time trends, vulnerability to climate change, and those which could also be used as communication tools. Four key criteria for utility were identified, namely robust and credible indicators, specificity, data availability, and being able to be spatially represented. The variability of risk factors in different regions, lack of resources, and data and methodological issues were identified as the main barriers to indicator development. This study demonstrates a high level of stakeholder awareness of the health impacts of climate change, and the need for indicators that can inform policy makers regarding interventions.

There is a growing need to develop health-related indicators for climate change to assist in policy, planning, and evaluation of preventive measures. To date, no environmental health indicators of climate change have been developed specifically for Australia. We conducted a review of the Australian literature relevant to climate change health impacts to find out which exposure-response relationships could be readily used as indicators. The bulk of the literature relates to direct health-related outcomes of extreme heat, and indirect outcomes associated with air pollution and infectious disease agents. Based on this information, evidence-based indicators were chosen using the modified Driving force-Pressure-State-Exposure-Effect-Action framework. Three groups of health outcome indicators are proposed: direct heat related, air pollution related, and climate-sensitive infectious diseases. Indicators of human vulnerability to these outcomes are also included. The potential usefulness of and barriers to their use are discussed in the context of relevance for policy makers.

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