The health impact assessment calculator is easy to use and does not require any special training. However, users should familiarize themselves with the instructions for use.

The calculator can be informative in supporting decisions related to urban environment development policies and strategies, as well as raising awareness of the health impacts of the urban environment. It allows the burden of a disease or health condition associated with exposure to a particular factor (exposure) in the urban environment to be determined. This burden is calculated as the absolute number of cases, the number of cases per 100 000 population, and the percentage of cases of a given outcome (disease) that can be linked to a given level of exposure. Although it is not possible to determine exactly which individuals will be affected, the method gives an idea of what proportion of the registered cases of the disease in the population can be assumed to be attributable to the impact of the factor in question.

The results are indicative and should not be used as the sole basis for regulatory, policy, or clinical decisions. The calculator does not calculate the effect on the health of individuals, but provides an average estimate for the entire population. The developers are not responsible for the consequences of using or interpreting the results.

Urban environmental factors that users can choose from may be both health risks, such as air pollution and noise pollution, and protective factors, such as the presence of green spaces. Almost all of the risk coefficients are taken from scientific literature and a synthesis of the results of numerous studies, but some preliminary results from the current project are also included, marked with “(BG)” after the type of disease in the drop-down list.

After downloading the file, make sure that the use of embedded macros is not blocked on your computer.

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Limitations of the calculator

• For the time being, users can choose from a limited number of combinations of exposure and disease. Their selection is dictated by the scope of the project and the availability of scientific evidence of a causal link with health risk. In the future, this list will be expanded, and the risk coefficients themselves are likely to change due to advances in scientific research and the emergence of new and more precise evidence. The focus is on some of the best-studied characteristics of the urban environment, but at present the impact of drinking water and bathing water pollution, other chemical environmental factors, behavioral or social factors are not included.

• The impact of exposures is calculated separately, without taking into account the potential combined impact of multiple factors or interactions between them.

• The calculations are also based on the assumption of a closed and unchanging population over time in the various scenarios compared, without taking into account potential population movements, changes in health status, life expectancy, and behavior resulting from changes in environmental conditions. In this sense, the health impact assessment can be considered a basic snapshot, as there are more optimal approaches for a comprehensive assessment of different scenarios for urban development.

• In its current version, the calculator does not calculate economic indicators that translate the calculated health impact to a financial equivalent or other health burden indicators. Such functionality could be added in a future version of the calculator.

• When determining the uncertainty interval for the calculated health indicators, only the uncertainty associated with the risk coefficient is taken into account, but not that associated with the exposure assessment or other assumptions. Although it is possible to add additional functionality to account for other sources of uncertainty, this would not typically result in a significant change in the uncertainty intervals, but would complicate the user’s input of parameters.

Copyright

Extracts from the calculator may be freely viewed, reproduced, or translated for research, professional, or personal purposes, but not for sale or commercial use. Any use of the calculator and its results must be accompanied by a reference to the source of information and the project that funded the generation of the data.

Suggested citation of the calculator: Dzhambov AM, Burov A, Markevych I, Helbich M, Dimitrova D, Nieuwenhuijsen MJ. (2026). Health Impact Assessment Calculator (Version 1) [Excel file]. Strategic Research and Innovation Program for Development of the Medical University - Plovdiv.

Contact the project team for further information on the calculation algorithm used in the calculator, as well as for assistance in conducting an extended health impact assessment upon request.

Disclaimer

This health impact assessment calculator is provided as is for informational purposes. The results are indicative and based on available data, models, and assumptions that carry uncertainty. They should not be used as the sole basis for regulatory, policy, or clinical decisions. The calculator does not calculate the health impact on individuals, but provides an average estimate for the entire population. The developers are not responsible for the consequences of using or interpreting the results.

Other tools for assessment of health impacts

• The BEST-COST project (https://best-cost.eu/) develops tools for measuring the health burden and socio-economic cost of environmental factors. The developed “healthiar” package (https://cran.r-project.org/web/packages/healthiar/index.html) for the statistical analysis software R has extended functionality and flexibility in performing quantitative health impact assessmen, but requires skills in statistical analysis.

• AirQ+ is a software tool developed by the World Health Organization for the quantitative assessment of the health consequences and impact of air pollution (https://www.who.int/tools/airq).

• The Health Economic Assessment Tool (HEAT) for walking and cycling (https://www.who.int/tools/heat-for-walking-and-cycling) is a web-based tool developed by the World Health Organization to assess the health and economic consequences of increasing walking and cycling.