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Both the state department of environmental protection

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raised health concerns. Both the state Department of Environmental Protection and the driller active in the area are cooperating with the agency[Kinney PL, 2008]. The solutions of the environmental health problems must be approached through group action.
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Stakeholders may be classified in many different ways. Often, the main distinction tends to be between policy-makers and the public[Noji E, Lee CY, 2005]. This, however, ignores the subtle, and often overlapping, roles that stakeholders may play in environmental health issues. Examples of the range of stakeholders who can be involved in specific issues and assessments are as follows. Perpetrators: Individuals or groups who are responsible for generating the events or motivating the changes that ultimately causes the health impacts. Informants: People and organizations who provide information on the issue and its associated consequences (e.g. scientists, monitoring agencies, risk assessors, media). Purveyors: Individuals or groups who may deliberately or accidentally act to transmit the effects through the wider population (e.g. carriers of a disease; distributors of contaminated foodstuffs). Beneficiaries: People and organizations that stand to benefit from the issue, or from its management (e.g. commercial organizations who can sell their services as a result). Managers: People and organizations responsibilities for managing the issue and/or its consequences (e.g. policy-makers, regulators, planners, emergency services, health services). Victims: People and organizations who will be involuntarily affected by the issue (e.g. subject to the risks); usually members of the public. For decision making purposes, the cost effectiveness environmental health interventions are helpful. Most studies express outcomes in terms of cost per case averted cost per death averted and/or cost per DALY averted or QALY gained. However, some studies present other outcomes due to difficulties of estimating health impacts, such as cost per person covered or protected from vectors [Conteh, L., 2004], or per breeding container reduced , or for hygiene education, cost per percent increase in knowledge [Mascie-Taylor, 2003]. One study measures cost and effluent
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