Background The project aims to develop and set up a methodological tool for land-use development and planning, taking into account the possible health implications of any decisions taken. The proposed tool consists of a “Health Impact Assessment” (HIA) procedure and will be developed by examining a ‘real life’ case study: a waste-to-energy plant planned for the neighbourhood of Florence. The project will assess the positive and negative effects on the health of the local population of such an activity and will seek to find solutions to any negative impacts. The study’s main objective will be the development of a sound and rigorous scientific methodology that could become a useful tool for future land-use development and planning. Objectives The project’s main objective was to show any negative or positive impact on the health of a population of a proposed waste-to-energy plant in an urban environment. Other objectives were to: • Support local authorities in achieving local public health targets and to point the way towards more “healthier” decision-making at a local or regional level. • Improve any action needed to mitigate any possible health implications. • Encourage acceptance of the new plant installation. • Demonstrate that HIA can be a suitable tool to aid decision-making. Results 1. The project fully met its main objective of developing an innovative HIA methodology - sound and rigorously scientific - integrated with other land-use development and planning tools, such as urban planning, transport planning, industrial activities development planning, land-use integrated planning, waste management planning, air monitoring and air-quality planning. The principle idea was not to create an additional planning tool, but to elaborate on an integrated analysis platform in order to summarise and harmonise the bulk of environmental data and indicators provided by the various existing planning tools. 2. As envisaged the methodology was tested on a ‘real-life’ case study: a waste-to-energy plant planned for the neighbourhood of Florence. The basic tasks allowed the collection and the framing within GIS (Geographic Information Systems) the detailed current and future description of the area involved, as well as of the process to be inserted in the area. This data included geo-morphologic, meteorological, natural and land-use characteristics. It also analysed resource use and emission releases (solid, liquid and gaseous); and in terms of population, considered density, age, sex, health status and behavioural patterns. 3. The project core tasks enabled a prognosis of future pollution – using diffusion models, dispersion pattern models of chemicals and physical agents from the point sources in the various environmental media and considering the food chain – and the prognosis of health impact – including qualitative assessment of changes to area features and quality-of-life and quantitative evaluation for agents responsible of health risks. The tool offered the possibility of assessing the effects of counteractions to balance the possible negative effects due to the introduction of the new plant. 4. To summarise, the overall outcome of this application was the recommendation of an alternative location (Case Passerini) to the one originally planned at Osmannoro. The former site showed a number of advantages over the location originally planned, in terms of health conditions, of a lower impact on the population, and of improved traffic flows. The tool highlighted the dramatic effects of inserting a belt of green areas to compensate for the negative effects due to the new plant.