At the end of the nineties in public health in Europe and the USA a new term Health Impact Assessment (HIA) was introduced. Since time immemorial preven- tive medicine has been investigating evaluating and solving negative impact of the environment and society on health. With regard to different views on HIA in different countries and with regard to article 152 of the Amsterdam treaty in 1999 in Gothenburg views on HIA were unified and a strategic document was elabora- ted. This document is discussed and commented in relation to conditions in this country and the position of the hygiene service and teaching at medical faculties. The authors discuss the problemof teaching at medical faculties in relation to the contemporary needs of the hygiene service in the Czech Republic. Possibilities of applying act no. 258/2000 in the process of HIA are discussed as well as limitations of this act in the comprehensive concept of influences on health which is under way, similarly as EIA (Environmental Health Assessment) in Europe. A document of WHO/EURO is being elaborated to incorporate the HIA process into the SEA process (Strategic Environmental Assessment) consistent with the recommenda- tions of the London Ministerial Conference on Environmental andHealth). During the agenda on SEA it was found the „health“ must be conceived as part of the „environment“ and thus impacts of human activities on the environment cannot beevaluatedwhileomitting impacts onhealth. HIAis closelylinkedwith„evidence based medicine“, i. e. medicine based on proved relations between factor and effect.

        Key words: health impact assessment - hygiene service - impact on health