A wide range of research activities have been undertaken in European seas over the last 150 years. Many have been, and continue to be, under the auspices of regional organisations. In general, whenever human health has been considered, it is usually as a sub-component of a much larger research endeavour.
Around 150 million people live along the 46,000 km of Mediterranean coastline, with an additional 200 million tourists visiting the region each year. Their impact is added to by more than 200 petrochemical and energy installations, chemical industries and chlorine plants located along the Mediterranean coast . Concerns about the decline in the quality of the Mediterranean Sea led the United Nations Environment Programme (UNEP) to introduce the Protocol for the Protection of the Mediterranean Sea against Pollution from Land-Based Sources and Activities (1980, amended in 1996) and the Dumping and Hazardous Wastes Protocols. The marine pollution assessment and control component of the Mediterranean Action Plan, the MED POL Programme , undertakes follow-up work. It assists Mediterranean countries in the formulation and implementation of pollution-monitoring programmes, including pollution control measures, and the drafting of action plans aimed at eliminating pollution from land-based sources.
Pollution of the Mediterranean arises in large part due to municipal wastewater treatment and disposal, urban solid waste disposal activities, contributions from atmospheric deposition, release of harmful concentrations of nutrients into the marine environment and storage, transportation and disposal of radioactive and hazardous waste and as a result of the destruction of the coastline and coastal habitats. The preparation and adoption by the Contracting Parties of the Barcelona Convention (2005) of a Strategic Action Programme (SAP MED) of regional and national activities to address land-based pollution is one of the major breakthroughs in the Mediterranean countries' coordinated efforts to combat land-based pollution. It is implied that this, in turn, will reduce risks to human health and the environment.
Another organisation that was one of the earliest to consider “Oceans and Human Health” issues in Europe is the Mediterranean Science Commission (CIESM) . The commission, with members from 22 Mediterranean countries, incorporates a number of different marine-related disciplines involving the biological processes, hydrography, marine geophysics and chemistry of the Mediterranean Sea, as well as tracking and analysing the impacts of climate change on sea levels and water masses, and changes in marine biodiversity, coastal morphology and bioaccumulation of trace metals in marine organisms. In September 2006, CIESM took the unprecedented step of organising a workshop looking at the relationship between the marine sciences and public health. The monograph that emerged following the event covered a wide range of topics including pollutant toxicity and biomarkers, pathogens and pharmaceuticals in the sea, and climate change and remote sensing, all in the context of potential threats to public health [16, 17].
Elsewhere, northern European countries have demonstrated interest in the impacts of the marine environment on human health. The Helsinki Commission (HELCOM)  was established in 1992 following the signing of the Helsinki Convention to protect the Baltic Sea from pollution and is made up of member countries surrounding the Baltic Sea. The aim of HELCOM is to ensure that the Baltic Sea has a healthy marine environment and good ecological status, and is rich in biodiversity. It is hoped that this will then support a wide variety of sustainable economic and social activities within the Baltic Sea. Although not specifically targeting human health, reducing pollution clearly has health benefits. HELCOM has been involved with the reduction of point source discharges of organic pollutants and nutrients, improved treatment of wastewaters resulting in fewer beach closures and restricting or prohibiting the use of hazardous compounds such as dioxins, furans, PCBs and DDT.
Alongside the work of HELCOM, the EU BONUS programme  was created to unite marine science with maritime and socio-economic research to address the problem of pollution within the Baltic Sea. The interdisciplinary approach used by BONUS has given rise to a wide range of initiatives including sustainable development research and the creation of policies and regulations to improve the Baltic Sea region . As with HELCOM, BONUS is not primarily aimed at protecting human health, but this is a more general ambition of the programme.
Perhaps of all the European seas, the condition of the Black Sea has given rise to most concern with regard to human health. Extensive contamination with chemical pollutants and microbial pathogens (including Vibrio cholerae) has provided incontrovertible evidence of the causal links between marine ecosystem quality and human health . The Black Sea Environment Programme was established in 1991 and initiated in June 1993 under the leadership of the United Nations Development Programme, but with the close involvement of the World Bank and UNEP. A series of reports and publications summarise progress; a milestone was the Black Sea Pollution Assessment (1998) .
Beyond the examples provided above, the overarching responsibility for the marine environment of Europe lies with the European Environment Agency (EEA) . The regulation establishing the EEA was adopted by the European Union in 1990. It came into force in late 1993 immediately after the decision was taken to locate the EEA in Copenhagen. Work started in earnest in 1994. Its aim was to provide sound, independent information on the environment. It is a major information source for those involved in developing, adopting, implementing and evaluating environmental policy, and also for the general public. Currently, the EEA has 32 member countries. Its primary remit is environmental protection, but it has also highlighted the fact that a clean environment is essential for human health and well-being. Nevertheless, it has not delved specifically into oceans and human health issues to date. Its strategy has been to employ the “Precautionary Principle” in cases where health impacts might arise due to poor water quality and insufficient sanitation.