Environmental Geochemistry & Atmospheric Research Group, Institute of Environmental Assessment & Water Research, Barcelona, Spain

Health effects of desert dust and sand storms X. Querol, A. Tobías, A. Karanasiou, F. Amato, A. Alastuey, M. Stafoggia

First Global Conference on Air Pollution and Health: Improving Air Quality, Combatting Climate Change – Saving Lives Geneva, 30th October to 1st November 2018

Department of Epidemiology, Lazio Regional Health Service, Rome, Italy

• Transport of dust and duration

http://idaea.csic.es/egar 2

• Dust sources, areas and emission

Ginoux et al., Rev Geophys 2012

Global mineral dust aerosols: 1.2-1.8 Giga(109)-tons North Africa 790-840 Mt/yr Gobi 140-220 Mt/yr Central Asia 10- 60 Mt/yr Eastern Australia 10- 60 Mt/yr Atacama and South Africa 10- 60 Mt/yr Southern US-Northen Mexico 2- 60 Mt/yr (Prospero, Rev Geophys 2002; Ginoux et al., Rev Geophys 2012; Huneeus et al., Atmos Chem Phys 2011; Washington et al., Ann Assoc Am Geogr 2003; Ginoux et al., J Geophys Res Atmos 2010; Varga, Hungarian Geogr Bull 2012)

Jun-Oct

Feb-May

Modified from Griffin, Clin Microbiol Rev 2007

Atmospheric life time, hours-2 weeks Duration, hours to several weeks

• PM levels and size

(Goudie, Environ Int 2014)

Worldwide Median dust-mass size 9±2 µm (5 to 13±1.5 to 2 µm) (Reid et al., J Geophys Res 2003)

0

10

20

30

40

50

60

70

10 100 1000 10000

PM2.

5/PM

10 (%

)

PM2.5 (µg/m3)

Rationale: Dust is a major contributor to ambient PM

http://idaea.csic.es/egar 3

Silicates &

aluminium-

silicates

Silicates Quartz SiO2 (mineral grains or diatomea fragments) *****

Clay minerals

Kaolinite Al2Si2O5(OH)4 **** Illite (K,H3O)(Al,Mg,Fe)2(Si,Al)4O10[(OH)2,(H2O)] **** Chlorite ((MgFe)5Al)(AlSi3)O10(OH)8 *** Palygorskite (Mg,Al)2Si4O10(OH)·4(H2O) *** Montmorillonite (Na,Ca)0.33(Al,Mg)2(Si4O10)(OH)2·nH2O ***

Feldspars Albite NaAlSi3O8 ** Anorthite CaAl2Si2O8 ** Microcline/orthocl. ‎KAlSi3O8 **

Other silicate Zircon ZrSiO4 * Hornblende Ca2(Mg,Fe,Al)5(Al, Si)8O22(OH)2 *

Carbonates Ca &Mg

Carb.

Calcite CaCO3 ****

Dolomite (CaMg)2CO3 **

Oxides Iron oxides Hematite Fe2O3 ** Magnetite Fe3O4 * Goethite α-FeO(OH) **

Other oxides Anatase & rutile TiO2 *

Salts

Chlorides Halite NaCl *

Sulphates Gypsum CaSO4.2H2O ** Thenardite Na2SO4 * Epsomite MgSO4 *

Phosphates Apatite ‎Ca5(PO4)3(F,Cl,OH) *

Desert dust mineralogy Querol et al., 2018. In prep African dust days Barcelona, 2009-2016

• Is only mineral matter that matters in dust outbreaks?

1. Mineral dust 2. Anthropogenic load 2.1. Co-emitted in the source origin 2.2. Co-transported with dust (i.e., China pollution + dust to Japan) 2.3. Interaction of dust with receptor pollution 2.4. Concentration local pollution by low thickness of PBL 3. Bio-aerosols

µg/m

3

µg/m

3

0

1

2

3

4

5

6

NA NWA SWA NAF MED EU REG WAE

UB

RB

CB

PM10 nss SO42-

0

1

2

3

4

5

6

NA NWA SWA NAF MED EU REG WAE

UB

RB

CB

PM1 nss SO42-

Rationale: What part of PM matters during dust events?

µg/m

3

µg/m

3

0

2

4

6

8

10

12

14

16

18

OM nss SO42- Mineral SIA

UB

RB

CB

PM10 ADO days

0

2

4

6

8

10

12

14

16

18

OM nss SO42- Mineral SIA

UB

RB

CB

PM10 Non-ADO days

0

2

4

6

8

10

12

14ADO Non-ADO

UBi

UBTi

RBi

RBTi

EFiUB/RB =

• What should be monitored in dust events to evaluate health effects? – Dust load of PMx – Anthropogenic load of PMx – Meteorological parameters

• Dust and PM parameters to be used in epidemiological (time-series) studies – PMx – PMx (dust) – PMx (non-dust)

http://idaea.csic.es/egar 4

Rationale: Study designs of epi studies of dust storms

http://idaea.csic.es/egar 5

Objective: A systematic review of the evidence

• To conduct a systematic review of the scientific evidence on the health effects of desert dust and sand storms.*

• To inform the update of the WHO Global Air Quality Guidelines (AQGs)**

Coordinated by: *WHO headquarters in Geneva (Switzerland) **WHO Regional Office’s European Centre for Environment and Health (ECEH) in Bonn (Germany)

http://idaea.csic.es/egar 6

• By geographical area – 33 Eastern Asia, 17 Europe, 5 Middle East, 10 others no in

Africa

• By design – 58 in single city/area, 7 multicentre studies – 27 time-series, 32 case-crossover, 6 case-series – 50 direct effects, 17 PM effect modification, 4 PM sources

• By identification of dust events – 35 single method, 23 combination of methods, 7 not

reported – Average PM10 on dust days 96 µg/m3 vs. non-dust 46 µg/m3

Studies included: Varied study areas and designs

http://idaea.csic.es/egar 7

Main results: Direct effects

Direct effects= evaluate possible incremented risk in dust days vs non dust days

http://idaea.csic.es/egar 8

3 1.0 (0.2 ,1.8) 0% 2.7 (1.3 , 4.1) 31%

3 3.4 (1.1 , 5.8) 5% 4.6 (3.4 , 5.7) 0%

2 2.1 (-0.1 ,4.2) 0% 9.0 (4.7 , 13.3) 31% 2 -2.4 (-3.9 , -1.0) 0% 14 (8.3 , 19.3) 0% 1 1.1 (-5.9 , 4.6) - 9.1 (7.1 , 11.1) -

Main results: PM effect modification

PM effect modification= evaluate possible incremented risk /increase 10 µg/m3 PM10 for dust days vs non-dust days

• Multicentre study in 5 prefectures in Japan – Larger effects of Asian Dust PM than Total Suspended PM but not different statistically

For each increase 10 µg/m3

• Multicentre study in 13 Southern European cities – Similar effects of African dust PM10 and non-desert PM10

For each increase 10 µg/m3

• Study in Barcelona – Larger effects on cardiovascular mortality of the local contribution to PM10 on

dust days than non-dust PM10 days, and than Saharan contribution to PM10

http://idaea.csic.es/egar 9

Main results: Effect Modification dust and anthropogenic PM Evaluating independently PM-dust vs PM-anthropogenic

increased risk/10 µg/m3 PM10 for dust days vs non-dust days

Asian dust TSPM Mortality cause RR RR All heart disease 0.6% -0.2% Ischemic heart disea. 0.8% -0.8% Arrhythmia 2.1% -2.9%

African dust PM10 Non-desert PM10 Mortality cause RR RR All cause 0.7% 0.6% Cardiovascular 1.1% 0.5% Respiratory 1.3% 2.1%

Dust days Non-dust days Local PM10 Dust PM10 Local PM10 Mortality cause RR RR RR Cardivascular 9.7% 4.0% 2.8%

• Inconsistent study designs in terms of geographical area and methods to assess the health effects of dust

• Overall, direct effects of dust (mainly conducted in Eastern Asia) and dust as effect modifier (in Europe) show an increase of risk for cardiovascular mortality and for respiratory and child asthma morbidity

• Studies considering independently effects of dust PM and anthropogenic PM (during and out of dust outbreaks) show different effects in Eastern Asia and Europe

http://idaea.csic.es/egar 10

Conclusions

http://idaea.csic.es/egar 11

What is needed to move forward?

• Development and design of common epidemiological study protocols to understand the effects of dust both independently and as a modifier of anthropogenic PM

• Studies in Africa and other regions • Dust monitoring systems should be developed and

used: – To alert the most sensitive populations – To take appropriate measures to reduce local emissions of

[anthropogenic] air pollutants – And to apply methods to abate resuspension after intensive

episodes (e.g. street washing.

Acknowledgements

• This systematic review has been funded by the World Health Organization, supported by the Ministry of Foreign Affairs of Norway. Thanks to Dr. F. Forastiere and Dr. Katherine Walker for their constructive comments and suggestions

http://idaea.csic.es/egar 12

Thank you very much for your attention!!!! xavier.querol@idaea.csic.es