Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la...
-
Upload
medi-ambient-generalitat-de-catalunya -
Category
Technology
-
view
515 -
download
0
Transcript of Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la...
Air Quality, Barcelona 17Air Quality, Barcelona 17 --18 June 201018 June 2010
WHO assessments WHO assessments of health effects of health effects of air pollutionof air pollution
Michal Krzyzanowski, Sc.D .European Centre for Environment and Health, Bonn Office
World Health Organization, Regional Office for Europe
Air quality and health Air quality and health –– WHO assessmentWHO assessment
This presentation:
• WHO assessments of health effects of air pollution
• Air quality in Europe and related health effects
• Recent research results
WHO assessments of health risks WHO assessments of health risks of air pollution of air pollution
• Health effects of transport-related air pollution (WHO 2005)
• WHO Air quality guidelines – global update 2005 (WHO 2006)
• Health risk of particulate matter from LRTAP (WHO 2006)
• Health risk of ozone from LRTAP (WHO 2008)
• Annual reports on health effects of AP presented to CLRTAP (http://www.unece.org/env/lrtap/lrtap_h1.htm )
WHO AQG: Global update: WHO AQG: Global update: Summary of updated AQG valuesSummary of updated AQG values
20 µg/m3
500 µg/m324 hour10 minute
Sulfur dioxide, SO 2
40 µg/m3
200 µg/m31 year1 hour
Nitrogen dioxide, NO 2
100 µg/m38 hour, daily maximumOzone, O 3
10 µg/m3
25 µg/m3
20 µg/m3
50 µg/m3
1 year24 hour (99th percentile)
1 year24 hour (99th percentile)
Particulate matterPM2.5
PM10
AQG valueAveraging timePollutant
AQG levels recommended to be achieved everywhere in order to significantly reduce the adverse health effects of poll ution
WHO AQG: Global update: WHO AQG: Global update: Particulate matter Particulate matter -- annual meanannual mean
Lowest levels at which total, CP and LCA mortality have been shown to increase (Pope et al., 2002). The use of PM2.5guideline is preferred.
1020Air quality guideline (AQG)
Mortality risk reduced by approximately 6% compared to IT2 levels.
1530Interim target-3 (IT-3)
Risk of premature mortality decreased by approximately 6% compared to IT1
2550Interim target-2 (IT-2)
Levels associated with about 15% higher long-term mortality than at AQG
3570Interim target-1 (IT-1)
Basis for the selected levelPM2.5(µg/m 3)
PM10(µg/m 3)
Annual mean level
PassingPassing interim interim targetstargets on on thethe way way towardstowardsAQG AQG
Exposure
Effect
AQG IT-2 IT-1
Long term exposure to PM and risk of mortality in AC S cohort (ca. 0.5 million people followed for 16 years)
Source: Pope et al, JAMA 2002
Air quality and health Air quality and health –– WHO assessmentWHO assessment
This presentation:
• WHO assessments of health effects of air pollution
• Air quality in Europe and related health effects
• Recent research results
PM2.5 concentration map, annual average, 2005
Based on the combination of scaled rural and urban PM10 maps using region specific PM2.5/PM10 ratios;
Population weighted mean PM2.5:
EU27: 16.6 – 17.0 µg/m3Spain: 16.1 – 17.6 µg/m3
Source: F. De Leeuw, J. Horalek, ETC/ACC, 2009
PM10 annual mean 1999-2008
all stations<-6 %/yr
-6 - -3 %/yr
-3 - 0 %/yr
> 0 %/yr
source: ETC/ACC-AIRBASE February -2010
PM10trend(%/yr)1999-2008
PM10 annual mean
0
10
20
30
40
50
1998 2000 2002 2004 2006 2008
urban traffic rural
Source: F. de Leeuw, ETC ACC
PM10 – annual mean
PM10 concentration in Spanish cities (urban background)
0
10
20
30
40
50
60
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007
Madrid
Barcelona
Sevilla
Zaragoza
Málaga
Palma de Mallorca
Vitoria/Gasteiz
Oviedo
Pamplona/Iruña
Santander
Toledo
Badajoz
Bilbao
Córdoba
Granada
Móstoles
Jerez de la Frontera
San Sebastián/Donostia
Burgos
Salamanca
Albacete
Jaén
Marbella
Torrejón de Ardoz
Source: Airbase
Effect indicator:Premature mortality attributable to PM2.5 (2005)
Source: F. De Leeuw, J. Horalek, ETC/ACC, 2009
Total: 492,000 premature deaths per year; 4892,000 YLL
Spain:Spain:373,100 YLL373,100 YLL
HealthHealth --relevant indicator of ozone levels relevant indicator of ozone levels (SOMO35) in 2000 and expected in 2020(SOMO35) in 2000 and expected in 2020
2000
Source: CAFE 2004
2020
Number of deaths attributed to O3 exposure in Number of deaths attributed to O3 exposure in EU25EU25
0
1000
2000
3000
4000
5000
Aus
tria
Bel
gium
Den
mar
k
Fin
land
Fra
nce
Ger
man
y
Gre
ece
Irel
and
Italy
Luxe
mbo
urg
Net
herla
nds
Por
tuga
l
Spa
in
Sw
eden UK
Cze
ch R
ep.
Est
onia
Hun
gary
Latv
ia
Lith
uani
a
Pol
and
Slo
vaki
a
Slo
veni
a
2000 2010 2020
Source: CAFE 2004
Ozone Ozone levelslevels in urban in urban backgroundbackground locationslocations of of selectedselected countriescountries , 1997 , 1997 -- 20072007
Source: AirBase
Note: all countries average based on data from varying number ofcities & countries (223 cities in 27 countries in 2008)
0
2000
4000
6000
8000
10000
12000
14000
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
SO
MO
35 u
g/m
3 *
day
sall countries
AT
BE
CH
CZ
DE
ES
NL
PL
SI
SK
GB
Air quality and health Air quality and health –– WHO assessmentWHO assessment
This presentation:
• WHO assessments of health effects of air pollution
• Air quality in Europe and related health effects
• Recent research results
RR for deaths for all causes RR for deaths for all causes per 10 per 10 µµg/m3 annual mean PM10g/m3 annual mean PM10
Health impacts of ozone –an update of evidence
Jerrett et al, NEJM 2009
Exposure-response curve for relation between long term O3 exposure and risk of death due to respiratory causes. Results of analysis of ACS cohort of 448,000 adults followed for up to 18 years
RR per 10 ppb = 1.040 (95% CI 1.010 - 1.067)(2-pollutant model with O3 and PM2.5)
Exposure to air pollution and infections, asthmatic and Exposure to air pollution and infections, asthmatic and allergic symptoms at 4 years old childrenallergic symptoms at 4 years old children
Birth cohort study of ca. 4,000 children in Netherlands. Exposure to traffic-related air pollution based on validated models.
Source: Brauer, Hoek et al, ERJ 2007
32*45*55*Allergen sensitivity (lab tests in sub-group)
1418*21*Doctor diag. flu / cold
17*15*13Ear / nose / throat infections
-10-10-22Doctor diag. bronchitis
111311Dry cough at night
121515Doctor diagnosed asthma
131823*Wheeze
NO2SootPM2.5
% change in risk (per inter-quartile range)
* p<0.05
Association between incident asthma with NO2*) as a n Association between incident asthma with NO2*) as a n indicator of trafficindicator of traffic --related air pollutionrelated air pollution
*) Effect estimates are over a 6.2-ppb (12.4 µg/m3) exposure contrast
10-18 years old children followed for 8 years in S. California.
Source: Jerrett EHP 2008
Respiratory effects of exposure to diesel traffic: Respiratory effects of exposure to diesel traffic: randomized study of 60 adults with asthma in Londonrandomized study of 60 adults with asthma in London
Mean % changes during and after 2 h walk on Oxford street and Hyde Park
McCreanor et al, NEJM 2007
Ischemic and thrombotic effects of dilute diesel Ischemic and thrombotic effects of dilute diesel exhaust inhalation in men with coronary heart disea seexhaust inhalation in men with coronary heart disea se
p<0.001
Myocardial inchemia during 15-minute intervals of exercise-induced stress and exposure to diesel exhaust or filtered air in the 20 subjects
Mills et al, NEJM 2007
Reduction of PM exposure and increase of life expectancy in the US
Fine particulate air pollution and life expectancy in the United States ( Pope AC et al, NEJM 2009): A decrease of 10 µg/m3 of PM2.5 associated with increase of life expectancy by 0.61 years between 1980 and 2000
Reduction in PM accounts for 15% of overall increas e in life expectancy
Potential reduction in YLL for two scenarios for PM2.5 reduction: LV compliance and AEI-reduction target
Source: F. De Leeuw, J. Horalek, ETC/ACC, 2009
ConclusionsConclusions
• Large and still growing body of evidence on adverse health effects of air pollution (PM2.5, PM10, ozone)
• Impacts of air pollution cause loss of life expectancy by ca. 8.8 months in Europe (half a year in Spain) and contribute to morbidity of adults and children
• Slight decrease in PM10 levels in urban areas in 2007-8 after several years of no decrease in most countries of Europe – no clear trends in Spanish cities
• Constant or growing (with exception of 2003 peak) O3 levels
• Population exposure reduction – recommended strategy for Europe