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Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)
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Michal Kryzanowski - (Valoracions de l’OMS dels impactes de la contaminació de l’aire sobre la salut a Europa)

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  • 1. Air Quality, Barcelona 17-18 June 2010 WHO assessments of health effects of air pollution Michal Krzyzanowski, Sc.D. European Centre for Environment and Health, Bonn Office World Health Organization, Regional Office for Europe
  • 2. Air quality and health – WHO assessment This presentation: • WHO assessments of health effects of air pollution • Air quality in Europe and related health effects • Recent research results
  • 3. WHO assessments of health risks 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 )
  • 4. WHO AQG: Global update: Summary of updated AQG values AQG levels recommended to be achieved everywhere in order to significantly reduce the adverse health effects of pollution Pollutant Averaging time AQG value Particulate matter PM2.5 1 year 10 µg/m3 24 hour (99th percentile) 25 µg/m3 PM10 1 year 20 µg/m3 24 hour (99th percentile) 50 µg/m3 Ozone, O3 8 hour, daily maximum 100 µg/m3 Nitrogen dioxide, NO2 1 year 40 µg/m3 1 hour 200 µg/m3 Sulfur dioxide, SO2 24 hour 20 µg/m3 10 minute 500 µg/m3
  • 5. WHO AQG: Global update: Particulate matter - annual mean Annual mean PM10 PM2.5 Basis for the selected level level (µg/m3) (µg/m3) Interim target-1 70 35 Levels associated with about (IT-1) 15% higher long-term mortality than at AQG Interim target-2 50 25 Risk of premature mortality (IT-2) decreased by approximately 6% compared to IT1 Interim target-3 30 15 Mortality risk reduced by (IT-3) approximately 6% compared to IT2 levels. Air quality 20 10 Lowest levels at which total, CP guideline and LCA mortality have been (AQG) shown to increase (Pope et al., 2002). The use of PM2.5 guideline is preferred.
  • 6. Passing interim targets on the way towards AQG Effect Exposure AQG IT-2 IT-1
  • 7. Long term exposure to PM and risk of mortality in ACS cohort (ca. 0.5 million people followed for 16 years) Source: Pope et al, JAMA 2002
  • 8. Air quality and health – WHO assessment This presentation: • WHO assessments of health effects of air pollution • Air quality in Europe and related health effects • Recent research results
  • 9. 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/m3 Spain: 16.1 – 17.6 µg/m3 Source: F. De Leeuw, J. Horalek, ETC/ACC, 2009
  • 10. PM10 annual mean 1999-2008 PM10 trend(%/yr) 1999-2008 all stations <-6 %/yr -6 - -3 %/yr -3 - 0 %/yr PM10PM10 – annual mean annual mean urban traffic rural > 0 %/yr 50 40 30 20 10 0 source: ETC/ACC-AIRBASE February -2010 1998 2000 2002 2004 2006 2008 Source: F. de Leeuw, ETC ACC
  • 11. PM10 concentration in Spanish cities (urban background) Madrid 60 Barcelona Sevilla Zaragoza 50 Málaga Palma de Mallorca Vitoria/Gasteiz Oviedo 40 Pamplona/Iruña Santander Toledo 30 Badajoz Bilbao Córdoba Granada 20 Móstoles Jerez de la Frontera San Sebastián/Donostia 10 Burgos Salamanca Albacete 0 Jaén 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 Marbella Torrejón de Ardoz Source: Airbase
  • 12. Effect indicator: Premature mortality attributable to PM2.5 (2005) Total: 492,000 premature deaths per year; 4892,000 YLL Spain: 373,100 YLL Source: F. De Leeuw, J. Horalek, ETC/ACC, 2009
  • 13. Health-relevant indicator of ozone levels (SOMO35) in 2000 and expected in 2020 2000 2020 Source: CAFE 2004
  • 14. 0 1000 2000 3000 4000 5000 Austria EU25 Belgium Denmark Finland France Germany Greece Ireland Italy Luxembourg Netherlands 2000 Portugal Spain 2010 Sweden UK 2020 Czech Rep. Estonia Hungary Latvia Lithuania Poland Slovakia Slovenia Source: CAFE 2004 Number of deaths attributed to O3 exposure in
  • 15. Ozone levels in urban background locations of selected countries, 1997 - 2007 14000 all countries 12000 AT S O M O 3 5 u g /m 3 * d a y s BE 10000 CH 8000 CZ DE 6000 ES 4000 NL 2000 PL SI 0 SK 97 98 99 00 01 02 03 04 05 06 07 GB 19 19 19 20 20 20 20 20 20 20 20 Source: AirBase Note: all countries average based on data from varying number of cities & countries (223 cities in 27 countries in 2008)
  • 16. Air quality and health – WHO assessment This presentation: • WHO assessments of health effects of air pollution • Air quality in Europe and related health effects • Recent research results
  • 17. RR for deaths for all causes per 10 µg/m3 annual mean PM10
  • 18. Health impacts of ozone – an update of evidence 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) Jerrett et al, NEJM 2009
  • 19. Exposure to air pollution and infections, asthmatic and allergic 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. % change in risk (per inter-quartile range) PM2.5 Soot NO2 Wheeze 23* 18 13 Doctor diagnosed asthma 15 15 12 Dry cough at night 11 13 11 Doctor diag. bronchitis -22 -10 -10 Ear / nose / throat 13 15* 17* infections Doctor diag. flu / cold 21* 18* 14 Allergen sensitivity (lab 55* 45* 32* tests in sub-group) * p<0.05 Source: Brauer, Hoek et al, ERJ 2007
  • 20. Association between incident asthma with NO2*) as an indicator of traffic-related air pollution 10-18 years old children followed for 8 years in S. California. *) Effect estimates are over a 6.2-ppb (12.4 µg/m3) exposure contrast Source: Jerrett EHP 2008
  • 21. Respiratory effects of exposure to diesel traffic: randomized 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
  • 22. Ischemic and thrombotic effects of dilute diesel exhaust inhalation in men with coronary heart disease Myocardial inchemia during 15-minute intervals of exercise-induced stress and exposure to diesel exhaust or filtered air in the 20 subjects p<0.001 Mills et al, NEJM 2007
  • 23. 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 increase in life expectancy
  • 24. 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
  • 25. Conclusions • 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

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