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Jordi Sunyer Deu - (Efectes sobre la salut de la contaminació per trànsit)
 

Jordi Sunyer Deu - (Efectes sobre la salut de la contaminació per trànsit)

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    Jordi Sunyer Deu - (Efectes sobre la salut de la contaminació per trànsit) Jordi Sunyer Deu - (Efectes sobre la salut de la contaminació per trànsit) Presentation Transcript

    • HEALTH EFFECTS OF TRAFFIC AIR POLLUTION: new findings for regulation Jordi Sunyer CREAL June 2010
    • Known adverse effects of airborne particles (PM) on health WHO air quality guidelines - global update 2005 - Mortality and hospital admissions in chronic obstructive pulmonary disease patients - Exacerbation of symptoms and increased use of therapy in asthma - Mortality and hospital admissions in cardiovascular disease patients - Mortality and hospital admissions in diabetes mellitus - Increased risk for myocardial infarction - Lung inflammation - Systemic inflammation - Endothelial and vascular dysfunction - Development of atherosclerosis - Increased incidence of infection - Respiratory cancer
    • Ultrafine particles promote early atherosclerosis and systemic oxidative stress Araujo et al. (Circ Research, 2008)
    • Southern California Association between residential distance to busy roads and childhood asthma 1 Asthma risk RR=1.4 s(big3dist, 3) 0 RR=1.0 -1 0 0 100 100 200 200 300 300 400 400 500 meters 500 Distance to busy road big3dist McConnell et al, EHP2006
    • Novel evidence Traffic proximity and chronic disease HEI report* Author Outomce Exposure metric Fickelstein, Jerrett, & Sears Cardiovascular mortality Distance from freeway or main 2005 Cerebrovascular mortality road (50m) Ontario, Canada Hoffmann et al. 2009, Coronory Heart disease Living within 50m major roads Germany Morgenstern et al 2007 Munich, Asthma incidence Living ≤50m to major road Germany *Source: Health Effects Institute panel on the health effects of traffic-related air pollution. Traffic-related air pollution: a critical review o the literature on emissions, exposure, and health effects.
    • New evidence Traffic proximity and exposure Beckerman et al. 2008
    • Particulate Matter and health effects Gaps of knowledge • What is causing health effects? • What are the sources of the most toxic agents? • What are the biological mechanisms of toxicity of agents?
    • Outline • 1. Size of PMs • 2. Coarse PM and Saharan dust • 3. New effects early in life • 4. Impact assesment
    • Urban PM fractions and health effects in Barcelona Mass distribution Variables n Mean (sd) Min. Max. IQR PM10-2.5 (µg/m3) 931 14.0 (9.5) 0.1 93.1 11.0 PM2.5-1 (µg/m3) 931 5.5 (3.8) 0.6 45.5 4.5 PM1 (µg/m3) 931 20.0 (10.3) 1.9 80.1 11.1 Correlation PM10-2.5 PM2.5-1 PM1 PM10-2.5 1.00 0.45 0.09 PM2.5-1 1.00 0.24 PM1 1.00
    • Urban PM fractions and health effects Perez et al.2009 Odds ratio per 10 ug/m3* Respiratory Cardiovascular Cerebrovascular Fraction mortality mortality mortality 1.059 1.098 PM10-2.5 Not significant (1.026-1.094) (1.030-1.171) Lag1 Lag1 1.206 Not significant Not significant PM2.5-1 (1.028-1.416) Lag2 1.028 1.063 PM1 Not significant (1.000-1.058) (1.004-1.124) Lag1 Lag1 *Only maximum lag effect for tri-pollutant model presented
    • PM fraction composition in Barcelona Elemental carbon 78% Adapted from Perez et al. Atmos. Environ. 2008
    • PM fraction composition in Barcelona Metals Combustion Break, tire and road erosion Adapted Perez et al. Atmos. Environ. 2008
    • Saharan dust outbreaks in Barcelona •Occur 7-15 times a year •Predominant in spring and autumn •On average, outbreak lasts 3-5 days (Rodriguez et. al 2003)
    • Saharan dust and health effects Distribution daily mass concentrations (µg/m3) Pollutant n Mean (SD) Min-Max IQR PM2.5 All days 602 24.9 (11.7) 6.1-85.0 12.8 Saharan dust days 90 29.9 (11.2) 9.8-65.2 12.2 Non Saharan dust 512 24.0 (11.6) 6.1-85.0 11.5 days PM10-2.5 All days 602 15.1 (9.7) 0.07-93.1 10.7 Saharan dust days 90 16.4 (7.8) 1.6-36.7 11.0 Non Saharan dust 512 14.9 (10.0) 0.07-93.1 10.7 days R correlation PM2.5-PM10-2.5=0.34 (all days, Lag 1) R correlation PM2.5-PM10-2.5=0.22 (Saharan dust days, Lag 1)
    • Saharan dust and health effects Results-Total mortality Lag 1 per 10 µg/m3* PM2.5 P PM10-2.5 P interaction interaction 1.032 1.016 All days -- -- (1.015, 1.05) (0.996, 1.036) By Saharan 1.035 1.013 dust days No (1.016, 1.055) (0.992, 1.034) 0.558 0.052 1.050 1.084 Yes (1.005, 1.097) (1.015, 1.158) *Two-pollutant model
    • Saharan dust and health effects Growing evidence
    • Chemical composition of PMs in Barcelona Saharan dust days (n=9) vs Non-Saharan dust days (n=80) *: p <0.05 for comparision of mass adjusted concentrations
    • TRAFFIC, SUSCEPTIBILITY AND CHILDHOOD ASTHMA (McConell R; Env Health Persp 2006)
    • UFP and brain in rats • Intratracheal instillation of particles<100 nm labeled with tech-99, radioactivity was subsequently detected in the brain (Nemmar AJRCCM 2001) • Direct translocation Mn (8nm) in contralateral olfactory bulb (Elder EHP 2006) • PM>200 nm (TiO2) may be phagocytized by macrophages and dendritic cells which may carry the particles to lymph nodes in the lung or to those closely associated with the lungs (Peters 2006) • Oxidative stress and pro-inflammatory cytokines overexpressed in brain tissue (Calderon C 2008, Campbell 2009)
    • 1. SAMPLING SITES SELECTION 500m- grid Sampling points Cohort addresses 57 sampling points were selected to represent the gradient of exposure in the cohort
    • Sabadell SPAIN
    • Longitudinal growth curves Head circumference Estimated fetal weight 3940 350 3660 310 3380 3100 Estimated Fetal Weight (gr) Head circumference (mm) 270 2820 2540 230 2260 190 1980 1700 150 1420 1140 110 860 70 580 300 female male female male 30 20 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 gestational age (weeks) gestational age (weeks)
    • Birth weight (g) for an IQR increase (µg/m3) in exposure to NO2 during pregnancy and each trimester (Aguilera 2009) BTEX 9-month -76.6 (-146.3 to -7.0) 1st -52.5 (-125.8 trimester to 20.8) 2nd -101.9 (-176.2 trimester to -27.6) 3rd -59.7 (-130.9 trimester to 11.5) a Adjusted for child's sex, gestational age, season of conception, parity, maternal educational level, maternal smoking, maternal height and pre-pregnancy weight and paternal height
    • Change in Z-scores of fetal size and growth for an IQR increase in exposure to NO2 (µg/m3) between weeks 1-12 (Aguilera, EHP2010) 10 8 6 4 2 % Change 0 -2 -4 -6 -8 -10 -12 FL HC AC BPD EFW w_12 w_20 w_32 w_12_20 w _20_32 * Adjusted for season of conception, parity, maternal education, and maternal smoking
    • Mortality WHO scenario % of total cases Indicator Mean (95% CI) (95% CI) Deaths per year 3.500 (2.200-4.800) 12% (7%-16%) Of which Death due to acute 520 (350-690) 2% (1%-2%) exposure per year Infant deaths per year 15 (7-22) 13% (6%-19%)
    • Morbidity per year WHO scenario % of total cases Indicator Mean (95% CI) (95% CI) Respiratory Chronic bronchitis adults 5.100 (550-8.500) 25% (3%-41%) Acute bronchitis children 31.100 (17.500-40.500) 49% (28%-64%) Asthma attacks adults 41.500 (21.000-60.500) 11% (6%-16%) Asthma attacks children 12.400 (6.400-15.200) 11% (6%-14%) Hospitalizations Respiratory causes 1.150 (630-1.670)) 3% (2%-5%) Cardiovascular causes 620 (310-930) 2% (1%-3%)
    • Estimating impact of traffic exposure Population distribution from roads >10,000 vehicle/day
    • Conclusions: Particle Size – In urban areas, all PM size fractions have health effects. – PMs generated by both traffic-related combustion and non-combustion processes may increase mortality. – PMs generated by both traffic-related combustion and non-combustion processes may share a common mechanism of action.
    • Conclusions • Saharan dust – In some areas exposure to coarse PMs from natural sources such as Saharan dust may increase daily mortality. • Early life exposure – Provides unexpected new effects due to air pollution • Health impact assessment – Very likely have been underestimated
    • Thank you jsunyer@creal.cat
    • Perera FP. Env Health Persp 2006;114:1287-92. • PAH in particulate mode—collected with individual pumps during two consecutive days in 181 pregnant women from New York City (USA)— was associated to mental health measured at age 3 in the offspring • Limitations: The short measurement of the exposure (only two days), their narrow variability (only low and high levels), and the poor specificity of PAH (the principal source is smoking)
    • Suglia SF. Am J Epidemiol 2008;167:280-6. • Average air pollution during childhood (carbon particles at home address derived by spatial modeling) to intelligence at age 9 in 202 children from Boston (USA) • Limitations: follows only 20% of those recruited and did not measure prospectively the variations in air pollution or the time-activity patterns of the participants. No adjustment for noise.
    • Non-combustion traffic related particles is an important source of health effects Source % of PM10 emissions in Barcelona Combustion 56% Brake erosion 5% Tire erosion 3% Pavement erosion 6% Soil resuspension 30% Total 100% Source: Departament de Mediambient i Habitatge, 2007
    • PM10 in Barcelona metropolitan area Media anual de PM10 indicador de la contaminació atmosfèrica ** Mapa elaborado por el Departamento de Medio Ambiente y Vivienda