Air Pollution and Health - Evidence, Impacts and Policy Options - Dr Carlos Dora

904 views

Published on

Presentation given by Dr Carlos Dora at the 2015 Clean Air Conference, 28/09/15, Dublin

Published in: Environment
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
904
On SlideShare
0
From Embeds
0
Number of Embeds
3
Actions
Shares
0
Downloads
53
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Air Pollution and Health - Evidence, Impacts and Policy Options - Dr Carlos Dora

  1. 1. Public health and environment1 | Air Pollution and Health – Evidence, impacts and policy options: the future direction of clean air policy Dr Carlos Dora Coordinator Department of Public Health and Environment Key messages for mini-campaign
  2. 2. Public health and environment2 | 2 in 3 deaths are from NCDs Cardiovascular disease, mainly heart disease, stroke Cancer Chronic respiratory diseases Diabetes Injuries Today Enormous Burden of NCDs Costs: Trillions of U$ dollars
  3. 3. Public health and environment3 | Vulnerable (urban, older) populations are growing rapidly
  4. 4. Public health and environment4 | Risk factors for NCDs most often considered: • Tobacco • Physical inactivity • Diet (fat, sugar, fiber…) • Excess use of alcohol
  5. 5. Public health and environment5 | PM<10mm – Coarse PM<2.5mm – Fine PM<1mm – Ultrafine Medgadget .com Air Pollution is a major risk to NCDs Substantial new evidence showing that particles smaller than 2.5mm penetrate deep into the lungs and effect the body more systematically leading to diseases like stroke, heart disease, in addition to the cancers, COPD and pneumonia/URLI.
  6. 6. Public health and environment6 | Lungs exposed to tobacco and to Indoor air pollution Pathology slides - Courtesy Prof. Saldiva, São Paulo, Brazil
  7. 7. Public health and environment7 | “Review of evidence on health aspects of air pollution - REVIHAAP”, WHO 2013 selected conclusions on PM (A1) Confirm and strengthen results form the 2005 WHO Guidelines on Air Quality and Health. –New studies on short- and long-term effects; –Long-term exposures to PM2.5 are a cause of cardiovascular mortality and morbidity; –More insight on physiological effects and plausible biological mechanisms linking short- and long-term PM2.5 exposure with mortality and morbidity; –Studies linking long-term exposure to PM2.5 to several new health outcomes (e.g. atherosclerosis, adverse birth outcomes, childhood respiratory disease). 7
  8. 8. Public health and environment8 | Meta-analysis of the association between long-term exposure to PM2.5 and cardiovascular mortality 1.00 2.001.15 Study % weight RR (95%CI) per 10 µg/m3 Hoeketal,EnvHealth2013 8 2002 2011 2011 2011 2012 2013 2012 2011 2007 2008 Pub. year
  9. 9. Public health and environment9 | Mortality and long-term exposure to PM2.5 Cesaronietal.EHP2013 c= % increase in risk per 10 µg/m3 c=10 % c=6%c=4% AQG EU LV 9 Results of a cohort study in Rome (1.3 million adults followed from 2001 to 2010) PM2.5: 3-dimensional Eulerian model (1x1 km)
  10. 10. Public health and environment10 | Carotid artery wall thickness (=risk of atherosclerosis) and long-term PM2.5 exposure AQG EU LV Bauer et al, JACC 2010 %change inarterywall thickness Home outdoor PM2.5 (µg/m3) 10 Heinz Nixdorf RECALL study, Ruhr region, Germany
  11. 11. Public health and environment11 | Long term O3 exposure and risk of death due to respiratory causes ACS cohort of 448 thousand adults followed for 18 years 11Jerrett et al, NEJM 2009 RR per 10 ppb = 1.040 (95% CI 1.010 - 1.067) (2-pollutant model with O3 and PM2.5)
  12. 12. Public health and environment12 | Short-term exposure to ozone, mortality and hospital admissions European cities in the APHENA study Outcome Per cent increase in deaths/admissions (95% CI) per 10 µg/m3 increment in daily maximum 1-hour ozone concentrations Single pollutant Adjusted for PM10 All-cause mortality a 0.18 (0.07–0.30) 0.21 (0.10–0.31) Cardiovascular mortality: 75 years and older a 0.22 (0.00–0.45) 0.21 (-0.01–0.43) Cardiovascular mortality: younger than 75 years a 0.35 (0.12–0.58) 0.36 (0.10–0.62) Respiratory mortality b 0.19 (-0.06–0.45) 0.21 (-0.08–0.50) Cardiac admissions: older than 65 years a -0.10 (-0.46–0.27) 0.64 (0.36–0.91) Respiratory admissions: older than 65 years b 0.19 (-0.28–0.67) 0.32 (0.05–0.60) 12 a lag 0-1 results; b lag 1 results Katsouyanni et al 2009
  13. 13. Public health and environment13 | REVIHAAP: Indoor, occupational and commuting exposures vary more than exposure to OAP •In the absence of tobacco smoke: Commuting can increase exposures to PM, NO2, CO and benzene, and is a major contributor to the exposure to UFP, BC and metals (Fe, Ni and Cu in the underground); Ambient air dominates population exposures to NO2 (not gas appliances), PM2.5, BC, O3, CO and SO2 (also BaP, As, Cd, Ni and Pb); The high end of the individual exposures to PM10-2.5 and naphthalene originate from indoor sources and commuting; Solid fuel fired indoor fireplaces and stoves, where used in suboptimal conditions, dominate the high end of the exposures to PM2.5, BC, UFP, CO, benzene and BaP of the affected individuals. 13
  14. 14. Public health and environment14 | IARC 2012 finding: Diesel a carcinogen LONDON/GENEVA (Reuters) - The air we breathe is laced with cancer-causing substances and is being officially classified as carcinogenic to humans, the World Health Organization's cancer agency said on Thursday.
  15. 15. Public health and environment15 | Ischemic and thrombotic effects of diluted diesel exhaust inhalation in men with coronary heart disease Myocardial ischemia during 15-minute exercise-induced stress and exposure to diesel exhaust or filtered air in 20 subjects Millsetal,NEJM2007 15
  16. 16. Public health and environment16 | Deaths attributed to HAP + Outdoor Air Pollution ~ 7 million deaths globally in 2012 AP a main RF for around 1/5 of NCDs
  17. 17. Public health and environment17 | Estimating human exposure to air pollution Burden of disease is estimated from: 1. Air pollution concentrations & human exposure 2. Evidence from epidemiology about the health impacts of air pollution 1. Diseases affected 2. Disease response to levels of AP (dose-response curves) 3. Baseline disease rates 4. Counterfactual – e.g. zero pollution, lowest existing levels.
  18. 18. Public health and environment18 | Estimates of outdoor air pollution exposures used by WHO for BOD estimates Brings together existing data from: 1. Urban ground monitoring stations – pollutant concentrations 2. Satellite remote sensing (sparsely covereed areas) 3. Estimates of air pollution levels based on emissions from sectors (e.g. transport, industry, power production, etc.) Mathematical models - combining information from monitoring, from satellite remote sensing, chemical transport models to fill gaps and improve estimates
  19. 19. Public health and environment19 | Burden is from household as well as ambient air pollution Indoor Air Pollution ~50% of all pneumonia deaths among children under 5 ~30% of all COPD (Chronic obstructive pulmonary disease) deaths ~18% of disease & deaths from ischaemic heart disease Outdoor Air pollution ~22 % of disease & deaths from ischaemic heart disease ~15 % of deaths from pneumonia in children under 5 ~5% of COPD deaths – (from ambient ozone pollution) Air pollution also is a factor in: Cancers, Asthma (ozone), Cataracts, Adverse pregnancy outcomes, TB (WHO, 2009/Lim, Lancet, 2012)
  20. 20. Public health and environment20 | 4.3 million deaths were attributed to household air pollution exposure in 2012 • Over half of deaths from childhood pneumonia are attributed to the exposure to HAP • 88% of these deaths are to non- communicable diseases like cardiovascular disease and chronic obstructive pulmonary disease (COPD). 534,000 12% 272,000 6% 928,000 22%1,462,000 34% 1,096,000 26% ALRI Lung cancer COPD Stroke IHD
  21. 21. Public health and environment21 | HAP Exposure, 2012 • 2.9 billion people exposed or… • 42% of the global population • % exposed has decreased, but the absolute # exposed has remained relatively constant
  22. 22. Public health and environment22 | Existing WHO Air Quality Guidelines (AQG) • Global update (ambient) 2005: – PM2.5, PM10 – Chapter on IAP • Indoor AQG: – Dampness and Mould: 2009 – Selected pollutants: 2010 – Household fuel combustion: this project
  23. 23. Public health and environment23 | New Air Quality Guidelines: for fuels and technologies used for cooking, heating and lighting in the home: 1. Don't use Kerosene 2. Don't use Coal 3. Use only very efficient cookstoves (following emission rates provided by WHO) 4. Use clean fuels – LPG, Biogas, ethanol…
  24. 24. Public health and environment24 |
  25. 25. Public health and environment25 | Household air pollution data base (WHO) • Data from over 800 household surveys • Survey information about fuels and technologies used for cooking, • Now adding questions on heating, lighting, stacking • Base for estimates of IAP and related mortality
  26. 26. Public health and environment26 | Energy solutions that work in your context • Test them to check they are clean – Using the emission rates given in the guidelines • Evaluate actual use and satisfaction of user – To avoid fuel stacking • Evaluate health benefits and air pollution reductions in a sample of users/non users – To demonstrate costs and benefits
  27. 27. Public health and environment27 | Extensive Evidence Reviews • Fuel use: Global; for cooking, heating & lighting • Emissions: range of technology & fuel options, how relate to AQG • Levels: HAP and exposure • Health impacts of HAP: risk for pneumonia, COPD, lung cancer, etc., including exposure-response. • Burns and poisoning: risks, burden and interventions • Intervention impacts: HAP/exposure in routine use • Adoption at scale: barriers and enablers, costs/benefits, finance
  28. 28. Public health and environment28 | Model linking emissions to air quality Inputs: • Emission rates: – PM2.5 – CO • Kitchen volume • Air exchange rate • Duration of use (hours per day) Outputs: • Predicted average concentrations of: – PM2.5 – CO Assumes uniform mixing of pollutants and air in kitchen
  29. 29. Public health and environment29 | Focus on emissions reductions – why? • Outdoor  indoor • Evidence base stronger than for other approaches • Implementation practicality – via design, production, standards, etc • Some options (clean fuels), are relatively independent of user behaviour.
  30. 30. Public health and environment30 | 3.7 million deaths were attributed to ambient air pollution exposure in 2012 Breakdown of by disease ~21 % of all deaths from ischaemic heart disease (IHD) ~23% of all deaths due to stroke ~13 % of all deaths to chronic obstructive pulmonary disease (COPD)
  31. 31. Public health and environment31 | Urban Air Quality Data (WHO) 1600 cities, but sparse coverage for Africa, Latin America, Middle East – no coverage in rural areas
  32. 32. Public health and environment32 | First World Health Assembly Resolution on Air Pollution and Health 7 million deaths a year due to household and ambient air pollution
  33. 33. Public health and environment33 | The resolution: • key role health authorities in raising awareness about the potential to save lives and reduce health costs, if air pollution is addressed effectively. • Need for strong cooperation between different sectors and integration of health concerns into all national, regional and local air pollution-related policies. • It urges Member States to develop air quality monitoring systems and health registries to improve surveillance for all illnesses related to air pollution; • It urges Member States to strengthen international transfer of expertise, technologies and scientific data in the field of air pollution.
  34. 34. Public health and environment34 | Asks the WHO Secretariat: • To build capacity to implement the "WHO air quality guidelines" and "WHO indoor air quality guidelines; • Regularly update the WHO guidelines • Compile and analyse data on air quality, health • Conduct cost-benefit assessment of mitigation measures; • disseminate evidence-based best practices on effective indoor and ambient air quality interventions and policies related to health • Advance research into air pollution’s health effects and effectiveness. • Propose a road map for an enhanced global response by the health sector that reduces the adverse health effects of air pollution.
  35. 35. Public health and environment35 | collaborate, as appropriate, with relevant international, regional and national stakeholders, to compile and analyse data on air quality, with particular emphasis on health related aspects of air quality to create, enhance and update, in cooperation with relevant United Nations agencies and programmes a public information tool of WHO analysis, including policy and cost-efficiency aspects, of specific and available clean air technologies to address the prevention and control of air pollution, and its impacts on health; advise and support tools to assist the health and other sectors at all levels of government, especially the local level and in urban areas, taking into account different sources of pollution in tackling air pollution and their health effects; raise awareness of the public health risks of air pollution and th multiple benefits of Improved air quality, in particular in the context of the discussions on the post - 2015 development agenda cooperation with relevant United Nations agencies
  36. 36. Public health and environment36 | Focus on the sources of AP: Energy-efficient homes reduce air pollution & other housing risks such as... Housing risks • Indoor/outdoor air pollution • Damp, mould & allergens • Poor indoor ventilation • Planning, transport access • Urban waste, sanitation & water • Heat Island • Storms/flooding Health impacts • Chronic/acute respiratory disease • Allergies, respiratory disease • Respiratory disease • Physical inactivity, NCDs, traffic injuries • Water and sanitation-borne disease • Strokes • Injuries/poverty
  37. 37. Public health and environment37 | « Improved insulation saved 0.26 months of life per person » (UK Warm Front Programme) Housing that is good for health Reduction of respiratory illness by 9% to 20% and increase of individual productivity between 0.48% and 11% with natural ventilation startegies « Reduced wheezing, days-off school, doctors' visits were reported by occupants of insulated homes « (NZ Insulation study) Photo 1 (graphic, table, map, etc) zone
  38. 38. Public health and environment38 | Health co-benefits in housing Energy-efficient heating, cooling and natural ventilation can reduce strokes and respiratory illness as well as TB and vector-borne diseases; A focus on slums /sub-standard housing - where needs are greatest/benefits could be multiplied Solar hot water heating - India Slum in Mexico City
  39. 39. Public health and environment39 | Light a billion lives – solar substitutes kerosene, India Solar hot water heating is an fast-growing, popular technology in Turkey, China, South Africa, Middle East, etc. China is mass marketing next-generation solar PV & passive. Below passive solar "combi" hot water space heating raised night-time winter temperatures from 6-8º C lows in village near Beijing Health co-benefits in energy
  40. 40. Public health and environment40 | Cape Town, South Africa's Kuyasa neighborhood slum upgrade: First to be financed by UN Clean Development Mechanism (CDM). Solar hot water systems, sewage and insulation (below) will help reduce heat-related, respiratory and waterborne diseases. Health Impact Assessment of urban innovations can demonstrate health benefits and enhance global support and financing for scale-up
  41. 41. Public health and environment41 | A significant fraction of NCDs is attributable to exposure to traffic-related air pollution Source: APHEKOM
  42. 42. Public health and environment42 | Gain in life expectancy (months) in 25 Aphekom cities for a decrease in PM2.5 to WHO AQG (10 μg/m3) (age 30+)
  43. 43. Public health and environment43 | • Better fuels and engines help, but private vehicle transport increases congestion, injuries, pollution, and physical inactivity. Rapid transit/NMT improves access to schools, jobs & services for poor, children, women, elderly & disabled, improving equity. It can reduce injury, cardiovascular disease & support healthy physical activity. Cycling to work reduced premature mortality by 30% among commuter groups in Shanghai & Copenhagen. 'Healthy' urban transport can reduce chronic disease, injuries and improve health equity
  44. 44. Public health and environment44 |
  45. 45. Public health and environment45 | Evidence: Health outcomes directly linked to type of urban infrastructure investment Infrastructure for different travel modes (including presence and proximity of infrastructure) Increased walking, cycling or active transport 94,133,138,144,146,147,154,175,223–229 Less active transport 179 Increased physical activity 104,154,155,160,176,184,223,228,230–239 Reduced BMI or obesity 111,118,119,165,224,234,238–240 Reduced air pollution-related effects 234 Improved reported health status 224 Reductions in specific health problems 222,224 More infrastructure facilitating walking (including general assessments of “walkability” of neighbourhoods as well as presence of specific features, e.g. pavements) Lower mortality / higher life expectancy 47 Increased walking, cycling or active transport 94,136–139,141,144,171,175,241–243 More infrastructure facilitating cycling Increased physical activity 27,104,157,159,161,184,244 Increased walking, cycling or active transport 44,133,140,146 Less walking, cycling or active transport 89,94,150,152,179,245 Increased physical activity 103,140,157,159,182 Reduced BMI or obesity 113,117 More infrastructure facilitating public transport use Reduced air pollution-related effects 246 Increased walking, cycling or active transport 245,247 Less infrastructure facilitating car travel (including parking, motorways) Reduced BMI or obesity 73 Review of studies on infrastructure investment, physical activity and health – WHO/Health in Green Economy (forthcoming)
  46. 46. Public health and environment46 | Effectiveness of interventions - BCA: WHO tool for estimating health economic gains from cycling HEAT for cycling and user guide from www.euro.who.int/transport/policy/20070503_ 1
  47. 47. Public health and environment47 | Access to clean/sustainable energy in Health Care • Adopt energy efficient medical technologies • Substitute diesel generators for sustainable sources (solar, hydro…) • Access to sustainable transport • Energy efficient buildings … Solar suitcase powering a health care facility in Nigeria. Solar powered refrigerator in Vietnam.
  48. 48. Public health and environment48 | A vision of health & equity in Sustainable Development
  49. 49. Public health and environment49 | Preventing disease – addressing their route causes in the environment and in development
  50. 50. Public health and environment50 | Global Platform on Air Quality and Health • To ensure best estimates of human exposure to air pollution will continue to be regularly available for Burden of Disease estimates, as well as to ensure accountability, transparency and wide access of these results worldwide. • Established in January 2014, • A wide collaboration with international agencies including UNECE, WMO, UNEP, JRC, IIASA, World Bank, space research agencies (e.g. NASA, JAXA), as well as national agencies and research institutions. • Yearly meetings to update on progress and results. • Task forces to provide improvements in methods and outputs from one year to the next. First year – improvements in data integration and statistical fusion, (using data from monitors, atmospheric transport models and satellite remote sensing). – First database of source apportionment studies (n=500)
  51. 51. Public health and environment51 | Second year: • Data fusion: Global air quality data as a result of fusion from various data sources, report on progress and work ahead, • Emission sources information, including from emission inventories and source apportionment • Exposure-risk relationship: Integrated dose-response functions that relate levels of air pollution indoors and outdoors to a range of diseases, report on progress and work ahead. • Surface monitoring: key air pollution indicators to be monitored, minimum data sets for health purposes; systematic data collection and display; • Automated Data acquisition, portable monitors etc. quality of outputs form different sources, • Household air pollution: exposure assessment, progress in IAP data, availability of exposure data from Europe New task forces proposed: • Data fusion and synthesis – further improvements • Models for integrating Household and Ambient Air Polluton exposure estimates • Guidance on the collection of ground measurement data. • Guidance on source apportionment studies.
  52. 52. Public health and environment52 | Establishment of a web-based resource providing access/ web linkage to: • Results from the platform – methods, tools, results • Tools for estimating health impacts from air pollution at local level • Exposure-response functions • Air quality databases: – WHO ambient air quality in cities, – WHO household air pollution database, – Joint ambient/ household air pollution (future) • Analysis of trends. • Burden of disease estimates. • Awareness raising and communication tools. • Collection of cost-effective interventions/ best practices to address air pollution and health.
  53. 53. Public health and environment53 | Priorities for addressing the health impacts of air pollution 1. Indicators for SDGs linking health, air pollutants and its sources (Note to UN Statistics Divison) 2. Road map for implementing the WHA resolution on air pollution and health 3. Targeted actions/early wins – Global Platform AQH, implementation of IAQ guidelines
  54. 54. Public health and environment54 | Health indicators for Post-2015 Sustainable Development WHO related health to SD policies, through the • Defining health-relevant indicators for sustainable development goals (EB 136/30) •Convened consultation on health indicators for Rio + 20 themes/disseminated through civil society/government partners at the conference •Constributions to the UN Statistics Commission 2015-2016
  55. 55. Public health and environment55 | SDG 11: cities Goal 11 Make cities and human settlements inclusive, safe, resilient and sustainable. Target 11.7 By 2030, reduce the adverse per capita environmental impact of cities, including by paying special attention to air quality, municipal and other waste management.
  56. 56. Public health and environment56 | Target Current Indicator Recommended update to indicator 11.7 Level of ambient particulate matter (PM10 and PM2.5) Annual mean levels of fine particulate matter (i.e. PM2.5) air pollution in cities (population weighted)
  57. 57. Public health and environment57 | Data sources • WHO urban air quality data base – 1600 cities • Global platform air quality and health – cooperation with many partners, facilitated by WHO, currently improving estimates for many more cities, synthesizing data from: – Satellite remote sensing – Emission inventories and source apportionment studies – Air pollutant transport models – Ground level monitoring of air quality
  58. 58. Public health and environment58 | SDG 7: Energy Goal 7 Ensure access to affordable, reliable, sustainable, and modern energy for all Target 7.1 By 2030, ensure universal access to affordable, reliable and modern energy services Target Indicators currently proposed Recommended update to indicator 7.1 7.1.1 Percentage of population with electricity access n/a 7.1.2 Percentage of population with primary reliance on non-solid fuels (%) Percentage of population with primary reliance on clean fuels and technologies at the household level* * Recommandation 4 WHO guidelines
  59. 59. Public health and environment59 | Recommendation 4: – Household combustion of kerosene is discouraged Rationale: – High levels of emissions of PM and other health-damaging emissions. – Epidemiologic studies suggest links to tuberculosis, cancer, respiratory disease, adverse birth outcomes, etc., but are not of adequate consistency/quality. – Kerosene use carries substantial risks of burns and poisoning.
  60. 60. Public health and environment60 | Recommendation 1: For 90% of homes to meet the WHO AQGs for PM2.5, emission rates should not exceed the emission rate targets (ERTs) set out on the right. Emissions rate targets (ERT) Emission rate (mg/min) Percentage of kitchens meeting AQG (10 µg/m3) Percentage of kitchens meeting AQG IT-1 (35 µg/m3) Unvented Final 0.23 90% 100% Vented Final 0.80 90% 100% Recommendation 2: • Promote clean fuels where and when possible • For many, it will take time to meet AQGs (especially PM2.5), so intermediate steps (solid fuel stoves) may be required • Solid fuels: test emissions (ref Recommendation #1), use best possible options • Monitor use and air pollution (not just laboratory) Rationale: – Health evidence: need low levels for major health benefits (ALRI) – In practice, solid fuel stoves not achieving low levels (some vented wood stoves 35-70 µg/m3) – Even clean fuel users well above IT- 1 (other sources) – Based on evidence, requires (near) exclusive use of clean fuels to achieve AQG (PM2.5). Recommendation 3: Unprocessed coal should not be used as a household fuel Rationale: – High levels of emissions of PM and other health-damaging emissions. – Epidemiologic studies suggest links to tuberculosis, cancer, respiratory disease, adverse birth outcomes, etc., but are not of adequate consistency/quality.
  61. 61. Public health and environment61 | Data source: WHO household energy data base*: Population Primarily Relying on Solid fuels for cooking in 2012 • based on over 800 household surveys, • being upgraded to include: fuels and technologies for lighting, heating and cooking as well as fuel stacking Used as input to SE4All and other global energy tracking
  62. 62. Public health and environment62 | SDG 3: Health Goal 3 Ensure healthy lives and promote well-being for all at all ages Target 3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution from contamination. Target Current Indicator Recommended update to indicator 3.9 3.9.1 Population in urban areas exposed to outdoor air pollution levels above WHO guideline values 3.9.1. Mean levels of exposure to ambient air pollution (population weighted) Rationale: dicotomous value (WHO guideline levels) is a good target but a poor measure to track progress, and annual levels are linked to health OR: Mean levels of exposure to ambient and indoor air pollution
  63. 63. Public health and environment63 | Alternative SDG 3: Health Goal 3 Ensure healthy lives and promote well-being for all at all ages Target 3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution from contamination. Target Current Indicator Recommended update to indicator 3.9 3.9.1 Population in urban areas exposed to outdoor air pollution levels above WHO guideline values 3.9.1. Mean levels of exposure to ambient and indoor air pollution (population weighted) Using initially both indicators for AAP and IAP, and later an integrated indicator of AP exposure.
  64. 64. Public health and environment64 | Data sources • WHO urban air quality data base – 1600 cities • Global platform air quality and health –cooperation with many partners, facilitated by WHO, currently improving estimates for many more cities, synthesizing data from: – Satellite remote sensing – Emission inventories and source apportionment studies – Air pollutant transport models – Ground level monitoring of air quality • WHO household energy data base: – based on over 800 household surveys, – being upgraded to include: fuels and technologies for lighting, heating and cooking as well as fuel stacking – Further data integration of all the above under the global platform on air quality and health – being prepared
  65. 65. Public health and environment65 | Monitoring and reporting. Member States commit to redouble their efforts on: • strengthening international cooperation • collecting and utilizing data relevant to the health outcomes of air quality, • working towards harmonization of health- related indicators which could be used by decision makers • optimize the linkages (of health surveillance) with monitoring systems of air pollutants
  66. 66. Public health and environment66 | Monitoring and reporting. request the WHO to: • provide enhanced cooperation between WHO relevant international regional and national stakeholders, • compile and analyse data on air quality, with particular emphasis on the health-related aspects of air quality, • take account of sources of air pollution in tackling their health effects • cooperate with relevant UN agencies and programmes to create, enhance and update a public information tool of WHO analysis, including policy and cost-efficiency aspects.
  67. 67. Public health and environment67 | Making the link - Health benefits from Policies to Mitigate Climate Change and Air Pollution Transport,energy,landuse policies/Combustion Air pollution (PM) Climate change (CO2) Local/ short term health impacts Global/long term health impacts Climate change (SLCPs) Injuries, physical activity, noise, diet,

×