Recent developments in air quality and health - Summary of conclusions from WHO project REVIHAAP - Marie-Eve Heroux
Recent developments inAir quality and health –Summary of conclusions fromWHO project REVIHAAPMarie-Eve HérouxTechnical Officer, Air Quality & NoiseEuropean Centre for Environment and HealthWHO Regional Office for Europe
Air Science Policy Event15 April 2013, DublinPresentation outline• WHO projects REVIHAAP and HRAPIE• Context, process, progress, timeline• Results from evidence review• Main conclusions from REVIHAAP
Air Science Policy Event15 April 2013, DublinContext for REVIHAAP and HRAPIE work
Air Science Policy Event15 April 2013, DublinReview of evidence on health aspects ofair pollution for guidance of EU policyOBJECTIVE:To provide the European Commission and itsstakeholders with scientific evidence- based advice onhealth aspects of air pollution in support of thecomprehensive review of air quality legislation due in2013.*While some of the questions directly address policies, therecommendations from the projects are based solely on scientificconclusions on health aspects of air pollution, and do not considerother issues which are relevant for policy formulation.
Air Science Policy Event15 April 2013, DublinWHO projects- Jointly financed WHO/EC- Coordinated by WHO-ECEH- Provide answers to 26 key questions posed by the ECREVIHAAP(24 questions)Review ofevidencereview onhealthaspects ofairpollutionOct 2011– April2013(18months)HRAPIE(2 questions, building onREVIHAAP work)Identificationofconcentration-responsefunctions forkey pollutantsand healthoutcomesSurvey onnewlyemergingissues onrisks tohealth fromairpollutionSept2012 –Sept2013(12months)
Air Science Policy Event15 April 2013, DublinREVIHAAP: Process and progressScientific Advisory Committee• 8 experts• Offer guidance and oversight of project• SAC meetings December 2011 & June 2012Review of evidence and development of answers• 29 experts authors• Across various relevant disciplines• Represent wide range of countries and institutions• Work together in small groups• 32 experts external reviewers• Comment on completeness, validity and clarity• WHO Expert meetings August 2012 & January 2013Publications:• REVIHAAP First results published January 2013• Full technical report available April 2013
Air Science Policy Event15 April 2013, DublinREVIHAAP Key questions• PM, ozone, NO2, SO2, metals (As, Cd, Hg, Pb, Ni), PAHs• New findings regarding health effects• Concentration-response functions and thresholds• Air pollution constituents and sources• Integration of evidence and policy implications• WHO air quality guidelines• EU policies• Critical data gaps
Air Science Policy Event15 April 2013, DublinEvidence on health effects of PM (1/2)• The scientific conclusions of the 2005 WHO Guidelines about theevidence for a causal link between PM2.5 and adverse healthoutcomes in humans have been confirmed and strengthened and,thus, clearly remain valid• New studies on short- and long-term effects• Studies linking long-term exposure to PM2.5 to several newhealth outcomes (e.g. atherosclerosis, adverse birth outcomes,childhood respiratory disease, neurodevelopment and cognitivefunction, diabetes)• Associations between long-term exposure to PM2.5 and mortalityat levels below the current annual WHO AQG• Effects of long-term exposure greater than those of short-term
Air Science Policy Event15 April 2013, DublinEvidence on health effects of PM (2/2)• Both short-term (such as 24-hour average) and long-term (annualmeans) exposure to PM2.5 affect health• Maintaining independent short-term and long-term limit values forambient PM10 in addition to PM2.5 to protect against the healtheffects of both fine and coarse particles is well supported• In the absence of a threshold and in light of linear or supra-linearrisk functions, public health benefits will result from any reduction ofPM2.5 concentrations, whether or not the current levels are above orbelow the limit values
Air Science Policy Event15 April 2013, DublinEvidence on PM sources, fractions andcomponents• Three important components – black carbon, secondaryorganic aerosols, and secondary inorganic aerosols – for whichthere is substantial exposure and health research findingassociations and effects– may provide valuable metrics for the effects of mixtures ofpollutants from a variety of sources• Short-term exposures to coarse particles (including crustalmaterial) are associated with adverse respiratory andcardiovascular health effects, including premature mortality• Increasing, though as yet limited, epidemiological evidence onthe association between short-term exposures to ultrafine(<0.1 µm) particles and cardio-respiratory health, as well as thecentral nervous system
Air Science Policy Event15 April 2013, DublinEvidence on health effects of ozone• New evidence for an effect of long-term exposure to ozone on:– mortality, especially among persons with potentially predisposingconditions (COPD, diabetes, congestive heart failure, andmyocardial infarction)• asthma incidence, asthma severity, hospital care for asthma andlung function growth• Adverse effects of exposure to daily ozone concentrations (maximumdaily 1-hr or 8-hr mean) on:• all-cause, cardiovascular and respiratory mortality• respiratory and cardiovascular hospital admissions, afteradjustment for the effects of particles (PM10)• The evidence for a threshold for short-term exposure not consistent,but likely to lie below 45 ppb (90 µg/m3) (max 1-hr)
Air Science Policy Event15 April 2013, DublinEvidence on health effects of NO2• New studies document associations between day-to-day variations inNO2 and variations in mortality, hospital admissions, and respiratorysymptoms.• New studies showing associations between long-term exposure toNO2 and mortality and morbidity.• Both short- and long-term studies found these adverse associationsat concentrations at or below the current EU LV (= WHO AQG).• The associations between NO2 and short-term health effects in manystudies remain after adjustment for other pollutants (including PM10,PM2.5, black smoke).• … it is reasonable to infer that NO2 has some direct effects.• No health evidence to suggest changing the averaging time forthe short-term EU limit value (1-hour).
Air Science Policy Event15 April 2013, DublinEvidence of health risks from proximity toroads• Elevated health risks associated with living in close proximity toroads is unlikely to be explained by PM2.5 mass.• Current evidence does not allow discernment of the pollutantsor pollutant combinations that are related to different healthoutcomes, although association with tail pipe primary PM isincreasingly identified.• Toxicological research indicates that non-exhaust pollutantscould be responsible for some of the observed health effects.
Air Science Policy Event15 April 2013, DublinREVIHAAP Main conclusions• Considerable amount of new scientific information on health effectsof PM, ozone and NO2 has been published in the recent years– Evidence has strengthened– Effects observed at levels commonly present in Europe– Supports the scientific conclusions of the WHO Air QualityGuidelines, last updated in 2005– Indicates that the effects can occur at air pollutionconcentrations lower than those serving to establish the 2005Guidelines• Provides scientific arguments for the decisive actions to improve airquality and reduce the burden of disease associated with airpollution in Europe.