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Air quality and its implications on our health

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Presentation by Vlatka Matkovic at the OpenDataDay event 'Towards Clean Air with Open Data'. The event took place at BeCentral in Brussels on Saturday 3 March 2018.

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Air quality and its implications on our health

  1. 1. Air quality and its implications on our health Vlatka Matkovic, PhD in Public Health Health & Environment Alliance (HEAL) @VlatkaMatkovic Towards Clean Air with Open Data Brussels, March 2018
  2. 2. 6.5 million premature deaths are caused by air pollution each year. Nearly half are due to outdoor air pollution.1 Air pollution is driving a global health crisis. 80 percent of people in urban areas* are exposed to air pollution levels exceeding the WHO safety limits.2 *where air pollution is monitored Photo: GCCA/GregMcNevin
  3. 3. Air pollutants HEI, Health Effects Institute. Air pollution is a complex mixture of gaseous, volatile, semi-volatile and particulate matter, and its exact composition varies widely.
  4. 4. What are particles?
  5. 5. Why is size important? Kreyling et al. 2006 Small size • High alveolar deposition of PM2.5 and smaller • Ultra fine PM can escape alveolar clearing mechanisms • Diffusion through physiologic membranes High specific surface • Adsorption of toxins • Place for oxygen radical generation Clearing Instant 0.5 hr 3 hrs 6 hr 24 hrs Lung tissue: Months, years
  6. 6. Biological mechanisms HEI Perspectives 3, 2013 Cellular level
  7. 7. Health risks from various pollutants, pollutant guideline values for ambient air and limit values POLLUTANT RELATED HEALTH RISKS (WHO) WHO GUIDELINES EU LIMITS Sulphur dioxide (SO2) Lung functions, aggravation of asthma and chronic bronchitis, infections of the respiratory tract; irritation of eyes; cardiac disease; ischaemic stroke. 20 μg/m3 (day) 125 μg/m3 (24 hours), not to be exceeded > 3 times/year Nitrogen dioxide (NO2) Asthma development (suspected), asthma exacerbation, chronic obstructive pulmonary disease, stunted lung development; cardiac arrhythmias, ischemic stroke. Reacts with volatile organic compounds (VOCs) in sunlight to form ground- level ozone which is also harmful to health. 40 μg/m3 (annual) 40 μg/m3 (annual) Particulate matter (PM) Asthma development (suspected), asthma exacerbation, chronic obstructive pulmonary disease, stunted lung development (PM2.5); lung cancer, Cardiac arrhythmias, acute myocardial infarction, congestive heart failure (PM2.5),Ischaemic stroke. PM2.5: 10 μg/m3 (year) PM10: 20 μg/m3 (year) PM2.5: 25 μg/m3 target (year) PM10: 40 μg/m3 (year) limit
  8. 8. WHO EHC 188, 1997, 2nd edition “On the basis of a background level of 15 µg/m3 (0.008 ppm) and the fact that significant adverse health effects occur with an additional level of 28.2 µg/m3 (0.015 ppm) or more, an annual guideline value of 40 µg/m3 (0.023 ppm) is proposed. This value will avoid the most severe exposures.” Where does the NO2 40 µg/m3 annual average AQG come from?
  9. 9. WHO AQG Air Quality Standards for annual PM2.5 concentration EU Limit Value US EPA Standard Figure from Pope, JAWMA 2006
  10. 10. EHP 2014 WHO AQG
  11. 11. Relative Risk (RR) per 10 µg/m3 increase above 10 µg/m3 (PM2.5) or 20 µg/m3 (PM10)
  12. 12. MORTALITY HOSPITALIZATIONS BRONCHITIS/ASTHMA WORK DAYS LOST
  13. 13. Number of publications “air pollution” or “(nitrogen dioxide or NO2)” or “(particulate matter or PM10 or PM2.5 or black smoke or sulphate or nitrate or secondary particles)” and health (PubMed) 0 5000 10000 15000 20000 25000 30000 35000 1980 1985 1990 1995 2000 2005 2010 2017 Number of publications (air pollution) Number of publications (NO2) Number of publications (PM) Absence of evidence is NOT evidence of absence.
  14. 14. Committee on the Medical Effects of Air Pollutants (update provisional, pending full report) https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/632916/air-quality-plan-technical-report.pdf Policy CRF Source Comment Reductions of all traffic pollutants 1.023 (95% CI: 1.008, 1.037) per 10μg/m3 annual average NO 2 Single pollutant model meta-analysis Newer studies than HRAPIE, general population only; 1.06 for PM2.5 as alternative Reductions primarily targeting NOx emissions 1.006 – 1.013 20% reduction adjustment for PM2.5, then expert judgement NO2 30-70% of this Typical % reduction from studies with more moderate correlations Add effect on nitrate to both 1.06 (95% CI: 1.04 – 1.08) per 10μg/m3 annual average Hoek et al (2013) Location will be different Burden Not appropriate for NO2 alone, consider for mixture
  15. 15. ESTIMATED N OF ANNUAL PREMATURE DEATHS ATTRIBUTED TO PM Global Burden of Disease EEA NETHERLANDS 6,800 11,200 FINLAND 1,600 2,150 FRANCE 20,000 34,880 EU 28 258,000 399,000
  16. 16. DIFFERENCES BETWEEN Global Burden of Disease AND EEA APPROACH GBD EEA Concentrations Sat., CTM, Meas., geog. 10x10 km Airbase interpol. 1x1 km Counterfactual 2.4-5.9 μg/m3 0 or 2.5 μg/m3 Basis AAP, HAP, SHS, AS AAP Causes IHD, Stroke, LRI, COPD, Lung CA Non-accidental all-cause Shape Curvilinear Linear Age dep. RR YES (IHD only) NO COD recoding YES NO

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