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Health Impact Assessment of Air Pollution on Zagreb population
Krešimir Šega
Instiute for Medical Research and Occupational Health, Zagreb
24-26 May 2007
AMGI/EURASAP Workshop, Zagreb
This investigation was partly presented at:
• ZAŠTITA ZRAKA '01, Šibenik 26-29. rujan 2001.
• 15th IUAPPA regional conference - 17th EFCA
speciality conference, 5-8 september 2006 Lille, France
• HEALTH IMPACT ASSESSMENT OF BLACK SMOKE
AND AIRBORNE PARTICULATES ON ZAGREB
POPULATION, WHO COLABORATING CENTRE FOR AIR QUALITY MANAGEMENT
AND AIR POLLUTION CONTROL NEWSLETTER,2006
24-26 May 2007
AMGI/EURASAP Workshop, Zagreb
HEALTH ENDPOINTS RELATED TO AIR POLLUTION
ASSESSMENT
MODELLING
Determination of relationship between
air pollution levels and negative health
effects.
Demands:
•Large and complete databases
•Control over possible cofounders
•Educated and well equipped personal
24-26 May 2007
Use of developed models for health
risk evaluation.
Enable so called “risk governing”:
•Cost estimation for pollution level
reduction.
•Estimation of primary and secondary
health costs.
•Adoption of new or improvement of
existing air pollution limit values.
AMGI/EURASAP Workshop, Zagreb
ZAGREB
MODELLING
Šimic, D., Jazbec, A., Pavlovic, M. et al.: Short term effects of ambient NO2 on
mortality in Zagreb, Croatia. Proceedings of the 20th International Conference on Information
Technology Interfaces, Kalpic Damir, Hljuz-Dobric Vesna (ur.). Pila, Hrvatska: SRCE
University Computing Centre, Univerity of Zagreb, 1998., 143-148.
Jazbec, A., Šimic, D., Hršak, J. et al.: Short-term effects of ambient nitrogen oxides
on the number of emergency asthma cases in Zagreb, Croatia, Arh. hig. rada toksikol. 1999, 50,
171-182.
Šimic, D., Pavlovic, M., Jazbec, A. et al.: Short-term effects of air pollution on
general mortality in Zagreb, Croatia, Proceedings of the 21st International Conference on
Information Technology Interfaces ITI'99, Kalpic Damir, Hljuz-Dobric Vesna (ur.). Pula,
Hrvatska: SRCE University Computing Centre, Univerity of Zagreb, 1999., 169-175.
Šimic, D., Pavlovic, M., Jazbec, A. et al.: Utjecaj oneišenja zraka na uestalost
pogoršanja simptoma opstruktivne bolesti plua un odraslih osoba, Zaštita zraka 99, Vali
Fedor i Šega Krešimir (ur.). Zagreb: Hrvatsko udruenje za zaštitu zraka, 1999., 347-354.
Šimic, D., Pavlovic, M., Šega, K. et al.: Is association between mortality and air
pollution due to a short temporal displacement? In: D Kalpi and V Hljuz Dobri (eds.)
Proceedings of the 23rd International Conference on Information Technology Interfaces ITI
2001,Pula, Croatia, June 19-22, 2001. Zagreb: University Computing Centre, University of
Zagreb, pp. 279-83, 2001.
Šimić, D.: Povezanost onečišćenja zraka i smrtnosti u gradu Zagrebu, Doktorska
disertacija, Zagreb 2001.
24-26 May 2007
AMGI/EURASAP Workshop, Zagreb
ASSESSMENT
AirQ - software
•WHO Regional Office for Europe
•Evaluation of RR related to mortality or morbidity for toptal population or
population subgroup and certain air pollutant
•Quantification on the basis of atrributable risk proportion (AP) which could be
atrribute to the exposure to certain air pollutant by controlling possible
cofounders.
•Main principle: ONE POPULATION- ONE EXPOSURE DATASET
•RR defined for air pollutant concentartion incerase of 10 μg m-3
•Concentration treshold defined at 10 µg m-3, assuming that lower
concentrations do not cause observable health effects:
(C < 10 µg m-3 Y RR=1)
24-26 May 2007
AMGI/EURASAP Workshop, Zagreb
NUMBER OF SASMPLING SITES AND
MEASURING PERIODS
TSP: 2 measuring sites, 1976-2000
BS: 6 measuring sites, 1976-2005
SO2: 6 measuring sites, 1976-2000
PM10: 1 measuring site, 1999-2005
PM2.5: 1 measuring site, 1999-2004
5 measuring sites, 2005
24-26 May 2007
AMGI/EURASAP Workshop, Zagreb
TOTAL SUSPENDED
PARTICULATE MATTER
•
•
•
•
Total mortality
Cardiovascular moratilty
Respiratory mortality
COPD
24-26 May 2007
AMGI/EURASAP Workshop, Zagreb
BLACK SMOKE
•
•
•
•
•
Total mortality
Cardiovascular moratilty
Respiratory mortality
Hospital admisson – COPD
Hospital admisson – respiratory diseases
(15-64)
• Hospital admisson – asthma (<15)
• Hospital admisson – asthma (15-64)
• Accute miocard infarction
24-26 May 2007
AMGI/EURASAP Workshop, Zagreb
SO2
•
•
•
•
•
Total mortality
Cardiovascular moratilty
Respiratory mortality
Hospital admisson – COPD
Hospital admisson – respiratory diseases
(15-64)
• Hospital admisson – asthma (<15)
• Accute miocard infarction
24-26 May 2007
AMGI/EURASAP Workshop, Zagreb
PM10
•
•
•
•
•
Total mortality
Cardiovascular moratilty
Respiratory mortality
Hospital admisson – cardiovascular diseases
Hospital admisson – respiratory diseases
PM2.5
•Total mortality
24-26 May 2007
AMGI/EURASAP Workshop, Zagreb
TSP
50
120
TOTAL MORTALITY I = 1013
RR = 1.003 (1.002-1.007)
40
# / 100 000 stanovnika godišnje
# / 100 000 stanovnika godišnje
100
80
60
RESIRATORY MORTALITY I = 66
RR = 1.008 (1.004-1.018)
PP (%)
4.5 1976.
1.1 2000.
40
30
20
PP (%)
3.0 1976.
0.7 2000.
10
20
0
1976
1979
1982
1985
1988
1991
1994
1997
0
1976
2000
16
14
1979
1982
1985
1988
1991
1994
1997
2000
1997
2000
14
CARDIOVASCULAR MORTALITY I = 497
RR = 1.002 (1.000-1.006)
COPD
I = 101.4
RR = 1.0044 (1.0000-1.0094)
12
10
# / 100 000 stanovnika godišnje
# / 100 000 stanovnika godišnje
12
PP (%)
11.2 1976.
2.7 2000.
8
6
4
8
PP (%)
6.4 1976.
1.6 2000.
6
4
2
2
0
1976
10
1979
1982
24-26 May 2007
1985
1988
1991
1994
1997
2000
0
1976
1979
1982
AMGI/EURASAP Workshop, Zagreb
1985
1988
1991
1994
DIM
30
25
PP (%)
1.8 1976.
0.5 2000.
15
25
# / 100 000 stanovnika godišnje
# / 100 000 stanovnika godišnje
20
TOTAL MORTALITY I = 1013
RR = 1.0026 (1.0018-1.0034)
10
5
CARDIOVASCULAR MORTALITY I = 497
RR = 1.004 (1.002-1.008)
20
15
PP (%)
2.7 1976.
0.8 2000.
10
5
0
1976197819801982198419861988199019921994199619982000
0
1976197819801982198419861988199019921994199619982000
8
6
5
COPD
I = 101.4
RR = 1.0061 (1.0020-1.0120)
RESPIRATORY MORTALITY I = 66
RR = 1.008 (1.004-1.014)
4
3
PP (%)
5.2 1976.
1.7 2000.
2
1
4
PP (%)
4.0 1976.
1.3 2000.
2
0
0
1976197819801982198419861988199019921994199619982000
24-26 May 2007
# / 100 000 stanovnika godišnje
# / 100 000 stanovnika godišnje
6
1976197819801982198419861988199019921994199619982000
AMGI/EURASAP Workshop, Zagreb
DIM
5
12
HOSPITAL ADMISSION – RESPIRABLE DISEASES
(15-64 years) I = 66 RR = 1.0056 (1.0012-1.0102)
10
PP (%)
3.8 1976.
1.2 2000.
3
2
1
# / 100 000 stanovnika godišnje
# / 100 000 stanovnika godišnje
4
8
6
2
0
1976197819801982198419861988199019921994199619982000
1976197819801982198419861988199019921994199619982000
5
ACCUTE MIOCARD INFARCTION I = 132
RR = 1.016 (1.0053-1.0290)
HOSPITAL ADMISSION – ASTHMA
(15-64 years)
I = 66
RR = 1.0042 (1.000-1.0118)
PP (%)
1.9 1976.
0.6 2000.
2
1
24-26 May 2007
20
# / 100 000 stanovnika godišnje
# / 100 000 stanovnika godišnje
25
3
0
PP (%)
4.0 1976.
1.2 2000.
4
0
4
HOSPITAL ADMISSION – ASTHMA
(<15 years)
I = 100
RR = 1.006 (1.000-1.017)
15
PP (%)
4.5 1976.
1.1 2000.
10
5
0
AMGI/EURASAP Workshop,
Zagreb
1976197819801982198419861988199019921994199619982000
1976197819801982198419861988199019921994199619982000
S02
50
8
TOTAL MORTALITY I = 1013
RR = 1.004 (1.003-1.0048)
RESPIRATORY MORTALITY I = 66
RR = 1.010 (1.006-1.014)
PP (%)
3.7 1976.
0.8 2000.
30
20
10
6
# / 100 000 stanovnika godišnje
# / 100 000 stanovnika godišnje
40
0
PP (%)
9.2 1976.
2.3 2000.
4
2
0
1976197819801982198419861988199019921994199619982000
1976197819801982198419861988199019921994199619982000
80
3
CARDIUOVASCULAR MORTALITY I = 497
RR = 1.012 (1.008-1.020)
2.5
PP (%)
10.9 1976.
2.7 2000.
40
20
0
1976197819801982198419861988199019921994199619982000
24-26 May 2007
# / 100 000 stanovnika godišnje
# / 100 000 stanovnika godišnje
60
2
1.5
HOSPITAL ADMISSION –
RESPIRABLE DISEASES
(15-64 years) I = 66
RR = 1.0018 (1.000-1.005)
PP (%)
1.8 1976.
0.5 2000.
1
0.5
0
1976197819801982198419861988199019921994199619982000
AMGI/EURASAP Workshop,
Zagreb
S02
20
10
5
0
1976197819801982198419861988199019921994199619982000
COPD
I = 101.4
RR = 1.0044 (1.000-1.011)
8
# / 100 000 stanovnika godišnje
HOSPITAL ADMISSION – ASTHMA
(<15 years)
I =100 RR = 1.015 (1.0052-1.0250)
PP (%)
13.2 1976.
3.3 2000.
6
PP (%)
4.2 1976.
1.0 2000.
4
2
0
1976197819801982198419861988199019921994199619982000
7
6
# / 100 000 stanovnika godišnje
# / 100 000 stanovnika godišnje
15
10
ACCUTE MIOCARD INFARCTION I = 132
RR = 1.0034 (1.0014-1.0052)
5
4
3
PP (%)
3.3 1976.
0.8 2000.
2
1
24-26 May 2007
0
AMGI/EURASAP Workshop, Zagreb
1976197819801982198419861988199019921994199619982000
TSP
Year
Number of cases in
100 000 /#
Attributable proportion
/%
Total mortality
2000
10,5
4,0
24,1
1,03
0,69
2,38
2001
8,2
5,5
18,9
0,81
0,54
1,87
2002
9,9
6,7
22,9
0,98
0,66
2,26
2003
12,4
8,3
28,5
1,22
0,82
2,81
2004
11,7
7,8
26,9
1,16
0,77
2,66
2005
11,1
7,4
25,6
1,10
0,74
2,54
Cardiovascular mortality
24-26 May 2007
2000
3,4
0,0
10,2
0,69
0,00
2,05
2001
2,7
0,0
8,0
0,54
0,00
1,61
2002
3,3
0,0
9,7
0,66
0,00
1,94
2003
4,1
0,0
12,0
0,82
0,00
2,42
2004
3,8
0,0
11,4
0,77
0,00
2,29
2005
3,7
0,0
10,8
0,74
0,00
2,18
AMGI/EURASAP Workshop, Zagreb
TSP
Year
Number of cases in
100 000 /#
Attributable proportion
/%
Respiratory mortality
2000
1,8
0,9
3,9
2,71
1,37
5,90
2001
1,4
0,7
3,1
2,13
1,08
4,67
2002
1,7
0,9
3,7
2,58
1,30
5,61
2003
2,1
1,1
4,6
3,20
1,62
6,92
2004
2,0
1,0
4,3
3,02
1,54
6,56
2005
1,9
1,0
4,1
2,89
1,47
6,28
Hospital admission – COPD
24-26 May 2007
2000
1,5
0,0
3,2
1,51
0,00
3,17
2001
1,2
0,0
2,5
1,18
0,00
2,50
2002
1,5
0,0
3,1
1,43
0,00
3,01
2003
1,8
0,0
3,8
1,78
0,00
3,74
2004
1,7
0,0
3,6
1,69
0,00
3,54
2005
1,6
0,0
3,4
1,61
0,00
3,38
AMGI/EURASAP Workshop, Zagreb
PM10
Year
Number of cases in 100
000 /#
Attributable proportion
/%
Total mortality
2000
23,8
20,0
27,6
2,35
1,98
2,72
2001
21,9
18,4
25,4
2,16
1,82
2,51
2002
22,6
19,0
26,1
2,23
1,88
2,59
2003
23,9
20,1
27,7
2,37
1,99
2,74
2004
20,1
16,9
23,3
1,98
1,67
2,30
2005
24,4
20,5
28,2
2,40
2,02
2,78
Cardiovascular mortality
24-26 May 2007
2000
12,6
8,0
27,5
2,54
1,60
5,53
2001
11,6
7,3
25,4
2,34
1,47
5,11
2002
11,9
7,5
26,1
2,41
1,52
5,27
2003
12,7
8,0
27,6
2,55
1,61
5,57
2004
10,6
6,7
23,3
2,14
1,35
4,69
2005
12,9
8,1
28,1
2,59
1,64
5,65
AMGI/EURASAP Workshop, Zagreb
PM10
Year
Number of cases in 100
000 /#
Attributable proportion
/%
Respiratory mortality
2000
2,5
1,0
7,1
3,76
1,54
10,74
2001
2,3
0,9
6,6
3,46
1,41
9,96
2002
2,4
1,0
6,7
3,57
1,46
10,25
2003
2,5
1,0
7,1
3,78
1,55
10,81
2004
2,1
0,9
6,1
3,18
1,30
9,19
2005
2,5
1,7
7,2
3,84
2,59
10,97
Hospital admission – respiratory diseases
24-26 May 2007
2000
22,5
13,6
31,3
1,83
1,11
2,55
2001
19,9
12,0
27,7
1,61
0,97
2,23
2002
20,9
12,6
29,0
1,70
1,03
2,37
2003
22,6
13,7
31,5
1,84
1,11
2,55
2004
17,6
10,6
24,5
1,45
0,87
2,01
2005
32,7
19,8
45,3
2,59
1,57
3,59
AMGI/EURASAP Workshop, Zagreb
PM10
Year
Number of cases in 100
000 /#
Attributable proportion
/%
Hospital admission – cardiovascular diseases
2000
12,4
8,3
17,7
2,84
1,91
4,06
2001
11,4
7,7
16,3
2,62
1,76
3,74
2002
11,8
7,9
16,8
2,70
1,82
3,86
2003
12,4
8,4
17,8
2,86
1,93
4,08
2004
10,5
7,0
15,0
2,40
1,61
3,43
2005
12,5
8,5
18,1
2,91
1,96
4,15
Asthma attacks in children
24-26 May 2007
2000
14,23
13,26
15,17
2001
13,23
12,32
14,12
2002
13,61
12,67
14,52
2003
14,31
13,34
15,26
2004
12,24
11,39
13,07
2005
14,51
13,53
15,48
AMGI/EURASAP Workshop, Zagreb
PM10
Year
Number of cases in 100
000 /#
Attributable proportion
/%
Asthma attacks in adults
24-26 May 2007
2000
1,28
0,00
2,54
2001
1,18
0,00
2,34
2002
1,22
0,00
2,41
2003
1,29
0,00
2,55
2004
1,08
0,00
2,14
2005
1,31
0,00
2,59
AMGI/EURASAP Workshop, Zagreb
PM2.5
Year
Number of cases in
100 000 /#
Attributable
proportion /%
Total mortality
24-26 May 2007
2000
32,2
23,8
40,5
3,18
2,35
3,99
2001
31,7
23,5
39,9
3,14
2,32
3,95
2002
31,6
23,4
39,7
3,12
2,31
3,92
2003
34,7
25,7
43,6
3,43
2,54
4,30
2004
26,5
19,6
33,3
2,98
2,21
3,75
2005/1
36,4
27,0
45,7
3,60
2,66
4,51
2005/5
41,9
31,0
52,5
4,13
3,06
5,18
AMGI/EURASAP Workshop, Zagreb
CONCLUSIONS
Results show significant negative trend of health effects incidences
related to TSP, black smoke and SO2 as a consequence of the
negative concentration trends during the investigated period.
Further investigations should be based on PM10/PM2.5 particle
fractions and their constituents (metals, sulphates, nitrates,
chlorides, polycyclic aromatic hydrocarbons, organic and
elemental carbon etc.) and nitrogen oxides.
Simultaneously, further development of models based on Zagreb data
should be continued so in the future health impact assessment of air
pollution in Zagreb could be used on Zagreb population as much
more reliable.
24-26 May 2007
AMGI/EURASAP Workshop, Zagreb