Transcript Task Force on Health Recent results Particulate matter Michal Krzyzanowski TFH Chair Head, Bonn Office European Centre for Environment and Health WHO Regional Office for Europe.

Task Force on Health
Recent results Particulate matter
Michal Krzyzanowski
TFH Chair
Head, Bonn Office
European Centre for Environment and Health
WHO Regional Office for Europe
PM10 levels in European Region of WHO
Source: ENHIS
TFH for 30th Session of WGE
27-29 Sept 2011
American Heart Association, Scientific Statement 2010:
Evidence on causal link of CVD with fine particulate matter
• The overall evidence is consistent with a causal relationship between
PM2.5 exposure and cardiovascular morbidity and mortality.
• This body of evidence has grown and been strengthened substantially
since the first American Heart Association scientific statement was
published in 2004.
• PM2.5 exposure is deemed a modifiable factor that contributes to
cardiovascular morbidity and mortality.
http://circ.ahajournals.org/content/121/21/2331
TFH for 30th Session of WGE
27-29 Sept 2011
Loss of life expectancy due to PM2.5 exposure in Europe –
cause-of-death-specific vs. all cause estimates
TFH for 30th Session of WGE
27-29 Sept 2011
Predicted average gain in life expectancy (months) for
persons 30 years of age in 25 Aphekom cities for a
decrease in average annual level of PM2.5 to 10 μg/m3
TFH for 30th Session of WGE
27-29 Sept 2011
Associations between air pollution and the incidence of
asthma and wheeze – meta-analysis of cohort studies
Per 10 µg/m3 NO2
Per 10 µg/m3 PM2.5
Anderson et al, Air Qual Atmos Health 2011
(NB: no association between asthma prevalence and AP)
TFH for 30th Session of WGE
27-29 Sept 2011
Comparison of impacts of air pollution on exacerbations of
diseases using two different HIA approaches in Aphekom
TFH for 30th Session of WGE
27-29 Sept 2011
Reduction of PM exposure
and increase of life expectancy in the US
Pope AC et al, NEJM 2009
A decrease of 10 µg/m3 of PM2.5 associated with increase of life expectancy
by 7.3 months between 1980 and 2000
Reduction in PM accounts for 15% of overall increase in life expectancy
TFH for 30th Session of WGE
27-29 Sept 2011
Benefits and costs of the Clean Air Act of
the USA
Source: US EPA 2011
http://www.epa.gov/oar/sect812/prospective2.html
TFH for 30th Session of WGE
27-29 Sept 2011
European Study of Cohorts for Air Pollution
Effects - ESCAPE
• EU FP7 project, 25 patners, coordinated by
Univ Utrecht
• 30 cohorts, total 645,800 subjects followed
over several years, ca. 37,000 deaths
• ESCAPE monitors PM2.5, PM10, NO2,
NOx, BC, elemental composition of PM
(TRANSPHORM)
• Exposure assessment based on land use
regression models
• First results expected mid-2012
TFH for 30th Session of WGE
27-29 Sept 2011
TFH review of health effects of black
carbon (BC) – contents
• Metrics used to estimate BC exposure
• Effects of BC exposure observed in epidemiologic
studies
• Evidence from toxicology including human clinical
studies
• Conclusions
http://live.unece.org/fileadmin/DAM/env/documents/2011/eb/wge/ece.eb.air.wg.1.2011.11.pdf
TFH for 30th Session of WGE
27-29 Sept 2011
Single city, single pollutant estimates of risk of all
cause mortality associated with PM10 and BC
Janssen et al, EHP 2011
TFH for 30th Session of WGE
27-29 Sept 2011
TFH review of health effects of black
carbon (BC) –conclusions (1)
• Sufficient evidence on association of short-term (daily)
variations in BC concentrations with short term changes in
health and on associations of all cause and cardiopulmonary
mortality with long-term average BC exposure.
• Suggestive evidence from short-term studies for BC being a
better indicator of harmful particulate substances from
combustion sources - especially traffic - than undifferentiated
PM mass
• Insufficient evidence to allow of an evaluation of the
qualitative differences between health effects of exposure to
BC or to PM mass
http://live.unece.org/fileadmin/DAM/env/documents/2011/eb/wge/ece.eb.air.wg.1.2011.11.pdf
TFH for 30th Session of WGE
27-29 Sept 2011
TFH review of health effects of BC –
conclusions (2)
• TFH agreed that the reduction of exposure to PM2.5 containing BC,
and other combustion related PM material, for which BC is an indirect
indicator, should lead to reduction of the health effects associated with
PM.
• TFH recommended continuing the use of PM2.5 as the primary
approach in quantifying the human exposure to PM and its health
effects, and for predicting the benefits of exposure reduction measures.
• In evaluation of local actions aimed at reduction of population exposure
to combustion particles (e.g. from motorized traffic) the use of BC as an
additional indicator may be useful.
http://live.unece.org/fileadmin/DAM/env/documents/2011/eb/wge/ece.eb.air.wg.1.2011.11.pdf
TFH for 30th Session of WGE
27-29 Sept 2011