indicatoren voor gezondheidsimpact van fijn stof en ozon: dalys en externe kosten jurgen buekers...
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Indicatoren voor gezondheidsimpact van fijn
stof en ozon: DALYs en externe kosten
Jurgen Buekers & Rudi Torfs
05/04/2011
18/04/23 2© 2010, VITO NV
Introduction
Integrated science assessment for paticulate matter (US EPA 2009)
“a causal relationship exists between long-term exposures to PM2.5 and cardiovascular effects”
“a causal relationship exists between long-term exposures to PM2.5 and mortality”
Ozone and your health (US EPA 2009)
“Ozone can irritate your respiratory system, reduce lung function, aggravate asthma, etc.”
18/04/23 3© 2010, VITO NV
» Environmental health problems incomparable
» What is worse?
» 2 adults with a cardiovascular disease dying prematurely during a smog episode
» 10 children with asthma» 2 adults having some days problems with the lower
respiratory tract
Introduction
18/04/23 4© 2010, VITO NV
» DALYs» Combine information on the ‘quality’ and ‘quantity’ of
life» Give an indication of the potential number of ‘healthy’
life years lost due to premature mortality or morbidity
» DALY calculation = N x S x D» Number of people with environment-related
morbidity or mortality » Severity factor (0=healthy; 1=death) » Duration of disease
Disability Adjusted Life Years (DALYs)
18/04/23 5© 2010, VITO NV
Attributable cases (Number of people)Cases
Concentration
Observed Incidence Prevalence
Observed concentration
Relative risk Epidemiological studies (e.g. Pope et al., 2002)
18/04/23 6© 2010, VITO NV
Attributable cases (Number of people)Cases
Concentration
Observed Incidence Prevalence
Observed concentration
Threshold
Relative risk Epidemiological studies (e.g. Pope et al., 2002)
Basic frequency
Attributable cases
18/04/23 7© 2010, VITO NV
Disability or Severity weights
» Indication of the reduction in capacity due to the specific disease
» Varying from 0 (healthy) to 1 (death)
» Determined by experts (clinicians, researchers, etc.)
» Overviews available (WHO, Australian burden of disease study)
asthmaCardiovascular disease
18/04/23 8© 2010, VITO NV
Duration
» Duration for morbidity: years of life lived with disability (YLD)
» Duration for mortality: years of life lost (YLL)
18/04/23 9© 2010, VITO NV
DALYs
De Hollander A.E.M. Assessing and evaluating the health impact of environmental exposures “Deaths, DALYs of Dollars?”. University of Utrecht. 2004.
18/04/23 10© 2010, VITO NV
Uncertainties
» Framework of Knol Anne (2010)
» Context uncertainty e.g. selected stressor, endpoint» Model structure uncertainty e.g. causal relationship» Parameter & input data uncertainty e.g. health
statistics
Knol, A., 2010. Health and the Environment: assessing the impacts, addressing the uncertainties, Thesis Utrecht University, the Netherlands.
18/04/23 11© 2010, VITO NV
DALYs in general
» DALYs give an indication of the potential, relative order of magnitude of different (environmental) health problems, and can not be presented as absolute or completely representative numbers.
» Smoking, genetic ability, food consumption etc.
» Competing risks
18/04/23 12© 2010, VITO NV
Health outcomes
Based on NEEDS 2007 (New Energy Externalities Development for Sustainability)
18/04/23 13© 2010, VITO NV
MIRA - Particulate matter (PM2.5 & PM10)
0
50
100
150
200
2000 2010 2020 2030
Hea
lth
(DAL
Ys p
er 1
0 00
0 in
habi
tant
s)
Year
REFVISIEUR
18/04/23 14© 2010, VITO NV
MIRA - Ozone
0.0
0.5
1.0
1.5
2.0
2000 2010 2020 2030
Hea
lth(D
ALYs
per
10
000
inha
bita
nts)
Year
REFVISIEUR
18/04/23 15© 2010, VITO NV
EBoDE-project
» Quantification, comparison and ordering of different environmental stressors between EU countries
» Goal is to develop a uniform method to calculate the health impact of these stressors (DALY calculation) between different countries
» Create a platform for other countries
» http://en.opasnet.org/w/Ebode
World Health Organisation Europe
18/04/23 18© 2010, VITO NV
EBoDE / BoD
6-12% of the standard WHO BOD is associated with the nine environmental stressors.
18/04/23 19© 2010, VITO NV
External Costs (euro)
» Health effects expressed in term of external costs
» Quantification is based on attributable cases (identical as calculated for DALYs)
» Specific cost per case based on:-NEEDS (2007)-Reële milieugerelateerde gezondheidskosten in Vlaanderen (LNE, 2009 (Arcadis, MetroEconomia))
18/04/23 20© 2010, VITO NV
External Costs (euro) MIRA study
PM (euro/inhabitant) Ozone (euro/inhabitant)REF EUR VIS REF EUR VIS
2007 597 (±258) 597 (±258) 597 (±258) 39 (±18) 39 (±18) 39 (±18)2010 535 (±243) 520 (±220) 499 (±217) 42 (±20) 44 (±20) 43 (±18)2015 527 (±226) 472 (±198) 440 (±193) 46 (±20) 48 (±22) 45 (±20)2020 501 (±208) 409 (±184) 347 (±150) 47 (±22) 53 (±24) 43 (±20)2025 513 (±218) 402 (±181) 344 (±139) 50 (±22) 54 (±25) 42 (±19)2030 521 (±223) 410 (±173) 332 (±145) 53 (±24) 56 (±25) 39 (±17)
18/04/23 21© 2010, VITO NV
Summary
» DALY as indicator for health impact PM and O3
» Chronic exposure to PM2.5 largest health impact
» Particulate matter: REF > EUR > VISI
» EBoDE study: 9 stressors largest health impact exposure to air PM
» External costs