who european centre for environment and health
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WHO European Centre for Environment and Health. TASK FORCE INTEGRATED ASSESSMENT MODELLING (Twenty-eight session, Haarlem, 7-9 May 2003 ). Recent WHO Findings on Health Risks Introduction Projects Key findings Follow-up. Jürgen Schneider Project Manger WHO ECEH, Bonn, Germany. - PowerPoint PPT PresentationTRANSCRIPT
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Recent WHO Findings on Health Recent WHO Findings on Health RisksRisks
• Introduction Introduction • Projects Projects • Key findingsKey findings• Follow-upFollow-up
Jürgen Schneider Jürgen Schneider Project MangerProject Manger
WHO ECEH, Bonn, GermanyWHO ECEH, Bonn, Germany
TASK FORCE INTEGRATED ASSESSMENT MODELLINGTASK FORCE INTEGRATED ASSESSMENT MODELLING
(Twenty-eight session, Haarlem, 7-9 May 2003(Twenty-eight session, Haarlem, 7-9 May 2003 ))
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
WHO Air Quality and Health WHO Air Quality and Health
• Methodology of health impact assessment (participation in AIRNET & APHEIS)
• Systematic Review of Health Aspects of Air Quality in Europe (focus on ‘priority pollutants’ PM and ozone, NO2)
• Update of WHO Air Quality Guidelines
• Health impacts of transport-related air pollution
• Health risks of POPs from LRTAP
• AQ strategies for NIS
• Capacity building in air quality monitoring and assessment (NIS & ALB)
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
WHO Project WHO Project Systematic Review of Health Aspects of Air Quality in EuropeSystematic Review of Health Aspects of Air Quality in Europe
(2002-2004)(2002-2004)
Purpose:To provide the EC DG Environment (& CAFE) with a systematic, periodic, scientifically independent review of the health aspects of air quality in Europe.
Scientific Advisory Committee (SAC)
Guides the overall review
WHO Working Group (SAC + invited experts)Up-date the scientific evidence on health aspects of air pollution, agree on answers
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Systematic Review
Health aspects of PM, NO2 and ozone
• Focused on twelve questions received from the CAFE Steering Group
• Used state-of-the-art knowledge on epidemiology and toxicology
• Short answers, supported by more extensive justifiactions
• Extensively reviewed
• Presented to stakeholders in Brussels
• Now available on web:
http://www.euro.who.int/document/e79097.pdf
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
1) Is there new scientific evidence to justify reconsideration of the current WHO Guidelines for the pollutant?
Particulate matter: Yes • Association of PM exposure with health effects have been strengthened• Fine PM (measured as PM2.5) strongly associated with mortality and
other endpoints• PM10 is still considered to be a relevant metrics• BS should be re-evaluated
Ozone: Yes• Evidence from epidemiological studies on effects of short-term exposure
to ozone (mortality and morbidity)• Evidence of long-term effects on lung function
Nitrogen dioxide: No• Very limited new evidence on potential mechanisms of NO2 effects• Reiteration of important role of NO2 as indicator for traffic related air
pollution and precursor of both ozone and secondary PM
Systematic Review
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
2 ) Which effects can be expected of long-term exposure?
PM• Long-term exposure may lead to a marked reduction in life
expectancy. Increases in lower respiratory symptoms and reduced lung function in children, COPD and reduced lung function in adults
Ozone• Reduced lung functions in children
NO2
• Some evidence for decreased lung function and increase of risk of respiratory syndroms
Systematic Review
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
3) Is there a threshold below which no effects on health are expected to occur in all people?
For all three pollutants: No
• The population distribution of susceptibility may be such that effects are expected at very low levels
• Thresholds differ depending on endpoint selected• Increasingly sensitive epidemiological study designs have identified
adverse effects of air pollution at increasingly lower levels
Replacing the threshold concept with a more complete concept using exposure risk functions should be considered
Systematic Review
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
4) Are the effects dependent on the subject’s characteristics?
PM • Elderly and those with pre-existing disease are at higher risk• Socially disadvantaged and poorly educated are at higher risk for
mortality
Ozone• Mortality and hospital admissions increase with age• Effects on asthmatic children might be greater• Larger effects in children which spend more time outdoor
Nitrogen dioxide
Systematic Review
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
6) Is the considered pollutant per se responsible for effects on health?
PM: Yes – even though no single causative agent can be identified
Ozone: Yes
Nitrogen dioxide: A clear answer can not be given
Systematic Review
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
7) For PM: which of the physical and chemical characteristics of particulate air pollution are responsible for health effects?
• Fine PM is more hazardous than larger particles• Metal content• Organic components such as PAH• Endotoxins• Extremely small particles (< 100 nm)
Systematic Review
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
10) Which are the critical sources of the pollutant?
• Motor vehicle emissions• Other combustion processes• Wind-blown dust of crustal origin: less critical
Systematic Review
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
12) What averaging period is most relevant from the point of view of protecting human health?
Particulate matter:
• Short-term (24 hours) and long-term (annual) guidelines are recommended
Ozone:
• Short-term: 8-hour average is appropriate • Long-term: associations are not clear enough to allow specific
recommendation
Nitrogen dioxide:
• Both, short-term (1 h) and long-term are warranted
Systematic Review
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Follow-up: Meta-analysis to derive concentration-response functions for
Particualte matter• Mortality (cause-specific)• Hospital admissions (cause-specific)
Ozone• Mortality (cause-specific)• Hospital admissions (cause-specific)• Symtom exacerbation in astmatics
Nitrogen dioxide• The working group did not recommend the use of regression
coefficients for NO2 from regression models to assess the effect of NO2 by itself.
Systematic Review
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Second round of questions by CAFE Steering Group
• Relevance of peak exposure? • Uncertainties• Specific populations at risk?• Why should we keep the annual AQG for NO2?• Other polluants relevant?
Systematic Review
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
• WHO AQG published in 2000, but work finalised in 1996 • Systematic review recommended an update for PM and ozone• Update a world-wide activity • Process initiated; request for funding• Finalise until end of 2004
Update WHO AQG
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Joint UN/ECE WHO Task Force on Health
6. Meeting 22-23 May in Bonn
• Approaches to risk assessment• Modelling and assessment of health impacts of particulate matter and
ozone from long range transboundary air pollution • Relevance of secondary inorganic aerosols for PM-related health
effects • Is the AOT60 approach still appropriate?• Possible approaches to include effects on morbidity into IAM
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
CAFE WG on PM
PM is a priority pollutant of CAFE -> WG on PM
Revision of Position Paper on PMAttainability of current LV (stage I and II)Guidance on targets for CAFE/IAM, based on advice from WHO, but also
other considerations like attainability, cost-effectivness, etc. Draft version of the revised position paper will be discussed at a
stakeholder conference in October 2003
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
Health impacts of transport-related air pollution
ObjectiveThe objective of the WHO workshop is to provide a systematic literature review on transport-related health hazards.
Time schedule 15th July, submission of papers 1st September, the draft monograph for external review Mid October 2003 - WHO WG Workshop in WHO Bonn
Office• End 2003 - finalizing the monograph Contents1. Factors Determining Emissions in the European Regions2. Contribution of Traffic to Ambient Air Pollution Levels in the
European Region3. Human Exposure to Transport Related Air Pollution and Dose4. Epidemiological Studies on Transport Related Health Effects5. Toxicological Studies on Transport-Related Health Effects6. Assessment of Health Hazards of Transport-Related Air
Pollution
WHO European Centre for Environment and HealthWHO European Centre for Environment and Health
TASK FORCE INTEGRATED ASSESSMENT MODELLINGTASK FORCE INTEGRATED ASSESSMENT MODELLING
(Twenty-eight session, Haarlem, 7-9 May 2003(Twenty-eight session, Haarlem, 7-9 May 2003 ))