Monitoring environmental health around Schiphol airport

Carla van Wiechen, Danny Houthuijs, Siem Heisterkamp, Erik Lebret

2EUROHEIS 30-31 March 2003 | Carla van Wiechen

F

GB

DB

NL

3EUROHEIS 30-31 March 2003 | Carla van Wiechen

Health Impact Assessment Schiphol (HIAS)

Monitoring programme 2002 - 2006

Aims

• to keep the “finger on the pulse”

• to assess changes in environmental quality and environmentally related health effects

• to support the decision making process on the development of air traffic

4EUROHEIS 30-31 March 2003 | Carla van Wiechen

HIAS - Monitoring

Combination of various study designs

• cross-sectional questionnaire survey (2002)– reference data

• panel study (2002 - 2005)– in areas with expected changes in aircraft noise

• small area level analyses with routine data– follow-up spatial pattern of disease

5EUROHEIS 30-31 March 2003 | Carla van Wiechen

HIAS - small area health statisticsHealth data• hospital admissions

– cardiovascular diseases– respiratory diseases

• medication use– cardiovascular– respiratory– sleeping pills / sedatives

• Environment Advisory Committee Schiphol– number of complainants about aircraft noise

6EUROHEIS 30-31 March 2003 | Carla van Wiechen

HIAS - small area health statistics

Population data• per postcode area, by 5-year age and sex

– yearly updated (national statistical office)

Health determinants at postcode level• socio-economic indicators

– % high and low income– average value of housing stock

• % non-Western immigrants• smoking

– estimation of % smokers

7EUROHEIS 30-31 March 2003 | Carla van Wiechen

HIAS - small area health statisticsGeographical data

• spatial link

via postcode

• area 55 km2

• 490 postcodes

• total population:

2,890,000

• postcode average:

5,900 inhabitants

[10 - 21,000]

8EUROHEIS 30-31 March 2003 | Carla van Wiechen

HIAS - small area health statistics

Environmental exposure data

air traffic noise

Lden (day, evening, night)

50 dB(A)

58 dB(A)

9EUROHEIS 30-31 March 2003 | Carla van Wiechen

HIAS - small area health statistics

Environmental exposure data

Lnight (23:00-7:00)

49 dB(A)

10EUROHEIS 30-31 March 2003 | Carla van Wiechen

11EUROHEIS 30-31 March 2003 | Carla van Wiechen

Average Lden per postcode with min. and max. values (2000)

25

30

35

40

45

50

55

60

65

70

75

80dB(A)

12EUROHEIS 30-31 March 2003 | Carla van Wiechen

variance:

• between postcodeshigh (30)

• within postcodeslow (1)

• between yearslowest (0.5)

Average values of Lden

per postcode

<= 41

42 - 45

46 - 49

50 - 53

54 - 57

58 - 61

62 - 65

> 65

50 dB(A)-contour (Lden), 2000<= 41

42 - 45

46 - 49

50 - 53

54 - 57

58 - 61

62 - 65

> 65

50 dB(A)-contour (Lden), 2000 0 km 10

13EUROHEIS 30-31 March 2003 | Carla van Wiechen

HIAS - small area health statistics

Statistical method– Bayesian disease mapping– spatiotemporal modelling– Markov chain Monte Carlo simulation methods

(MCMC)– compare competing models:

exchangeableconditional autoregressive (CAR)

– use of Expected Predicted Deviance (EPD)

14EUROHEIS 30-31 March 2003 | Carla van Wiechen

Complainantsaircraft noise

– Standard Ratio– year 2000– model:

exchangeable – interaction

of time and site

<=90

>90-110

>110-150

>150-200

>200-300

>300

50 dB(A)-contour (Lden), 2000not significant

<=90

>90-110

>110-150

>150-200

>200-300

>300

50 dB(A)-contour (Lden), 2000 0 km 10

15EUROHEIS 30-31 March 2003 | Carla van Wiechen

x-axis: average Lden per postcode (logarithmic)y-axis: Mean SMR (complainants), Exchangeable-model + interaction, year 2000 where postcode areas have >= 100 inhabitants

0

200

400

600

800

1,000

25 30 35 40 45 50 55 60 65 70

100

16EUROHEIS 30-31 March 2003 | Carla van Wiechen

HIAS - small area health statistics

Resuming• ingredients to get started• further development of aggregated health

determinants• search for solutions to constraints• further exploration of exposure co-variables

Thank you for your attention!

17EUROHEIS 30-31 March 2003 | Carla van Wiechen

HIAS - Monitoring

Environmental exposure data

Expected changes

between years

2000 and 2005

(Lden)

noise decrease

noise increase

18EUROHEIS 30-31 March 2003 | Carla van Wiechen

HIAS - Monitoring

Environmental exposure data

Road traffic

Lday (7:00-23:00)

49 dB(A)

19EUROHEIS 30-31 March 2003 | Carla van Wiechen

Health Impact Assessment Schiphol (HIAS)

Phase I 1991-1993

Health studies in relation to environmental pollution,as part of Environmental Impact Assessment

Phase II 1995-2002

Fill up gaps in knowledge

• Ecological studies: health registries

• Epidemiological field studies on e.g.:- annoyance, self-reported health, perceived risks- sleep disturbance - respiratory complaints in children- performance of children (RANCH)