Task Force on HealthRecent results -

Particulate matter

Michal Krzyzanowski

TFH Chair

Head, Bonn Office

European Centre for Environment and Health

WHO Regional Office for Europe

TFH for 30th Session of WGE

27-29 Sept 2011

Source: ENHIS

PM10 levels in European Region of WHO

TFH for 30th Session of WGE

27-29 Sept 2011

• 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

American Heart Association, Scientific Statement 2010: Evidence on causal link of CVD with fine particulate matter

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

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

Pope AC et al, NEJM 2009

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 TFH review of health effects of black carbon (BC) – contentscarbon (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