10.6.2009

Ella Nave, M.P.H - Coalition for Public HealthJames Krikun, PhD.- Coalition for Public Health

Special Thanks to Dr. Moshe Shirav Schwartz and Dr. Ziona Haklai Dr. James Krikun and Neveen Matar Dahdal

Taken on summer 22.6.200622.6.200622.6.200622.6.2006

Ella Nave

The Coalition For Public Health: "Past, Present and Future; what awaits the kids in the Haifa–bay area?"

Massive Exposure of the Local Population to extremely high levels of pollutants, such as: Transition Metals, Volatile Organic Compounds, etc. Factories working with no emission control means. Considering the unique topography, low stack height, and meterology of Haifa, pollutants are “stuck”

On the Other hand, Environmental Epidemiological Research is limited due to lack of Accurate Exposure Assessment (Only SO2 and NO2 monitored until 90's, no volatiles measured in the neighboring cities etc), diffucult pollutant modelling etc.

In the past…Pollution

© 2006אלה נ ו וה

Even though this, Associations are found in the 80's between high pollution areas and several respiratory diseases, compared with low pollution areas. For Instance, a local research found elevated risks for more than 3 colds per year, Bronchitis, and suptum without cold.) Goren A.I. et al. 1990 Prevalence of Respiratory Conditions among Schoolchildren Exposed to Different levels of Air Pollutants in the Haifa Bay Area, Israel.

Another research: “The effects of exposure to air pollution (defined by levels of SO2) were also studied in a representative sample of over 3,500 households in the greater Haifa area.. The sample was drawn from 16 high and low pollution neighborhoods .... A very significant relationship was found between levels of pollution in residential and work areas and self-reported respiratory symptoms and diseases…

Epstein et al. 1991 Air pollution and morbidity in the Haifa region Area, Israel. Harefuah 1991 Jun 16;120(12):709-14.

In the past…Research

Also found in the 80's – are high levels of blood lead in high pollution areas compared with low pollution areas.

Richter ED, Berant M, et al. Blood zinc protoporphyrin levels in the children and wives of lead battery workers: a preliminary report. Isr. J. Med Sci. 1985 Sep;21(9):761-4.

Richter ED, Berant M, et al. Zinc protoporphyrin levels in children in Haifa: a pilot study. Sci. Total Environ. 1986 Jan; 48(1-2):109-21.

.

In the past…Research

YES. The Embryo, child and teenager is more affected by environmental pollution, and specifically, by air pollution. Some reasons for that are:

1. Embryos have exposure windows, when exposure to environmental pollutants would be more harmful than at different timing, For instance: when bronchi or brain are developed.

2. Lungs - babies have less alveoli than 4 year old kids. Also, the ratio of Surface to

body mass is greater in kids, enabling them to breath 50% more air per kg than adults ! If lung functions are decreased due to air pollution, the heart might be also affected.

3. The body tissues of a child are still developing, and therefore are more vulnerable to pollutants harming DNA etc.

4. A child's Immune system as not yet developed at birth, and so more affected by environmental toxins than in adulthood.

5. Liver Enzymes less effective than at adulthood, therefore- detoxifying toxins is more of a challenge to them.

Are kids more vulnerable?

Epidemiology at Present…

Exposure ? � Morbidity ?

Are kids in Haifa-bay area still exposed? Are kids in Haifa-bay area

any sicker than in other places?

Only hints will be given, your answer is needed !

Are kids in Haifa-bay area still exposed?

YES.

These Pictures were taken April 2009…Fact is that this is NOT a dust storm.

14:30 PM2.5 level were 67micrograms/m3 in Neve Shannan, 55 in K. Tivon and 41 in Ahuza 01/04/09

1. Data from Monitoring Stations of Haifa District Municipal Association for the Environment– 80’s-2009 showing Long term exposure to high

levels of particulate matter and other pollutants. According to these,

Industry and Electricity production are the major polluters of Haifa Bay area with Particulates, and VOC’s, which we know today is the more problematic fraction of air pollution.

2. Data from Geological Surveys – 2007 (validating long term exposure to transition metals, as detected by high anthropogenic attributed ground levels)

3. Data from The Israeli Environmental Protection Agency – 4 samples in 20 spots were carried out in 2007-2008, some air samples showing exceeding levels of carcinogens in schools, residential neighbourhoods, etc.

Are kids in Haifa-bay area still exposed after 2000?

YES . How do we know?

קצב פליטת חומר חלקיקי מתעשיות ויצור חשמל,

בהשוואה לפליטות מתחבורה, בשנים 2002-2007 (טון לשנה)

1410

1594

13051437

1012

635

902 964

666561

22879

0

200

400

600

800

1000

1200

1400

1600

1800

2002 2003 2004 2005 2006 2007שנה

השנלן/טובת טוליפב צק

פליטות חלקיקים

מתעשיה ויצור

חשמל

פליטות חלקיקים

מתחבורה

הת עשייה ויצור ה חש מל באזור . יחסי הפ ליטו ת ת חבו רה ל ת ע שיה הן לרע ת ה ת עש יה ויצור החשמ ל: ניתן לרא ו תבין . 2002-2007כ כל ס קטו ר ה תחב ור ה בשנים " מאשר סהPM10מפרץ חיפה פו לטים יו תר חל קיקים מ סוג

ות איגוד ערים ות איגוד ערים ות איגוד ערים ות איגוד ערים """"דוחדוחדוחדוח: : : : מקורמקורמקורמקור. ( הייתי ירידה בקצב פליטות ה חומ ר ה ח לקיקי ם בשני הסקט ו רים2007- ל 2002השנים ))))2007200720072007----1998199819981998חיפה לשנים חיפה לשנים חיפה לשנים חיפה לשנים

Source: Annual reports, Haifa District Municipal Association for the Environment

4.4פי

8פי

2.5פי

1. Rate of Particulate Matter Emission (PM10) from

Industries and Electricity Production in Comparison to Mobile Sources years 2002-2007 Ton/year – Haifa area

התעשייה וי צור . יחס י הפליטות תחבורה לתעשיה הן לרעת התעשיה ויצור הח שמל:ניתן לראותכ כל " יותר תרכובות אורגניות נדיפות מאשר סה2החשמל באזור מפרץ חיפה פולטים כ מעט פי

אפשר להתייח ס לירידה בסקטור התעשיה ויצור ה חשמל . 2004-2007סקטור התחבורה בשנים ות איגוד ות איגוד ות איגוד ות איגוד """"דוחדוחדוחדוח: : : : מקורמקורמקורמקור. ( למצב גרוע, כאל ירי דה ממצב גרוע מאוד2007- ל2004בין השנ ים

))))2007200720072007----2002200220022002ערים חיפה לשנים ערים חיפה לשנים ערים חיפה לשנים ערים חיפה לשנים

VOCs

Transportation

3.1פי

2פי

1. Rate of Volatile Organic Compounds Emissions from Industries and Electricity Production in Comparison to Mobile

Haifa area----Sources years 2002-2007 Ton/year

קצב פליטת תרכובות אורגניות נדיפות (VOC's) מתעשיות ויצור חשמל,

בהשוואה לפליטות מתחבורה, בשנים 2002-2007 (טון לשנה)

13473 13473 13473 13473

10932.59896

7271 7411

8839

6631

3521.5

5344

2000

4000

6000

8000

10000

12000

14000

2002 2003 2004 2005 2006 2007שנה

השנלן/טובת טוליפב צק 1.85פי

3.1פי VOCs

Industry, Electriciy

production

Does any of you know what weighs 13,000 tons?

Answer: 1 bus without passengers is ~13 tons.

Imagine 1000 buses – this is the weight of

VOC’s spreading in yearly between 2002-2005 on your hometowns.

Remember, that some Volatiles show no threshold limit for causation of cancer…

Just for general knowledge….

ריכוז החלקיקים הממוצע השנתי (PM10) שנמדד בשנים 2006 ו2007 במפרץ חיפה

micrograms/m3

48

5559

42

50

42

5349

39

48

0

10

20

30

40

50

60

70

נווה שאנן נשר קרית אתא שוק תלפיות איגוד- צ'ק פוסט

תחנת ניטור

PM

10ם קיקיחלז כורי

2006

2007

1. Annual averages of Particulate Matter Emission (PM10) concentrations - Comparison between different areas of the bay - years 2006-2007

Validation of 2. Environmental Exposure to Transition Metals

Soil SamplingFrom Manganese/Iron RatioAnthropogenic

פוגע = נוירוטוקסי� = מנג� *

במערכת העצבי�

Validation of 2. Environmental Exposure to

Soil SamplingMetals From

502Cadmium/PAnthropogenic

מסרט� ודאי לאד�= קדמיו� *

some air samples showing exceeding levels of carcinogens in schools, residential neighborhoods, etc.

0.097 0.3180

16.24

18.373

0.1620.499

0.083

10.485

13.67

0.153

6.519

0.356 0.5230.153

16.006

0.440.404

16.495

0.3820.559

0123456789

1011121314151617181920

יוני-07 ספטמבר-07 פברואר08 אפריל-08

תאריך הדגימה

קמ"ם/רוגרקמית דוחיביז כורי

נווה שאנן תל חי

(ביה"ס)כפר הנוער הדתי

חסידיםבי"ס דגניה

אולם ספורט קרית

חייםמעון גן אור

חוצות המפרץ

(מנהלה)

3. Data from The Israeli Environmental Protection Agency –Benzene Concentrations in several educational institutions and schools carried out in 2007-2008,

ערך הייחוס

היממתי

מסרט� ודאי לאד�= בנז� *

K. Haim, K. Binyamin (Ata), Neve Shannan, Kfar Hasidim

all air samples shown exceed levels of carcinogens allowed. Don’t forget, these are schools, residential neighborhoods, etc.

3. Data from The Israeli Environmental Protection Agency –Formaldehyde Concentrations in several educational institutions, and schools carried out in 2007-2008,

מסרט� ודאי לאד�= בנז� *

K. Haim, K. Binyamin (Ata), Kfar Hasidim

1.722

2.74

4.94

2.99

1.891

3.81

3.328

2.63 2.554

1.516

2.19

1.64

2.829

1.549

2.939 2.765 2.862

0

1

2

3

4

5

6

ספטמבר-07 פברואר08 אפריל08

תאריך הדגימה

קמ"ם/וגרקמית דוחיבים המזהז כורי

נווה שאנן תל חי (ביה"ס)

כפר הנוער הדתי חסידים

בי"ס דגניה

אולם ספורט קרית חיים

מעון גן אור

חוצות המפרץ (מנהלה)

ערך הייחוס

היממתי

מסרט� ודאי לאד�= פורמלי� *

These are considered in the world literature high levels of Dioxins.

3. Data from The Israeli Environmental Protection Agency –Dioxins Concentrations in several educational institutions, and schools carried out in 2007-2008,

K. Haim (almost 60 phemtograms), K. Binyamin (Ata) – 60-70 phemtograms

ערך הייחוס

היממתי 0

0.01

0.02

0.03

0.04

0.05

0.06

0.07

0.08

ני2007 יו ספטמבר2007 פברואר2008 אפריל2008

תאריך הדגימה

קמ"ם/רגקופיבז כורי

נווה שאנן תל חי (ביה"ס)

כפר הנוער הדתי חסידים

בי"ס דגניה

אולם ספורט קרית חיים

מעון גן אור

חוצות המפרץ (מנהלה)

מסרט� ודאי לאד�= דיוקסי�*

What does the World Health Organization declare about air pollution and Causality?

http://www.euro.who.int/HEN/Syntheses/short/20060224_1?PrinterFriendly=1&who

“Effects for which evidence is sufficient to infer a causal relationship with exposure to air pollutionThere is now substantial evidence on the adverse effects of air pollution on different pregnancy outcomes and infant health. The evidence shows that air pollution, with concentrations typical of many European cities, increases the risk of death from respiratory causes in the postneonatal period.The evidence also shows a relationship between exposure to ambient air pollutants and adverse effects on the development of lung function. Reversible lung function deficits, chronically reduced lung growth rates and lower lung function levels are associated with exposure to air pollution. Moreover,

the evidence shows clearer relationships for particulate matter and traffic-related air pollution (indicated by nitrogen dioxide) than for other pollutants. Based on current knowledge, air pollutants seem to interact with other environmental factors, such as allergens, viruses and diet, that influence the overall impact of air pollutants on children's health.

The report concludes that there is a causal relationship between exposure to air pollutants and aggravation of asthma. The evidence is also sufficient to assume a causal link between exposure to particulate matter and increased prevalence and incidence of cough and bronchitis.In particular, such environmental contaminants as certain heavy metals and persistent organic pollutants show significant adverse effects on the development of the nervous system and behaviour in children. Also, there is sufficient evidence of a causal

relationship between exposure to lead and neurobehavioral deficits in children, in terms of cognitive

"impairment.

Reduction of particulate air pollution levels

improves the health and lung functions of children and adults, and saves from mortality.

Laden et al., Pope et al., Avol et al.) (

This is a scientifically approved fact (see WHO report).

There are also good news: We also know that….

Epidemiology at Present…

� Morbidity ?

Are kids in Haifa-bay area any sicker than in other places?

Only hints will be given, your answer is needed !

General Hospitalizations of Children ages 0-4 presented at precentage above/under the country’s ,

average (o line) at several cities and districts in years 1998-2002.

Source: Lamas

0

200

400

600

800

1000

1200

1400

1600

1800

פתצ

רתכנ

אלרע

יז עכו

פהחי

רהחד

רוןשה

והתק

ח-פת

להרמותוברחלון

שקא

בעשר-

בא

נפה

10

0,0

00לו פזשאתהשם דיל ירעושי

2004

2005

2006

Hospitalizations due to Aggravation of Asthma of Children 0-4 presented at rate/100,000 in several nafot in years 2004-2006.

Source: Ministry of Health, at request

) אשפו זים עקב ה חמרה של אס טמ ה(

This is not the whole picture… Innovative Studies

New Air Pollution Cohorts► Effects on Children’s Cognition through the Olfactory nerve and circulation to brain.

► Effects on Obesity (PCB’s)

► Effects on the risk of developing Asthma in 1st

year of life.

► Effects on DNA methylation

)BAMSE( מחקר ק וה ור ט פרוספקט יב י - שוודיה•

what awaits the kids in the Haifa–bay area?

?שאלות

It’s in our hands to decide!Change Policy-altogether with

better Research !