WHO-Project Environmental Health Indicators Experiences from Germany

1
WHO-ProjectEnvironmental Health
IndicatorsExperiences from Germany

• Project coordination
• Federal Environmental Agency
• Division of Environment and Health
• WHO CC Air Quality Management/Air Pollution
  Control
• J. Thelen, MPH, M.Sc.
• Dr. H.-G. Mücke
• Funded by the Ministry of Health and Social
  Security

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Environmental Health Indicators

• Project Workplan for the Pilot Study

• 06/2002 Start of the Pilot Phase in Germany
• 06-10/2002 Indicator Definition
  Review/Adjustment
• Testing of EuroIndy (1.1 to 1.5)
• 10/2002-5/2003 Identification of Dataholders,
  Data collection
• Data Compliation
• 06-10/2003 Development of Methods for
  Ind.calculation
• Work on the Fact-sheets
• Quality control of EuroIndy Database
• 08-12/2003 Analysis and Reporting

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Objectives of the Project

• Test Feasibility and Applicability of the EHI
  Set in Germany
• Develop Information Tools for
• Stakeholders in the field of Environment and
  Health (Politicis, Sience, Media,
  Organisations)
• Monitoring and Evaluation of Measures and Plans
  concering Health Protection from environmental
  Risks
• Communication to the Public and within the
  Administration (horizontal und vertical)
• International und national Networking of the
  Stakeholders in the field of environment related
  Health Protection
• Establishment of national und international
  Reporting Structures for assesment and comparison
  (Benchmarking, Best-Practice Modelle)
• Scientific Analysis

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Data availability for Germany (national level)
(29.03.2003)
(Number of Variables in the field of ...)

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Data Collection, Analysis

• Testing and Trail Operation of EuroIndy (1.1-1.5)
• Spatial Breakdown to NUTS 1-3 and large Cities
• Data availability
• NUTS1 good NUTS2 limited NUTS3 no data
• Large Cities
• Data from NUTS 2 and 3 is difficult to obtain
• Problems
• Action Indicators are Subject to Bias (subjective
  Assessment)
• Database EuroIndy needs further Development
• No Common Strategy for Health Impact Assessment

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Remarks on the thematic fields

• Most relevant for Germany Reports
• Air Quality yes
• Noise yes
• Traffic Accidents yes
• Drinking and Bathing Water Quality yes
• Relevant further Developement needed
• Chemical Safety (Emergencies) yes
• Food Safety partly
• Radiation yes

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Remarks on the thematic fields

• Relevant Health Impact uncertain Reports
• Waste and Contaminated Land yes
• Relevant Comprehensive Reporting
• by the National Agency
• Workplace

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Air Quality Results from Germany
Air_D1 Passenger Traffic Demand (by mode of
transportation)
Policies to Reduce Exposure to ETS (Air_A1) (not
shown)
Air_P1 Emissions of Air Pollutants
State (no Indicator)
Air_Ex1 Exposure of urban Population to Air
Pollutants
Health Impact (Air_E1, E2 and E3 not
evaluated) To be considered as an own Indicator,
or as part of the Assessment within Air_Ex1 ?
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Air_D1 Passenger transport demand per
inhabitant(Germany 1996-2001)
Source BMVBW, DIW (2003) Traffic in Figures
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Air_P1 Emissions of Air Pollutants
NOx
PM10
Ozone Precursors
SO2
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Air_Ex1 Exposure to Air Pollutants (urban
population)

• Methodology
• Large Cities gt100.000 Inhabitants Annual
  average Population
• Measuring Data from Urban Background Stations
  (yearly mean)
• Assumption Background Level represents long
  term Exposure
• More than one Station ? Mean of background
  Stations
• Limitation only exposure to Ambient Air
• Calculation of Exposure classes for urban
  Population in Germany

Background Station 1
City Population (Annual Mean)
City xy
Background Station 2

• Urban Air Quality
• (Annual Mean Station n)/n Stations
• for PM10 and NO2
• For Ozone Number of days gt 120µg/m3

Background Station 3
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Air_Ex1 Exposure to Air Pollutants (urban
population) PM10
(1999/30/EU) Annual Mean 40 µg/m3 Daily Mean
50 µg/m3
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Air_Ex1 Exposure to Air Pollutants (urban
population) NO2
1999/30/EG Annual Mean 40 µg/m3 1h-Mean 200
µg/m3
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Air_Ex1 Exposure to Air Pollutants (urban
population) OzoneNumber of Days over gt 120
µg/m3 (8h average)
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Health Impact (Air_E1 Air_E2 not evaluated)
Reduction of Statistical Life Expectancy by
Exposure to PM2.5
Calculation of statistical Life Expectancy (Life
table) RR 1.06 (95 CI 1.02-1.11) For all
cause mortality Pope et al., 2002 ACS Cohort
Study 500.000 US-Americans gt 30 J. PM2.5
Country Mean (Model) 1990 33.7 2010
(CLE) 15.7 2010 (MFR) 12.3 CLE Current
Legislation MFR Maximum Feasible Reduction
Szenario 2010
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Reduction of Statistical Life Expectancy by
Exposure to PM2.5 for 1990 und 2010
(CLE/MFR)International Comparison
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Prevention of MortalityEstimated Effect of
Particle Filters for Diesel Vehicles
Mortality Prevention potential (Excess Risk) 95 CI Cases Preventable Cases Range of different Models
All cause 1,8 1,2-3,3 800.000 14.400 9.600-19.200
Cardio-pulmonary 2,7 0,9-4,8 460.000 12.420 8.280-16.560
Lung cancer 4,2 1,2-6,9 40.000 1680 1.120-2.240
Wichmann 2003
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Environmental Health IndicatorsMany Wishes
Little Resources

• Current Indicator Projects in Germany
• (including EH Indicators)
• Some Examples
• WHO-Environmental Health Indicators
• WHO/EU ECOEHIS Project
• National Core Indicators for Sustainable
  Development
• Indicators for the Health Reporting of the
  Federal States
• Core Indicators for Sustainable Development of
  the Federal States

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EHI for the EU

• European Union
• Public Health Action Programme (1786/2002/EC)
• EH Indicators for the European Union
• WHO-Project ECOENHIS/ENHIS
• First Meeting in May 2003
• Discussion of the WHO Indicator Set
• Modifications needed for the use in the European
  Union
• Environment Health Strategy (COM(2003)338
  final)
• Working group on Environment and Health
  Indicators
• Health Impact Assessment
• Data should be useful for Health Impact Assessment

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Further Work (Dec. 2003)

• Finalisation of selected Fact Sheets
• Revision of the Methodology for Air Quality
  Indicators
• National Project Report
• Collaboration at the international Report (H.-G.
  Mücke)
• WHO Workshop (16./17. Oct. 2003)
• Specification of Report Structure Discussion of
  Fact Sheets for the International Report

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Thank you for your attention
For further information please contact juergen.th
elen_at_uba.de Federal Environmental Agency
www.umweltbundesamt.de WHO CC Air Quality
Management/Air Pollution Control www.umweltbundes
amt.de/whocc/title/title21.htm