Health Impacts of Air Pollutants

1
Health Impacts of Air Pollutants

• Bert Brunekreef, Hanna Boogaard

2
Starting point CAFE questions

• Which health effects are caused by AP?
• Epidemiological, human experimental and animal
  experimental evidence of CVD effects considerably
  strengthened
• First EU cohort study suggesting PM2.5 mortality
  effects
• Joint analysis of traffic air pollution and noise
  suggests independent effects
• More evidence of effects on lung growth,
  sensitisation, infections from child cohorts
• Suggestive evidence of CNS effects

3
CAFE..

• Which population groups are at highest risk?
• More information on genotypes
• More information on SES
• More information on diet as effect modifier
• More information on clinical features of
  sensitive subjects eg MI survivors, diabetics etc

4
CAFE..

• Does pollution reduction help?
• HEI accountability initiative
• CS/LEZ studies from London (HEI)
• German reunification studies (HEI)
• Extended follow-up of Six Cities cohort
• Follow-up of SCARPOL SAPALDIA studies

5
CAFE..

• Are there safe pollution levels?
• Thresholds addressed for PM and ozone in new time
  series analyses including three independent meta
  analyses on ozone

6
Further PM issues

• Relevance of coarse PM including non-exhaust road
  traffic PM (ERJ review, new original toxicology
  and epidemiology data)
• Wood smoke, wild fire and other biomass fuel
  combustion products (Naeher review, California,
  Brazil studies etc.)
• Wind blown dust (Asian studies)
• Ultra fine particles (HEAPSS) do not explain PM
  mass epidemiology but of health interest by
  themselves
• Relevance of short lt24 h exposures

7
Traffic

• Several new traffic studies
• Asthma in children (CHS)
• Lung growth (CHS)
• Resp. infections, Otitis Media (PIAMA)
• Sensitisation (PIAMA, BAMSE)
• Resp. symptoms (several birth cohorts)
• Emerging traffic participation studies (Riediker
  US patrol men, Peters NEJM MI survivors etc)
• HEI prepares new literature review
• Emerging literature on participation in traffic
  subways

8
CAFE Ozone.

• Averaging time? New analysis of human laboratory
  data
• Long term effects emerging

9
CAFE NO2

• Mixed new EPI long term results (PATY ACS
  negative, EU cohort mortality studies generally
  positive)
• Important new findings from CHS study re lung
  growth and asthma
• Changing NO/NOx ratio in primary exhaust

10
WHO support for new SO2 AQG?

• New data on PM composition from Hong Kong
  intervention role of nickel? (Lippmann papers)

11
Climate change and air pollution

• Effects on ozone episodes effects modeled
• Effects on length of pollen season and on
  geographic distribution of allergenic plants

12
Comparative Risk Assessment

• Deaths vs. DALYs and associated approaches to
  communicate risk
• WHO Environmental Burden of Disease report
• IOM Comparative analysis of PM2.5, ETS and
  traffic accident burdens in UK
• GBD update started

13
Research questions on (outdoor) air pollution and
health

• E-R functions for long term effects (HIA
  Policy)
• Independent role of coarse PM
• Non-exhaust traffic PM
• Growing importance of wood smoke, wild fires
  (relation with climate land use change)
• CNS effects
• Relative toxicity of local and background PM
• Toxicity evaluation of new technology
• Effect modification by SES, nutrition etc
• Vulnerability markers
• Validation of exposure models
• Changing composition of roadside air pollution
  mixtures potential consequences for NO2 LV

14
Research questions on (outdoor) air pollution and
health

• Accountability studies effects of abatement
  measures on air pollution levels
• Accountability studies effects of changes in
  pollution on health
• Transport health effects of participation in
  traffic on health subway/public transport
  environments zoning questions noise air
  pollution spatial planning issues physical
  exercise/obesity urban cycling air quality,
  accidents air quality impacts near airports
  role of shipping emissions (new impact estimates
  published, loading of Sahara dust moving across
  Mediterranean???)