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Cost-effective control of urban air pollution Joint workshop of the TFIAM and TFMM, IIASA, Laxenburg 16-17 November 2006

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Title: Cost-effective control of urban air pollution Joint workshop of the TFIAM and TFMM, IIASA, Laxenburg 16-17 November 2006


1
Cost-effective control of urban air
pollution Joint workshop of the TFIAM and TFMM,
IIASA, Laxenburg 16-17 November 2006
Global update of WHO Air Quality Guidelines and
findings from recent epidemiological studies
Dr. Michal Krzyzanowski Regional Adviser, Air
Quality and Health WHO Regional Office for
Europe European Centre for Environment and
Health, Bonn Office http//www.euro.who.int/air
2
This presentation
  • Background
  • Process of WHO AQG Update
  • Summary of the Updated Guidelines for PM. O3,
    NO2 and SO2
  • Examples of recent epi results

3
WHO Air Quality Guidelines 20 years tradition
  • Air Quality Guidelines for Europe, 1987
  • Air Quality Guidelines for Europe, 2nd edition,
    2000

http//www.euro.who.int/air/activities/20050223_3
  • Assessment of health aspects of air pollution in
    Europe, EC funded project 2003-5
  • update of AQG for PM, O3 NO2 recommended

4
WHO AQG Global update the process
  • Oct Nov 2004 Steering Group established
  • January 2005 Steering Group agrees on the
    update scope structure recommendation of
    authors of background material
  • July Sept 2005 review of the 1st draft
  • 18-20 October 2005 WG meeting, Bonn (report
    published Feb 2006)
  • Dec 2005 June 2006 finalization of
    background materials based on reviewers comments
    (drafts 2-4)
  • 5 October 2006 formal announcement of AQG
  • WHO editing / printing ? publication End 2006

http//www.euro.who.int/Document/E87950.pdf
http//www.who.int/phe/air/aqg2006execsum.pdf
5
WHO AQG Global update 2005 Table of contents
authors of 1st drafts
Chapter Title Authors
Part 1. Application of AQG for policy development and risk reduction Part 1. Application of AQG for policy development and risk reduction Part 1. Application of AQG for policy development and risk reduction
1 Sources of air pollution R. Harrison (UK)
2 Air pollution levels B. Sivertsen (Norway)
3 Human exposure to air pollution N. Janssen (The Netherlands), S. Mehta (US)
4 Health effects of air pollution N. Gouveia (Brazil), M. Maisonet (PAHO/Chile)
5 Determinants of susceptibility M. Utell (US), M. Frampton (US)
6 Environmental equity P. Kinney (US), MS ONeill (US)
7 Health impact assessment B. Ostro (US)
8 Applications of guidelines in policy formulation A. Fernandez (Mexico), M. Zuk (Mexico)
9 Indoor air quality special issues in risk assessment and management K. Balakrishnan (India), NG Bruce (UK)
Part 2. Risk assessment of selected pollutants Part 2. Risk assessment of selected pollutants Part 2. Risk assessment of selected pollutants
10 Particulate matter J. Samet (US), M. Brauer (Canada) R.Schlesinger (US)
11 Ozone P. Saldiva (Brazil), N. Künzli (US / Switzerland)
12 Nitrogen dioxide F. Forastiere (Italy), A. Peters (Germany) F. Kelly (UK), ST Holgate (UK)
13 Sulfur dioxide M. Lippmann (US), K. Ito (US)
Full list of reviewers WG Meeting Report
6
WHO AQG Global update Main results
  • Guideline values for PM, ozone, NO2 and SO2
  • the epidemiological evidence indicates that the
    possibility of adverse effects remains, even if
    the guideline value is achieved
  • some countries might select even lower
    concentrations for their standards.
  • Interim targets for each pollutant
  • define steps in a progressive reduction of air
    pollution in more polluted areas
  • promote a shift from concentrations with acute,
    serious health consequences to concentrations
    that, if achieved, would result in significant
    reductions in risks for acute and chronic
    effects.

7
WHO AQG Global update Particulate matter -
annual mean
Annual mean level PM10 (µg/m3) PM2.5 (µg/m3) Basis for the selected level
Interim target-1 (IT-1) 70 35 Levels associated with about 15 higher long-term mortality than at AQG
Interim target-2 (IT-2) 50 25 Risk of premature mortality decreased by approximately 6 compared to IT1
Interim target-3 (IT-3) 30 15 Mortality risk reduced by approximately 6 compared to IT2 levels.
Air quality guideline (AQG) 20 10 Lowest levels at which total, CP and LCA mortality have been shown to increase (Pope et al., 2002). The use of PM2.5 guideline is preferred.
8
WHO AQG Global update PM rationale for the
annual mean guideline value
  • Robust associations between PM2.5 and mortality
    in several studies with PM2.5 in the range 9-33
    µg/m3
  • No apparent thresholds but statistical
    uncertainty at PM2.5 below 13 µg/m3
  • Annual mean of 10 µg/m3 should be below the mean
    for most likely effects
  • Although adverse effects on health cannot be
    entirely ruled out below 10 µg/m3, its attainment
    is expected to significantly reduce the health
    risks
  • AQG and IT-s for PM10 recommended in addition to
    PM2.5 guidelines in recognition of harmul effects
    of coarse PM (fraction between 2.5 and 10 µm).

9
WHO AQG Global update Particulate matter 24-h
mean
24-hour mean level ) PM10 (µg/m3) PM2.5 (µg/m3) Basis for the selected level
Interim target-1 (IT-1) 150 75 About 5 increase of short-term mortality over AQG
Interim target-2 (IT-2) 100 50 Aabout 2.5 increase of short-term mortality over AQG
Interim target-3 (IT-3) 75 37.5 About 1.2 increase in short-term mortality over AQG
Air quality guidelines (AQG) 50 25 Based on relation between 24-hour and annual PM levels
) 99th percentile (3 days / year)
10
WHO AQG Global update Particulate matter
rationale for the 24-h guidelines
  • The annual average is recommended to take
    precedence over the 24-h mean since there is less
    concern about remaining episodic excursions at
    low PM levels
  • Meeting the 24-h AQG should protect against
    peaks of pollution leading to substantial excess
    morbidity or mortality
  • Immediate action recommended in case of
    exceeding 24-h guidelines

11
WHO AQG Global update Ozone daily maximum 8-h
mean
Daily maximum 8-hour mean Effects at the selected ozone level
High level 240 µg/m3 Significant health effects, substantial proportion of vulnerable population affected.
Interim target-1 (IT-1) 160 µg/m3 Important health effects, an intermediate target for populations with ozone concentrations above this level. Does not provide adequate protection of public health.
Air quality guideline (AQG) 100 µg/m3 This concentration will provide adequate protection of public health, though some health effects may occur below this level.
12
WHO AQG Global update Nitrogen dioxide
  • The guideline values remain unchanged at the
    following levels
  • 40 µg/m3 for annual mean
  • 200 µg/m3 for 1-hour mean.
  • Rationale
  • Experimental data NO2 toxic above 200 µg/m3
  • Epi studies NO2 marker of mixture of
    combustion related pollution
  • Precursor of ozone and PM2.5

13
WHO AQG Global update Sulfur dioxide
24-hour average SO2 10-minute average SO2
Interim target-1 (IT-1) (2000 AQG level) 125 µg/m3 -
Interim target-2 (IT-2) 50 µg/m3 Intermediate goal based on controlling either (1) motor vehicle (2) industrial emissions and/or (3) power production feasible goal to be achieved leading to significant health improvements that would justify further improvements -
Air quality guidelines (AQG) 20 µg/m3 500 µg/m3
14
WHO AQG Global update Summary of updated AQG
values
AQG levels recommended to be achieved everywhere
in order to significantly reduce the adverse
health effects of pollution
Pollutant Averaging time AQG value
Particulate matter PM2.5 PM10 1 year 24 hour (99th percentile) 1 year 24 hour (99th percentile) 10 µg/m3 25 µg/m3 20 µg/m3 50 µg/m3
Ozone, O3 8 hour, daily maximum 100 µg/m3
Nitrogen dioxide, NO2 1 year 1 hour 40 µg/m3 200 µg/m3
Sulfur dioxide, SO2 24 hour 10 minute 20 µg/m3 500 µg/m3
15
This presentation
  • Background
  • Process of WHO AQG Update
  • Summary of the Updated Guidelines for PM. O3,
    NO2 and SO2
  • Examples of recent epi results

16
Long-Term Exposure to Urban Air Pollution and
Myocardial Infarction (Stockholm County)
Rosenlund M et al, Epidemiology 2006
17
Long-term exposure to ambient air pollution and
cardiopulmonary mortality in women (NRW, Germany)
Gehring et al, Epidemiology 2006
18
Long-term exposure to ambient air pollution and
cardiopulmonary mortality in women (NRW, Germany)
Adjusted RR (95CI) of cardiopulmonary mortality
and interquartile range increase in 5 yr mean AP
or distance of home to roads with gt10,000 cars/day
Road lt 50m vs. gt 50 m 1.70 (1.02 2.81)
NO2 1.74 (1.29 2.33)
PM10 1.59 (1.23 2.04)
Gehring et al, Epidemiology 2006
19
Modeled PM2.5 Concentration Levels in the Los
Angeles Basin (Jerrett, Epidemiology 2005)
20
(No Transcript)
21
Relative risk (RR) and 95 CIs associated with a
10 µg/m3 increase in ambient PM2.5 by cause of
death
Jerrett et al, Epidemiology 2005
22
Fine PM and hospital admission for CPD 204 US
urban counties with 11.5 million Medicare
enrolees (aged gt65)
PM2.5 mean (1999-2002) 13.4 µg/m3, IQR
11.3-15.2 µg/m3
Dominici et al, JAMA 2006
23
Fine PM and hospital admission for CPD 204 US
urban counties with 11.5 million Medicare
enrolees (aged gt65)
Dominici et al, JAMA 2006 letter
24
Long term air pollution exposure and acceleration
of atherosclerosis and vascular inflammation in
an animal model (Sun et al, JAMA Dec 2005)
PM2.5 exposure 6h/day, 5 days/week, 6 months
(Tuxedo NY mainly LRTAP) 6 months PM2.5 average
exposure 15.2 µg/m3
25
Reduction in fine PM and mortality extended
follow up of Harvard six Cities Study
Period 1 1974-89 (mean PM2.5 1980-85) Period
2 1990-98
Laden et al. AJRCCM 2006
26
Conclusions
  • AQG provide challenging targets for air
    pollution control
  • European cohort studies consistent with US
    cohorts
  • Health risks of PM possibly higher if exposure
    assessment more precise
  • Heterogenity of risk due to PM2.5 mass needs
    to be studied further
  • Risk to health also at low PM2.5 level
  • Increasing evidence on cardiovascular effects of
    fine PM
  • Evidence for reduction of risk level with
    reduction of exposure

Health relevance of particulate matter from
various sources WHO Workshop, Bonn, 26-27 March
2007 (followed by 10th TFH meeting on 28 March)
27
Cost-effective control of urban air
pollution Joint workshop of the TFIAM and TFMM,
IIASA, Laxenburg 16-17 November 2006
Thank you
http//www.euro.who.int/air
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