HEALTH RISKS OF PARTICULATE MATTER AIR POLLUTION An

HEALTH RISKS OF PARTICULATE MATTER AIR POLLUTION An overview for the 41 st Session of GRPE M. Krzyzanowski WHO ECEH Bilthoven Division WHO European Centre for Environment and Health

Urban Particulate Matter – TEM image of a filter Source: Beru. Be et al, in Particulate Matter, ed. Maynard & Howard, BIOS Sc Publ 1999

WHO Air Quality Guidelines, 2 nd edition Particulate matter (PM 10 or PM 2. 5) • “Available information does not allow a judgement to be made of concentrations below which no effects would be expected” • “Use risk estimates for standard setting” WHO European Centre for Environment and Health

Studies on health impacts of PM • Short term changes in pollution level (Time-series; panel) • Efects of long-term exposure (cohort studies) WHO European Centre for Environment and Health

Health effect estimates per 10 mg/m 3 increase in 24 -h mean PM 10 concentrations Source: WHO AQG 2 nd ed. WHO European Centre for Environment and Health

Questions in interpretation of studies on short-term impacts of PM • Physiopathological mechanism of effects? • Extent of displacement of time of health effect? • Harvesting? WHO European Centre for Environment and Health

Recent studies on effects of PM on cardiovascular system • Increase in blood viscosity in days with high PM (Peters et al, 1997; no effect in Seaton et al 1999) • Increased heart rate associated with increased PM level (Stone & Godleski 1999, Peters et al, 1999, Pope et al. 1999) • Incidence in cardiac arrhythmia and PM level (Peters et al, 2000) WHO European Centre for Environment and Health

Estimated effect of a 10 µg/m 3 increase in PM 2. 5 Source: Schwartz, Am J Epi 2000

WHO -AQG WHO European Centre for Environment and Health

Relative risk of mortality by cause of death Re-analysis of US cohort studies 6 -cities Study* RR ACS Study** * Per 18. 6 µg/m 3 PM 2. 5 ** Per 24. 5 µg/m 3 PM 2. 5 Source: HEI 2000 WHO European Centre for Environment and Health

RR for all cause mortality in ACS Study Re-analysis of US cohort studies Source: HEI 2000

% increase in mortality per 10 µg/m 3 PM 10 by PM 2. 5 / PM 10 ratio Meta-analysis of 19 US time-series studies % PM 2. 5/PM 10 Source: Levy et al, 2000 WHO European Centre for Environment and Health

Inflammogenic properties of carbon black particles by particle size % neutrophils in BAL 14 nm 50 nm 260 nm Source: Donaldson et al. , 1999 WHO European Centre for Environment and Health

Effects of different size of ultrafine and fine PM on daily mortality, Erfurt, 1995 -8 Best 1 day lag / distributed lag model Source: Spix et al, 2000

Estimated contribution of the main sources to PM emissions in Europe*) in 1993 *) excluding former Soviet Union WHO European Centre for Environment and Health Source: Holman et al, 1999

Ambient concentrations of ultrafine (UP) and fine (FP) particles Erfurt Sachsen-Anhalt UP = NC 0. 01 – 0. 1; FP = MC 0. 01 – 2. 5 PM 2. 5 Source: Wichmann & Peters 2000 WHO European Centre for Environment and Health

1) All deaths except accidents WHO European Centre for Environment and Health

WHO European Centre for Environment and Health

Number of cases attributable to air pollution in France per year (Künzli et al. , Lancet 2000; 356: 795 -801) Health outcome Cases 95% CI Mortality (long term st. ), adults>30 y 31700 19200 - 44400 Respiratory hospital admissions 13800 1400 – 26300 Cardiovascular hospital admissions 19800 10400 – 29400 Chronic bronchitis incidence (>25 y) 36700 3300 – 73100 Bronchitis (<15 y) 450000 198500 – 813600 Restricted activity days (>20 y) (million) 26. 4 20. 7 – 28. 5 Asthma attacks (<15 y) (person-days) 243000 149000 - 337000 Asthma attacks (>15 y) (person-days) 577000 281000 -879000 WHO European Centre for Environment and Health

CONCLUSIONS • PM is associated with a wide range of health effects, with significant public health consequences • Significant role of fine PM • Role of ultrafine particles – to be studied WHO European Centre for Environment and Health

Understanding the Health Effects of Particulate Air Pollution: Recent Advances and Outstanding Questions A Meeting for Members of Government, Industry and the General Public Organized by WHO and HEI in cooperation with EC DG Environment Brussels , 6 -7 March 2001 Information: mkr@who. nl or rokeefe@healtheffects. org WHO European Centre for Environment and Health