1 / 39

Under The Supervision Of: Dr. Ayana Goren Department of Epidemiology and Preventive Medicine

Short term effects of air pollution on health. The association between daily air pollution levels and mortality from respiratory and cardio-vascular diseases. Rony Braunstein Department of Epidemiology and Preventive Medicine Sackler School of Medicine Tel-Aviv University.

eavan
Download Presentation

Under The Supervision Of: Dr. Ayana Goren Department of Epidemiology and Preventive Medicine

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Short term effects of air pollution on health.The association between daily air pollution levels andmortality from respiratory and cardio-vascular diseases.Rony BraunsteinDepartment of Epidemiology and Preventive MedicineSackler School of MedicineTel-Aviv University Under The Supervision Of: Dr. Ayana Goren Department of Epidemiology and Preventive Medicine Sackler School of Medicine Prof. David Steinberg Department of Statistics and Operation Research Schreiber School of Mathematical Sciences

  2. VERY IMPORTANT NOTICE !!! This Power Point Presentation is not yet ready. Please consider it as an unfinished work. I hope it will be finished ASAP.

  3. Air is essential for the survival of human beings as well as other populations. The importance of air can be illustrated by the fact that the average adult requires about 15 kilograms of air per day compared with less than 1.5 kilograms of food and about 2 kilograms of water (source: Goldsmith, 1968). Compared with other necessities of life, obligatory continuous consumption is a unique property of air. The average adult can live 5 weeks without food, 5 days without water and only a few minutes without air. Air is essential for life and the absence of clean air can lead to severe health problems and even to death. Air and Air - Pollution Since air pollution seems to be constantly increasing both in the industrialized and in the developing parts of the world, many studies have been conducted throughout the world to examine its characteristics and its effects on human health. There are several known reasons for the increase in air pollution (see e.g. Stern, 1968), among which are the increasing amount of cars, factories and power stations, which emit various pollutants typical of urban and industrial sources. Air Pollution and Health

  4. 1. Air Pollution - An Introduction 1.1 Definition 1.2 History 1.3 Types 1.4 Effects 1.5 Sources Topics 2. The Current Research - Methods and Results 2.1 Objectives 2.2 Time Frame, Region and Population 2.3 Data Bases 24 Theoretical Model and Practical Fitting 2.5 Results: Conclusions and Discussion 2.6 The Delayed Effect 2.7 A Comparative Study: 80’s vs. 90’s. 2.8 Estimating the Count of Deaths Related to Air Pollution Air Pollution and Health

  5. Air Pollution - Definition Normal air consists of a mixture of several gases (see e.g. Tebbens, 1968). The air will be considered as polluted whenever: (i) Other gases and or particle matters will be present OR (ii) When the balance of the normal air mixture will be changed. The concentrations of the various gases are represented in the table in parts per million (PPM). • Concentration Of Gases Comprising Dry Air • Gas Concentration (PPM) • Nitrogen 780900 • Oxygen 209400 • Argon 9300 • Carbon dioxide 315 • Neon 18 • Helium 5.2 • Methane 1.0-1.2 • Krypton 1.0 • Nitrous oxide 0.5 • Hydrogen 0.5 • Xenon 0.08 • Nitrogen dioxide 0.02 • Ozone 0.01-0.04 • Source: Kuiper 1952. Air Pollution and Health

  6. HISTORY OF AIR POLLUTION AND HEALTH STUDIES 1. Acute Effects Whenever a major air pollution event occurred, it was noticed that the population tended to suffer more frequently and more severely from respiratory as well as from cardio vascular diseases. Example: The London episode of air pollution (December 1952). A tremendous increase in mortality and morbidity from respiratory and cardio vascular diseases (3500 - 4000 excess deaths). 2. Long Term Effects Later on, the research was focused on the long term and cumulative effects of air pollution on health. 3. Short Term Effects New research directions deal with the short-term effects of changes in air pollution concentrations, not necessarily acute ones, on health. The research of short-term effects of air pollution on health is considered to be most important nowadays and epidemiologists are trying to deal with this question in many places in the developed parts of the world. Air Pollution and Health

  7. 1. Sulfurcompounds. Combustion of sulfur containing fuels contributes large amounts of SO2 and some SO3. Many industrial processes generate H2S. Types of Pollutants 2. Nitrogencompounds.NO and NO2 are produced in some industrial operations and in automobile engines. The measurements of NO and NO2 are combined together and called NOX. • 3. Carboncompounds. Carbon dioxide and carbon monoxide arise in huge amounts from the combustion of carbonaceous fuels. In large cities, most of the daily production of CO and CO2 results from incomplete utilization of carbon in gasoline in automobile engines, industrial machineries and power plants. • 4. Photochemical compounds. The photochemical compounds are defined as “Secondary Pollutants”. The process of creating photochemical compounds needs bright sunlight in which nitrogen oxides, hydrocarbons and oxygen interact chemically to produce oxidants like ozone and peroxyacetyl nitrate (PAN). • 5. Halogencompounds. Some industrial and metallurgical processes produce inorganic halogen compounds such as HF and HCl. • 6. Organic compounds. The organic compounds are emitted principally as vapors and the less volatile compounds may occur as liquid droplets or solid particles. Their sources are: (i) Household products including paints, paint strippers and other solvents, (ii) wood preservatives, (iii) aerosol sprays and air fresheners, (iv) insect repellents and disinfectants, (v) stored fuels and automotive products and (vi) dry-cleaned clothing. • 7. Fine solids and coarse particles. The finer aerosols include man-made particles of metal, carbon, tar, oxides, nitrates, sulfates, chlorides, fluorides and silicates on one side and natural particles such as dust, resin, pollen, fungi and bacteria on the other side. All those fine solids are less than 10 in diameter. • 8. Radioactive compounds. Atmospheric radioactivity originates from natural as well as artificial sources. The natural radioactivity results from the presence of radionuclides, which originate from radioactive minerals or from the interaction of cosmic radiations with the gases of the atmosphere. Radon (Rn) is an example for a natural radioactivity source. The man-made radioactivity is a by-product of the developed nuclear activity in the last fifty years. Air Pollution and Health

  8. Air Pollution Effects • 1. Visibility reduction: The effect of air pollution on visibility is currently the most easily observed. The effect of reduction in visibility is produced by the scattering of light from the surface of airborne particles. • 2. Materialdamage: Air pollution causes damage to certain materials. Direct damage is caused to structural metals, surface coatings, fabrics and other materials of commerce. The destruction is related to many types of pollutants. • 3. Agriculturaldamage: A large number of food, forage and ornamental crops have been shown to be damaged by air pollution and in particular by halogen compounds such as HF and HCl. Photochemical compounds, sulfur compounds and nitrogen compounds also contribute to agricultural damage. • 4. Psychologicaleffects: Fear is a recognizable element in public reactions to air pollution and the psychological aspects of the phenomenon cannot be ignored. It is possible that psychosomatic illnesses are related to air pollution events. • 5. Physiologicalandhealtheffects: There is a lot of evidence that air pollution can be destructive to human health and can even result in death. Air pollution affects human health by causing respiratorydiseases, cardio-vasculardiseases, lungcancer and otherdiseases. Air Pollution and Health

  9. Health Effects • Acute sickness or death. • Insidious or chronic disease, shortening of life or impairment of growth. • Alteration of important physiological functions, such as ventilation of the lung transport of oxygen by hemoglobin or various functions of the nervous system. • Unpleasant odor, impairment of visibility or other effects sufficient to lead individuals to change residence or place of employment. • Air pollution is known to be a causal factor in chronic pulmonary diseases like lung cancer, bronchitis, emphysema, and asthma. • Aggravation of existing cardiovascular disease. • Eye and respiratory tract irritation, headache, dizziness, visual disorders, and memory impairment are among the immediate symptoms that people have experienced soon after exposure to some organic compounds. Air Pollution and Health

  10. Air Pollution Sources 1. Natural Sources 1.1 Eruptions of volcanoes pollute the air with dust and ash. 1.2 Dust storms can fill the air with particles. 1.3 Forest fires create black smoke and emit noxious gases. 1.4 Radioactive minerals and cosmic radiations are the causes for atmospheric radioactivity. 2. Artificial Sources 2.1 Energy sources like wood and coal emitting black smoke and produce noxious gases. 2.2 Extensive use of petroleum in industry and transportation. 2.3 Industrial processes produce pollutants as side effects of their industrial process. 2.4 Nuclear power stations and nuclear experiments (andaccidents) contribute to radioactive pollution. Air Pollution and Health

  11. APHEA2 - 32 European Cities (1996 – 2001)Air Pollution and Health a European Approach K.Katsouyanni (Greece), J.Schwartz (USA) • B. Kriz, M. Celko, J. Danova (Prague, CzechRepublic); F. Kotesovec, J. Skorkovski (Teplice, CzechRepublic); J. Pekkanen, P. Tittanen (Finland); S. Medina, A. Le Tertre, P. Quenel, L. Pascale, A. Boumghar (Paris, France); D. Zmirou, F. Balducci (Grenoble, France); C. Spix, A. Zanobetti, H.E. Wichmann (Germany); K.Katsouyanni, G. Touloumi, E. Samoli, A. Gryparis, Y. Monopolis, E. Aga, D. Panagiotakos (Greece, Coordinating center); A. Paldy, J. Bobvos, A. Vamos, G. Nador, I. Vincze, P. Rudnai, A. Pinter (Hungary);Clancy, P. Goodman (Ireland);A. Goren, R. Braunstein (Israel); MA. Vigotti, G. Rossi, E. Cadum, G. Costa, L. Albano, D. Mirabelli, P. Natale, L. Bisanti, A. Bellini, M. Baccini, A. Biggeri, P. Michelozzi, F. Forastiere (Italy); J. Schouten, J. Vonk (The Netherlands); B. Wojtyniak, D. Rabczenko, K. Szafraniek (Poland); E. Niciu, V. Frunza, V. Bunda, (Romania); M. Macarol-Hitti, P. Otorepec (Slovenia); J. Sunyer, M. Saez, F. Ballester, S. Perez-Hoyos, E. Alonso, K. Kambra, A. Arangues, A. Gandarillas (Spain); B. Forsberg, B. Segerstedt, (Sweden); C. Schindler (Switzerland); Z. Dortbudak (Turkey); HR Anderson, R. Atkinson, J. Ayres (U.K.); . Air Pollution and Health

  12. Research Objectives General Objective:The general aim of this research is to examine the short-term effects of air pollution on mortality from respiratory and cardio-vascular diseases. The first objective is to fit a Mathematical/Statistical model to the data set in order to be able to define and measure the short-term effects caused by various air-pollutants on mortality from several related diseases. The second objective is to examine the delayed effect of air pollution on mortality from cardio vascular and respiratory diseases. The third objective is to conduct a comparative study on air-pollution in the Tel-Aviv metropolis area over time. In this study air-pollution concentrations in the early 1980’s are compared to those in the early 1990’s. Air Pollution and Health

  13. Study Design This study was based on data sets that were collected in an earlier stage. The design of the research was a historical prospective cohort since: (i) we used data that were already collected in the past (ii) we examined the count of deaths (the outcome) while levels of air pollution (the exposure) were given. . In this study the individual sample unit is a single day for which we had: (i) the count of deaths from the relevant diseases (ii) the exposure levels of air pollution (iii) the measurements of several confounding variables. Air Pollution and Health

  14. THE RESEARCH TIME FRAME 1/1/1991 – 31/12/1996 Six Years 2192 Days THE RESEARCH AREA Metropolitan Tel-Aviv THE RESEARCH POPULATION Includes all the people living in the wider Tel-Aviv Area. No limitations regarding age or sex or any other condition. Population Size in the Tel-Aviv Area (In Thousands) YEARCOUNTPCT of Change 1991 1164.1 0.00% 1992 1175.4 0.97% 1993 1173.9 0.84% 1994 1174.5 0.89% 1995 1177.5 1.15% 1996 1177.2 1.12% Air Pollution and Health

  15. Monitoring Stations in Tel-Aviv 1991-1996 Table Key:1 - SO2, 2 - NOX, 3 - O3, 4 - PM10 Source:Israeli Electrical Company Air Pollution and Health

  16. The Tel-Aviv Metropolis Map IEC Monitoring Stations Network 1991-1996 Air Pollution and Health

  17. 1. Dependent Variables 1.1 Daily Count of Deaths from Cardio-Vascular Diseases ( 11.5 cases ) 1.2 Daily Count of Deaths from Respiratory Diseases ( 1.5 cases ) THE RESEARCH VARIABLES 2. Independent Variables 2.1 Daily Average of SO2( 22.18 g/m3 ) 2.2 Daily Average of NOX( 139.87 g/m3 ) 2.3 Daily Average of O3 ( 36.67 g/m3 ) 2.4 Daily Average of PM10( 50.21 g/m3 ) 3. Confounding Variables 3.1 Daily Amount of Rain ( 14.69 mm ) 3.2 Daily Relative Humidity ( 65.96 % ) 3.3 Daily Average Temperature ( 20.38 Centigrade ) 3.4 Day of the Week 3.5 Holidays 3.6 Sequence Date – Time Air Pollution and Health

  18. Data Bases 1. The mortality data file:The source for this file was the Department of information and computation in the Ministry of Health. This file is based on death certificates, which are coded in a data file and are kept in the Ministry of Health data base. Each record in the mortality data file contains the daily count of deaths from respiratory and cardio vascular diseases as defined by theICD9. 2.The air pollution data file:The source for the air pollution data file is the Israeli Electrical Company (IEC). The IEC has a network of monitoring stations in Tel-Aviv where the pollutants SO2 , NOX , O3 and PM10 are measured every day. Each record in the air pollution data file contains the daily average concentration for each one of the pollutants. 3. The meteorological data file:The source for the meteorological data file are the Meteorological Services. The meteorological services have a meteorological station in Tel-Aviv in which several meteorological factors such as temperature, amount of rain, relative humidity and cloudiness are measured daily. Each record in the meteorological data file contains the daily meteorological measurements. Air Pollution and Health

  19. FITTING THE MODEL Poisson Regression Model Time Series Model (not AR) Generalized Additive Model WHERE: C1…Cc - are the confounders Si- is a smooth function (loess) for the i’th confounder X1…XK- are the pollutants gj- is an appropriate transformation for the j’th pollutant Steps: 1. Adjusting the confounding effects 2. Adding the explanatory variables Air Pollution and Health

  20. Base Model Fitting Quasi-likelihood model. The estimated dispersion parameter = 1.09 Cardio Vascular Mortality Model Fitting and the Residuals AIC = 2301 Cardio Vascular Mortality Smooth Functions (Loess) for the confounding effects Air Pollution and Health

  21. Results (Cardio Vascular Mortality) • Cardio Vascular Mortality • RR of the Four Pollutants as Non-Linear Terms Air Pollution and Health

  22. Results (Respiratory Mortality) • Respiratory Mortality • RR of the Four Pollutants as Non-Linear Terms Air Pollution and Health

  23. More ResultsCardio Vascular Diseases | Respiratory Diseases Air Pollution and Health

  24. THE DELAYED EFFECT OF THE POLLUTANTS Lag Model for a Single Pollutant Lag Model for Multiple Pollutants Unstable Model Coefficients => Unstable RR’s Air Pollution and Health

  25. THE POLYNOMIAL DISTRIBUTED LAG MODELAlmon S. (1965) • P – is the polynomial degree • l – is the lag of the coefficient (l=0…L) • Ai- coefficients describing the polynomial shape of the lag coefficients Matrix Notation: Air Pollution and Health

  26. Example: Air Pollution and Health

  27. PDLM - A Numerical Example:CVD andSO2 Air Pollution and Health

  28. CI for the Lagged RR Air Pollution and Health

  29. PDLM: Final Results - CVD & Respiratory Air Pollution and Health

  30. PDLM: SUMMARY & CONCLUSIONS Air Pollution and Health

  31. Changes in Air-Pollution Levels with TimeThe 1980’s vs. The 1990’s– A Comparative Study Air Pollution and Health

  32. Changes in Air-Pollution Levels in the 1990’s Example: Changes In SO2 Daily Concentrations 1/1/1991 – 31/12/1996 SO2Crude Data SO2Crude Data In Log Scale SO2Lowess Smoother 90% Fraction SO2Time Series Plot SO2Lowess Smoother 10% Air Pollution and Health

  33. Changes in Air-Pollution Levels in the 1990’s Air Pollution and Health

  34. Changes in Mortality Levels in the 1990’s Air Pollution and Health

  35. Single-Pollutant Model Estimation of the Count of Saved or Lost Lives Confidence interval for LS Multi-Pollutant Model Confidence interval for Multiple LS SE2 in Matrix Notation Air Pollution and Health

  36. Estimation of Saved or Lost Lives 1980’s vs. 1990’s Cardio Vascular Diseases 102 excess deaths per year in the 90’s as compared to the 80’s the 95% CI.=.{-125 , +343}. Respiratory Diseases 4excessdeaths per year in the 90’s as compared to the 80’s the 95% CI.=.{-71 , +91}. Air Pollution and Health

  37. Estimation of Saved or Lost Lives - 1993 vs. 1996 Cardio Vascular Diseases 29 more deaths in 1996 as compared to 1993 the 95% CI.=.{-66 , +128}. Respiratory Diseases 38 excess lives in 1996 as compared to 1993 the 95% CI.=.{+5 , +70}. Air Pollution and Health

  38. Estimation of Saved or Lost Lives Sensitivity Analysis Air Pollution and Health

  39. That’s All Folks Thank You Until Next Time !!!! Air Pollution and Health

More Related