Health effects of particulate matter: Policy implications for EECCA countries

1. Health effects of particulate matter: Policy implications for EECCA countries • Marie-Eve Héroux • Technical Officer, Air Quality & Noise • European Centre for Environment and Health • WHO Regional Office for Europe

2. Presentation Outline • Importance of air quality as a risk factor for health • Burden of disease of air pollution • WHO recommendations on air quality • Risk management – what can be done? • Implications for policy makers

3. Premature mortality Hospital admissions Emergency room visits Visits to doctor Restricted activity/reduced performance Medication use Symptoms Impaired pulmonary function Sub clinical (subtle) effects Severity of health effect Proportion of population affected Air pollution health effets pyramid Source: American Thoracic Society, 2000

4. Burden of disease from 20 leading causes in 2010 (% global DALYs) • Ambient air pollution (PM2.5): • Globally: • - 3.1 million deaths • - ~ 3.0% of all DALYs • In Western, Central and Eastern Europe: • - 430,000 premature deaths; • - over 7 million years of healthy life lost Lim et al. LANCET (2012)

5. Years of life lost due to PM Europe Lim S et al. Lancet 2012 5 10 0 million

6. PM2.5 annual exposure estimates for 2005 – GBD 2010 Project The PM2.5 estimates are generated from the grid cell average of SAT and TM5 and calibrated with a prediction model incorporating surface measurements Brauer et al. EST (2012)

7. Levels of and trends in PM in the WHO European Region (2010 data) = WHO guideline

8. Gain in life expectancy (months) in 25 Aphekom cities for a decrease in PM2.5 to WHO AQG (10 μg/m3) (age 30+) Source: APHEKOM

9. NCDs attributable to exposure to traffic-related air pollution Source: APHEKOM

10. WHO Air Quality Guidelines • Air quality guidelines – Global update (2005) • Indoor air quality – dampness and mould (2009) • Indoor air quality – selected pollutants (2010) • Indoor air quality – household fuel combustion (planned: fall 2013)

11. WHO AQG Summary (2005) Levels recommended to be achieved everywhere in order to significantly reduce the adverse health effects of pollution

12. IARC Monographs Next upcoming IARC monograph Ambient air pollution (WG meeting 8-15 October 2013)

13. Risk management and air quality abatement • Concerted action needed from public authorities, industries, and individuals at international/regional/sub regional/national/local levels • Regulatory measures: stricter AQ standards, emission limits, ... • Structural changes: change in transport modes, land use planning, clean energy production, ... • Behavioural changes: choice of cleaner transportation modes or household energy sources, ... • Co-benefits of integrating climate change and air pollution management strategies • Clean energy = low PM and other air pollutants, AND low greenhouse gas emissions

14. Main directions for formulating policies and actions • Evidence on health effects of air pollution increases • Recent WHO evidence review “REVIHAAP” confirming conclusions of WHO AQG Global Update 2005 • Cardiovascular morbidity and mortality particularly increased by PM exposure • PM pollution is widespread and reduces life expectancy • Important burden of disease from urban air pollution • Implementation of actions to cut air pollution can result in measurable, significant health benefits and contribute to • Mitigation of GHG emission • Primary prevention of non-communicable diseases

15. THANK YOU FOR YOUR ATTENTION!