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Indicatoren voor gezondheidsimpact van fijn stof en ozon: DALYs en externe kosten

Indicatoren voor gezondheidsimpact van fijn stof en ozon: DALYs en externe kosten. Jurgen Buekers & Rudi Torfs. 05/04/2011. Introduction. Integrated science assessment for paticulate matter (US EPA 2009)

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Indicatoren voor gezondheidsimpact van fijn stof en ozon: DALYs en externe kosten

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  1. Indicatoren voor gezondheidsimpact van fijn stof en ozon: DALYs en externe kosten Jurgen Buekers & Rudi Torfs 05/04/2011

  2. Introduction Integrated science assessment for paticulate matter (US EPA 2009) “a causal relationship exists between long-term exposures to PM2.5 and cardiovascular effects” “a causal relationship exists between long-term exposures to PM2.5 and mortality” Ozone and your health (US EPA 2009) “Ozone can irritate your respiratory system, reduce lung function, aggravate asthma, etc.”

  3. Introduction • Environmental health problems incomparable • What is worse? • 2 adults with a cardiovascular disease dying prematurely during a smog episode • 10 children with asthma • 2 adults having some days problems with the lower respiratory tract

  4. Disability Adjusted Life Years (DALYs) • DALYs • Combine information on the ‘quality’ and ‘quantity’ of life • Give an indication of the potential number of ‘healthy’ life years lost due to premature mortality or morbidity • DALY calculation = N x S x D • Number of people with environment-related morbidity or mortality • Severity factor (0=healthy; 1=death) • Duration of disease

  5. Attributable cases (Number of people) Cases Observed Incidence Prevalence Relative risk  Epidemiological studies (e.g. Pope et al., 2002) Concentration Observed concentration

  6. Attributable cases (Number of people) Cases Observed Incidence Prevalence Attributable cases Basic frequency Relative risk  Epidemiological studies (e.g. Pope et al., 2002) Concentration Observed concentration Threshold

  7. Disability or Severity weights • Indication of the reduction in capacitydue to the specificdisease • Varyingfrom 0 (healthy) to 1 (death) • Determinedby experts (clinicians, researchers, etc.) • Overviewsavailable (WHO, Australianburden of diseasestudy) asthma Cardiovascular disease

  8. Duration • Durationformorbidity: years of lifelivedwithdisability (YLD) • Durationformortality: years of life lost (YLL)

  9. DALYs De Hollander A.E.M. Assessing and evaluating the health impact of environmental exposures “Deaths, DALYs of Dollars?”. University of Utrecht. 2004.

  10. Uncertainties • Framework of Knol Anne (2010) • Context uncertainty e.g. selected stressor, endpoint • Model structure uncertainty e.g. causal relationship • Parameter & input data uncertainty e.g. health statistics Knol, A., 2010. Health and the Environment: assessing the impacts, addressing the uncertainties, Thesis Utrecht University, the Netherlands.

  11. DALYs in general • DALYsgiveanindication of the potential, relative order of magnitude of different (environmental) healthproblems, and cannotbepresented as absoluteorcompletelyrepresentativenumbers. • Smoking, geneticability, foodconsumptionetc. • Competingrisks

  12. Health outcomes Based on NEEDS 2007 (New Energy Externalities Development for Sustainability)

  13. MIRA - Particulate matter (PM2.5 & PM10)

  14. MIRA - Ozone

  15. World Health Organisation Europe EBoDE-project • Quantification, comparison and ordering of different environmental stressors between EU countries • Goal is to develop a uniform method to calculate the health impact of these stressors (DALY calculation) between different countries • Create a platform for other countries • http://en.opasnet.org/w/Ebode

  16. EBODE-project DALYs/million averaged over 6 participating countries

  17. EBODE project

  18. EBoDE / BoD 6-12% of the standard WHO BOD is associated with the nine environmental stressors.

  19. External Costs (euro) • Health effects expressed in term of external costs • Quantification is based on attributable cases (identical as calculated for DALYs) • Specific cost per case based on: -NEEDS (2007) -Reële milieugerelateerde gezondheidskosten in Vlaanderen (LNE, 2009 (Arcadis, MetroEconomia))

  20. External Costs (euro) MIRA study

  21. Summary • DALY as indicator forhealth impact PM and O3 • Chronicexposure to PM2.5  largesthealth impact • Particulate matter: REF > EUR > VISI • EBoDEstudy: 9 stressors  largesthealth impact exposure to air PM • Externalcosts

  22. Thank you for the attention!

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