Air pollution: Health impacts across UK and Sussex Dr Sotiris Vardoulakis Group Leader, Air Pollution and Climate Change Centre for Radiation, Chemical & Environmental Hazards
Environmental Sustainability Air Pollution Public Health Climate Change
Outdoor Pollution Sources Road traffic and other means of transport (e.g. airports, shipping) Industrial activities Energy generation Domestic activities Waste disposal Farming and agriculture Accidental releases Forest fires Pollen and other bioallergens Desert dust episodes
Indoor Air Pollution Sources ` Space heating Cooking Smoking Building materials and furnishings (asbestos, flame retardants, etc.) Household products (cleaning, DIY, etc.) Radon (from soil) Dampness and mould Pathogens (bacteria and viruses)
Global Burden of Disease Study 2010 Cancer Cardio-vascular Disease Chronic Respiratory Disease Lower Respiratory Infections (Lim et al. 2012) DALYs (%)
European cities exceeding pollution limits 90% of EU city dwellers are exposed to harmful air pollutants, including particulate matter and ground-level ozone
Health aspects of air pollution and review of EU policies WHO-Europe international projects: REVIHAAP (hazard) HRAPIE (risk) To provide the European Commission and its stakeholders with evidence-based advice on the health aspects of air pollution (including those regulated in the AQ Directives). Results will support the revision of EU air quality policies which began in 2013. Policies will undergo cost-benefit analysis.
http://www.iarc.fr/en/media-centre/iarcnews/pdf/pr221_e.pdf
National Air Quality Strategy Regulated Pollutants Particles (PM 10 and PM 2.5 ) Nitrogen dioxide Ozone Sulphur dioxide PAH (B[a]P) Benzene 1,3-Butadiene Carbon monoxide Lead
Fine particles (PM 2.5 )
Particulate Mater: What determines toxicity? Particle size? (PM10, PM2.5) Components? Elemental or organic carbon Metals (especially transition) PAHs Oxidative potential Sources? Primary/secondary Age?
Ultrafine hypothesis Suggested that ultrafine particles may be particularly important: Dominate particle number High surface area Cause local lung inflammation Leading to release of mediators, which alter blood coagulability and increase risk of heart attacks (Seaton et al. 1995)
Six Cities Study Long-term exposure to particulate pollution Six US Cities: Portage (P), Topeka (T), Watertown (W), St Louis (L), Harriman (H), Steubenville (S) (Dockery et al. 1993)
American Cancer Society study Long-term exposure to particulate pollution 151 US metropolitan areas particulate air pollution was associated with cardiopulmonary and lung cancer mortality Increasing ambient fine particle mass was associated with increased mortality Pope et al, AJRCCM; 1995
Health Burden of Particulate Pollution in UK COMEAP (2010) estimated the mortality burden of human-made particulate pollution in UK in 2008 as: an effect equivalent to 29,000 deaths a loss of 340,000 years of life average loss of 6 months of life expectancy from birth http://comeap.org.uk/
3.01: Fraction of mortality attributable to particulate air pollution
Fraction of mortality (%) attributable to particulate air pollution in Sussex in 2011 England 5.4 South East 5.5 London 7.2 5.2 5.7 4.9 5.3 4.9 5.1 5.2 4.8 4.9 5.2 5.3 5.6 4.9 5.1 5.0
Attributable fraction, attributable deaths, years of life lost All local authority areas Guidance on estimating mortality attributable to long-term exposure to anthropogenic PM2.5 at Local Authority level
Use of the PHE report Scope the scale of the public health problem associated with air pollution. Raise awareness of the need to consider air pollution when establishing priorities for action to improve public health locally. The estimates can be used within a local authority area for comparison with health burdens from other risk factors. The report is not intended for the quantitative evaluation of the health impacts of local measures to reduce air pollution. Comparisons of mortality burdens between local authorities are not an appropriate basis to impute good or poor practice.
PM2.5 source apportionment (PCM model, Birmingham) Climate Change and Health (AQEG, 2012)
Traffic Management Low Emission Zones Parking & stopping restrictions Pedestrianisation schemes Public transport interventions Park & ride schemes Walking and cycling Relocation of road space (bus lanes, etc.)
Urban Green Spaces Create a better environmental context for development Improve air quality Improve flood risk management Enhance biodiversity and ecological values Secondary health benefits (e.g. mental health, physical activity) East London Green Grid http://www.pureframework.org/
Summary Multiple sources of outdoor and indoor air pollution, but road traffic is currently the main source in the UK. Acute and chronic health effects of air pollutants. Evidence continues to grow for adverse health effects of particles, ozone, and nitrogen dioxide at ambient levels. PM 2.5 is the main metric for quantification of the effects of long-term exposure to air pollution. Traffic management, active travel, urban greening, etc. can bring local air quality benefits (and other public health and climate change mitigation co-benefits)
COMEAP Information for the public http://www.comeap.org.uk/
Acknowledgements APCC group members, particularly Alison Gowers COMEAP members, particularly Frank Kelly, Fintan Hurley, Brian Miller, John Stedman, Bob Maynard and Heather Walton Annual Air Pollution Research Review meeting Solihull, 3-4 June 2014 sotiris.vardoulakis@phe.gov.uk