Health Impact Assessment of PM10 on Mortality and Morbidity in Children in Central-Eastern European Cities

Abstract

SAA5-O-07 Background and Objective: The 4th Ministerial Conference on Environment and Health adopted the Children's Environment Health Action Plan in 2004. The aim of regional priority goal III is to prevent and reduce respiratory diseases due to outdoor air pollution, and the frequency of asthmatic attacks. The objective of this study was to estimate the potential benefits in terms of childhood deaths and morbidity that could be prevented by improving ambient air quality in Central-Eastern European cities of the Apheis network participating in the ENHIS programme. Methods: Exposure-Response Functions for HIA in children were selected for long-term effects of PM10: total and respiratory postneonatal mortality (Lacasaña et al, 2005), postneonatal Sudden Infant Death Syndrome (SIDS) (Woodruff et al, 1997), and for short-term effects we looked at hospital respiratory admissions in birth to 14-yr-old children (Anderson et al, 2004). Six Central-Eastern European cities summing 8 millions inhabitants provided data on PM10, mortality and morbidity of children for the year 2001. Attributable cases were estimated using software created by the French Air Pollution and Health Surveillance Programme (PSAS-9). Two scenarios were used for long-term effects of PM10 and postneonatal mortality (total, respiratory, and SID syndrome): reduction of the annual mean value of PM10 to a level of 40 μg/m3, to 20 μg/m3 (Limit of 1999/30/CE Directive for 2010), and by 5 μg/m3. For HIA on short-term effects of PM10 and hospital respiratory admissions in children under 15 year: reduction of PM10 levels to a 24-hour value of 50 μg/m3 in all days exceeding this value (Limit of 1999/30/CE Directive), to 20 μg/m3 and reducing by 5 μg/m3 of all the 24-hour values. Results: The yearly mean values of PM10 ranged from 22.0 to 62.0 μg/m3. All other things being equal in the participating cities, reduction of the annual mean value of PM10 to a level of 40 μg/m3 would prevent yearly around 7 cases of total postneonatal mortality in Cracow and Bucharest. A reduction to a level of 20 μg/m3 would prevent 21 total postneonatal deaths in the 6 cities, one respiratory and 2 SID cases in 3 cities with available data. A short-term reduction of PM10 concentration to a 24-hour value of 20 μg/m3 would prevent 186 hospital admissions for respiratory diseases in 3 cities. Discussion: The results indicate that reductions in PM10 concentrations can beneficially protect children's health in Central-Eastern European cities. Acknowledgements: The ENHIS programme is supported by the European Commission DG SANCO (Grant No. SPC 2003112). The Apheis programme was supported by the European Commission DG SANCO programme of Community action on pollution-related diseases (Contract Nos. SI2.131174 [99CVF2-604]; SI2.297300 [2000CVG2-607]; SI2.326507 [2001CVG2-602]) and the participating institutions in 12 European countries.