Health Impact Assessment Of Air Pollution Research Articles

2.E. Workshop: Health in Green Deal and Climate Pact

Abstract Health does not only imply the absence of disease but complete physical, mental and social well-being as well. Nowadays, it seems, more than ever, that we are aware of how solemn these words are and how unreachable health is. Public health can be regarded as the science and art of achieving health in the community and implementing preventive measures and all activities contributing to public health. However, this cannot be achieved without proper environmental conditions. The EU Green Deal (EU GD) and the Climate Pact (CP) initiative, provide a clear trajectory and highlights priorities for improving the environment. Since the pollution emitted in one country affects other countries, the scope of the EU GD encompasses the whole continent, including the Western Balkans. South east Europe will be used as a case study in this workshop. The workshop is dedicated to the topic of the EU GD and the CP and connecting research, project activities and the activities of citizens and civil society in achieving the set goals of the EU Green Deal. Health impact assessment (HIA) combined with scenario analysis provides useful quantitative estimations about the implications of air quality policies that should be used for air quality management design. The impact of these international initiatives and its instruments will be analysed. Will this improve the health situation enough? Priority task of EU GD is certainly to improve of air quality throughout Europe, which requires research into the best ways for HIA of air pollution. The activities in engaging with key decision makers involved in climate change and health adaptation across Europe, providing knowledge, understanding interlinkages and identifying areas for action to promote climate policies that enhance health benefits will be presented by ENBEL project. Public health professionals should insist on health in these priorities, use them to reduce externalities, activate citizens to contribute through certain individual and non-health-related decisions and invest in the health of future generations. The GD and the CP are therefore essential processes for improving both individual and public health. An example, by delivering on the Green Deal's zero pollution ambition for health, which will be presented by HEAL. Furthermore, the role of Climate Pact Ambassadors (CPA) could be used as opportunity for dissemination aims and mission of EU GD, Western Balkan Green Agenda, as well as to provide better communication, collaboration and actions among researchers, citizens and decision makers. CPA could help in advocacy and actions to achieve better health through EU GD and CP.

What does calculating impacts of specific morbidity outcomes add to perceptions of air pollution health impact assessment?

Introduction: Health impact assessments often use broad categories of outcomes, e.g. all respiratory or all cardiovascular admissions. This minimises diagnostic misclassification but does not fully communicate the evidence on associations between air pollution and specific diseases. More specific health impact calculations may resonate with the public more than severe but rarer outcomes.Methods: Literature searches were done for meta-analyses pooling evidence on a variety of pollutants (PM10, PM2.5, NO2 and O3) and 40 health outcomes. We investigated the effects of short- and long-term exposure to pollution and did final calculations on 17 morbidity outcomes, rejecting those with weaker evidence, lack of baseline rates, and no priority from focus groups. The selected concentration-response functions were combined with monitoring site, baseline rate/cases and population (e.g. beside roads) data to calculate health impacts in up to 4 scenarios (roadside vs background (daily and annual); 75th vs 25th percentile daily average and a 20% reduction in annual average) across 9 UK and 4 Polish cities. The largest result per pollutant was given rather than summing across pollutants.Results: The largest change in number of cases was for children with low lung function in London (7927 for a 20% reduction in NO2). Changes in cases of acute bronchitis in children in London were also high (3683 for a 20% reduction in PM10). Warsaw had greater impacts on cardiovascular than respiratory endpoints compared with London. Other example statements include ‘living near busy roads in Oxford may stunt lung growth in children by 14%’ and ‘in London on higher pollution days, 142 more children with asthma experience symptoms than on lower pollution days’.Conclusions: Health impact statements for a wider variety of outcomes may aid communication of the importance of different health effects to policymakers and the public.

Health Impact Assessment of Volcanic Ash Inhalation: A Comparison With Outdoor Air Pollution Methods.

This paper critically appraises the extrapolation of concentration‐response functions (CRFs) for fine and coarse particulate matter, PM2.5 and PM10, respectively, used in outdoor air pollution health impact assessment (HIA) studies to assess the extent of health impacts in communities exposed to volcanic emissions. Treating volcanic ash as PM, we (1) consider existing models for HIA for general outdoor PM, (2) identify documented health effects from exposure to ash in volcanic eruptions, (3) discuss potential issues of applying CRFs based on the composition and concentration of ash‐related PM, and (4) critically review available case studies of volcanic exposure scenarios utilizing HIA for outdoor air pollution. We identify a number of small‐scale studies focusing on populations exposed to volcanic ash; exposure is rarely quantified, and there is limited evidence concerning the health effects of PM from volcanic eruptions. That limited evidence is, however, consistent with the CRFs typically used for outdoor air pollution HIA. Two health assessments of exposure to volcanic emissions have been published using population‐ and occupational‐based CRFs, though each application entails distinct assumptions and limitations. We conclude that the best available strategy, at present, is to apply outdoor air pollution risk estimates to scenarios involving volcanic ash emissions for the purposes of HIA. However, due to the knowledge gaps on, for example, the health effects from exposure to volcanic ash and differences in ash composition, there is inherent uncertainty in this application. To conclude, we suggest actions to enable better prediction and assessment of health impacts of volcanic emissions.

Epidemiological Approaches to Morbidity Forecasting for Health Impact Assessment of Air Pollution

Background: Forecasting future baseline morbidity rates is crucial to air pollution benefits assessment and disease burden analysis. Although numerous methods have been developed, no standard epidemiological approaches have been proposed. The purpose of this review is to provide an overview of available methods and examine sensitivity of forecasts to method selected.Methods: A literature search on morbidity forecasting was conducted using PubMed and Google Scholar. Sensitivity analyses were conducted using age-specific hospitalization rate data and population estimates.Results: Morbidity forecasting approaches can be grouped into standard regression models and dynamic microsimulation models. Regression models assume that predictor and dependent variables are uniformly correlated over time. However, this is not always the case. While the aging population is expected to increase morbidity, this may be partially offset by improved medical care and reduced exposures to risk factors like smoking. Dynamic microsimulation models have emerged as a reliable tool to address this evolution. The models simulate individuals’ risks and health determinants, and consider alternative “what if” scenarios to accurately project health outcomes. Using a conventional forecasting method based on population age distribution and age-specific all-cause hospitalization rates in Canada, we found that the projected rate increased from 91 per 1,000 population in 2001-02 to 102 per 1,000 in 2015-16. Conversely, the observed rate in 2015-16 decreased to 84 per 1,000, indicating an overestimation of 20%. Results differ for specific causes of hospitalization. Several studies also found that neglecting demographic dynamics and using unadjusted age-expenditure profile could overestimate healthcare expenditure by between 10% and 20%.Conclusion: Demographic dynamics and other factors must be considered to ensure the accuracy of baseline morbidity projections in air pollution health impact assessment.

Health and climate benefits of offshore wind facilities in the Mid-Atlantic United States

Electricity from fossil fuels contributes substantially to both climate change and the health burden of air pollution. Renewable energy sources are capable of displacing electricity from fossil fuels, but the quantity of health and climate benefits depend on site-specific attributes that are not often included in quantitative models. Here, we link an electrical grid simulation model to an air pollution health impact assessment model and US regulatory estimates of the impacts of carbon to estimate the health and climate benefits of offshore wind facilities of different sizes in two different locations. We find that offshore wind in the Mid-Atlantic is capable of producing health and climate benefits of between $54 and $120 per MWh of generation, with the largest simulated facility (3000 MW off the coast of New Jersey) producing approximately $690 million in benefits in 2017. The variability in benefits per unit generation is a function of differences in locations (Maryland versus New Jersey), simulated years (2012 versus 2017), and facility generation capacity, given complexities of the electrical grid and differences in which power plants are offset. This work demonstrates health and climate benefits of offshore wind, provides further evidence of the utility of geographically-refined modeling frameworks, and yields quantitative insights that would allow for inclusion of both climate and public health in benefits assessments of renewable energy.

Survey of Ambient Air Pollution Health Risk Assessment Tools.

Designing air quality policies that improve public health can benefit from information about air pollution health risks and impacts, which include respiratory and cardiovascular diseases and premature death. Several computer-based tools help automate air pollution health impact assessments and are being used for a variety of contexts. Expanding information gathered for a May 2014 World Health Organization expert meeting, we survey 12 multinational air pollution health impact assessment tools, categorize them according to key technical and operational characteristics, and identify limitations and challenges. Key characteristics include spatial resolution, pollutants and health effect outcomes evaluated, and method for characterizing population exposure, as well as tool format, accessibility, complexity, and degree of peer review and application in policy contexts. While many of the tools use common data sources for concentration-response associations, population, and baseline mortality rates, they vary in the exposure information source, format, and degree of technical complexity. We find that there is an important tradeoff between technical refinement and accessibility for a broad range of applications. Analysts should apply tools that provide the appropriate geographic scope, resolution, and maximum degree of technical rigor for the intended assessment, within resources constraints. A systematic intercomparison of the tools' inputs, assumptions, calculations, and results would be helpful to determine the appropriateness of each for different types of assessment. Future work would benefit from accounting for multiple uncertainty sources and integrating ambient air pollution health impact assessment tools with those addressing other related health risks (e.g., smoking, indoor pollution, climate change, vehicle accidents, physical activity).

Health impact assessment of air pollution in Shiraz, Iran: a two-part study

We aimed to assess health-impacts of short-term exposure to the air pollutants including PM10, SO2, and NO2 in Shiraz, Iran in a two-part study from 2008 to 2010. In part I, local relative risks (RRs) and baseline incidences (BIs) were calculate using generalized additive models. In part II, we estimated the number of excess hospitalizations (NEHs) due to cardiovascular diseases (CDs), respiratory diseases (RDs), respiratory diseases in elderly group (RDsE—people older than 65 years old), and chronic obstructive pulmonary diseases (COPDs) as a result of exposure to air pollutants using AirQ model, which is proposed approach for air pollution health impact assessment by World Health Organization. In part I, exposure to increase in daily mean concentration of PM10 was associated with hospitalizations due to RDs with a RR of 1.0049 [95% confidence interval (CI), 1.0004 to 1.0110]. In addition, exposure to increase in daily mean concentration of SO2 and NO2 were associated with hospitalizations due to RDsE and COPDs with RRs of 1.0540 [95% CI, 1.0050 to 1.1200], 1.0950 [95% CI, 1.0700 to 1.1100], 1.0280 [95% CI, 1.0110 to 1.0450] and 1.0360 [95% CI, 1.0210 to 1.0510] per 10 μg/m3 rise of these pollutants, respectively. In part II, the maximum NEHs due to CDs because of exposure to PM10 were in 2009—1489 excess cases (ECs). The maximum NEHs due to RDs because of exposure to PM10 were in 2009—1163 ECs. Meanwhile, the maximum NEHs due to RDsE and COPDs because of exposure to SO2 were in 2008, which are 520 and 900 ECs, respectively. In conclusion, elevated morbidity risks were found from acute exposure to air pollutants.