Health Impact Assessment Research Articles

Health impact assessment of pet cats caused by organohalogen contaminants by serum metabolomics and thyroid hormone analysis

Companion animals are in close contact with the human surroundings, and there is growing concern about the effects of harmful substances on the health of pet cats. In this study, we investigated the potential health effects of organohalogen compounds (OHCs) on thyroid hormone (TH) homeostasis and metabolomics in Japanese pet cats. There was a significant negative correlation between concentrations of several contaminants, such as polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), hydroxylated PCBs (OH-PCBs), hydroxylated PBDEs (OH-PBDEs), and THs in cat serum samples. These results suggested that exposure to OHCs causes a decrease in serum TH levels in pet cats.In this metabolomics study, each exposure level of parent compounds (PCBs and PBDEs) and their hydroxylated compounds (OH-PCBs and OH-PBDEs) were associated with their own unique primary metabolic pathways, suggesting that parent and phenolic compounds exhibit different mechanisms of action and biological effects. PCBs were associated with many metabolic pathways, including glutathione and purine metabolism, and the effects were replicated in in-vivo cat PCB administration studies. These results demonstrated that OHC exposure causes chronic oxidative stress in pet cats. PBDEs were positively associated with alanine, aspartate, and glutamate metabolism. Due to the chronic exposure of cats to mixtures of these contaminants, the combination of their respective metabolic pathways may have a synergistic effect.

Social cohesion and local democracy as determinants of health: Testing the liveability framework for health impact assessment of a major infrastructure

Social cohesion and local democracy (SCLD) are determinants of health. They contribute to health via complex pathways that include the free exchange of ideas and values, mutual trust and benefit, the sharing of resources and a sense of agency and efficacy in one's community. Like other determinants, SCLD can be affected by major infrastructures in subtle yet pervasive ways, both positively and negatively. Health impact assessment (HIA) is an established method of assessing major infrastructure projects and is capable of detecting and proposing responses to such impacts. Despite this, HIA is not undertaken as frequently as could be beneficial. Given governments' interest in the concept of liveability, we conducted an independent study to apply one domain of a previously introduced, eleven-domain liveability conceptual framework for HIA to assess a level crossing removal (LXR) project in Australia. Social cohesion and local democracy was assessed using a survey, interviews and data obtained via freedom of information (FOI). Local democracy was significantly negatively affected, primarily due to shallow and non-genuine consultation, with impacts on the mental health of a small but important segment of the community. Paradoxically, social cohesion was positively affected as a result of the new community groups and networks that evolved in opposition to the project. We conclude that the government's broadly granted social licence, established using popular but unproven claims that the LXR would increase safety and decrease congestion, allowed tokenistic local consultation. We comment on our experience with FOI processes, and on the potential of using ‘liveability’ to raise the profile of HIA, to yield better results for community health from major projects.

Scenarios of demographic distributional aspects of health co-benefits from decarbonising urban transport

There is limited knowledge on the distribution of the health co-benefits of reduced air pollutants and carbon emissions in the transport sector across populations. This Article describes a health impact assessment used to estimate the health co-benefits of alternative land passenger transport scenarios for the city of Beijing, China, testing the effect of five transport-based scenarios from 2020 to 2050 on health outcomes. New potential scenarios range from implementing a green transport infrastructure, to scenarios primarily based on the electrification of vehicle fleets and a deep decarbonisation scenario with near zero carbon emissions by 2050. The health co-benefits are disaggregated by age and sex and estimated in monetary terms. The results show that all the alternative mitigation scenarios result in reduced PM2·5 and CO2 emissions compared to a business-as-usual scenario during 2020-50. The near zero scenario achieves the largest health co-benefits and economic benefits annually relative to the sole mitigation strategy, preventing 300 (95% CI 229-450) deaths, with health co-benefits and CO2 cost-saving an equivalent of 0·01% (0·00-0·03%) of Beijing's Gross domestic product in 2015 by 2050. Given Beijing's ageing population and higher mortality rate, individuals aged 50 years and older experience the greatest benefit from the mitigation scenarios. Regarding sex, the greatest health benefits occur in men. This assessment provides estimates of the demographic distribution of benefits from the effects of combinations of green transport and decarbonising vehicles in transport futures. The results show that there are substantial positive health outcomes from decarbonising transport in Beijing. Policies aimed at encouraging active travel and use of public transport, increasing the safety of active travel, improving public transport infrastructure, and decarbonising vehicles lead to differential benefits. In addition, disaggregation by age and sex shows that the health impacts related to transport pollution disproportionately influence different age cohorts and genders. National Natural Science Foundation of China and FRIEND Project (through the National Research Foundation of Korea, funded by the Ministry of Science and ICT).

Long-term exposure to ozone and cardiovascular mortality in China: a nationwide cohort study

The evidence for a causal relationship between long-term ozone exposure and cardiovascular mortality is inconclusive, and most published data are from high-income countries. We aimed to investigate the association between long-term exposure to ozone and cardiovascular mortality in China, the most populous middle-income country. We did a nationwide cohort study comprising Chinese adults aged 18 years and older from the 2010-11 China Chronic Disease and Risk Factors Surveillance project; participants were followed up until Dec 31, 2018, or the date of death. Data on participants' deaths were obtained through linkage to the Disease Surveillance Point system, a national death registration database. Residential ozone exposure was estimated with a previously developed random forest model. We applied stratified Cox proportional hazards models to estimate the associations of ozone with mortality due to overall cardiovascular diseases, ischaemic heart disease, and stroke. The models were stratified by age and sex and adjusted for a set of individual-level and regional covariates. Warm-season average ozone concentration for the previous 1-3 years was added as a time-varying variable. We also did subgroup analyses by age, sex, level of education, smoking status, urban or rural residence, and geographical region. Data were analysed for 96 955 participants. The warm-season average ozone concentration during the follow-up period was 89·7 μg/m3 (SD 14·4). In the fully adjusted models, we observed significant and positive associations between ozone and mortality from overall cardiovascular diseases (hazard ratio [HR] 1·093 [95% CI 1·046-1·142] per 10 μg/m3 increase in warm-season ozone concentrations), ischaemic heart disease (1·184 [1·099-1·276] per 10 μg/m3 increase in warm-season ozone concentrations), and stroke (1·063 [1·002- 1·128] per 10 μg/m3 increase in warm-season ozone concentrations). After adjusting for fine particulate matter, the associations with overall cardiovascular disease and ischaemic heart disease mortality were almost unchanged, whereas the association with stroke mortality lost statistical significance. The association of long-term ozone exposure with cardiovascular mortality was more prominent in people aged 65 years and older than in those younger than 65 years. We did not find any effect modification of sex, level of education, smoking status, urban or rural residence, and geographical region. We observed an almost linear exposure-response relationship between ozone and cardiovascular mortality. This study is, to the best of our knowledge, the first nationwide cohort study to show that long-term ozone exposure contributes to elevated risks of cardiovascular mortality, particularly from ischaemic heart disease, in a middle-income setting. The exposure-response function generated from this study could potentially inform future air quality standard revisions and environmental health impact assessments. National Natural Science Foundation of China.

Applying Existing Particle Paradigms to Inhaled Microplastic Particles.

Ambient particulate pollution originating from plastic contaminates air, including indoor and urban environments. The recent discovery of ambient microplastic (MP) particles of a size capable of depositing in the thoracic region of the airway, if inhaled, has raised concern for public exposure and health impacts following lessons learned from other particle domains. Current microplastic exposure estimates are relatively low compared to total ambient particulate matter, but optimal analytical techniques and therefore data for risk and health impact assessments are lacking. In the absence of such an evidence base, this paper explores paradigms, metrics and dose-response curves developed in other particle domains as a starting point for predicting whether microplastic are of concern. Bio-persistence, presence of reactive sites and soluble toxicants are likely key properties in microplastic toxicity, but these are not measured in environmental studies and hence are challenging to interpret in exposure. Data from a MP inhalation study in rats is available but the study was conducted using conditions that do not replicate the known human health effects of PM2.5 or surrogate exposures: compromised, aged animal models are recommended to investigate potential parallels between MPs and PM2.5. One of these parallels is provided by tire wear particles (TWP), which form part of current ambient PM and are sometimes regarded as microplastic. A connection to epidemiological studies where PM filters are still available is recommended and consequently analytical advances are required. In summary, established particle domains and existing paradigms provide valuable insight and data that can be used to predict MP toxicity, and direct study design and key properties to consider in this emerging field.

An Integrated Approach to Characterize Temporal–Spatial Variations in PM2.5 Concentrations at the Ground Level and Its Implication on Health Impact Assessments

Although PM2.5 concentrations measured by the governmental air quality monitoring station (AQMS) have been widely used for conducting exposure assessments, it might be not able to reflect the residents’ exposures, especially for those associated with ground emissions. The present study was conducted in a city area for 1 year. A mobile monitoring station (MMS) was established to measure the PM2.5 concentrations at the ground level. A significant linear relationship (R2 = 0.53) was found between the MMS-measured concentrations and the corresponding concentrations obtained from the AQMS (15 m above the ground level), and the former was ∼ 1.11 times (95% CI: 1.08-1.15) in magnitude higher than that of the latter. To characterize the spatial variation of the area, the MMS-measured values were further classified into three different regions. A consistent trend was found in the present study for all collected data as industry region≒urban region > harbor region. The aforementioned results clearly indicate that the residents’ ambient PM2.5 exposures do have spatial differences. Seven-year AQMS-measured concentrations (i.e., AQMS7-yr) were used to establish the long-term PM2.5 concentrations at the ground level (i.e., MMS7-yr) of the three different regions using the linear regression equations obtained from the MMS and AQMS. Health impact functions and local health data were used to quantify the PM2.5-attributable health burden for both AQMS7-yr and MMS7-yr, respectively. Results show that the former is ∼ 10.4% lower in magnitude than the latter in the estimated lung cancer death attributed fraction (AF). In particular, the decrease of unit PM2.5 (μg/m3) would lead to a 0.75 and 0.71% decrease in the estimated AF of lung cancer death for AQMS7-yr and MMS7-yr, respectively. As a result, directly using AQMS7-yr would lead to an underestimation of ∼ 1,000 lung cancer deaths annually in Taiwan in comparison with those using MMS7-yr. The aforementioned results clearly indicate the importance of characterizing ground-level exposures for assessing the health impact of residents, and the methodology developed by the present study would be helpful for solving the aforementioned problem.

Potential Health Benefit of NO2 Abatement in China's Urban Areas: Inspirations for Source-specific Pollution Control Strategy

Potential Health Benefit of NO2 Abatement in China's Urban Areas: Inspirations for Source-specific Pollution Control Strategy

A refined and updated health impact assessment of the Global Programme to Eliminate Lymphatic Filariasis (2000–2020)

BackgroundLymphatic filariasis (LF) is a neglected tropical disease (NTD). In 2000 the World Health Organization (WHO) established the Global Programme to Eliminate Lymphatic Filariasis (GPELF). A key component of this programme is mass drug administration (MDA). Between 2000 and 2020, the GPELF has delivered over 8.6 billion treatments to at-risk populations. The last impact assessment of the programme evaluated the treatments provided between 2000–2014. The goal of this analysis is to provide an updated health impact assessment of the programme, based on the numbers treated between 2000–2020.MethodsWe updated and refined a previously established model that estimates the number of clinical manifestations and disability-adjusted life years (DALYs) averted by the treatments provided by the GPELF. The model comprises three different population cohorts that can benefit from MDA provided (those protected from acquiring infection, those with subclinical morbidity prevented from progressing and those with clinical disease alleviated). The treatment numbers were updated for all participating countries using data from the WHO. In addition, data relating to the estimated number of individuals initially at risk of LF infection were updated where possible. Finally, the DALY calculations were refined to use updated disability weights.ResultsUsing the updated model and corresponding treatment data, we projected that the total benefit cohort of the GPELF (2000–2020) would consist of approximately 58.5 million individuals and the programme would avert 44.3 million chronic LF cases. Over the lifetime of the benefit cohorts, this corresponded to 244 million DALYs being averted.ConclusionThis study indicates that substantial health benefits have resulted from the first 20 years of the GPELF. It is important to note that the GPELF would have both additional benefits not quantified by the DALY burden metric as well as benefits on other co-endemic diseases (such as soil-transmitted helminths, onchocerciasis and scabies)—making the total health benefit underestimated. As with the past impact assessments, these results further justify the value and importance of continued investment in the GPELF.Graphical

Estimating risk factor attributable burden – challenges and potential solutions when using the comparative risk assessment methodology

BackgroundBurden of disease analyses quantify population health and provide comprehensive overviews of the health status of countries or specific population groups. The comparative risk assessment (CRA) methodology is commonly used to estimate the share of the burden attributable to risk factors. The aim of this paper is to identify and address some selected important challenges associated with CRA, illustrated by examples, and to discuss ways to handle them. Further, the main challenges are addressed and finally, similarities and differences between CRA and health impact assessments (HIA) are discussed, as these concepts are sometimes referred to synonymously but have distinctly different applications.ResultsCRAs are very data demanding. One key element is the exposure-response relationship described e.g. by a mathematical function. Combining estimates to arrive at coherent functions is challenging due to the large variability in risk exposure definitions and data quality. Also, the uncertainty attached to this data is difficult to account for. Another key issue along the CRA-steps is to define a theoretical minimal risk exposure level for each risk factor. In some cases, this level is evident and self-explanatory (e.g., zero smoking), but often more difficult to define and justify (e.g., ideal consumption of whole grains). CRA combine all relevant information and allow to estimate population attributable fractions (PAFs) quantifying the proportion of disease burden attributable to exposure. Among many available formulae for PAFs, it is important to use the one that allows consistency between definitions, units of the exposure data, and the exposure response functions. When combined effects of different risk factors are of interest, the non-additive nature of PAFs and possible mediation effects need to be reflected. Further, as attributable burden is typically calculated based on current exposure and current health outcomes, the time dimensions of risk and outcomes may become inconsistent. Finally, the evidence of the association between exposure and outcome can be heterogeneous which needs to be considered when interpreting CRA results.ConclusionsThe methodological challenges make transparent reporting of input and process data in CRA a necessary prerequisite. The evidence for causality between included risk-outcome pairs has to be well established to inform public health practice.

Health Impact Assessment (HIA) of a Daily Physical Activity Unit in Schools: Focus on Children and Adolescents in Austria Up to the 8th Grade.

Physical activity has a variety of health benefits for young people. The World Health Organization (WHO) recommends that children and adolescents aged 5–17 years should be physically active for at least 60 min a day. This Health Impact Assessment (HIA) examined the potential impact of a daily physical activity unit in Austrian schools, with a focus on children and adolescents up to eighth grade. The HIA methodology systematically followed several stages: screening and scoping, appraisal, and formulation of recommendations. A literature review, an online survey (n = 712), focus group discussions (n = 4), and appraisal workshops (n = 2) have been carried out. The analyzed results indicate a primarily positive impact on the individual health of children and adolescents, on social and community-related networks, on living and working conditions, and on the system level. Recommendations for the implementation include ensuring equal opportunities and support for disadvantaged children and schools. Furthermore, the comprehensible selection of pilot regions and the nationwide resource planning should be considered. Additional important factors include the education and further training of pedagogical staff and coaches, and the availability of sufficient infrastructure. In the long term, the fixed integration of five additional teaching units of physical activity per week, and an increased focus on the elementary/nursery school sector were identified as significant.

Assessment of local health security fund implementation for well-being promotion and health mechanism development at the local level

This research employed Participatory Action Research (PAR) with the purpose of applying the health impact assessment on the local health security fund implementation for well-being promotion and health mechanism development at the local level. This case study was conducted in Sankhaburi District, Chai Nat Province as the pilot area for the integrated model to drive the promotion of well-being in the local health security fund which according to the successful verification of the integrated community health mechanism in the province during the fiscal year 2020, the sub-district health fund supported funding for 1,193 quality projects. Among these projects, the quality projects in Sankhaburi District gained the highest support for the first rank in the province. In this research, health impact was assessed by collecting data from the main informants who were the main responsible officers at the regional level, the mentors of the provincial health security funds, and stakeholders in the integrated implementation of the local health mechanism. The study methods included in-depth interviews and focus group discussion. Research found that the local health security funds used the integrated system for well-being promotion and health mechanism development at the local level. The focus was on increasing the implementation potential at the regional level which was used to support effective project planning by using the online follow-up and evaluation system. In addition, the health system at the regional level was developed through the mechanism of the health security funds in relation to the well-being promotion projects of the local health security funds. Implementation was planned for problem-solving management and life quality development at the district level according to the application of the health impact assessment on the local health security fund. Implementation opportunities were provided for different parties to share knowledge, develop their implementation of well-being promotion, and develop the health mechanism at the local level.

Trends, Issues and Future Directions of Urban Health Impact Assessment Research: A Systematic Review and Bibliometric Analysis.

Health impact assessment (HIA) has been regarded as an important means and tool for urban planning to promote public health and further promote the integration of health concept. This paper aimed to help scientifically to understand the current situation of urban HIA research, analyze its discipline co-occurrence, publication characteristics, partnership, influence, keyword co-occurrence, co-citation, and structural variation. Based on the ISI Web database, this paper used a bibliometric method to analyze 2215 articles related to urban HIA published from 2012 to 2021. We found that the main research directions in the field were Environmental Sciences and Public Environmental Occupational Health; China contributed most articles, the Tehran University of Medical Sciences was the most influential institution, Science of the Total Environment was the most influential journal, Yousefi M was the most influential author. The main hotspots include health risk assessment, source appointment, contamination, exposure, particulate matter, heavy metals and urban soils in 2012–2021; road dust, source apposition, polycyclic aromatic hydrocarbons, air pollution, urban topsoil and the north China plain were always hot research topics in 2012–2021, drinking water and water quality became research topics of great concern in 2017–2021. There were 25 articles with strong transformation potential during 2020–2021, but most papers carried out research on the health risk assessment of toxic elements in soil and dust. Finally, we also discussed the limitations of this paper and the direction of bibliometric analysis of urban HIA in the future.

Benefits of Increasing Greenness on All-Cause Mortality in the Largest Metropolitan Areas of the United States Within the Past Two Decades.

Across the United States, cities are creating sustainability and climate action plans (CAPs) that call to increase local vegetation. These greening initiatives have the potential to not only benefit the environment but also human health. In epidemiologic literature, greenness has a protective effect on mortality through various direct and indirect pathways. We aimed to assess how an increase in greenness could decrease mortality in the largest urban areas in the United States. We conducted a nationwide quantitative health impact assessment to estimate the predicted reduction in mortality associated with an increase in greenness across two decades (2000, 2010, and 2019). Using a recently published exposure-response function, Landsat 30 m 16-day satellite imagery from April to September, and publicly available county-level mortality data from the CDC, we calculated the age-adjusted reduction in all-cause mortality for those 65 years and older within 35 of the most populated metropolitan areas. We estimated that between 34,000 and 38,000 all-cause deaths could have been reduced in 2000, 2010, and 2019 with a local increase in green vegetation by 0.1 unit across the most populated metropolitan areas. We found that overall greenness increased across time with a 2.86% increase from 2000 to 2010 to 11.11% from 2010 to 2019. These results can be used to support CAPs by providing a quantitative assessment to the impact local greening initiatives can have on mortality. Urban planners and local governments can use these findings to calculate the co-benefits of local CAPs through a public health lens and support policy development.

Professional workforce training needs for Health Impact Assessment in spatial planning: A cross sectional survey

ObjectivesHeath Impact Assessment (HIA) in spatial planning can influence wider determinants and prevent ill-health, promote good health and reduce inequalities. They remain underutilised in England, partly due to inadequate workforce training. This study sought to identify the training needs of Public Health Professionals, Planners and Impact Assessment Practitioners in England in 2021. Study designCross-sectional survey. MethodsA survey was undertaken of Public Health Professionals, Planners and Impact Assessment Practitioners to ascertain their training needs. Descriptive statistics, frequency tables and charts summarised feedback. Results76% (68) of 90 total respondents, never received any training in HIAs. Quantifying impact of planning on health, especially in monetary terms and monitoring success of HIA recommendations, were common challenges for all professions. Musculoskeletal health and infectious disease were among specific health impacts where professionals welcomed further training. Public Health professionals requested support to identify high-impact interventions and work more collaboratively with Planners and a need to justify budgets for undertaking HIAs. Planners expressed training needs around justifying requirement for HIAs, data collection; and identifying local public health priorities. Impact Assessment Practitioners expressed uncertainty about policy triggers needed to undertake HIAs citing that the scale of HIAs must be proportional to project scope, the challenge of identifying planning interventions and a need to apply consistent methodological approaches in HIAs. ConclusionThere is need for baseline training to upskill all professionals, alongside tailored-training on key topic areas to address profession- and locality-specific needs to ensure spatial planning decisions better influence wider determinants and address local health priorities.

Improving indoor air quality and occupant health through smart control of windows and portable air purifiers in residential buildings

Indoor exposure to PM2.5 (particulate matter with aerodynamic diameter less than 2.5 μm) has a substantial negative impact on people’s health. However, indoor PM2.5 can be controlled through effective ventilation and filtration. This study aimed to develop a smart control framework that (1) combines a portable home air purifier (HAP) and window control system to reduce indoor PM2.5 concentrations whilst maintaining thermal comfort; (2) evaluates the associated health impacts and additional energy use. The proposed framework was demonstrated through a simulation-based case study of a low-energy apartment. The simulation results showed that joint control of HAP and window openings has great potential to not only maintain thermal comfort but also achieve effective PM2.5 removal which, consequently, can lead to considerable health benefits at a low additional energy cost. Compared to similar previous studies, the strength of the proposed control framework lies in combining window operations and HAPs in the same system and including both thermal comfort and indoor PM2.5 as the control targets. This work also introduces a novel concept of linking a building control system with a health impact assessment, an important and innovative step in the creation of holistic and responsive building controls. Practical application: This study proposes a novel control framework that jointly controls portable home air purifiers (HAPs) and windows to maintain thermal comfort and achieve effective PM2.5 removal. The simulation results suggest that such a hybrid control strategy can result in considerable health benefits at low additional energy costs.

Assessment of Health Impact of Heavy Metals Contained in Wild Berries of Shrubs for the Population of the Murmansk Region

Background: Studies of wild berries of local shrubs carried out in the Murmansk Region showed an increased accumulation of heavy metals in them, especially near the Severonickel plant. High concentrations of industrial pollutants were measured in blueberries, lingonberries and crowberries. Objective: To assess health effects of population exposure to nickel and copper in wild berries of small shrubs in the Murmansk Region. Materials and methods: We tested metal contents in blueberries, lingonberries and crowberries gathered in August–September of 2016–2018 at ten stationary monitoring plots located along the industrial pollution gradient in the meridional (south) direction on the leeward side of the Severonickel plant. Health risk assessment was conducted in accordance with Guidelines R 2.1.10.1920-04, Health Risk Assessment from Environmental Chemicals. Results: Values of carcinogenic risk from oral exposure to nickel contained in the berries were unacceptably high (> 1.0E-03) at all monitoring plots. Estimates of chronic non-carcinogenic risk from nickel exposure were also high while those from copper exposure were unacceptable only for crowberry. Hazard index values for the unidirectional effect of copper and nickel on the digestive tract and liver were unacceptably high (> 1.0) at most monitoring plots for all the berries studied. Discussion: High risk values for the local population necessitate the development of recommendations for exposure reduction, such as limiting the annual consumption of berries to 6 kg, avoiding berry picking at a distance of up to 15 km from the Seve- ronickel plant, etc. Conclusions: The predicted levels of carcinogenic and non-carcinogenic risks associated with exposure to nickel and copper were estimated as unacceptably high, thus indicating a pronounced industrial impact on boreal ecosystems in the zone of influence of the enterprise, extending more than 15 km from its industrial site. It is critical to develop appropriate recommendations for the population consuming wild-growing blueberries, cowberries and crowberries picked in this industrially contaminated area.

Projecting the Suicide Burden of Climate Change in the United States.

We quantify and monetize changes in suicide incidence across the conterminous United States (U.S.) in response to increasing levels of warming. We develop an integrated health impact assessment model using binned and linear specifications of temperature‐suicide relationship estimates from Mullins and White (2019), in combination with monthly age‐ and sex‐specific baseline suicide incidence rates, projections of six climate models, and population projections at the conterminous U.S. county scale. We evaluate the difference in the annual number of suicides in the U.S. corresponding to 1–6°C of warming compared to 1986–2005 average temperatures (mean U.S. temperatures) and compute 2015 population attributable fractions (PAFs). We use the U.S. Environmental Protection Agency’s Value of a Statistical Life to estimate the economic value of avoiding these mortality impacts. Assuming the 2015 population size, warming of 1–6°C could result in an annual increase of 283–1,660 additional suicide cases, corresponding to a PAF of 0.7%–4.1%. The annual economic value of avoiding these impacts is $2 billion–$3 billion (2015 U.S. dollars, 3% discount rate, and 2015 income level). Estimates based on linear temperature‐suicide relationship specifications are 7% larger than those based on binned temperature specifications. Accounting for displacement decreases estimates by 17%, while accounting for precipitation decreases estimates by 7%. Population growth between 2015 and the future warming degree arrival year increases estimates by 15%–38%. Further research is needed to quantify and monetize other climate‐related mental health outcomes (e.g., anxiety and depression) and to characterize these risks in socially vulnerable populations.

Surveillance of Indoor Air Concentration of Volatile Organic Compounds in Luxembourgish Households.

Exposure to air pollution is a well-known health risk. For instance, volatile and very volatile organic compounds (VOCs and VVOCs) are known to cause respiratory, haematologic or immune diseases, and even cancer. Based on the Luxembourgish indoor pollution surveillance program, we performed an exploratory analysis for the period 2014–2019, in order (1) to evaluate the prevalence of VOCs and VVOCs in households, and (2) to estimate the risks of lifelong exposure to selected VOCs on the health of the adult population. The database included 715 indoor air samples from 159 different households. Observed VOC and VVOC levels were similar to those in neighbouring countries. Our health impact assessment identified some health risks associated with the observed concentrations in Luxembourg. Furthermore, this study shows the major public health importance of having a national indoor pollution surveillance system in place. Highlights: (1) This study provides an overview of the domestic indoor pollution in Luxembourg. (2) (V)VOCs levels in Luxembourg were similar to those in neighbouring countries. (3) The results clearly show the importance of having a surveillance system in place.

The role of risk communication in radon mapping, risk assessment and mitigation activities in Sardinia (Italy)

Abstract. In 2014, the Sardinian Regional Department of Hygiene, Health and Social Security promoted the Regional Prevention Plan, which embraced the protection of the population from exposure to indoor pollutants, including radon gas. The programme foresaw: the drafting of “Guidance for the construction/renovation of buildings”; radon monitoring and mapping activities during a dedicated campaign based on geological surveying; a radon health impact assessment; community involvement and a radon risks communication campaign. The objectives of the programme were focused to protect Sardinian population from radon risk, with special reference to vulnerable and susceptible subjects, spread knowledge about risks and the opportunities to reduce them. Using a Health Impact Assessment procedure, the number of attributable deaths was estimated based on radon exposure levels, also visible as preventable events by implementing preventive actions. The purpose of this article is to illustrate the activities carried out, with specific reference to the use of communication to develop each action, to understand strengths and weaknesses and the lessons to be applied in Sardinia and other areas. Monitoring and evaluation results indicate that the health of populations living in radon-exposed areas can be significantly improved by reducing exposure to radon and synergistic risk factors. It is essential to strengthen awareness-raising events using historical and acquired knowledge, and to monitor progress in order to reinforce further actions, as these schemes should be planned for the long term, with central coordination and continuous evaluation. The case of radon risk management and communication in Sardinia offers a number of suggestions and lessons learned, both for the continuation of the work that is expected to be very intense in the coming years, and for the problems that may arise in other regions and countries affected by radon risk.

ZIP Code-Level Estimation of Air Quality and Health Risk Due to Particulate Matter Pollution in New York City.

Exposure to PM2.5 is associated with hundreds of premature mortalities every year in New York City (NYC). Current air quality and health impact assessment tools provide county-wide estimates but are inadequate for assessing health benefits at neighborhood scales, especially for evaluating policy options related to energy efficiency or climate goals. We developed a new ZIP Code-Level Air Pollution Policy Assessment (ZAPPA) tool for NYC by integrating two reduced form models—Community Air Quality Tools (C-TOOLS) and the Co-Benefits Risk Assessment Health Impacts Screening and Mapping Tool (COBRA)—that propagate emissions changes to estimate air pollution exposures and health benefits. ZAPPA leverages custom higher resolution inputs for emissions, health incidences, and population. It, then, enables rapid policy evaluation with localized ZIP code tabulation area (ZCTA)-level analysis of potential health and monetary benefits stemming from air quality management decisions. We evaluated the modeled 2016 PM2.5 values against observed values at EPA and NYCCAS monitors, finding good model performance (FAC2, 1; NMSE, 0.05). We, then, applied ZAPPA to assess PM2.5 reduction-related health benefits from five illustrative policy scenarios in NYC focused on (1) commercial cooking, (2) residential and commercial building fuel regulations, (3) fleet electrification, (4) congestion pricing in Manhattan, and (5) these four combined as a “citywide sustainable policy implementation” scenario. The citywide scenario estimates an average reduction in PM2.5 of 0.9 μg/m3. This change translates to avoiding 210–475 deaths, 340 asthma emergency department visits, and monetized health benefits worth $2B to $5B annually, with significant variation across NYC’s 192 ZCTAs. ZCTA-level assessments can help prioritize interventions in neighborhoods that would see the most health benefits from air pollution reduction. ZAPPA can provide quantitative insights on health and monetary benefits for future sustainability policy development in NYC.