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WMOs Global Atmosphere Watch Symposium Air Quality & Health

18 March 2013, Geneva, Switzerland

PUBLIC HEALTH AND ENVIRONMENT

WMOs Global Atmosphere Watch Symposium:


Air Quality & health

Heather Adair-Rohani Technical Officer Interventions for a Healthy Environment Unit Dept. of Public Health & Environment WHO HQ

WHO's Public Health and Environment Department s role is to promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health.

WMOs Global Atmosphere Watch Symposium:


Air Quality & health

Presentation Overview:

Health Impacts of Air Pollution

Exposure & Disease Burden Moving forward: Better estimating exposure


Moving forward: WHO Activities for healthy air

Health Impacts: Air Pollutants Products of incomplete combustion


CO2 emissions Air are not a direct problem for health---rather it is a mixture Outdoor Pollution of pollutants that are released during the incomplete combustion of carbonbased fuels that have direct impacts on health. The products of incomplete combustion (PICS) include but are not limited to things like particulate matter, ozone, methane, poly-aromatic hydrocarbons, carbon monoxide, etc The single most studied and one of the most important health-damaging pollutant is particulate matter (PM).

CH4 NOx

PAH

PM CO2

CO CH2O NMVOCs
SOx

Health Impacts: Air Pollutants Particulate Matter


PM in urban and non-urban environments Outdoor Air Pollution which can be formed primarily or secondarily, is a complex mixture of chemical components that have diverse chemical & physical characteristics that can impact health such as size, particle core chemistry, metals, biogenic origin etc. The toxicity of PM may potentially arise from the particles presence on biological tissues, to the actions of chemical constituents, including absorded components or a combination of these factors. Exposure to PM is associated with bronchial irritation, inflammation, increased reactivity, reduced mucociliary clearance, genotoxic events (i.e. carcinogenic) and reduced macrophage response.

Health Impacts: Growing Evidence-base Specific health outcomes


1. Outdoor Air Pollution
Outcome Child ALRI, Lung cancer, COPD, LBW, Cataract Strength of Evidence Strong

TB, Cancer of UADT


Ca cervix, adult ALRI, asthma, O/Media

Moderate
Moderate

Exposure: How big is the problem?


Pollution

Outdoor air pollution Household air pollution

Exposure: Who & how much? Outdoor Air Pollution (OAP)


oInefficient fossil fuel combustion from the industry, and transport sectors along with biomass burning are some of the largest contributors to OAP. oThe greatest health impacts from exposure to outdoor air pollution are seen more in middle- to highincome countries.
oExposure to OAP in urban areas was responsible for to 1 million premature deaths & accounted for 0.5% of the total disease burden in 2004.

Exposure: Who & how much? Outdoor Air Pollution (OAP)

oA recent Lancet study, estimates that in 2010, 3.3 million deaths and 3.1% of the global disease burden from were attributed to OAP in both urban & rural areas 0.5 million of these deaths or 16% can be attributed to the outdoor air pollution from household air pollution leaking outdoors. o A large part of the variations in OAP disease estimates are due to urban/rural coverage, different underlying disease burden estimates & greater number of disease outcomes (e.g. CVD) accounted for in OAP recent estimates

Exposure: WHO & how much? Household Air Pollution (HAP)


oAround 2.7 billion people, mostly in developing countries, rely on the traditional use of solid fuels (i.e. wood, dung, coal, crop waste) to meet their cooking, needs.

1. Outdoor Air Pollution

o In 2004, WHO estimates nearly two million deaths were attributed to household air pollution from the use of open fires and simple stoves for cooking accounting for 2.7% of the global disease burden

Exposure: WHO & how much? Household Air Pollution (HAP)


o The 2012 Lancet study shows an increase in disease burden to HAP---3.5 million deaths and 4.5% of the total disease burden attributed to HAP oSimilar to OAP, a greater number of disease outcomes accounted in new deaths and disease estimates including cardiovascular disease, lung cancer from biomass use, and cataract. o These estimates only account from the deaths and disease from primary cooking fuel---mortality & morbidity estimates are likely to be higher if secondary fuel use, and other end uses (heating, lighting) were accounted for in exposure estimates.

1. Outdoor Air Pollution

Moving Forward: Growing Evidence-base for health Integrated Concentration-response function 1. Outdoor Air Pollution

Kirk R. Smith, Jennifer L. Peel Environ Health Perspect. 2010 December; 118(12): 16431645. Published online 2010 August 20.

Moving Forward: Growing Evidence-base for health Integrated Concentration-response function 1. Outdoor Air Pollution

Kirk R. Smith, Jennifer L. Peel Environ Health Perspect. 2010 December; 118(12): 16431645. Published online 2010 August 20.

Moving forward: Estimating OAP Exposure


Satellite-based estimates provide a truly global picture of the burden of disease due to outdoor air pollution

Outdoor Air Pollution

Unger, 2010

Brauer M, Ammann M, Burnett R et al. GBD 2010 Outdoor Air Pollution Expert Group 2011 Submitted under review

Moving forward: Estimating OAP Exposure


Satellite-based estimates provide a truly global picture of the burden of disease due to outdoor air pollution

Outdoor Air Pollution

2005 population-weighted regional estimated average PM2.5

Unger, 2010

Brauer M, Ammann M, Burnett R et al. GBD 2010 Outdoor Air Pollution Expert Group 2011 Submitted under review

Distributions of selected regional 2005 estimated PM2.5 by urban and rural areas

Canadian Census Cohort (1991 2001)

Crouse D, Burnett RD et al. Risk of Mortality in Relation to Long-term Exposure to Low Concentrations of Fine Particulate Matter: A Canadian National-level Cohort Study. Submitted 2011 16

Moving Forwarding: Estimating OAP Exposure


Satellite-based estimates of Moscow smoke event
Before Fires During Fires

MODIS-based (IQR)

From: A van Donkelaar et al. Atmospheric Environment 2011 van Donkelaar

et al., in prep

Moving Forwarding: Estimating OAP Exposure


Satellite-based estimates and HAP
Before Fires During Fires

Source: S Guttikunda. Urban Air Pollution Analysis for Ulaanbaatar. World bank report 2007

van Donkelaar et al., in prep

Moving Forwarding: Guidance for Healthy Air


WHO Activities for policy-makers & implementation
Before Fires During Fires

Indoor Air Quality WHO Air Quality Guidelines for household fuel combustion Expansion of WHO Global Household Energy Database Outdoor Air Quality Update & expansion of WHOs Outdoor Air Pollution database Update of WHO Air Quality Guidelines, Global update 2005 Support to countries for air quality monitoring and intervention implementation e.g. Sustainable Energy for All Global Tracking Framework, UN Energy Raising awareness for health co-benefits of climate change adaptation & mitigation strategies Health in the Green Economy Series, WMO/WHO Climate & Health Atlas, Clean Air Coalition for Short-Lived Pollutants
van Donkelaar et al., in prep

Before Fires

During Fires

Thank you and any questions?

van Donkelaar et al., in prep