2. HEALTH EFFECTS 2.1 INTRODUCTION DISCUSSION OF HEALTH EFFECTS BY
Section 6 Health Effects
-
Upload
stella-foley -
Category
Documents
-
view
14 -
download
1
description
Transcript of Section 6 Health Effects
AREPGURME
Section 6Health Effects
2
AREPGURME
Section 6 – Health Effects
A Brief History of PM
3
AREPGURME
Section 6 – Health Effects
The Houses of Parliament, Stormy Sky
Claude Monet, 1904
4
AREPGURME
Section 6 – Health Effects
Air Pollution Disasters
1930 Meuse River Valley, BelgiumA three-day episode of severe air pollution makes 6,000 ill and kills 63.
1948 Denora, PAOct. 26 to 31: air pollution episode
leaves 20 dead out of 14,000 persons.
1952 London, EnglandDec. 4 to 9: “Killer Fog” leaves three
to four thousand people dead.
London buses are escorted by lantern at 10:30 in the morning.
Donora, PA at noon on Oct. 29, 1948
5
AREPGURME
Section 6 – Health Effects
Human LungHuman LungHuman LungHuman Lung
Air conducting•Trachea•Bronchi•Bronchioles
Gas exchange•Respiratory bronchioles•Alveoli
6
AREPGURME
Section 6 – Health Effects
Mouse lung exposed to Diesel Exhaust
Diesel Exhaust Particles (DEP) augment inflammation by increasing receptors for bacterial lipopolysaccharide. The effect is to make the lungs highly sensitive to the presence of normal levels of bacteria. This results in greatly heightened production of pro-inflammatory mediators from the
cells.
Normal mouse lung Exposed mouse lung
7
AREPGURME
Section 6 – Health Effects
Schwartz, 1994
Mortality attributed to London Smog
8
AREPGURME
Section 6 – Health Effects
Outdoor Air PollutionRegulatory Categories
Criteria Pollutants • Present everywhere• Ambient air quality standards•Widely monitored
Air toxics• Long list (>180)•Many carcinogens• Less frequent ambient measurements
9
AREPGURME
Section 6 – Health Effects
Criteria Pollutants
•Particulate matter– PM10 (PM < 10 microns)– PM2.5 (PM < 2.5 microns)– (PM10-PM2.5 = coarse fraction)
•Nitrogen dioxide (NO2)•Sulfur dioxide (SO2)•Ozone (O3)•Carbon monoxide• Lead
10
AREPGURME
Section 6 – Health Effects
11
AREPGURME
Section 6 – Health Effects
Disease and environmental factors
Estimates of the burden of disease attributable to environmental factors vary depending on
– Type of disease– Vulnerability– Genetics– Population group– Socioeconomic aspects
Large differences between people living in– Industrialized/developing countries– East/West of Europe– and others
12
AREPGURME
Section 6 – Health Effects
Disease and environmental factors
Major health impacts and their association with environmental factors
Cancer: air pollution, mainly PM 2.5 and smaller, PAHs, metals (AS Cd Cr)
Cardiovascular disease: air pollution (CO, O3, PM, Pb)
Respiratory diseases: SO2, NO2, PM10 and PM 2.5, O3
Developmental disorders: Pb, Hg, Cd
Nervous system disorders: Pb, PCBs, Methyl Hg, Mn
13
AREPGURME
Section 6 – Health Effects
Disease and environmental factors
Air pollution is the environmental factor with the greatest health impact in Europe!
Effect is expressed by number of deaths (mortality rates), and by DALYs:
– “Disability-Adjusted Life Years”– An indicator of “burden of disease”, – Gives an indication how disease can alter the ability of people
to live a normal life compared with those with no disease. Expresses years of lost life.
Effect also expressed as morbidity, such as increased frequency of chronic bronchitis, respiratory hospital
admissions, restricted activity days.
14
AREPGURME
Section 6 – Health Effects
Disease and environmental factorsWHO estimates for Europe (51 countries)
• Children age 0-4 years: 1.8 – 6.4 % of deaths from all causes due to outdoor air pollution
• Mild mental retardation due to lead exposure: 4.4 % of all DALYs
In a selection of European cities each year: • Air pollution responsible for 100 000 deaths and • 725 000 years of lost life (DALYs)
European Commission estimates in CAFÉ:• 350 000 premature deaths in 2000 due to outdoor air pollution of
PM2.5 alone =• Average loss of life expectancy of 9 months for each European
citizen
Ozone causes 20 000 premature deaths annually
15
AREPGURME
Section 6 – Health Effects
Disease and environmental factors
Heat waves cause excess deaths; however, large portion due to air pollution
Heat wave in Europe summer 2003, in United Kingdom:• 2045 excess deaths 4-13 August (compared with
1998-2002 average)• Deaths due to air pollution:
– 225 – 593 due to ozone– 207 due to PM10– Above represent 21 – 38 % of the excess deaths (John R. Stedman)
16
AREPGURME
Section 6 – Health Effects
Disease and environmental factors
Strength of association between environmental factors and selected diseases, corresponding population impact and prevention possibilities (EEA and IPCC)• Neurodevelopment (Pb): very likely 90-99 %, moderate, high• Neurodevelopment (Hg): very likely 90-99 %, low, high• Respiratory diseases (air pollution): very likely 90-99 %,
high, moderate• Asthma causation (air pollution): medium likelihood 33-66 %,
high, moderate
Many examples show that respiratory health and life quality improves with improved air quality.
17
AREPGURME
Section 6 – Health Effects
Strength of association between environmental factors and selected diseases, corresponding population impact and prevention possibilities (EEA and IPCC)
Neurodevelopment (Pb): very likely 90-99 %, moderate, high
Neurodevelopment (Hg): very likely 90-99 %, low, high
Respiratory diseases (air pollution): very likely 90-99 %, high, moderate
Asthma causation (air pollution): medium likelihood 33-66 %, high, moderate
Many examples show that respiratory health and life quality
improves with improved air quality.
18
AREPGURME
Section 6 – Health Effects
PM is derived from many different sources
19
AREPGURME
Section 6 – Health Effects
Ultra Fine
10 um1 um0.1 um
Anthropogenic:SulfatesNitratesAmmoniaCarbonLead Organics
CoarseFine
Natural: Soil Dust Seasalt Bioaerosols
2.5 um
Particulate Matter Sizes and Composition
20
AREPGURME
Section 6 – Health Effects
PM relative to hair cross section
Human Hair PM10(10 m)
PM2.5(2.5 m)
Hair cross section (60 m)
21
AREPGURME
Section 6 – Health Effects
Particles Affect the Lungs
Respiratory system effects: Respiratory symptoms – irritation of
airways, cough Decreased lung function Airway inflammation Asthma attacks, bronchitis Chronic bronchitis
22
AREPGURME
Section 6 – Health Effects
Public Health Risks Are Significant
Particles are linked to: Premature death from heart and lung
diseases Aggravation of heart and lung diseases,
with increased:•Hospital admissions•Doctor and ER visits•Medication use• School and work absences
23
AREPGURME
Section 6 – Health Effects
Some Groups Are More at Risk
People with heart or lung disease
Greater deposition with chronic obstructive pulmonary disease (COPD)
Older adultsGreater prevalence of heart and lung disease
Children• More likely to be active• Breathe more air per kg• Bodies still developing
24
AREPGURME
Section 6 – Health Effects
Nitrogen dioxide (NO2)
Emissions from high temperature combustion processes: motor vehicle exhaust and stationary sources for power production
Exposures indoors due to (unvented) gas appliances and infiltration of ambient NO2
(Complex atmospheric chemistry – can be transformed to HNO3 and nitrate particles)
25
AREPGURME
Section 6 – Health Effects
Nitrogen dioxide (NO2) effects
Strong oxidant and respiratory irritant (forms nitrous and nitric acids in contact with water)
NO2 irritates the nose, throat and lungs especially in people with asthma.
Lowers resistance to respiratory infections such as influenza.
Contributes to ozone formation (and thus to ozone effects indirectly).
26
AREPGURME
Section 6 – Health Effects
Sulfur dioxide (SO2)
Irritant gas resulting mainly from combustion of sulfur-containing fossil fuels (power plants, large industrial facilities, diesel vehicles) and metal smelting.
(Is oxidized/hydrated to form sulfuric acid particles)
27
AREPGURME
Section 6 – Health Effects
SO2 Effects
Usually short-term concentration peaks
SO2 reduces lung function:
Constricts breathing passages, causing wheezing, shortness of breath and coughing, happens quickly.
Lung function returns to normal about an hour after exposure ends.
Causes above in healthy subjects and asthmatics; latter are substantially more sensitive
28
AREPGURME
Section 6 – Health Effects
Ozone (O3)
Ubiquitous exposure - formed by natural processes as well as human activities
Principal constituent of photochemical smog – not emitted directly
Highly reactive, but poorly soluble, allowing deep lung penetration
Acute toxicity is related to dose = Concentration x Ventilation Rate x Time – increased risk from outdoor exertion
29
AREPGURME
Section 6 – Health Effects
Ozone Irritates Airways
Symptoms:•Cough• Sore or scratchy throat• Pain with deep breath, or chest pain• Fatigue
Rapid onset, but effect is greater 24 hours after exposure
Similar symptoms for people with or without asthma
30
AREPGURME
Section 6 – Health Effects
Public Health Risks Are Significant
Ozone is linked to:• Aggravation of lung diseases, increased•Hospital admissions•Doctor and ER visits•Medication use• School and work absences
Permanent lung changes
31
AREPGURME
Section 6 – Health Effects
Public Health Risks Are Significant
Respiratory hospital admissions by daily maximum ozone level, lagged one day
114
112
110
108
106
104
102
114
112
110
108
106
104
102
Ozone concentration (ppm)Ozone concentration (ppm)
Res
pira
tory
Adm
issi
ons
Res
pira
tory
Adm
issi
ons
.01 .02 .03 .04 .05 .06 .07 .08 .09 .1.01 .02 .03 .04 .05 .06 .07 .08 .09 .1
(Burnett et al, 1994)(Burnett et al, 1994)
32
AREPGURME
Section 6 – Health Effects
Some Groups Are More at Risk
Children and adults who are active outdoors
People with lung diseases, such as asthma
People who are unusually sensitive to ozone
33
AREPGURME
Section 6 – Health Effects
Air Quality Index
Descriptors Cautionary Statement
Good 0 – 50 No message
Moderate 51 – 100 Unusually sensitive individuals
Unhealthy for Sensitive Groups
101 - 150
Identifiable groups at risk - different groups for different pollutants
Unhealthy
151 - 200
General public at risk; sensitive groups at greater risk
Very Unhealthy
201 - 300
General public at greater risk; sensitive groups at greatest risk
34
AREPGURME
Section 6 – Health Effects
Use AQI to Reduce Risk
Dose = Concentration x Ventilation rate x Time• Reduce concentration – schedule
activities when pollution levels lower• Reduce ventilation rate by taking it easier• Reduce time spent in vigorous outdoor
activities
Pay attention to symptoms
35
AREPGURME
Section 6 – Health Effects
Health advisories make a difference
Roper 2002 survey of 2000 people across the US:• 52 % had heard of AQI “Code Orange” or
“Code Red” air quality days• Of those, 46 % have reduced exposure to
air pollution
UCLA – Neidell et al.:• 4 to 7 % reduction in pediatric hospital
admissions for asthma attributable to advisories
36
AREPGURME
Section 6 – Health Effects
Will It Matter if Air Pollution Decreases?
The Dublin Experience
• Dublin’s air quality deteriorated in the 1980s after a switch from oil to cheaper bituminous coal for heating.
• In 1990 the Irish Government banned the use of bituminous coal within the city of Dublin, resulting in a reduction in PM concentrations.
• Change in age-standardized total, cause-specific, and age-specific mortality rates for Dublin County Borough for 72 months before and after ban of sale of coal in Dublin: decrease from 4.5 to 15.5 % depending on the specific group.
37
AREPGURME
Section 6 – Health Effects
The Utah ValleySteel mill closed due to a labor dispute
0
25
50
75
100
125
150
1985 1986 1987 1988
Steel Mill Closed
PM
(g
/m3 )
0
20
40
60
80
1985 1986 1987 1988
Mo
nth
ly A
sth
ma
Ad
mis
sio
ns
Steel Mill Closed
38
AREPGURME
Section 6 – Health Effects
Example of Action
Phasing out leaded gasoline
Mental retardation due to lead exposure was estimated to be nearly 30 times higher in regions where leaded gasoline was still being used compared with regions where leaded gasoline had been completely phased out.
39
AREPGURME
Section 6 – Health Effects
Information sources
Talks by:• Susan Lyon Stone, Michael Lipsett• Robert Devlin, John R Stedman
Guidelines on Biometeorology and Air Quality Forecasts, WMO, Public Weather Service
Environment and Health, EEA Rep No 10/2005
Preventing disease through healthy environments, WHO, 2006
EPA (US), AIRNow: www.airnow.gov
40
AREPGURME
Section 6 – Health Effects
Need Chemical Weather Forecasting
PORT PHILLIP BAY
260 280 300 320 340 360
EASTING (km)
DND
BRI
FTSPSY
PTC
MTC ALP
PTHGLS
GVD
PLP BXH
5740
5760
5780
5800
5820
5840
NORTHIN
G(km)
LIGHT
MODERATE
HEAVY
AIR QUALITY FORECAST-MELBOURNE
AIR QUALITY FORECASTAIR QUALITY FORECAST--MELBOURNEMELBOURNE
NORTH EAST
HOUR
IND
EX
NORTH EAST
HOUR
IND
EX
Tomorrow will be fine and sunnyTomorrow will be fine and sunny--with moderate to heavy air pollutionwith moderate to heavy air pollution
PORT PHILLIP BAY
260 280 300 320 340 360
EASTING (km)
DND
BRI
FTSPSY
PTC
MTC ALP
PTHGLS
GVD
PLP BXH
5740
5760
5780
5800
5820
5840
NORTHIN
G(km)
LIGHT
MODERATE
HEAVY
AIR QUALITY FORECAST-MELBOURNE
AIR QUALITY FORECASTAIR QUALITY FORECAST--MELBOURNEMELBOURNE
PORT PHILLIP BAY
260 280 300 320 340 360
EASTING (km)
DND
BRI
FTSPSY
PORT PHILLIP BAY
260 280 300 320 340 360
EASTING (km)
DND
BRI
FTSPSY
PTC
MTC ALP
PTHGLS
GVD
PLP BXH
5740
5760
5780
5800
5820
5840
NORTHIN
G(km)
LIGHT
MODERATE
HEAVY
AIR QUALITY FORECAST-MELBOURNE
AIR QUALITY FORECASTAIR QUALITY FORECAST--MELBOURNEMELBOURNE
NORTH EAST
HOUR
IND
EX
NORTH EAST
HOUR
IND
EX NORTH EAST
HOUR
IND
EX
NORTH EAST
HOUR
IND
EX
Tomorrow will be fine and sunnyTomorrow will be fine and sunny--with moderate to heavy air pollutionwith moderate to heavy air pollution