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WMOs Global Atmosphere Watch
SymposiumAir Quality & Health
18 March 2013, Geneva, Switzerland
PUBLIC HEALTH AND ENVIRONMENT
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WMOs Global Atmosphere Watch Symposium:Air Qual ity & h eal th
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.
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WMOs Global Atmosphere Watch Symposium:Air Qual ity & h eal th
Presentation Overview:
Health Impacts of Air Pollution
Exposure & Disease Burden
Moving forward: Better estimating exposure
Moving forward: WHO Activities for healthy air
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Health Impacts: A ir Pol lutantsProduc ts of incomplete combus t ion
Outdoor Air Pollution CO2 emissions are not a direct problem for health---rather it is a mixtureof pollutants that are released during the incomplete combustion of carbon-
based 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-aromatichydrocarbons, carbon monoxide, etc
The single most studied and one of the most important health-damaging
pollutant is particulate matter (PM).
PAH COCH4 NMVOCs
NOxSOx
CH2O
CO2
PM
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Health Impacts: A ir Pol lutantsParticu late Matter
Outdoor Air PollutionPM in urban and non-urban environments
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, part icl e
core chemistry, metals, bio genic or ig in etc.
The toxicity of PM may potentially arise from
the particles presence on biological tissues, to
the actions of chemical constituents, includingabsorded components or a combination of these
factors.
Exposure to PM is associated with bronch ia l
ir r i tat ion , inf lammation , inc reased react iv i ty,
redu ced mu coci l iary clearance, geno toxi c
event s (i.e. carcinogen ic)and reduced
macrophage respo nse.
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Health Impacts: Growing Evidence-baseSpecific health outcomes
1. Outdoor Air Pollution
Outcome Strength of
Evidence
Child ALRI, Lung
cancer, COPD, LBW,
Cataract
Strong
TB, Cancer of UADT Moderate
Ca cervix, adult
ALRI, asthma,
O/Media
Moderate
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Exposure:How b ig is the prob lem?
Pollution Outdoor air pollution
Household air pollution
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Exposure: Who & how much?Outdoor A i r Pol lu t ion (OAP)
oInefficient foss i l fuel combust ionfrom the industry,
and t ranspor tsectors along with biomass burn ing
are some of the largest contributors to OAP.
oThe greatest health impacts from exposure to
outdoor air pollution are seen more in middle- to high-
income countries.
oExposure to OAP in urban areas was responsible forto 1 million premature deaths & accounted for0.5% of
the total disease burden in 2004.
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Exposure: Who & how much?Outdoor A i r Pol lu t ion (OAP)
oA recent Lancet study, estimates that in 2010, 3.3
m i l lion d eathsand 3.1% of the global disease burden
from were attributed to OAP in both urban & rural
areas
0.5 million of these deaths or16%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
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Exposure: WHO & how much?Househo ld A ir Pol lut ion (HAP)
1. Outdoor Air PollutionoAround 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.
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 cookingaccounting
for2.7%of the global disease burden
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Exposure: WHO & how much?Househo ld A ir Pol lut ion (HAP)
1. Outdoor Air Pollutiono The 2012 Lancetstudy shows an increase in disease
burden to HAP---3.5 m il l iondeaths and 4.5% of the
total disease burden attributed to HAP
oSimilar to OAP, a greater number of diseaseoutcomes 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 pr imary cook ing 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.
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Moving Forward: Growing Evidence-base for healthIntegrated 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.
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Moving Forward: Growing Evidence-base for healthIntegrated Concentration-response function
1. Outdoor Air Pollution
Kirk R. Smith, Jenn ifer L. Peel
Environ Health Perspect. 2010 December;
118(12): 16431645. Published online 2010August 20.
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Moving forward: Estimating OAP ExposureSatell i te-based estimates pro vid e a truly global pic ture o f the
burden of dis ease due to ou tdoo r air pol lut ion
Outdoor Air Pollution
Unger, 2010
Brauer M, Ammann M, Burnett R et al. GBD 2010 Outdoor AirPollution Expert Group 2011 Submitted under review
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Moving forward: Estimating OAP ExposureSatell i te-based estimates pro vid e a truly global pic ture o f the
burden of dis ease due to ou tdoo r air pol lut ion
Outdoor Air Pollution
Unger, 2010
2005 population-weightedregional estimated average PM2.5
Distributions of selected regional2005 estimated PM2.5 by urban andrural areas
Brauer M, Ammann M, Burnett R et al. GBD 2010 Outdoor Air
Pollution Expert Group 2011 Submitted
under review
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16
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
Canadian Census Cohort (1991 2001)
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Moving Forwarding: Estimating OAP ExposureSatell i te-based estimates of Moscow smoke event
Before Fires During Fires
van Donkelaar et al., in prepFrom: A van Donkelaar et al.Atmospheric Environment 2011
MODIS-based (IQR)
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Moving Forwarding: Estimating OAP ExposureSatell i te-based estimates and HAP
Before Fires During Fires
van Donkelaar et al., in prep
Source: S Guttikunda. Urban Air Pollution Analysis for Ulaanbaatar. Worldbank report 2007
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Moving Forwarding: Guidance for Healthy AirWHO Act iv i ties for pol icy-makers & impl ementat ion
Before Fires During Fires
van Donkelaar et al., in prep
Indoor Air QualityWHO 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
implementatione.g. Sustainable Energy for All Global Tracking
Framework, UN Energy
Raising awareness forhealth co-benefits of climate change
adaptation & mitigation strategiesHealth in the Green Economy
Series, WMO/WHO Climate & Health Atlas, Clean Air Coalition for
Short-Lived Pollutants
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Before Fires During Fires
van Donkelaar et al in prep
Thank you and any questions?