WHO-ProjectEnvironmental Health
IndicatorsExperiences from Germany
Project coordination:
Federal Environmental AgencyDivision of Environment and Health
WHO CC Air Quality Management/Air Pollution Control
J. Thelen, MPH, M.Sc.Dr. H.-G. Mücke
Funded by the Ministry of Health and Social Security
Project Workplan for the Pilot Study
• 06/2002 Start of the Pilot Phase in Germany• 06-10/2002 Indicator Definition Review/Adjustment
Testing of EuroIndy (1.1 to 1.5)
• 10/2002-5/2003 Identification of Dataholders, Data collection
Data Compliation • 06-10/2003 Development of Methods for Ind.calculation
Work on the Fact-sheetsQuality control of EuroIndy
Database• 08-12/2003 Analysis and Reporting
Environmental Health Indicators
Objectives of the Project:
• Test Feasibility and Applicability of the EHI Set in Germany
• Develop Information Tools for• Stakeholders in the field of Environment and Health (Politicis, Sience, Media, Organisations):
Monitoring and Evaluation of Measures and Plans concering Health Protection from environmental Risks
Communication to the Public and within the Administration (horizontal und vertical)
International und national Networking of the Stakeholders in the field of environment related Health Protection
Establishment of national und international Reporting Structures for assesment and comparison (Benchmarking, Best-Practice Modelle)
Scientific Analysis
Data availability for Germany (national level) (29.03.2003)
Workplace (10)
Chemical Emergencies (15)
Food Safety (14)
Water and Sanitation (24)
Radiation (11 )
Waste and contam. Lands (4)
Noise (21)
Traffic Accidents (2)
Housing and Settlements (15)
Air Quality (80)
0 20 40 60 80 100
(Number of Variables in the field of ...)
%
Data: Collection, Analysis
• Testing and Trail Operation of EuroIndy (1.1-1.5)
• Spatial Breakdown to NUTS 1-3 and large Cities
–Data availability:
NUTS1: good NUTS2: limited NUTS3: no data
–Large Cities:
• Data from NUTS 2 and 3 is difficult to obtain
• Problems:
–Action Indicators are Subject to Bias (subjective Assessment)
–Database EuroIndy needs further Development
–No Common Strategy for Health Impact Assessment
Remarks on the thematic fields
Most relevant for Germany: Reports:
• Air Quality yes
• Noise yes
• Traffic Accidents yes
• Drinking and Bathing Water Quality yes
Relevant; further Developement needed
• Chemical Safety (Emergencies) yes
• Food Safety partly
• Radiation yes
Remarks on the thematic fields
Relevant; Health Impact uncertain Reports:
• Waste and Contaminated Land yes
Relevant; Comprehensive Reporting
by the National Agency
• Workplace
Air Quality: Results from Germany
Air_D1 Passenger Traffic Demand (by mode of transportation)
Air_P1 Emissions of Air Pollutants
State (no Indicator)
Air_Ex1 Exposure of urban Population to Air
Pollutants
Policies to
Reduce
Exposure to
ETS
(Air_A1)
(not
shown)Health Impact: (Air_E1, E2 and E3 not evaluated)To be considered as an own Indicator, or as part of the Assessment within Air_Ex1 ?
Air_D1: Passenger transport demand per inhabitant
(Germany 1996-2001)
Source: BMVBW, DIW (2003) Traffic in Figures
0
2000
4000
6000
8000
10000
12000
14000
1996 1997 1998 1999 2000 2001**Year
Pa
ss
en
ge
r-k
ilom
ete
r p
er
inh
ab
ita
nt
(Pk
m)
Motorised Individual Traffic Public Transport (local)
Public Transport (long distance) Human-Powered Mobility
Air_P1: Emissions of Air Pollutants
0
500
1000
1500
2000
2500
3000
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
Year
0
500
1000
1500
2000
2500
3000 Power Plant and DistrictHeating Plant
Industry Combustion
Small Consumer
Household
Road Traffic
other traffic
Industry Process
Agriculture
National Emission Ceiling by 2010
0
1000
2000
3000
4000
5000
6000
1996 1997 1998 1999 2000
Year
Emiss
ions
[kt (
TOFP
)] Transport
Agriculture
Domestic and services
Energy Industry
Industry-process and energy
0
200
400
600
800
1000
1200
1400
1600
1800
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
Year
Industry-process and energy
Transport
Domestic and services
Energy Industry
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
5500
6000
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
Year
Power Plant andDistrict Heating Plant
Industry Combustion
Small Consumer
Household
Road Traffic
other traffic
Industry Process
National Emission Ceiling by 2010
NOx
Ozone Precursors SO2
PM10
Air_Ex1: Exposure to Air Pollutants (urban population)
Methodology:• Large Cities >100.000 Inhabitants: Annual average Population• Measuring Data from Urban Background Stations (yearly mean)• Assumption: Background Level represents long term Exposure
More than one Station Mean of background StationsLimitation: only exposure to Ambient Air
• Calculation of Exposure classes for urban Population in Germany
City xy
Background Station 1
Background Station 2
Background Station 3
City Population (Annual Mean)
Urban Air Quality:(Annual Mean Station n)/n Stationsfor PM10 and NO2
For Ozone: Number of days > 120µg/m3
Air_Ex1: Exposure to Air Pollutants (urban population) PM10
0%
20%
40%
60%
80%
100%
1997 1998 1999 2000 2001
Year
Perc
enta
ge U
rban
Pop
ulat
ion
10
15
20
25
Urb
an P
opul
atio
n C
over
age
0-10
10-20 µg/m3
20-30 µg/m3
30-40 µg/m3
> 40 µg/m3
Population coverage
(1999/30/EU):Annual Mean: 40 µg/m3
Daily Mean: 50 µg/m3
Air_Ex1: Exposure to Air Pollutants (urban population) NO2
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1997 1998 1999 2000 2001
Year
Shar
e of
Urb
an P
opul
atio
n
10
15
20
25
Urb
an P
opul
atio
n co
vera
ge [
Mill
ions
]
0 - 10 µg/m3
10 - 20 µg/m3
20 - 30 µg/m3
30 - 40 µg/m3
> 40 µg/m3
Populationcoverage
1999/30/EGAnnual Mean: 40 µg/m3
1h-Mean : 200 µg/m3
Air_Ex1: Exposure to Air Pollutants (urban population) : Ozone
Number of Days over > 120 µg/m3 (8h average)
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1996 1997 1998 1999 2000 2001Year
Sh
are
of
Urb
an
po
pu
lati
on
10
12
14
16
18
20
22
Urb
an
Po
pu
lati
on
[M
illio
ns
]
0-10 days
10-20 days
20-30 days
30-40 days
>40 days
Populationcoverage
Health Impact (Air_E1; Air_E2 not evaluated) Reduction of Statistical Life Expectancy by
Exposure to PM2.5
Calculation of statistical Life
Expectancy (Life table)
RR = 1.06 (95% CI: 1.02-1.11)
For all cause mortality
Pope et al., 2002
ACS Cohort Study
500.000 US-Americans > 30 J.
PM2.5 Country Mean (Model)1990: 33.72010 (CLE): 15.72010 (MFR): 12.3
CLE: Current LegislationMFR: Maximum Feasible Reduction
0
200
400
600
800
1000
1200
1400
Germany1990
GermanyCLE
GermanyMFR
Day
s o
f Life
Lo
st
Source: Mecheler, Amann, Schöpp 2002
Szenario 2010
Reduction of Statistical Life Expectancy by Exposure to PM2.5 for 1990 und 2010 (CLE/MFR)
International Comparison
0
100
200
300
400
500
600
700
800
Country
Da
ys
of
Lif
e L
os
t
1990
CLE
MFR
Source: Mecheler, Amann, Schöpp 2002
Prevention of Mortality:Estimated Effect of Particle Filters
for Diesel VehiclesMortality Prevention
potential
(Excess Risk) [95% CI]
Cases Preventable Cases[Range of different
Models]
All cause 1,8 % [1,2-3,3] 800.000 14.400 [9.600-19.200]
Cardio-pulmonary
2,7 % [0,9-4,8] 460.000 12.420 [8.280-16.560]
Lung cancer
4,2 % [1,2-6,9] 40.000 1680 [1.120-2.240]
Wichmann 2003
Environmental Health Indicators
Many Wishes – Little Resources
Current Indicator Projects in Germany(including E&H Indicators)
Some Examples:• WHO-Environmental Health Indicators• WHO/EU ECOEHIS Project• National Core Indicators for Sustainable Development• Indicators for the Health Reporting of the Federal States• Core Indicators for Sustainable Development of the
Federal States
European Union:• Public Health Action Programme (1786/2002/EC):
EH Indicators for the European UnionWHO-Project ECOENHIS/ENHISFirst Meeting in May 2003:Discussion of the WHO Indicator Set:Modifications needed for the use in the European Union
• Environment & Health Strategy (COM(2003)338 final)Working group on Environment and Health Indicators
Health Impact Assessment
• Data should be useful for Health Impact Assessment
EHI for the EU
Further Work (Dec. 2003)
• Finalisation of selected Fact Sheets • Revision of the Methodology for Air Quality Indicators• National Project Report• Collaboration at the international Report (H.-G. Mücke)
• WHO Workshop (16./17. Oct. 2003)
Specification of Report Structure
Discussion of Fact Sheets for the International Report
For further information please contact:
Federal Environmental Agency:
www.umweltbundesamt.de
WHO CC Air Quality Management/Air Pollution Control:
www.umweltbundesamt.de/whocc/title/title21.htm
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