Presentation on theme: "AREP GURME Section 6 Health Effects. AREP GURME 2 Section 6 – Health Effects A Brief History of PM."— Presentation transcript:
AREP GURME Section 6 Health Effects
AREP GURME 2 Section 6 – Health Effects A Brief History of PM
AREP GURME 3 Section 6 – Health Effects The Houses of Parliament, Stormy Sky Claude Monet, 1904
AREP GURME 4 Section 6 – Health Effects Air Pollution Disasters 1930 Meuse River Valley, Belgium A three-day episode of severe air pollution makes 6,000 ill and kills Denora, PA Oct. 26 to 31: air pollution episode leaves 20 dead out of 14,000 persons London, England Dec. 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
AREP GURME 5 Section 6 – Health Effects Human Lung Air conducting Trachea Bronchi Bronchioles Gas exchange Respiratory bronchioles Alveoli
AREP GURME 6 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
AREP GURME 7 Section 6 – Health Effects Schwartz, 1994 Mortality attributed to London Smog
AREP GURME 8 Section 6 – Health Effects Outdoor Air Pollution Regulatory Categories Criteria Pollutants Present everywhere Ambient air quality standards Widely monitored Air toxics Long list (>180) Many carcinogens Less frequent ambient measurements
AREP GURME 9 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 (NO 2 ) Sulfur dioxide (SO 2 ) Ozone (O 3 ) Carbon monoxide Lead
AREP GURME 10 Section 6 – Health Effects
AREP GURME 11 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
AREP GURME 12 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
AREP GURME 13 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.
AREP GURME 14 Section 6 – Health Effects Disease and environmental factors WHO 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 deaths and years of lost life (DALYs) European Commission estimates in CAFÉ: 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 premature deaths annually
AREP GURME 15 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 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)
AREP GURME 16 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 %, moderate, high Neurodevelopment (Hg): very likely %, low, high Respiratory diseases (air pollution): very likely %, high, moderate Asthma causation (air pollution): medium likelihood %, high, moderate Many examples show that respiratory health and life quality improves with improved air quality.
AREP GURME 17 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 %, moderate, high Neurodevelopment (Hg): very likely %, low, high Respiratory diseases (air pollution): very likely %, high, moderate Asthma causation (air pollution): medium likelihood %, high, moderate Many examples show that respiratory health and life quality improves with improved air quality.
AREP GURME 18 Section 6 – Health Effects PM is derived from many different sources
AREP GURME 19 Section 6 – Health Effects Ultra Fine 10 um1 um0.1 um Anthropogenic: Sulfates Nitrates Ammonia Carbon Lead Organics CoarseFine Natural: Soil Dust Seasalt Bioaerosols 2.5 um Particulate Matter Sizes and Composition
AREP GURME 20 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)
AREP GURME 21 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
AREP GURME 22 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
AREP GURME 23 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 adults Greater prevalence of heart and lung disease Children More likely to be active Breathe more air per kg Bodies still developing
AREP GURME 24 Section 6 – Health Effects Nitrogen dioxide (NO 2 ) 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)
AREP GURME 25 Section 6 – Health Effects Nitrogen dioxide (NO 2 ) effects Strong oxidant and respiratory irritant (forms nitrous and nitric acids in contact with water) NO 2 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).
AREP GURME 26 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)
AREP GURME 27 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
AREP GURME 28 Section 6 – Health Effects Ozone (O 3 ) 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
AREP GURME 29 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
AREP GURME 30 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
AREP GURME 31 Section 6 – Health Effects Public Health Risks Are Significant Respiratory hospital admissions by daily maximum ozone level, lagged one day Ozone concentration (ppm) Respiratory Admissions (Burnett et al, 1994)
AREP GURME 32 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
AREP GURME 33 Section 6 – Health Effects Air Quality Index DescriptorsCautionary Statement Good 0 – 50 No message Moderate 51 – 100 Unusually sensitive individuals Unhealthy for Sensitive Groups Identifiable groups at risk - different groups for different pollutants Unhealthy General public at risk; sensitive groups at greater risk Very Unhealthy General public at greater risk; sensitive groups at greatest risk
AREP GURME 34 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
AREP GURME 35 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
AREP GURME 36 Section 6 – Health Effects Will It Matter if Air Pollution Decreases? The Dublin Experience Dublins 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.
AREP GURME 37 Section 6 – Health Effects The Utah Valley Steel mill closed due to a labor dispute
AREP GURME 38 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.
AREP GURME 39 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:
AREP GURME 40 Section 6 – Health Effects Need Chemical Weather Forecasting