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Air pollution and disease: are we asking the right questions? Dr Alex G Stewart CHaMPs July 2011.

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Presentation on theme: "Air pollution and disease: are we asking the right questions? Dr Alex G Stewart CHaMPs July 2011."— Presentation transcript:

1 Air pollution and disease: are we asking the right questions? Dr Alex G Stewart CHaMPs July 2011

2 Local authority level 1998 to 2004 Levels of PM 10 & 0 3 associated with mortality Effect estimate considerably higher than previous estimates CO NO 2 PM 10 O 3 All cause mortality (2007) CASEpaper, 128. Centre for Analysis of Social Exclusion, London School of Economics and Political Science, London

3 VOC – greater variety PM 10 as mass masks increase in fines (<1µm) – numbers matter MASS

4 Increase in fines Decrease in S, Pb and SCPs [spheriodal carbon particles] Daresbury Delph, east of Runcorn Magnetic concentrations = accumulation / flux Fines may travel some distance ALSO – fines generated downwind of PM 10 sources Worsley & Powell unpublished work shows an increase in fine particles at Daresbury Delph

5 AIRPORT POLLUTION SIGNAL Post-1975 national airport activity and Oglet Pb flux Worsley & Powell also showed an increase in lead flux at Oglet near Liverpool airport Which they related to the increase in air travel.

6 Passenger transport by mode in Great Britain in billion passenger kilometre 1952–2007. Douglas M J et al. J Public Health 2011;33:160-169 © The Author 2011, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved Data Source: Transport Statistics Great Britain, 2009.

7 Chris Crosby, working with Prof Worsley of Edge Hill university Has been able to measure concentrations of road dust Every 5m along main roads. Magnentic concentration – metals in PM – rapid, simple, cheap

8 Mersey Basin cross-regional signal Lower Mersey Regional cross-section shows, in pond sediments, the ability to look at temporal and spatial magnetic records, thus allowing a profile of metal deposition to be developed. Worsley & Powell

9 Ormskirk Liverpool Industrial sites C&M COMAH

10 Deprivation NWPHO

11 Particles (estimated) & Deprivation PM 10 IMD

12 Classic diseases of air pollution Ayres et al. Environmental Medicine 2010 Asthma exacerbation Chronic Obstructive Pulmonary Disease (COPD) exacerbation & death Cardiovascular deaths, admissions, arrythmias PM 2.5 SO 2 NO 2 O 3 PM 10 SO 2 NO 2 PM 10 SO 2 O 3 PM 10 (not O 3 ) PM 10 PM 2.5 NO 2

13 Other recorded diseases Lung cancer (small amount) All cause mortality Intra-uterine death Birth defects Pre-eclampsia Diabetes mellitus Predisposition to asthma? Ear infections? Lower respiratory infections <5y olds

14 Polycyclic Aromatic Hydrocarbons PAHs carcinogenic, mutagenic, teratogenic Neurological development Predispose to asthma Preterm delivery (Af-Am) Small for gestational age Head/weight ratio

15 What about transgenerational effects?

16 Most disease is multi-factorial Stone? Sponge? What about lifestyle diseases?

17 Canada (Jerrett et al. JECH, 2004) Less Social StressMore Social Stress Lower air pollution-Health effect Higher air pollutionHealth effectIncreased effect Stress RATS (Clougherty et al. EHP, 2010) No Social StressSocial Stress No PM-Respiration effects PMRespiration effectsInflammatory Response Social Stress = deprivation (measured by low education & high manufacturing employment) (1) Addition: workplace exposures + ambient exposures (2) Lower educated less mobile => less measurement error => less bias (3) Manufacturing & education = proxy for material deprivation => susceptibility

18 Increases risk of lung cancer X2 - X9 fold Radon Could other pollutants?

19 Map 6: Renal disease in north Cheshire: age-sex standardised admission ratio 1996 to 2002 [1991 census wards] – this study Warrington Halton Source: Hospital Admission Statistics; ONS

20 NW England Poor health 100 years Pollution? Poverty? Lifestyle? Generational effect? A mixture of all?

21 Acknowledgements Apologies Public Health Environmental Scientists Epidemiologists Clinicians Geographers ……..

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