1. 1 Environment and health information Content Scott Brackett

2. What would the information system look like in practice? Databases of concentrations of stressors in exposure media combined to yield EXPOSURE Databases of HEALTH IMPACTS Objective Assessment of health impacts of exposure Dose-response relations from research Policy formulation Source apportionment of exposure Need to ensure validation of dose- response relations used

3. 3 Environ- mental stressor 1.Limit values set in exposure media? Ambient air Indoor air Water Food 2. Exposure assessment possible using monitoring of compliance with limit values? 3. Health impact assessment possible? 4. Source apportionment of exposure possible? Chemical stressors Deliberate releases: Non- deliberate releases (contaminan ts)  Ambient air pollutants (PM, NOx, ozone, others)  … Phyiscal stressors: Biological stressors:

4. 4 Answers to questions for air quality 1. Are limit values set in the exposure medium? For ambient air, Yes, in ambient air quality legislation. For ambient air, Yes, in ambient air quality legislation. How are they set? On basis of toxicological studies (extrapolation from other species) On basis of toxicological studies (extrapolation from other species) On basis of information on occupational exposure (extrapolation from high exposures to low exposure) On basis of information on occupational exposure (extrapolation from high exposures to low exposure) On basis of epidemiological studies, based on measurement of actual environmental concentrations. On basis of epidemiological studies, based on measurement of actual environmental concentrations.

5. 5 2. Can an exposure assesment be done on the basis of compliance monitoring with limit values?  Can potentially calculate distribution of concentrations of pollutants across Europe  Can combine with population distribution to obtain population distribution of concentration  Problem is that concentration is used as a proxy for exposure.

6. 6 2a. How can exposure assessment be improved? Options  Direct monitoring of exposure by dosimetry. This is unlikely to be cost-effective across Europe.  Modelling of exposure by combining population distribution of concentration with activity patterns. Develop models Develop models Validate using actual exposure assessment in some key areas. Validate using actual exposure assessment in some key areas.

7. 7 2b. Implementation task for E&H Information System  Develop model integrating concentration distribution with activity data  Validate  Assess costs of implementation on European scale  Compare with benefits for policy development Conclusion: Implementation is/is not cost-effective in terms of improved policy-relevant information Action: Implement/do not implement on European scale

8. 8 3. Can the exposure assessment be translated into a health impact assessment?  Yes, to a certain extent. Population distribution of concentration is combined with concentration-effect relations to give attributable fraction of health outcome (e.g. respiratory mortality) due to ambient air pollution Population distribution of concentration is combined with concentration-effect relations to give attributable fraction of health outcome (e.g. respiratory mortality) due to ambient air pollution Attributable fraction multiplied by baseline health monitoring data to give actual health impact. Attributable fraction multiplied by baseline health monitoring data to give actual health impact.Problems: Concentration-effect relations used – because concentration is proxy for exposure. Concentration-effect relations used – because concentration is proxy for exposure. Health monitoring data always available at the right geographic scale? Health monitoring data always available at the right geographic scale?

9. 9 3a. How can assessment of health impacts be improved?  Develop exposure-effect relations that can be used with the revised models for calculating exposure (to replace concentration-effect relations) Will deliver better assessment of attributable fraction of health outcome Will deliver better assessment of attributable fraction of health outcome  Identify the geographic resolution of health monitoring data required to perform a health impact assessment on the basis of the attributable fraction.

10. 10 3b Implementation Task for E&H Information System  Pilot and validate the health impact assessment methodology, including the costs of making health data available on the right geographical scale  Assess costs of implementation across Europe  Compare with benefits for policy development Conclusion: Implementation is/is not cost-effective in terms of improved policy-relevant information Action: Implement/do not implement on European scale

11. 11 4. Is source apportionment of exposure possible?  Source apportionment essential for guiding interventions  Need models capable of assessing the effects on exposure, and hence on health impacts, of range of management options for the various sources Implementation task for the E&H Information System:  Develop and validate model for source apportionment of the new calculation of exposure (as developed under implementation task 2b) source apportionment of the new calculation of exposure (as developed under implementation task 2b) Assessment of the impact of interventions on exposure, and hence on health Assessment of the impact of interventions on exposure, and hence on health

12. 12 Result of implementation Improved EU-wide information on  exposure to ambient air pollution  the health impacts of that exposure  and the effects of potential management options Providing support for the development of the next generation of ambient air policy.

13. 13 Possible funding options being explored  Priority Research Infrastructures under FP7  LIFE +  Public Health Programme  Operational budgets of the relevant DGs

14. 14 Implementation programme Contributing activities  DG SANCO ENHIS project and its follow-ups  DG RTD FP6, Thematic priorities on Health, Environment and Food Quality and Safety  DG ENV support contract for developing an implementation plan for the Information System  DG JRC project for identifying existing information sources, assessing the feasibility for using them to provide the necessary information, and identifying research needs.  Programme setting out which activity will do what.

15. 15 Timing  Detailed timetable and allocation of tasks for developing Implementation Programme June 2005  Draft implementation programme October 2005  Finalised implementation programme for Information System January 2006