1 - HIA of long term exposure to particulate air pollution: sensitivity of

results to the correction of PM10 levels measured with TEOM

French Air Pollution and Health Surveillance Program

-Institut de veille sanitaire

1 - Context and objectives• HIA of LT exposure to PM10 based on E-R functions

obtained using gravimetric measurements of PM10• In most European cities, PM10 routinely measured using

TEOM• Use of a correction factor: local seasonal correction factor

when available, European correction factor (1.3) otherwise

What is the influence of the correction method used on HIA results ? What are the uncertainties associated to the use of the European factor for HIAs, and what local determinants may influence them (climate particulate air pollution sources) ?

1 - Method

• Search for local correction methods in participating cities

• Calculation of the nb. of attributable cases with PM10 levels obtained with various correction methods (European + at least one local correction method)

Required data : PM10 levels, local correction methods, annual mortality data, information on local climate and sources of particulate air pollution

1- Need for funds and timetable

• Mainly implies person-time from the centers involved (particulate air pollution measurement specialists, epidemiologists, administrative and financial specialists)

• If any centre needs to pay for the data, data collection costs

• Preparation of protocol/response to call for proposals: 3 monthsData collection: 4 monthsData analysis: 2 monthsReport/paper writing: 3 months

2 – Influence of health care organization on hospital

admissions data in European cities

French Air Pollution and Health Surveillance Program

-Institut de veille sanitaire

2 - Context and objectives

• In Apheis 2 and 3, hospital admission rates showed large unexplained variations across cities

• Organization of health care system (circumstances of hospitalization, “free” access to hospitals…) and of hospital information system may play a role in these variations

What are the characteristics of health care and hospital information systems that may influence hospital admissions rates?Do these characteristics, their differences among cities, and with regard to the data used to define the E-R function, represent a limit to the use of hospital admission data for HIA ?

2 - Method

• Description of local health care system• Description of local hospital information system (partly

done for Apheis 2 and 3)• Calculation of hospital admission rates for causes

relevant to AP. Relation between these rates and local characteristics

• Discussion of the limits that differences in health care and hospital information systems may represent for HIA

Required data : Hospital admission data, description of health care and hospital information systems, socio-demographic data

2 - Need for funds and timetable

• Mainly implies person-time from the centers involved (epidemiologists, health care and hospital information specialists)

• If any centre needs to pay for the data, data collection costs

• Preparation of protocol/response to call for proposals: 3 monthsData collection: 4 monthsData analysis: 2 monthsReport/paper writing: 3 months

3 – Feedback on practical use of study are definition guidelines

French Air Pollution and Health Surveillance Program

-Institut de veille sanitaire

3 - Context and objectives• Formalized study area definition guidelines given in Apheis

3, base on experiments in a sub-sample of participating city

Were the criteria specified in the guidelines:- relevant to the various situations encountered in European cities (AP sources, geographic and climatic characteristics) ?- helpful to define a study area in a non-equivocal way (availability of the data needed to apply the criteria, ability to answer the various interrogations that arose during study area definition process…) ?Answers to these questions would be helpful in writing improved study area definition guidelines

3 - Method

• Writing a questionnaire exploring the various aspects related to the local use of the guidelines

• Submission to the participating cities

• Analysis of answers

Required data : answers to the questionnaire

3 - Need for funds and timetable

• Mainly implies person-time from the centers involved (HIA specialists)

• Preparation of protocol/response to call for proposals: 3 monthsData collection: 2 monthsData analysis: 2 monthsReport/new guidelines writing: 2 months