24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
Health Impact Assessment of Air Pollution on Zagreb population
Krešimir Šega
Instiute for Medical Research and Occupational Health, Zagreb
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
This investigation was partly presented at:
• ZAŠTITA ZRAKA '01, Šibenik 26-29. rujan 2001.
• 15th IUAPPA regional conference - 17th EFCA speciality conference, 5-8 september 2006 Lille, France
• HEALTH IMPACT ASSESSMENT OF BLACK SMOKE AND AIRBORNE PARTICULATES ON ZAGREB POPULATION, WHO COLABORATING CENTRE FOR AIR QUALITY
MANAGEMENT AND AIR POLLUTION CONTROL NEWSLETTER,2006
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
HEALTH ENDPOINTS RELATED TO AIR POLLUTION
MODELLING
Determination of relationship betweenair pollution levels and negative health effects.
Demands:
•Large and complete databases•Control over possible cofounders•Educated and well equipped personal
ASSESSMENT
Use of developed models for health risk evaluation.
Enable so called “risk governing”:
•Cost estimation for pollution level reduction. •Estimation of primary and secondary health costs.•Adoption of new or improvement of existing air pollution limit values.
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
ZAGREBMODELLING
Šimic, D., Jazbec, A., Pavlovic, M. et al.: Short term effects of ambient NO2 on mortality in Zagreb, Croatia. Proceedings of the 20th International Conference on Information Technology Interfaces, Kalpic Damir, Hljuz-Dobric Vesna (ur.). Pila, Hrvatska: SRCE University Computing Centre, Univerity of Zagreb, 1998., 143-148.
Jazbec, A., Šimic, D., Hršak, J. et al.: Short-term effects of ambient nitrogen oxides on the number of emergency asthma cases in Zagreb, Croatia, Arh. hig. rada toksikol. 1999, 50, 171-182.
Šimic, D., Pavlovic, M., Jazbec, A. et al.: Short-term effects of air pollution on general mortality in Zagreb, Croatia, Proceedings of the 21st International Conference on Information Technology Interfaces ITI'99, Kalpic Damir, Hljuz-Dobric Vesna (ur.). Pula, Hrvatska: SRCE University Computing Centre, Univerity of Zagreb, 1999., 169-175.
Šimic, D., Pavlovic, M., Jazbec, A. et al.: Utjecaj one…išƒenja zraka na u…estalost pogoršanja simptoma opstruktivne bolesti pluƒa un odraslih osoba, Zaštita zraka 99, Valiƒ Fedor i Šega Krešimir (ur.). Zagreb: Hrvatsko udruenje za zaštitu zraka, 1999., 347-354.
Šimic, D., Pavlovic, M., Šega, K. et al.: Is association between mortality and air pollution due to a short temporal displacement? In: D Kalpiƒ and V Hljuz Dobriƒ (eds.) Proceedings of the 23rd International Conference on Information Technology Interfaces ITI 2001,Pula, Croatia, June 19-22, 2001. Zagreb: University Computing Centre, University of Zagreb, pp. 279-83, 2001.
Šimić, D.: Povezanost onečišćenja zraka i smrtnosti u gradu Zagrebu, Doktorska disertacija, Zagreb 2001.
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
ASSESSMENT
AirQ - software
•WHO Regional Office for Europe•Evaluation of RR related to mortality or morbidity for toptal population or population subgroup and certain air pollutant •Quantification on the basis of atrributable risk proportion (AP) which could be atrribute to the exposure to certain air pollutant by controlling possible cofounders.•Main principle: ONE POPULATION- ONE EXPOSURE DATASET•RR defined for air pollutant concentartion incerase of 10 μg m-3 •Concentration treshold defined at 10 µg m-3, assuming that lower concentrations do not cause observable health effects: - (C < 10 µg m -3 RR=1)
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
TSP: 2 measuring sites, 1976-2000
BS: 6 measuring sites, 1976-2005
SO2: 6 measuring sites, 1976-2000
PM10: 1 measuring site, 1999-2005
PM2.5: 1 measuring site, 1999-2004 5 measuring sites, 2005
NUMBER OF SASMPLING SITES AND MEASURING PERIODS
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
TOTAL SUSPENDED PARTICULATE MATTER
• Total mortality
• Cardiovascular moratilty
• Respiratory mortality
• COPD
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
BLACK SMOKE• Total mortality• Cardiovascular moratilty• Respiratory mortality• Hospital admisson – COPD• Hospital admisson – respiratory diseases (15-64)• Hospital admisson – asthma (<15)• Hospital admisson – asthma (15-64)• Accute miocard infarction
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
SO2
• Total mortality• Cardiovascular moratilty• Respiratory mortality• Hospital admisson – COPD• Hospital admisson – respiratory diseases (15-
64)• Hospital admisson – asthma (<15)• Accute miocard infarction
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
PM10
• Total mortality
• Cardiovascular moratilty
• Respiratory mortality
• Hospital admisson – cardiovascular diseases
• Hospital admisson – respiratory diseases
PM2.5
•Total mortality
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
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TSP
TOTAL MORTALITY I = 1013RR = 1.003 (1.002-1.007)
PP (%)4.5 1976.1.1 2000.
RESIRATORY MORTALITY I = 66RR = 1.008 (1.004-1.018)
PP (%)3.0 1976.0.7 2000.
CARDIOVASCULAR MORTALITY I = 497 RR = 1.002 (1.000-1.006)
COPD I = 101.4 RR = 1.0044 (1.0000-1.0094)
PP (%)11.2 1976.2.7 2000.
PP (%)6.4 1976.1.6 2000.
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1976197819801982198419861988199019921994199619982000
RESPIRATORY MORTALITY I = 66 RR = 1.008 (1.004-1.014)
COPD I = 101.4 RR = 1.0061 (1.0020-1.0120)
PP (%)5.2 1976.1.7 2000.
PP (%)4.0 1976.1.3 2000.
TOTAL MORTALITY I = 1013RR = 1.0026 (1.0018-1.0034)
PP (%)1.8 1976.0.5 2000.
DIM
CARDIOVASCULAR MORTALITY I = 497 RR = 1.004 (1.002-1.008)
PP (%)2.7 1976.0.8 2000.
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
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ACCUTE MIOCARD INFARCTION I = 132 RR = 1.016 (1.0053-1.0290)
DIM
HOSPITAL ADMISSION – RESPIRABLE DISEASES (15-64 years) I = 66 RR = 1.0056 (1.0012-1.0102) HOSPITAL ADMISSION – ASTHMA
(<15 years) I = 100 RR = 1.006 (1.000-1.017)
HOSPITAL ADMISSION – ASTHMA(15-64 years)
I = 66 RR = 1.0042 (1.000-1.0118)
PP (%)3.8 1976.1.2 2000.
PP (%)4.0 1976.1.2 2000.
PP (%)1.9 1976.0.6 2000.
PP (%)4.5 1976.1.1 2000.
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
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TOTAL MORTALITY I = 1013RR = 1.004 (1.003-1.0048)
CARDIUOVASCULAR MORTALITY I = 497 RR = 1.012 (1.008-1.020)
RESPIRATORY MORTALITY I = 66 RR = 1.010 (1.006-1.014)
HOSPITAL ADMISSION – RESPIRABLE DISEASES
(15-64 years) I = 66 RR = 1.0018 (1.000-1.005)
S02
PP (%)3.7 1976.0.8 2000.
PP (%)9.2 1976.2.3 2000.
PP (%)10.9 1976.2.7 2000.
PP (%)1.8 1976.0.5 2000.
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
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COPD I = 101.4 RR = 1.0044 (1.000-1.011)
ACCUTE MIOCARD INFARCTION I = 132 RR = 1.0034 (1.0014-1.0052)
HOSPITAL ADMISSION – ASTHMA (<15 years)
I =100 RR = 1.015 (1.0052-1.0250)
S02
PP (%)13.2 1976.3.3 2000. PP (%)
4.2 1976.1.0 2000.
PP (%)3.3 1976.0.8 2000.
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
Year Number of cases in 100 000 /#
Attributable proportion /%
Total mortality
2000 10,5 4,0 24,1 1,03 0,69 2,38
2001 8,2 5,5 18,9 0,81 0,54 1,87
2002 9,9 6,7 22,9 0,98 0,66 2,26
2003 12,4 8,3 28,5 1,22 0,82 2,81
2004 11,7 7,8 26,9 1,16 0,77 2,66
2005 11,1 7,4 25,6 1,10 0,74 2,54
Cardiovascular mortality
2000 3,4 0,0 10,2 0,69 0,00 2,05
2001 2,7 0,0 8,0 0,54 0,00 1,61
2002 3,3 0,0 9,7 0,66 0,00 1,94
2003 4,1 0,0 12,0 0,82 0,00 2,42
2004 3,8 0,0 11,4 0,77 0,00 2,29
2005 3,7 0,0 10,8 0,74 0,00 2,18
TSP
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
TSP
Year Number of cases in 100 000 /#
Attributable proportion /%
Respiratory mortality
2000 1,8 0,9 3,9 2,71 1,37 5,90
2001 1,4 0,7 3,1 2,13 1,08 4,67
2002 1,7 0,9 3,7 2,58 1,30 5,61
2003 2,1 1,1 4,6 3,20 1,62 6,92
2004 2,0 1,0 4,3 3,02 1,54 6,56
2005 1,9 1,0 4,1 2,89 1,47 6,28
Hospital admission – COPD
2000 1,5 0,0 3,2 1,51 0,00 3,17
2001 1,2 0,0 2,5 1,18 0,00 2,50
2002 1,5 0,0 3,1 1,43 0,00 3,01
2003 1,8 0,0 3,8 1,78 0,00 3,74
2004 1,7 0,0 3,6 1,69 0,00 3,54
2005 1,6 0,0 3,4 1,61 0,00 3,38
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
Year Number of cases in 100 000 /#
Attributable proportion /%
Total mortality
2000 23,8 20,0 27,6 2,35 1,98 2,72
2001 21,9 18,4 25,4 2,16 1,82 2,51
2002 22,6 19,0 26,1 2,23 1,88 2,59
2003 23,9 20,1 27,7 2,37 1,99 2,74
2004 20,1 16,9 23,3 1,98 1,67 2,30
2005 24,4 20,5 28,2 2,40 2,02 2,78
Cardiovascular mortality
2000 12,6 8,0 27,5 2,54 1,60 5,53
2001 11,6 7,3 25,4 2,34 1,47 5,11
2002 11,9 7,5 26,1 2,41 1,52 5,27
2003 12,7 8,0 27,6 2,55 1,61 5,57
2004 10,6 6,7 23,3 2,14 1,35 4,69
2005 12,9 8,1 28,1 2,59 1,64 5,65
PM10
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
Year Number of cases in 100 000 /#
Attributable proportion /%
Respiratory mortality
2000 2,5 1,0 7,1 3,76 1,54 10,74
2001 2,3 0,9 6,6 3,46 1,41 9,96
2002 2,4 1,0 6,7 3,57 1,46 10,25
2003 2,5 1,0 7,1 3,78 1,55 10,81
2004 2,1 0,9 6,1 3,18 1,30 9,19
2005 2,5 1,7 7,2 3,84 2,59 10,97
Hospital admission – respiratory diseases
2000 22,5 13,6 31,3 1,83 1,11 2,55
2001 19,9 12,0 27,7 1,61 0,97 2,23
2002 20,9 12,6 29,0 1,70 1,03 2,37
2003 22,6 13,7 31,5 1,84 1,11 2,55
2004 17,6 10,6 24,5 1,45 0,87 2,01
2005 32,7 19,8 45,3 2,59 1,57 3,59
PM10
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
Year Number of cases in 100 000 /#
Attributable proportion /%
Hospital admission – cardiovascular diseases
2000 12,4 8,3 17,7 2,84 1,91 4,06
2001 11,4 7,7 16,3 2,62 1,76 3,74
2002 11,8 7,9 16,8 2,70 1,82 3,86
2003 12,4 8,4 17,8 2,86 1,93 4,08
2004 10,5 7,0 15,0 2,40 1,61 3,43
2005 12,5 8,5 18,1 2,91 1,96 4,15
Asthma attacks in children
2000 14,23 13,26 15,17
2001 13,23 12,32 14,12
2002 13,61 12,67 14,52
2003 14,31 13,34 15,26
2004 12,24 11,39 13,07
2005 14,51 13,53 15,48
PM10
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
Year Number of cases in 100 000 /#
Attributable proportion /%
Asthma attacks in adults
2000 1,28 0,00 2,54
2001 1,18 0,00 2,34
2002 1,22 0,00 2,41
2003 1,29 0,00 2,55
2004 1,08 0,00 2,14
2005 1,31 0,00 2,59
PM10
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
Year Number of cases in 100 000 /#
Attributable proportion /%
Total mortality
2000 32,2 23,8 40,5 3,18 2,35 3,99
2001 31,7 23,5 39,9 3,14 2,32 3,95
2002 31,6 23,4 39,7 3,12 2,31 3,92
2003 34,7 25,7 43,6 3,43 2,54 4,30
2004 26,5 19,6 33,3 2,98 2,21 3,75
2005/1 36,4 27,0 45,7 3,60 2,66 4,51
2005/5 41,9 31,0 52,5 4,13 3,06 5,18
PM2.5
24-26 May 2007 AMGI/EURASAP Workshop, Zagreb
CONCLUSIONS
Results show significant negative trend of health effects incidences related to TSP, black smoke and SO2 as a consequence of the negative concentration trends during the investigated period.
Further investigations should be based on PM10/PM2.5 particle fractions and their constituents (metals, sulphates, nitrates, chlorides, polycyclic aromatic hydrocarbons, organic and elemental carbon etc.) and nitrogen oxides.
Simultaneously, further development of models based on Zagreb data should be continued so in the future health impact assessment of air pollution in Zagreb could be used on Zagreb population as much more reliable.