Indicatoren voor gezondheidsimpact van fijn

stof en ozon: DALYs en externe kosten

Jurgen Buekers & Rudi Torfs

05/04/2011

18/04/23 2© 2010, VITO NV

Introduction

Integrated science assessment for paticulate matter (US EPA 2009)

“a causal relationship exists between long-term exposures to PM2.5 and cardiovascular effects”

“a causal relationship exists between long-term exposures to PM2.5 and mortality”

Ozone and your health (US EPA 2009)

“Ozone can irritate your respiratory system, reduce lung function, aggravate asthma, etc.”

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» Environmental health problems incomparable

» What is worse?

» 2 adults with a cardiovascular disease dying prematurely during a smog episode

» 10 children with asthma» 2 adults having some days problems with the lower

respiratory tract

Introduction

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» DALYs» Combine information on the ‘quality’ and ‘quantity’ of

life» Give an indication of the potential number of ‘healthy’

life years lost due to premature mortality or morbidity

» DALY calculation = N x S x D» Number of people with environment-related

morbidity or mortality » Severity factor (0=healthy; 1=death) » Duration of disease

Disability Adjusted Life Years (DALYs)

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Attributable cases (Number of people)Cases

Concentration

Observed Incidence Prevalence

Observed concentration

Relative risk Epidemiological studies (e.g. Pope et al., 2002)

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Attributable cases (Number of people)Cases

Concentration

Observed Incidence Prevalence

Observed concentration

Threshold

Relative risk Epidemiological studies (e.g. Pope et al., 2002)

Basic frequency

Attributable cases

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Disability or Severity weights

» Indication of the reduction in capacity due to the specific disease

» Varying from 0 (healthy) to 1 (death)

» Determined by experts (clinicians, researchers, etc.)

» Overviews available (WHO, Australian burden of disease study)

asthmaCardiovascular disease

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Duration

» Duration for morbidity: years of life lived with disability (YLD)

» Duration for mortality: years of life lost (YLL)

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DALYs

De Hollander A.E.M. Assessing and evaluating the health impact of environmental exposures “Deaths, DALYs of Dollars?”. University of Utrecht. 2004.

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Uncertainties

» Framework of Knol Anne (2010)

» Context uncertainty e.g. selected stressor, endpoint» Model structure uncertainty e.g. causal relationship» Parameter & input data uncertainty e.g. health

statistics

Knol, A., 2010. Health and the Environment: assessing the impacts, addressing the uncertainties, Thesis Utrecht University, the Netherlands.

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DALYs in general

» DALYs give an indication of the potential, relative order of magnitude of different (environmental) health problems, and can not be presented as absolute or completely representative numbers.

» Smoking, genetic ability, food consumption etc.

» Competing risks

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Health outcomes

Based on NEEDS 2007 (New Energy Externalities Development for Sustainability)

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MIRA - Particulate matter (PM2.5 & PM10)

0

50

100

150

200

2000 2010 2020 2030

Hea

lth

(DAL

Ys p

er 1

0 00

0 in

habi

tant

s)

Year

REFVISIEUR

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MIRA - Ozone

0.0

0.5

1.0

1.5

2.0

2000 2010 2020 2030

Hea

lth(D

ALYs

per

10

000

inha

bita

nts)

Year

REFVISIEUR

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EBoDE-project

» Quantification, comparison and ordering of different environmental stressors between EU countries

» Goal is to develop a uniform method to calculate the health impact of these stressors (DALY calculation) between different countries

» Create a platform for other countries

» http://en.opasnet.org/w/Ebode

World Health Organisation Europe

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EBODE-project

DALYs/million averaged over 6 participating countries

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EBODE project

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EBoDE / BoD

6-12% of the standard WHO BOD is associated with the nine environmental stressors.

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External Costs (euro)

» Health effects expressed in term of external costs

» Quantification is based on attributable cases (identical as calculated for DALYs)

» Specific cost per case based on:-NEEDS (2007)-Reële milieugerelateerde gezondheidskosten in Vlaanderen (LNE, 2009 (Arcadis, MetroEconomia))

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External Costs (euro) MIRA study

PM (euro/inhabitant) Ozone (euro/inhabitant)REF EUR VIS REF EUR VIS

2007 597 (±258) 597 (±258) 597 (±258) 39 (±18) 39 (±18) 39 (±18)2010 535 (±243) 520 (±220) 499 (±217) 42 (±20) 44 (±20) 43 (±18)2015 527 (±226) 472 (±198) 440 (±193) 46 (±20) 48 (±22) 45 (±20)2020 501 (±208) 409 (±184) 347 (±150) 47 (±22) 53 (±24) 43 (±20)2025 513 (±218) 402 (±181) 344 (±139) 50 (±22) 54 (±25) 42 (±19)2030 521 (±223) 410 (±173) 332 (±145) 53 (±24) 56 (±25) 39 (±17)

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Summary

» DALY as indicator for health impact PM and O3

» Chronic exposure to PM2.5 largest health impact

» Particulate matter: REF > EUR > VISI

» EBoDE study: 9 stressors largest health impact exposure to air PM

» External costs

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Thank you for the attention!