Fine particle components and health--a systematic review and meta-analysis of epidemiological time series studies of daily mortality and hospital admissions.

Short-term exposure to fine particle mass (PM) has been associated with adverse health effects, but little is known about the relative toxicity of particle components. We conducted a systematic review to quantify the associations between particle components and daily mortality and hospital admissions. Medline, Embase and Web of Knowledge were searched for time series studies of sulphate (SO4(2-)), nitrate (NO3(-)), elemental and organic carbon (EC and OC), particle number concentrations (PNC) and metals indexed to October 2013. A multi-stage sifting process identified eligible studies and effect estimates for meta-analysis. SO4(2-), NO3(-), EC and OC were positively associated with increased all-cause, cardiovascular and respiratory mortality, with the strongest associations observed for carbon: 1.30% (95% CI: 0.17%, 2.43%) increase in all-cause mortality per 1 μg/m(3). For PNC, the majority of associations were positive with confidence intervals that overlapped 0%. For metals, there were insufficient estimates for meta-analysis. There are important gaps in our knowledge of the health effects associated with short-term exposure to particle components, and the literature also lacks sufficient geographical coverage and analyses of cause-specific outcomes. The available evidence suggests, however, that both EC and secondary inorganic aerosols are associated with adverse health effects

The Uniform World Model: A Methodology for Predicting the Health Impacts of Air Pollution

Throughout history, technological development and economic growth has led to greater prosperity and overall standard of living for many people in society. However, along with the benefits of economic development comes the social responsibility of minimizing the mortality and morbidity health impacts associated with human activities, safeguarding ecosystems, protecting world cultural heritage and preventing integrity and amenity losses of man-made environments. Effects are often irreversible, extend way beyond national borders and can occur over a long time lag. At current pollutant levels, the monetized impacts carry a significant burden to society, on the order of few percent of a country’s GDP, and upwards to 10% of GDP for countries in transition. A recent study for the European Union found that the aggregate damage burden from industrial air pollution alone costs every man, woman and child between 200 and 330 € a year, of which CO2 emissions contributed 40 to 60% (EEA 2011). In a sustainable world, an assessment of the environmental impacts (and damage costs) imposed by man\'s decisions on present and future generations is necessary when addressing the cost effectiveness of local and national policy options that aim at improving air quality and reducing greenhouse gas emissions. The aim of this paper is to present a methodology for calculating such adverse public health outcomes arising from exposure to routine atmospheric pollutant emissions using a simplified methodology, referred to as the Uniform World Model (UWM). The UWM clearly identifies the most relevant factors of the analysis, is easy to implement and requires only a few key input parameters that are easily obtained by the analyst, even to someone living in a developing country. The UWM is exact in the limit all parameters are uniformly distributed, due to mass conservation. The current approach can be applied to elevated and mobile sources. Its robustness has been validated (typical deviations are well within the ±50% range) by comparison with much more detailed air quality and environmental impact assessment models, such as ISC3, CALPUFF, EMEP and GAINS. Several comparisons illustrating the wide range of applicability of the UWM are presented in the paper, including estimation of mean concentrations at the local, country and continental level and calculation of local and country level intake factors and marginal damage costs of primary particulate matter and inorganic secondary aerosols. Relationships are also provided for computing spatial concentration profiles and cumulative impact or damage cost distributions. Assessments cover sources located in the USA, Europe, East Asia (China) and South Asia (India).Air Pollution, Urban Air Quality, Particulate Matter, Air Quality Modeling, Health Impact Assessment, Loss of Life Expectancy, Damage Costs of Air Pollution

The impact on human health of car-related air pollution in the UK, 1995-2005

We have analysed the impact on human health of emissions produced by the UK car fleet in the years 1995 and 2005. Calculations were based on reported measurements of pollutant concentration, literature values of exposure response coefficients and data for mortality and morbidity. A share was attributed to the car fleet based on emissions data. Although the total distance driven in the UK increased by 16% over this period to 460 billion km, there was a significant fall in engine emissions as increasingly stringent regulations (EURO standards) were introduced. As a result there was a decrease of some 25% in the number of deaths attributable to car-related air pollution – down to 5589 in 2005. The estimated number of years of life lost at 65 000 (England and Wales) in 2005, was about half that caused by road accidents involving cars in the same year. We report further calculations which show the effect of car-related pollution on hospital admissions. Our method is straightforward, providing acceptable estimates for health impacts on the predominantly urban population of the UK. There remains a need for more work, particularly cohort studies of morbidity, to establish the long-term effects of air pollution

State of Epidemiological Evidence for the Health Impacts of Ultrafine Particles

There has been increasing interest in the effect of ultrafine particles (UFP) on human cardiovascular and respiratory health. The adverse health impacts due to particle exposure are currently attributed to the mass concentration or the chemical composition of particles smaller than 10 μm (PM10) or 2.5 μm (PM2.5) in diameter. However, it has been hypothesised that it is actually UFP (< 0.1 μm) measured in terms of number concentration, as opposed to mass concentration, that might be responsible for the observed health effects. This paper presents the results of a critical literature review aimed at analysing the current state of epidemiological evidence for the effects of UFP on human health. In summary, the array of epidemiological studies conducted thus far suggests that UFP exposure is associated with human mortality, and respiratory and cardiovascular morbidity. This holds true despite the considerable gaps in knowledge that remain, and despite the inconsistencies found between some studies, resulting from some deficiencies in the study designs. The limited number of epidemiological studies conducted thus far indicates that there are comparable health effects of fine and ultrafine particles, which appear to be independent of each other. Fine particles show more immediate effects whilst ultrafine particles show more delayed effects on mortality. However, at present the database is too limited (in terms of both number of studies and number of subjects) and geographically restricted, to allow clear conclusions on the mode of action and/or generalisation to other settings. Consequently, it is recommended that further, better-designed studies be initiated to improve the understanding of health impacts of UFP

Fine particulate matter pollution and risk of community-acquired sepsis

While air pollution has been associated with health complications, its effect on sepsis risk is unknown. We examined the association between fine particulate matter (PM2.5) air pollution and risk of sepsis hospitalization. We analyzed data from the 30,239 community-dwelling adults in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort linked with satellite-derived measures of PM2.5 data. We defined sepsis as a hospital admission for a serious infection with &ge;2 systemic inflammatory response (SIRS) criteria. We performed incidence density sampling to match sepsis cases with 4 controls by age (&plusmn;5 years), sex, and race. For each matched group we calculated mean daily PM2.5 exposures for short-term (30-day) and long-term (one-year) periods preceding the sepsis event. We used conditional logistic regression to evaluate the association between PM2.5 exposure and sepsis, adjusting for education, income, region, temperature, urbanicity, tobacco and alcohol use, and medical conditions. We matched 1386 sepsis cases with 5544 non-sepsis controls. Mean 30-day PM2.5 exposure levels (Cases 12.44 vs. Controls 12.34 &micro;g/m3; p = 0.28) and mean one-year PM2.5 exposure levels (Cases 12.53 vs. Controls 12.50 &micro;g/m3; p = 0.66) were similar between cases and controls. In adjusted models, there were no associations between 30-day PM2.5 exposure levels and sepsis (4th vs. 1st quartiles OR: 1.06, 95% CI: 0.85&ndash;1.32). Similarly, there were no associations between one-year PM2.5 exposure levels and sepsis risk (4th vs. 1st quartiles OR: 0.96, 95% CI: 0.78&ndash;1.18). In the REGARDS cohort, PM2.5 air pollution exposure was not associated with risk of sepsis

Quantifying the health burden misclassification from the use of different PM2.5 exposure tier models: A case study of London

Exposure to PM2.5 has been associated with increased mortality in urban areas. Hence, reducing the uncertainty in human exposure assessments is essential for more accurate health burden estimates. Here we quantify the misclassification that occurs when using different exposure approaches to predict the mortality burden of a population using London as a case study. We develop a framework for quantifying the misclassification of the total mortality burden attributable to exposure to fine particulate matter (PM2.5) in four major microenvironments (MEs) (dwellings, aboveground transportation, London Underground (LU) and outdoors)in the Greater London Area (GLA), in 2017. We demonstrate that differences exist between five different exposure Tier-models with incrementally increasing complexity, moving from static to more dynamic approaches. BenMap-CE, the open source software developed by the U.S. Environmental Protection Agency, is used as a tool to achieve spatial distribution of the ambient concentration by interpolating the monitoring data to the unmonitored areas and ultimately estimate the change in mortality on a fine resolution. Our results showed that using the outdoor concentration as a surrogate for the total population exposure but ignoring the different exposure concentration that occurs indoors and the time spent in transit, would lead to a misclassification of 1,174 predicted mortalities in GLA. Indoor exposure to PM2.5 is the largest contributor to total population exposure, accounting for 80% of total mortality, followed by the London Underground which contributes 15%, albeit the average percentage of time spent there by Londoners is only 0.4%. We generally confirmed that increasing the complexity and incorporating important microenvironments, such as the highly polluted LU, could significantly reduce the misclassification in health burden assessments

Marginal External Costs of Peak and Non Peak Urban Transport in Belgium

This paper discusses intermediate results of an ongoing research project to estimate all external costs from all transport modes in Belgium. It gives estimates of the marginal external costs of air pollution from urban transport. The evaluation of the environmental impacts is based on the European ExternE accounting framework. This methodology uses the impact pathway analysis for the detailed bottom-up assessment of impacts from air pollutants. It integrates state of the art knowledge in the fields of emission modelling, dispersion modelling, dose-response functions and monetary valuation. This paper focuses on the impact of location (rural areas versus cities), regulation, traffic conditions and congestion on environmental externalities. These case studies for Belgium confirm earlier results of the ExternE project that external environmental costs of car transport are significant and that damage to public health is the dominant impact. In addition, it shows that externalities of urban peak traffic are 2 to 4 times higher than for normal urban driving conditions. Finally, it calculates which occupancy rates are required for urban public transport (trams and diesel buses) to have lower external costs compared to passenger cars.Externalities, Urban transport, Air pollution, Congestion, Sustainable mobility