Probabilistische Expositionsabschätzung in Umweltmedizin und Verbraucherschutz (Workshop)

Fehr R, Mekel OCL. Probabilistische Expositionsabschätzung in Umweltmedizin und Verbraucherschutz (Workshop). Umweltwissenschaften und Schadstoff-Forschung. 2000;12(2):105-105

Berücksichtigung von Variabilität und Unsicherheit in quantitativen Risikoabschätzungen (QRA)

Mekel OCL, Fehr R. Berücksichtigung von Variabilität und Unsicherheit in quantitativen Risikoabschätzungen (QRA). Umweltwissenschaften und Schadstoff-Forschung. 2000;12(1):43-50.Anhand des Anwendungsbeispiels einer bewohnten Altlast wird eine probabilistische Expositionsabschätzung durchgeführt und es werden Möglichkeiten aufgezeigt, Variabilität und Unsicherheit in der Schätzung separat zu erfassen. Zur Charakterisierung der Variabilität personenspezifischer Variablen (z.B. Körpergewicht) werden in das Expositionsmodell Wahrscheinlichkeitsverteilungen eingesetzt; die stoffspezifischen Expositionsparameter werden konstant gehalten. Zusätzlich wird die Ungewißheit einer ausgewählten Variablen (Bodeningestionsrate) modelliert. Der Vergleich mit denworst-case-Schätzungen zeigt, daß diese in den oberen Randbereichen bzw, außerhalb der Bereiche der probabilistischen Schätzung liegen und somit sehr konservative, u.U. unrealistische Schätzungen liefern.Using the example of residential living on a contaminated site, a probabilistic exposure assessment is performed with variability and uncertainty being modelled separately. Probability distributions are used in the exposure model in order to characterize person-related variables (e.g. body weight) only; chemical-specific parameters are being held constant. In addition, uncertainty concerning one selected variable (soil ingestion rate) was modelled. Comparing these results to conventional “worst case” estimates, we find those estimates located in the uppermost range of the probabilistic estimates. The worst case estimates tend to be highly conservative and possibly unrealistic

Präambel

Fehr R, Mekel OCL. Präambel. Umweltwissenschaften und Schadstoff-Forschung. 2000;12(3):169-169

Health impact assessment - A survey on quantifying tools

Fehr R, Mekel OCL, Hurley JF, Mackenbach JP. Health impact assessment - A survey on quantifying tools. ENVIRONMENTAL IMPACT ASSESSMENT REVIEW. 2016;57:178-186.Integrating human health into prospective impact assessments is known to be challenging. This is true for both approaches: dedicated health impact assessments (HIA) as well as inclusion of health into more general impact assessments. Acknowledging the full range of participatory, qualitative, and quantitative approaches, this study focuses on the latter, especially on computational tools for quantitative health modelling. We conducted a survey among tool developers concerning,the status quo of development and availability of such tools; experiences made with model usage in real-life situations; and priorities for further development. Responding toolmaker groups described 17 such tools, most of them being maintained and reported as ready for use and covering a wide range of topics, including risk & protective factors, exposures, policies, and health outcomes. In recent years, existing models have been improved and were applied in new ways, and completely new models emerged. There was high agreement among respondents on the need to further develop methods for assessment of inequalities and uncertainty. The contribution of quantitative modeling to health foresight would benefit from building joint strategies of further tool development, improving the visibility of quantitative tools and methods, and engaging continuously with actual and potential users. (C) 2016 Elsevier Inc. All rights reserved

Health status of 'Ruhr-City' in 2025--predicted disease burden for the metropolitan Ruhr area in North Rhine-Westphalia

Terschuren C, Mekel OCL, Samson R, Claßen T, Hornberg C, Fehr R. Health status of 'Ruhr-City' in 2025--predicted disease burden for the metropolitan Ruhr area in North Rhine-Westphalia. European Journal of Public Health. 2009;19(5):534-540.BACKGROUND: Demographic change is a driving force of disease burden. The German population is aging and simultaneously shrinking, due to a rising life expectancy and a declining fertility rate. North Rhine-Westphalia (NRW) is the most populous federal state of Germany including the Ruhr metropolitan area. The NRW population is expected to shrink by 2.5% until 2025, the population of the Ruhr area by 9.5%. At the same time, the population forecast predicts a growth of 30% in the age group > or =55 years for NRW. METHODS: The 'burden of disease' approach of the World Health Organisation (WHO) summarizes the health status of populations. This approach was used to predict the regional disease burden in 2025 by calculating disability adjusted life years (DALY) as the sum of life years lost due to premature death and years lived with disability due to selected diseases. Our projection included selected tumours, myocardial infarction (MI) and dementia. RESULTS: For the Ruhr area, increases in DALYs are expected for all causes studied, i.e. selected tumours (20%), MI (17%) and dementia (36%). The increase in the Ruhr area was estimated to be proportionally lower than in NRW in total, but the disease burden per inhabitant is higher. CONCLUSION: The population shrinking is no cure for 'Ruhr City'. The projection of disease burden shows that health status will decrease due to the demographic change. DALY estimates show the potential health gains, which can be won by implementing measures to reduce premature deaths and to prevent new cases