In the early 2000s, the GAINS (Greenhouse gas - Air pollution Interactions and Synergies) model used emerging epidemiological evidence to estimate premature mortality of the European population that can be attributed to the exposure to fine particulate matter and to identify cost-effective emission control strategies that reduce health impacts at least cost (Amann et al., 2011, p.accepted for publication). Based on the review of available studies on the health effects of PM conducted by the UNECE Task Force on Health (UNECE/WHO, 2003), the GAINS impact assessment employed the associations between population exposure to PM2.5 and all-cause mortality of the American Cancer Society study (Pope et al., 2002).
In the meantime, a wealth of new epidemiological studies have sharpened the evidence about health effects of particulate matter and revealed more specific associations between ambient concentrations of PM2.5 and health impacts (e.g., Pope et al., 2009). In particular, new studies establish robust relationships between exposure to fine particles and specific causes of deaths. These new insights should facilitate a more specific estimate of the role of particular death causes that are associated with bad air quality, and a more precise estimate of the total mortality impacts in different countries as baseline death rates from different diseases vary over countries.
This background paper describes a revised approach of the health impact assessment in GAINS that employs cause-specific concentration-response relationships for lung cancer, cardio-vascular and respiratory diseases for the European countries.
Data on cause-specific deaths in the European countries have been extracted from the 2010 version of the World Health Organization database on mortality indicators by 67 causes of death, age and sex (HFA-MDB) for the latest available year. As a result, the cause-specific approach results in higher impact estimates than the former calculation for all-cause mortality. The difference depends on the relative shares of death causes in the various countries; for the EU-27, cause-specific calculations for the year 2000 result in 16% higher health effects, keeping all other factors constant (i.e., PM exposure, population, etc.). In the non-EU countries, the difference amounts to 54%, essentially due to the higher share of cardio-vascular deaths
