Why is Air Pollution a Global Public Health Problem?

Daniel Krewski, PhD, MHAMcLaughlin Centre for

Population Health Risk Assessment

NERAM Colloquium V

October 16, 2006

McLaughlin Centre for Population Health Risk Assessment

Air Quality Risk ManagementColloquium Schedule

2001 University of Ottawa

2002 Johns Hopkins University

2003 Santo Spiroto Hospital, Rome

2005 Mexico Department of Public Health

2006 Wosk Centre for Dialogue, Vancouver

McLaughlin Centre for Population Health Risk Assessment

Science and Policy for Global Air Quality Management

Michal Krzyanowski

• WHO air quality guidelines• Health effects at near

ambient levels, which often exceed established guidelines

• Integration of air quality policy with that in other sectors (energy, climate, transport, agriculture, social)

• Global approach needed

McLaughlin Centre for Population Health Risk Assessment

Canada Wide Standards (by 2010)

• Fine Particulate Matter (PM2.5)– 30 µg/m3

– 24 hour average

• Ground Level Ozone (O3)– 65 ppb– 8-hour average

McLaughlin Centre for Population Health Risk Assessment

The Global Burden of Disease due to Air Pollution

Aaron Cohen

• CRA: Air pollution in context of other population health risk issues

• GBD: Cardiopulmonary disease and lung cancer due to PM (Pope et al., 2002)

• Magnitude: AF of 4 - 5%, 1.6 M deaths annually

• Uncertainties considered• Avoidable burden in 2010 and

2020

McLaughlin Centre for Population Health Risk Assessment

GBD Methodology: Cherobyl

Air Pollution Health Effects Air Pollution Health Effects PyramidPyramid

severity ofeffect

proportion of population affected

hospitaladmissions

mortality

emergency room visits

physician office visits

reduced physical activity

medication userespiratory symptoms

impaired lung functionsubclinical (subtle) effects

American Cancer Society CPS-II Cohort

Ongoing Analyses of ACS Cohort

• Continued follow-up through to 2002• Identification of critical exposure time windows• Intra-urban analyses in Los Angeles and New

York City• Improved exposure estimates in California: local

exposures, land use regression models, population mobility

• Modeling spatial patterns in air pollution and mortality data

McLaughlin Centre for Population Health Risk Assessment

13 Canadian cities90 U.S. cities,

counties or

regions

26 European cities

orregions

BrisbaneSydney

Shenyang7 Korean

citiesBeijing

Mexico City

Sao PauloSantiago

Bangkok+

++

++

+

+

++

Christchurch

+Melbourne

Location of studies of air pollution and mortalityLocation of studies of air pollution and mortality

NERAM Colloquia on Health and Air Quality:

Interpreting Science for Decision Makers

InterpretationScientificData

Social Issues Economic Issues

Poltical IssuesTechnological Issues

SciencePolicy

McLaughlin Centre for Population Health Risk Assessment