4.3.3 AQEshort – Air quality indicators: short term health effects
Version 3.1 by Emily West on 2022/01/06 13:29
4.3.3 AQEshort – Air quality indicators: short term health effects
| Topic | Urban challenges | Sub-challenges |
|---|---|---|
| Social | 4 - Public Health and Well-being | 4.3 - Health |
Description | The ASE estimates the number of preterm deaths due to ozone short-term exposure in urban areas (O3). The WHO REVIHAAP project argues that despite the many respiratory outcomes associated with O3, mainly adverse health outcomes with known baseline rates are suited for health impact assessments. Evidence from time-series studies of short-term exposure to O3 suggest that health impact assessment calculations can be undertaken for a range of end-points, including all-age, all-cause mortality (WHO 2013a). There is still scientific debate whether the effects on mortality of long-term exposure to O3 are well enough documented to be included in health impact assessments. Multi pollutant models in the largest European study of short-term exposure (APHEA2) reported short-term exposure increases of total mortality by approx. 0.3% per 10 µg m-3 using the daily 8-h or 1-h maximum, in a linear manner without a significant threshold (Gryparis et al. 2004). A WHO meta-analysis for the AQ guidelines (2003) reported a relative risk of 0.3% per 10 µg m-3 increase with the 95% (CI 0.1–0.4%) which we see as a robust exposure– response assumption to apply. WHO REVIHHAP conclude that the epidemiological evidence supports calculations that use all-year coefficients for daily maximum 8-h O3 (scaled from the 1-h measures reported in the literature), including adjustment for PM10. It is also recommended that health impact calculations for short-term exposures assume linear concentration–response relationships. Since the epidemiological evidence on linearity does not extend down to zero, appropriate cut-off points for health impact assessments are therefore recommended: at 10 ppb (20 µg m-3) for daily maximum 8-h O3 and at 35 ppb (70 µg m-3), for consistency with previous work using SOMO35 data (WHO 2013). Given the uncertainties in the effects of long-term exposure to O3 (see the REVIHAAP report) it was suggested that health impact assessments for long-term exposure and respiratory and cardiopulmonary mortality are undertaken as a sensitivity scenario. It is recommended the coefficients from single pollutant models from the American Cancer Society cohort study (Jerrett et al. 2009) are used, assuming an association exists within the range of O3concentrations studied. The WHO HRAPIE Project recommended use of a meta-coefficient from The APHENA Study (results from 32 European cities) of a 0.3% increase (95% CI 1.4 – 4.3) per 10 µg m-3 increase in daily maximum 8-h O3 (Katsouyanni et al. 2009) and cutoff at 35 ppb (SOMO35). |
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