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Health Risk Assessment of Air Pollution: General Principles

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Health Risk Assessment of Air Pollution: General Principles Health risk assessment of air pollution General principles Health risk assessment of air pollution General principles Abstract An air pollution health risk assessment (AP-HRA) estimates the health impact to be expected from mea- sures that affect air quality, in different socioeconomic, environmental, and policy circumstances. As such, it is an important tool for informing public policy decisions. This document introduces the concept of AP-HRA, describes in broad terms how the health risks of outdoor air pollution and its sources are estimated, and gives an overview of the general principles for the proper conduct of an AP-HRA for various scenarios and purposes. The information is aimed at a broad audience of readers who do not need to know how to apply the tools, but seek a general understanding of the concepts, scope and principles of AP-HRA. Keywords AIR POLLUTION - adverse effects AIR POLLUTION - analysis RISK ASSESSMENT - methods ENVIRONMENTAL MONITORING Citation advice Health risk assessment of air pollution – general principles. Copenhagen: WHO Regional Office for Europe; 2016. Address requests about publications of the WHO Regional Office for Europe to: Publications WHO Regional Office for Europe UN City Marmorvej 51 DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office website (http://www.euro.who.int/pubrequest). ISBN 978 92 890 51316 © World Health Organization 2016 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The views expressed by authors, editors, or expert groups do not necessarily represent the decisions or the stated policy of the World Health Organization or any other institution mentioned in the report. Text editing: Pat Butler Design: Christophe Lanoux, Paris, France Layout: Edb&Rdb di Daniela Berretta, Rome, Italy Photo copyrights: cover and p. viii © Shutterstock-Robert F. Balazik; p. 22 © Shutterstock; p. 26 © Emilio M. Dotto; p. 28 © Fotolia. ivii Contents Acknowledgements............................................................................................ iv Abbreviations..................................................................................................... v Executive summary............................................................................................ vi 1. Introduction.................................................................................................... 1 1.1 Scope and purpose of this publication................................................ 1 1.2 Background.......................................................................................... 1 1.3 What is a health risk assessment?....................................................... 3 2. Definition of the policy question..................................................................... 5 3. What information is needed to conduct an AP–HRA?.................................... 6 3.1 Planning the health risk assessment.................................................... 6 3.2 Estimating population exposure to air pollutants................................. 8 3.3 Estimating the health risk..................................................................... 8 3.4 Quantifying the health impact.............................................................. 9 4. Uncertainty in AP–HRA................................................................................... 11 5. Tools available................................................................................................ 13 6. Conclusions.................................................................................................... 17 References......................................................................................................... 18 Annex 1. Useful AP–HRA resources................................................................... 21 Annex 2. The Aphekom project.......................................................................... 22 Annex 3. Global Burden of Disease................................................................... 25 Annex 4. BenMAP............................................................................................... 28 iii Acknowledgements This publication was developed on the basis of discussions at the WHO Expert Meeting on Methods and Tools for Assessing the Health Risks of Air Pollution at Local, National and International Levels, held in Bonn, Germany, on 12–13 May 2014. It was prepared by Susan Anenberg (Environmental Health Analytics, LLC, Washington, DC, United States of America), Marie-Eve Héroux (WHO Regional Office for Europe, Bonn, Germany) and Susann Wothe (née Henschel) (Federal Institute for Occupational Safety and Health (BAuA), Dortmund, Germany) as part of the work of the Task Force on Health Aspects of Air Pollution under the Joint WHO/United Nations Economic Commission for Europe (UNECE) Convention on Long-range Transboundary Air Pollution, in accordance with the Memorandum of Understanding between UNECE and the WHO Regional Office for Europe. The Regional Office thanks the Swiss Federal Office for the Environment, the German Federal Ministry for the Environment, Nature Conservation, Building and Nuclear Safety, the French Ministry of Social Affairs and Health and the United States Environmental Protection Agency for their financial support of the work of the Task Force. The work is coordinated by the WHO Regional Office’s European Centre for Environment and Health, Bonn, Germany. The experts who participated in the Expert Meeting are thanked for their invaluable contributions, as well as their advice on a variety of health risk assessments. Menno Keuken (TNO, Utrecht, the Netherlands) and Patrick Kinney (Columbia University, New York, United States of America) provided comments on a draft version of this publication. iv Abbreviations Aphekom Improving Knowledge and Communication for Decision Making on Air Pollution and Health in Europe (project) AP-HRA air pollution health risk assessment AQG air quality guidelines BenMAP Environmental Benefits Mapping and Analysis Program CRA comparative risk assessment CRF concentration–response function DALY disability-adjusted life-year EC European Commission EPA Environmental Protection Agency EU European Union GBD Global Burden of Disease HIA health impact assessment NO2 nitrogen dioxide NOx nitrogen oxides O3 ozone PM particulate matter PM10 particulate matter with an aerodynamic diameter below 10 μm PM2.5 particulate matter with an aerodynamic diameter below 2.5 μm REVIHAAP review of evidence on health aspects of air pollution (project) RR relative risk SO2 sulfur dioxide SOx sulfur oxides TFH Task Force on Health Aspects of Air Pollution YLD years lost due to disability YLL years of life lost v Executive summary This publication introduces the concept of air pollution health risk assessment (AP- HRA), describes in broad terms how the health risks of outdoor air pollution and its sources are estimated, and gives an overview of the general principles for the proper conduct of an AP-HRA for various scenarios and purposes. The target audience includes policy-makers at the local, national and international level, and other users of health risk estimates in agencies, and research and advocacy groups. Because the publication was prepared in the context of the work of the UNECE Convention on Long-range Transboundary Air Pollution, the emphasis is mainly on European and North American tools and references. The main purpose of an AP-HRA is to estimate and communicate the health impact of exposure to air pollution or changes in air pollution in different socioeconomic, environmental, and policy circumstances. In many countries, an AP-HRA is formally required as part of the decision-making process for new programmes, projects, regulations, or policies that potentially have an effect on air quality. In other countries, where assessments were previously limited to qualitative descriptions, scientific advances are now allowing more detailed quantitative analyses of the health risks of air pollution. Thus an increasing number of AP-HRAs are being carried out for a variety of policy scenarios and
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