Health and economic benefits of meeting WHO air quality guidelines, Western Pacific Region.

Objective: To quantify the number of avoidable annual deaths and associated economic benefits from meeting the World Health Organization (WHO) air quality guidelines for ambient concentrations for fine particulate matter (PM2.5) for Member States of the WHO Western Pacific Region. Methods: Using the AirQ+ software, we performed a quantitative health impact assessment comparing country-level PM2.5 concentrations with the 2005 and 2021 air quality guidelines recommended maximum concentrations of 10 and 5 µg/m3, respectively. We obtained PM2.5 data from the WHO Global Health Observatory (latest available year 2016), and population and mortality estimates from the United Nations World Population Prospects database for the latest 5-year period available (2015-2019), which we averaged to 1-year estimates. A risk estimate for all-cause mortality, based on a meta-analysis, was embedded within AirQ+ software. Our economic assessment used World Bank value of a statistical life adjusted to country-specific gross domestic product (latest available year 2014). Findings: Data were complete for 21 of 27 Member States. If these countries achieved the 2021 guidelines for PM2.5, an estimated 3.1 million deaths would be avoided annually, which are 0.4 million more deaths avoided than meeting the 2005 guidelines. China would avoid the most deaths per 100 000 population (303 deaths) and Brunei Darussalam the least (5 deaths). The annual economic benefit per capita ranged from 5781 United States dollars (US$) in Singapore to US$ 143 in Solomon Islands. Conclusion: Implementing effective measures to reduce PM2.5 emissions would save a substantial number of lives and money across the Region.

Assessment of impact of traffic-related air pollution on morbidity and mortality in Copenhagen Municipality and the health gain of reduced exposure.

BACKGROUND: Health impact assessment (HIA) of exposure to air pollution is commonly based on city level (fine) particle concentration and may underestimate health consequences of changing local traffic. Exposure to traffic-related air pollution can be assessed at a high resolution by modelling levels of nitrogen dioxide (NO2), which together with ultrafine particles mainly originate from diesel-powered vehicles in urban areas. The purpose of this study was to estimate the health benefits of reduced exposure to vehicle emissions assessed as NO2 at the residence among the citizens of Copenhagen Municipality, Denmark. METHODS: We utilized residential NO2 concentrations modelled by use of chemistry transport models to calculate contributions from emission sources to air pollution. The DYNAMO-HIA model was applied to the population of Copenhagen Municipality by using NO2 concentration estimates combined with demographic data and data from nationwide registers on incidence and prevalence of selected diseases, cause specific mortality, and total mortality of the population of Copenhagen. We used exposure-response functions linking NO2 concentration estimates at the residential address with the risk of diabetes, cardiovascular diseases, and respiratory diseases derived from a large Danish cohort study with the majority of subjects residing in Copenhagen between 1971 and 2010. Different scenarios were modelled to estimate the dynamic impact of NO2 exposure on related diseases and the potential health benefits of lowering the NO2 level in the Copenhagen Municipality. RESULTS: The annual mean NO2 concentration was 19.6 µg/m3 and for 70% of the population the range of exposure was between 15 and 21 µg/m3. If NO2 exposure was reduced to the annual mean rural level of 6 µg/m3, life expectancy in 2040 would increase by one year. The greatest gain in disease-free life expectancy would be lifetime without ischemic heart disease (1.4 years), chronic obstructive pulmonary disease (1.5 years for men and 1.6 years for women), and asthma (1.3 years for men and 1.5 years for women). Lowering NO2 exposure by 20% would increase disease-free life expectancy for the different diseases by 0.3-0.5 years. Using gender specific relative risks affected the results. CONCLUSIONS: Reducing the NO2 exposure by controlling traffic-related air pollution reduces the occurrence of some of the most prevalent chronic diseases and increases life expectancy. Such health benefits can be quantified by DYNAMO-HIA in a high resolution exposure modelling. This paper demonstrates how traffic planners can assess health benefits from reduced levels of traffic-related air pollution.

Improving health through policies that promote active travel: a review of evidence to support integrated health impact assessment.

BACKGROUND: Substantial policy changes to control obesity, limit chronic disease, and reduce air pollution emissions, including greenhouse gasses, have been recommended. Transportation and planning policies that promote active travel by walking and cycling can contribute to these goals, potentially yielding further co-benefits. Little is known, however, about the interconnections among effects of policies considered, including potential unintended consequences. OBJECTIVES AND METHODS: We review available literature regarding health impacts from policies that encourage active travel in the context of developing health impact assessment (HIA) models to help decision-makers propose better solutions for healthy environments. We identify important components of HIA models of modal shifts in active travel in response to transport policies and interventions. RESULTS AND DISCUSSION: Policies that increase active travel are likely to generate large individual health benefits through increases in physical activity for active travelers. Smaller, but population-wide benefits could accrue through reductions in air and noise pollution. Depending on conditions of policy implementations, risk tradeoffs are possible for some individuals who shift to active travel and consequently increase inhalation of air pollutants and exposure to traffic injuries. Well-designed policies may enhance health benefits through indirect outcomes such as improved social capital and diet, but these synergies are not sufficiently well understood to allow quantification at this time. CONCLUSION: Evaluating impacts of active travel policies is highly complex; however, many associations can be quantified. Identifying health-maximizing policies and conditions requires integrated HIAs.

Social inequality and incidence of and survival from cancers of the mouth, pharynx and larynx in a population-based study in Denmark, 1994-2003.

We investigated the effects of socioeconomic, demographic and health-related indicators on the incidence of and survival from mouth, pharynx and larynx cancers diagnosed in 1994-2003 with follow-up through 2006 in Denmark using information from nationwide registers. The analyses were based on data on 3058 patients with mouth and pharynx cancer and 1799 with larynx cancer in a cohort of 3.22 million persons born between 1925 and 1973 and aged >or=30 years. The incidences of all the three cancers increased with decreasing socioeconomic position, measured as disposable income, work market affiliation, social class, housing tenure, cohabiting status and type of district. Similar differences in survival persisted for all 5 years observed. Immigrants had better survival from larynx cancer than native Danes. We could not determine the effects of differences in tobacco and alcohol consumption or their multiplicative interactions.