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Objectives: We evaluated studies that used the World Health Organization's (WHO) AirQ and AirQ+ tools for air pollution (AP) health risk assessment (HRA) and provided best practice suggestions for future assessments. Methods: We performed a comprehensive review of studies using WHO's AirQ and AirQ+ tools, searching several databases for relevant articles, reports, and theses from inception to Dec 31, 2022. Results: We identified 286 studies that met our criteria. The studies were conducted in 69 countries, with most (57%) in Iran, followed by Italy and India (â¼8% each). We found that many studies inadequately report air pollution exposure data, its quality, and validity. The decisions concerning the analysed population size, health outcomes of interest, baseline incidence, concentration-response functions, relative risk values, and counterfactual values are often not justified, sufficiently. Many studies lack an uncertainty assessment. Conclusion: Our review found a number of common shortcomings in the published assessments. We suggest better practices and urge future studies to focus on the quality of input data, its reporting, and associated uncertainties.
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BACKGROUND: Morbidity burdens from ambient air pollution are associated with market and non-market costs and are therefore important for policymaking. The estimation of morbidity burdens is based on concentration-response functions (CRFs). Most existing CRFs for short-term exposures to PM2.5 assume a fixed risk estimate as a log-linear function over an extrapolated exposure range, based on evidence primarily from Europe and North America. OBJECTIVES: We revisit these CRFs by performing a systematic review for seven morbidity endpoints previously assessed by the World Health Organization, including data from all available regions. These endpoints include all cardiovascular hospital admission, all respiratory hospital admission, asthma hospital admission and emergency room visit, along with the outcomes that stem from morbidity, such as lost work days, respiratory restricted activity days, and child bronchitis symptom days. METHODS: We estimate CRFs for each endpoint, using both a log-linear model and a nonlinear model that includes additional parameters to better fit evidence from high-exposure regions. We quantify uncertainties associated with these CRFs through randomization and Monte Carlo simulations. RESULTS: The CRFs in this study show reduced model uncertainty compared with previous CRFs in all endpoints. The nonlinear CRFs produce more than doubled global estimates on average, depending on the endpoint. Overall, we assess that our CRFs can be used to provide policy analysis of air pollution impacts at the global scale. It is however important to note that improvement of CRFs requires observations over a wide range of conditions, and current available literature is still limited. DISCUSSION: The higher estimates produced by the nonlinear CRFs indicates the possibility of a large underestimation in current assessments of the morbidity impacts attributable to air pollution. Further studies should be pursued to better constrain the CRFs studied here, and to better characterize the causal relationship between exposures to PM2.5 and morbidity outcomes.
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Poluição do Ar , Asma , Criança , Humanos , Avaliação do Impacto na Saúde , Poluição do Ar/efeitos adversos , Asma/epidemiologia , Morbidade , Material Particulado/efeitos adversosRESUMO
BACKGROUND: Indonesian peatlands have been drained for agricultural development for several decades. This development has made a major contribution to economic development. At the same time, peatland drainage is causing significant air pollution resulting from peatland fires. Peatland fires occur every year, even though their extent is much larger in dry (El Niño) years. We examine the health effects of long-term exposure to fine particles (PM2.5) from all types of peatland fires (including the burning of above and below ground biomass) in Sumatra and Kalimantan, where most peatland fires in Indonesia take place. METHODS: We derive PM2.5 concentrations from satellite imagery calibrated and validated with Indonesian Government data on air pollution, and link increases in these concentrations to peatland fires, as observed in satellite imagery. Subsequently, we apply available epidemiological studies to relate PM2.5 exposure to a range of health outcomes. The model utilizes the age distribution and disease prevalence of the impacted population. RESULTS: We find that PM2.5 air pollution from peatland fires, causes, on average, around 33,100 adults and 2900 infants to die prematurely each year from air pollution. In addition, peatland fires cause on average around 4390 additional hospitalizations related to respiratory diseases, 635,000 severe cases of asthma in children, and 8.9 million lost workdays. The majority of these impacts occur in Sumatra because of its much higher population density compared to Kalimantan. A main source of uncertainty is in the Concentration Response Functions (CRFs) that we use, with different CRFs leading to annual premature adult mortality ranging from 19,900 to 64,800 deaths. Currently, the population of both regions is relatively young. With aging of the population over time, vulnerabilities to air pollution and health effects from peatland fires will increase. CONCLUSIONS: Peatland fire health impacts provide a further argument to combat fires in peatlands, and gradually transition to peatland management models that do not require drainage and are therefore not prone to fire risks.
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Poluição do Ar , Incêndios , Agricultura , Criança , Humanos , Indonésia/epidemiologia , Material Particulado/efeitos adversosRESUMO
Local air quality co-benefits can provide complementary support for ambitious climate action and can enable progress on related Sustainable Development Goals. Here we show that the transformation of the energy system implied by the emission reduction pledges brought forward in the context of the Paris Agreement on climate change (Nationally Determined Contributions or NDCs) substantially reduces local air pollution across the globe. The NDCs could avoid between 71 and 99 thousand premature deaths annually in 2030 compared to a reference case, depending on the stringency of direct air pollution controls. A more ambitious 2 °C-compatible pathway raises the number of avoided premature deaths from air pollution to 178-346 thousand annually in 2030, and up to 0.7-1.5 million in the year 2050. Air quality co-benefits on morbidity, mortality, and agriculture could globally offset the costs of climate policy. An integrated policy perspective is needed to maximise benefits for climate and health.
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Agricultura/métodos , Poluição do Ar/prevenção & controle , Conservação dos Recursos Naturais/métodos , Saúde Pública/métodos , Agricultura/economia , Poluição do Ar/análise , Mudança Climática , Conservação dos Recursos Naturais/economia , Conservação dos Recursos Naturais/legislação & jurisprudência , Análise Custo-Benefício , Política Ambiental/economia , Política Ambiental/legislação & jurisprudência , Geografia , Carga Global da Doença/economia , Carga Global da Doença/legislação & jurisprudência , Carga Global da Doença/métodos , Aquecimento Global/prevenção & controle , Efeito Estufa/prevenção & controle , Humanos , Cooperação Internacional , Paris , Material Particulado/análise , Saúde Pública/economiaRESUMO
The study aims to explore the main drivers influencing the economic appraisal of heat warning systems by integrating epidemiological modelling and benefit-cost analysis. To shed insights on heat wave mortality valuation, we consider three valuation schemes: (i) a traditional one, where the value of a statistical life (VSL) is applied to both displaced and premature mortality; (ii) an intermediate one, with VSL applied for premature mortality and value of a life year (VOLY) for displaced mortality; and (iii) a conservative one, where both premature and displaced mortality are quantified in terms of loss of life expectancy, and then valued using the VOLY approach. When applying these three schemes to Madrid (Spain), we obtain a benefit-cost ratio varying from 12 to 3700. We find that the choice of the valuation scheme has the largest influence, whereas other parameters such as attributable risk, displaced mortality ratio, or the comprehensiveness and effectiveness of the heat warning system are less influential. The results raise the question of which is the most appropriate approach to value mortality in the context of heat waves, given that the lower bound estimate for the benefit-cost ratio (option iii using VOLY) is up to two orders of magnitude lower than the value based on the traditional VSL approach (option i). The choice of the valuation methodology has significant implications for public health authorities at the local and regional scale, which becomes highly relevant for locations where the application of the VOLY approach could lead to benefit-cost ratios significantly lower than 1. We propose that specific metrics for premature and displaced VOLYs should be developed for the context of heat waves. Until such values are available, we suggest testing the economic viability of heat warning systems under the three proposed valuation schemes (i-iii) and using values for VOLY commonly applied in air pollution as the health end points are similar. Lastly, periodical reassessment of heat alert plans should be performed by public health authorities to monitor their long-term viability and cost-effectiveness.
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The Global Burden of Disease (GBD) is a comparative assessment of the health impact of the major and well-established risk factors, including ambient air pollution (AAP) assessed by concentrations of PM2.5 (particles less than 2.5⯵m) and ozone. Over the last two decades, major improvements have emerged for two important inputs in the methodology for estimating the impacts of PM2.5: the assessment of global exposure to PM2.5 and the development of integrated exposure risk models (IERs) that relate the entire range of global exposures of PM2.5 to cause-specific mortality. As a result, the estimated annual mortality attributed to AAP increased from less than 1 million in 2000 to roughly 3 million for GBD in years 2010 and 2013, to 4.2 million for GBD 2015. However, the magnitude of the recent change and uncertainty regarding its rationale have resulted, in some cases, in skepticism and reduced confidence in the overall estimates. To understand the underlying reasons for the change in mortality, we examined the estimates for the years 2013 and 2015 to determine the quantitative implications of alternative model input assumptions. We calculated that the year 2013 estimates increased by 8% after applying the updated exposure data used in GBD 2015, and increased by 23% with the application of the updated IERs from GBD 2015. The application of both upgraded methodologies together increased the GBD 2013 estimates by 35%, or about one million deaths. We also quantified the impact of the changes in demographics and the assumed threshold level. Since the global estimates of air pollution-related deaths will continue to change over time, a clear documentation of the modifications in the methodology and their impacts is necessary. In addition, there is need for additional monitoring and epidemiological studies to reduce uncertainties in the estimates for low- and medium-income countries, which contribute to about one-half of the mortality.
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Poluição do Ar/efeitos adversos , Carga Global da Doença , Mortalidade , Países em Desenvolvimento , Saúde Global , Humanos , Renda , Fatores de RiscoRESUMO
BACKGROUND: Urban outdoor air pollution, especially particulate matter, remains a major environmental health problem in Skopje, the capital of the former Yugoslav Republic of Macedonia. Despite the documented high levels of pollution in the city, the published evidence on its health impacts is as yet scarce. METHODS: we obtained, cleaned, and validated Particulate Matter (PM) concentration data from five air quality monitoring stations in the Skopje metropolitan area, applied relevant concentration-response functions, and evaluated health impacts against two theoretical policy scenarios. We then calculated the burden of disease attributable to PM and calculated the societal cost due to attributable mortality. RESULTS: In 2012, long-term exposure to PM2.5 (49.2 µg/m³) caused an estimated 1199 premature deaths (CI95% 821-1519). The social cost of the predicted premature mortality in 2012 due to air pollution was estimated at between 570 and 1470 million euros. Moreover, PM2.5 was also estimated to be responsible for 547 hospital admissions (CI95% 104-977) from cardiovascular diseases, and 937 admissions (CI95% 937-1869) for respiratory disease that year. Reducing PM2.5 levels to the EU limit (25 µg/m³) could have averted an estimated 45% of PM-attributable mortality, while achieving the WHO Air Quality Guidelines (10 µg/m³) could have averted an estimated 77% of PM-attributable mortality. Both scenarios would also attain significant reductions in attributable respiratory and cardiovascular hospital admissions. CONCLUSIONS: Besides its health impacts in terms of increased premature mortality and hospitalizations, air pollution entails significant economic costs to the population of Skopje. Reductions in PM2.5 concentrations could provide substantial health and economic gains to the city.
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Poluição do Ar/efeitos adversos , Poluição do Ar/economia , Exposição Ambiental/economia , Nível de Saúde , Hospitalização/economia , Mortalidade Prematura , Material Particulado/economia , Poluição do Ar/análise , Doenças Cardiovasculares/mortalidade , Cidades , Exposição Ambiental/efeitos adversos , Hospitalização/estatística & dados numéricos , Humanos , Material Particulado/efeitos adversos , Material Particulado/análise , República da Macedônia do Norte , Doenças Respiratórias/mortalidade , Medição de RiscoRESUMO
Particulate matter (PM) is a significant contributor to death and disease globally. This paper summarizes the work of an international expert group on the integration of human exposure to PM into life cycle impact assessment (LCIA), within the UNEP/SETAC Life Cycle Initiative. We review literature-derived intake fraction values (the fraction of emissions that are inhaled), based on emission release height and "archetypal" environment (indoor versus outdoor; urban, rural, or remote locations). Recommended intake fraction values are provided for primary PM(10-2.5) (coarse particles), primary PM(2.5) (fine particles), and secondary PM(2.5) from SO(2), NO(x), and NH(3). Intake fraction values vary by orders of magnitude among conditions considered. For outdoor primary PM(2.5), representative intake fraction values (units: milligrams inhaled per kilogram emitted) for urban, rural, and remote areas, respectively, are 44, 3.8, and 0.1 for ground-level emissions, versus 26, 2.6, and 0.1 for an emission-weighted stack height. For outdoor secondary PM, source location and source characteristics typically have only a minor influence on the magnitude of the intake fraction (exception: intake fraction values can be an order of magnitude lower for remote-location emission than for other locations). Outdoor secondary PM(2.5) intake fractions averaged over respective locations and stack heights are 0.89 (from SO(2)), 0.18 (NO(x)), and 1.7 (NH(3)). Estimated average intake fractions are greater for primary PM(10-2.5) than for primary PM(2.5) (21 versus 15), owing in part to differences in average emission height (lower, and therefore closer to people, for PM(10-2.5) than PM(2.5)). For indoor emissions, typical intake fraction values are â¼1000-7000. This paper aims to provide as complete and consistent an archetype framework as possible, given current understanding of each pollutant. Values presented here facilitate incorporating regional impacts into LCIA for human health damage from PM.
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Exposição Ambiental/estatística & dados numéricos , Material Particulado , Meio Ambiente , HumanosRESUMO
Since much of the emission is in the form of metallic Hg whose atmospheric residence time is long enough to cause nearly uniform mixing in the hemisphere, much of the impact is global. This article presents a first estimate of global average neurotoxic impacts and costs by defining a comprehensive transfer factor for ingestion of methyl-Hg as ratio of global average dose rate and global emission rate. For the dose-response function (DRF) we use recent estimates of IQ decrement as function of Hg concentration in blood, as well as correlations between blood concentration and Hg ingestion. The cost of an IQ point is taken as $18,000 in the United States and applied in other countries in proportion to per capita GDP, adjusted for purchase power parity. The mean estimate of the global average of the marginal damage cost per emitted kg of Hg is about $1,500/kg, if one assumes a dose threshold of 6.7 mug/day of methyl-Hg per person, and $3,400/kg without threshold. The average global lifetime impact and cost per person at current emission levels are 0.02 IQ points lost and $78 with and 0.087 IQ points and $344 without threshold. These results are global averages; for any particular source and emission site the impacts can be quite different. An assessment of the overall uncertainties indicates that the damage cost could be a factor 4 smaller or larger than the median estimate (the uncertainty distribution is approximately log normal and the ratio median/mean is approximately 0.4).
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Poluentes Ambientais/toxicidade , Mercúrio/análise , Mercúrio/toxicidade , Medição de Risco , Poluentes Atmosféricos/toxicidade , Exposição Ambiental , Nível de Saúde , Humanos , Mineração , Modelos Econômicos , Modelos Estatísticos , Método de Monte CarloRESUMO
The methodology for evaluating the impacts and damage costs ('external costs') due to pollution from waste treatment is described and the results are presented, based on the ExternE project series of the European Commission. The damage costs of landfill and incineration of municipal solid waste are compared, with due account for energy and materials recovery, as well as possible differences in transport distance. We have not been able to quantify the total damage costs of leachates because of the complexity of the environmental pathways and of the long time horizon of some persistent pollutants, but we consider an extreme scenario to show that they are not worth worrying about in the sense that reducing the pollutants in leachates beyond current regulations would bring negligible benefit in comparison with the abatement of other sources of the same pollutants. The damage costs due to the construction of the waste treatment facility are negligible. The damage costs of waste transport, which are illustrated by an arbitrary choice of a 100 km round trip by a 16 tonne truck, are also negligible. The benefits of materials recovery make a small contribution to the total damage cost. The only significant contributions come from direct emissions (of the landfill or incinerator) and from avoided emissions due to energy recovery (from an incinerator). Damage costs for incineration range from about 4 to 21 EUR tonne waste(-1), and they are extremely dependent on the assumed scenario for energy recovery. For landfill the cost ranges from about 10 to 13 EUR tonne waste(-1); it is dominated by greenhouse gas emissions because only a fraction of the CH4 can be captured (here assumed to be 70%). Amenity costs (odour, visual impact, noise) are highly site-specific and we only cite results from a literature survey which indicates that such costs could make a significant contribution, very roughly on the order of 1 EUR tonne waste(-1).
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Meio Ambiente , Incineração/economia , Eliminação de Resíduos/economiaRESUMO
Environmental damage is one of the main justifications for continued efforts to reduce energy consumption and to shift to cleaner sources such as solar energy. In recent years there has been much progress in the analysis of environmental damages, in particular thanks to the ExternE (External Costs of Energy) Project of the European Commission. This article presents a summary of the methodology and key results for the external costs of the major energy technologies. Even though the uncertainties are large, the results provide substantial evidence that the classical air pollutants (particles, No(x), and SO(2)) from fossil fuels impose significant public health costs, comparable to the cost of global warming from CO(2) emissions. The total external costs are relatively low for natural gas (in the range of about 0.5-1 eurocents/kWh for most EU countries), but much higher for coal and lignite (in the range of about 2-6 eurocents/kWh for most EU countries). By contrast, the external costs of nuclear, wind, and photovoltaics are very low. The external costs of hydro are extremely variable from site to site, and the ones of biomass depend strongly on the specific technologies used and can be quite large for combustion.
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Conservação de Recursos Energéticos/economia , Custos e Análise de Custo , Poluentes Ambientais/economiaRESUMO
How large is the social cost penalty if one makes the wrong choice because of uncertainties in the estimates of the costs and benefits of environmental policy measures? For discrete choices there is no general rule other than the recommendation to always carefully compare costs and benefits when introducing policies for environmental protection. For continuous choices (e.g., the ceiling for the total emissions of a pollutant by an entire sector or region), it is instructive to look at the cost penalty as a function of the error in the incremental damage cost estimate. Using abatement cost curves for NOx, SO2, dioxins, and CO2, this paper evaluates the cost penalty for errors in the following: national emission ceilings for NOx and SO2 in each of 12 countries of Europe, an emission ceiling for dioxins in the UK, and limits for the emission of CO2 in Europe. The cost penalty turns out to be remarkably insensitive to errors. An error by a factor of 3 due to uncertainties in the damage estimates for NOx and SO2 increases the total social cost by at most 20% and in most cases much less. For dioxins, the total social cost is increased by at most 10%. For CO2, several different possible cost curves are examined: for some the sensitivity to uncertainties is greater than for the other pollutants, but even here the penalty is less than 30% and in most cases much less if the true damage costs are twice as high as the ones estimated. The paper also quantifies the benefit of improving the accuracy of damage cost estimates by further research.