Comparing the lung cancer burden of ambient particulate matter using scenarios of air quality standards versus acceptable risk levels

A New Global Air Quality Health Index Based on the WHO Air Quality Guideline Values With Application in Cape Town

Objectives: This study developed an Air Quality Health Index (AQHI) based on global scientific evidence and applied it to data from Cape Town, South Africa. Methods: Effect estimates from two global systematic reviews and meta-analyses were used to derive the excess risk (ER) for PM2.5, PM10, NO2, SO2 and O3. Single pollutant AQHIs were developed and scaled using the ERs at the WHO 2021 long-term Air Quality Guideline (AQG) values to define the upper level of the "low risk" range. An overall daily AQHI was defined as weighted average of the single AQHIs. Results: Between 2006 and 2015, 87% of the days posed "moderate to high risk" to Cape Town's population, mainly due to PM10 and NO2 levels. The seasonal pattern of air quality shows "high risk" occurring mostly during the colder months of July-September. Conclusion: The AQHI, with its reference to the WHO 2021 long-term AQG provides a global application and can assist countries in communicating risks in relation to their daily air quality.

Air Pollution and Birth Outcomes: Health Impact and Economic Value Assessment in Spain

Air pollution is considered an ongoing major public health and environmental issue around the globe, affecting the most vulnerable, such as pregnant women and fetuses. The aim of this study is to estimate the health impact and economic value on birth outcomes, such as low birthweight (LBW), preterm birth (PTB), small for gestational age (SGA), attributable to a reduction of PM₁₀ levels in Spain. Reduction based on four scenarios was implemented: fulfillment of WHO guidelines and EU limits, and an attributable reduction of 15% and 50% in annual PM₁₀ levels. Retrospective study on 288,229 live-born singleton children born between 2009-2010, using data from Spain Birth Registry Statistics database, as well as mean PM₁₀ mass concentrations. Our finding showed that a decrease in annual exposure to PM₁₀ appears to be associated with a decrease in the annual cases of LBW, SGA and PTB, as well as a reduction in hospital cost attributed to been born with LBW. Improving pregnancy outcomes by reducing the number of LBW up to 5% per year, will result in an estimate associated monetary saving of 50,000 to 7,000,000 euros annually. This study agrees with previous literature and highlights the need to implement, and ensure compliance with, stricter policies that regulate the maximum exposure to outdoor PM permitted in Spain, contributing to decreased environmental health risk, especially negative birth outcomes.

Health risk assessment of particulate matter 2.5 in an academic metallurgy workshop

Exposure to indoor PM_2.5 is associated with allergies, eye and skin irritation, lung cancer, and cardiopulmonary diseases. To control indoor PM_2.5 and protect the health of occupants, exposure and health studies are necessary. In this study, exposure to PM_2.5 released in an academic metallurgy workshop was assessed and a health risk assessment was conducted for male and female students and technicians. Polycarbonate membrane filters and an active pump operating at a flow rate of 2.5 L/min were used to collect PM_2.5 from Monday to Friday for 3 months (August-October 2020) from 08:00-16:00. PM_2.5 mass concentrations were obtained gravimetrically, and the Multiple-Path Particle Dosimetry model was used to predict the deposition, retention, and clearance of PM_2.5 in the respiratory tract system. The risk of developing carcinogenic and non-carcinogenic effects among students and technicians was determined. The average PM_2.5 mass concentration for August was 32.6 μg/m³ 32.8 μg/m³ for September, and 32.2 μg/m³ for October. The head region accounted for the highest deposition fraction (49.02%), followed by the pulmonary (35.75%) and tracheobronchial regions (15.26%). Approximately 0.55 mg of PM_2.5 was still retained in the alveolar region 7 days after exposure. The HQ for male and female students was <1 while that of male and female technicians was >1, suggesting that technicians are at risk of developing non-carcinogenic health effects compared with students. The results showed a risk of developing carcinogenic health effects among male and female technicians (>1 × 10^-5 ); however, there was no excess cancer risk for students (<1 × 10^-6 ). This study highlights the importance of exposure and health studies in academic micro-environments such as metallurgy workshops which are often less researched, and exposure is underestimated. The results also indicated the need to implement control measures to protect the health of the occupants and ensure that the workshop rules are adhered to.

Methods Matter: A Comparative Review of Health Risk Assessments for Ambient Air Pollution in Switzerland

Objectives: Air pollution health risk assessments (AP-HRAs) provide a method to quantify health effects for entire populations. In Switzerland, AP-HRAs are included in Swiss assessments for Transport Externalities (STEs), ordered by public authorities since the 1990s. This study aimed to describe the differences among national and international AP-HRAs for Switzerland. Methods: We compared input data, approaches and results across AP-HRAs over time. Results and input data for each AP-HRA were expressed as a ratio compared to the most recent STE (in most cases STE-2010). Results: Substantial variation across AP-HRAs was found. For all-cause adult mortality attributed to particulate matter (the most frequent outcome-pollutant pair), the ratio in HRAs oscillated from 0.40 to 2.09 (times the STE-2010 value). Regarding input data, the ratio ranged from 0.69 to 1.26 for population exposure, from 0 to 1.81 for counterfactual scenario, from 0.96 to 1.13 for concentration-response function and from 1.03 to 1.13 for baseline health data. Conclusion: This study demonstrates that methods matter for AP-HRAs. Transparent and possibly standardized reporting of key input data and assumptions should be promoted to facilitate comparison of AP-HRAs.

The role of burden of disease assessment in tracking progress towards achieving WHO global air quality guidelines

OBJECTIVES

More than 90% of the global population live in areas exceeding the PM2.5 air quality guidelines (AQGs). We provide an overview of the ambient PM2.5-related burden of disease (BoD) studies along with scenario analysis in the framework of the WHO AQG update on the estimated reduction in the BoD if AQGs were achieved globally.

METHODS

We reviewed the literature for large-scale studies for the BoD attributed to ambient PM2.5. Moreover, we used the latest WHO statistics to calculate the BoD at current levels and the scenarios of aligning with interim targets and AQG levels.

RESULTS

The most recent BoD studies (2010 onwards) share a similar methodology, but there are differences in the input data which affect the estimates for attributable deaths (2.9-8.9 million deaths annually). Moreover, we found that if AQGs were achieved, the estimated BoD would be reduced by up to 50% in total deaths worldwide.

CONCLUSIONS

Understanding the BoD across countries, especially in those that do not align with the AQGs, is essential in order to inform actions to reduce air pollution globally.