HIA of Particulate Pollution in Tallinn Using Fine Spatial Resolution and Modelling Techniques

8/14/2019 HIA of Particulate Pollution in Tallinn Using Fine Spatial Resolution and Modelling Techniques

1/35

This Provisional PDF corresponds to the article as it appeared upon acceptance. Fully formaPDF and full text (HTML) versions will be made available soon.

Health impact assessment of particulate pollution in Tallinn using fine sparesolution and modelling techniques

Environmental Health 2009, 8:7 doi:10.1186/1476-069X-8-7

Hans Orru ([email protected])Erik Teinemaa ([email protected])

Taavi Lai ([email protected])Tanel Tamm ([email protected])

Marko Kaasik ([email protected])Veljo Kimmel ([email protected])Kati Kangur ([email protected])

Eda Merisalu ([email protected])Bertil Forsberg ([email protected])

Environmental Health
mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]


2/35

HealthimpactassessmentofparticulatepollutioninTallinnusingfine

spatialresolutionandmodelingtechniques

HansOrru1,2*,ErikTeinemaa3,TaaviLai1,TanelTamm4,MarkoKaasik5,VeljoKimmel6,

KatiKangur7,EdaMerisalu1,BertilForsberg2

1DepartmentofPublicHealth,UniversityofTartu,Ravila19,Tartu50411,Estonia

2DepartmentofPublicHealthandClinicalMedicine,UmeaUniversity,UmeaSE-90187,

Sweden

3EstonianEnvironmentalResearchCentre,Marja4d,Tallinn10617,Estonia

4DepartmentofPhysics,UniversityofTartu,Riia142,Tartu50414,Estonia

5


3/35

KK:[email protected]

EM:[email protected]

BF:[email protected]


4/35


5/35

be0.64(95%CI0.171.10)years.Whileinthepollutedcitycentrethismayreach1.17

years,intheleastpollutedneighborhoodsitremainsbetween0.1and0.3years.When

dividingtheYLLbythenumberofprematuredeaths,thedecreaseinlifeexpectancy

amongtheactualcasesisaround13years.Asforthemorbidity,theshort-termeffectsof

airpollutionwereestimatedtoresultinanadditional71(95%CI43104)respiratoryand

204(95%CI131260)cardiovascularhospitalizationsperyear.Thebiggestexternalcosts

arerelatedtothelong-termeffectsonmortality:thisisonaverage150(95%CI40260)

millionannually.Incomparison,thecostsofshort-termair-pollutiondriven

hospitalizationsaresmall0.3(95%CI0.20.4)million.

Conclusions

SectioningthecityforanalysisandusingGISsystemscanhelptoimprovetheaccuracyof


6/35

Background

Healthimpactassessment(HIA)isacombinationofprocedures,methodsandtoolsby

whichapolicy,programmeorprojectmaybeevaluatedbasedonitspotentialeffectson

thehealthofapopulation,andthedistributionofthoseeffects[1].Knowledgeofthe

exposure,baselinemortalityormorbidityinthepopulationaswellasexposure-response

functionsfromepidemiologicalstudieshelpsustoestimatetrendsinnegativehealth

effectsassociatedwithalternativescenarios.

OneofthefirstimportantairpollutionHIAwasconductedbyKnzlietal.[2].Thisstudy

estimatedtheimpactoftrafficparticulatepollutantsinAustria,FranceandSwitzerland

whichwerefoundtocause40000prematuredeaths,25000newcasesofchronic


7/35

deaths.Theaveragelifeexpectancyatbirthwouldincreasemorethan2yearsinheavily

pollutedcitieslikeBucharest,Rome,TelAviv[9].IftheWHOairqualityguidelines

(PM2.5annually


8/35

duetoprematuremortalityand29billionfrommorbidity.Thisrepresentsmorethan1%

oftheUnionsGDPin2005[13].Itisalsoimportanttonotethatthemajorityofthe

morbidity-relatedexternalcostsfromairpollutionarerelatedtothepublichealthsector

andnottothehealthcaresector[17].

EventhoughseveralindicatorshavebeenusedforHIAs,themaingoalistoquantifythe

negativeeffectsofriskfactorsandprovideguidelinesforpolicymakers,developers,

planners,etc.,toassisttheminthemitigationofnegativehealtheffectsbydecreasing

exposuretoairpollution.

Tallinn


9/35

Methods

InthecurrentHIAstudy,dataonpopulation,baselinemortalityandmorbidity,air

pollutionexposure,exposure-responsefunctions,socio-economicalconditionandhealth-

careexpensesweregatheredandanalyzed.

Baselinepopulation,mortalityandmorbiditydata

PopulationdataforTallinnisbasedonthePopulationRegister(02.02.2007)accordingto

addressandregistrationinthefollowingagegroups:06,717,1827,2837,3847,48

57,5867,68+years.Thecitizensresidencesweredividedintosectionsaccordingto

neighborhoods(regionswithsimilargeographical,socio-economic,etc.,patterns),

formingsmalladministrativeunits(smallerthancitydistricts)usedincityplanningand


10/35

cardiovascular(I00I99)andrespiratorycauses(J00J99).Cardiacadmissions(I20I25)

andcerebrovascularadmissions(I60I69)werealsousedfortheexposure-responsework

oncardiovascularhospitalizations.Theshort-termeffectsofhighpollutionlevelson

mortalitywerenotcalculatedseparatelyasaccordingtoseveralauthors[2,9,16]theseare

alreadyincludedinexposure-responsefunctionoflong-termmortality.

Exposureassessment

Theannuallevelsoflocally-emittedPM2.5,aswellasPM10formodelvalidationwere

estimatedusingmodelAirViro[20],basedonemissiondatafortraffic,industry,localand

centralheatingalongwithmeteorologicalparameterswithgridresolution200x200meters.

Adatabaseoflocalheatingemissionswasdevelopedduringthecurrentstudy,usinga


11/35

trainspassingbyonadailybasis.Ineachmonitoringstation,theconcentrationofPM10is

routinelymeasuredbybeta-attenuationanalyzers(ThermoAndersenFH-62).Inthe

ismestation,thePM10levelsaremeasuredbythereferencemethod(DigitelDHA-80)

aswell.ThePM2.5levelismonitoredonlyattheismestation,andthisisdonebybeta-

attenuationanalyzer(ThermoAndersenFH-62).

TheannuallevelsofPM2.5werecalculatedforall84Tallinnsectionsusingtheaverage

concentrationofmodeledgridcellsinasection.Theaverageconcentrationforeach

sectionwasthenassignedtoallresidentsofthatneighborhood.Onlyindividualsofage

28+wereincludedinanalyses,astheUScohortstudy[23].


12/35

Thecases(mortalityandmorbidity)werecalculatedinabsoluteandrelativenumbersfor

allsectionsinTallinn.Thefollowingequationwasused:

)1()( = XO epopYY

whereY0isthebaselinerate;popthenumberofexposedpersons;theexposure-response

function(relativerisk)andXtheestimatedexcessexposure.

ThenumberofYLLwascalculatedusinglife-tablesmethodology,wherethe

hypotheticallifeexpectancyiscomparedwiththelifeexpectancyaffectedbyairpollution.

ThecalculationofYLLandchangesinlifeexpectancywerefacilitatedbyaWHOCentre

forEnvironmentandHealthdevelopedprogramAirQ2.2.3(AirQualityHealthImpact

AssessmentTool)[26].Forcalculationofhospitalizations,theshort-termeffectsmodule


13/35

Forthecountryasawholeanditsdevelopmentprospects,thelong-termoutcomesand

costsofairpollutioneffectsareevenmoreimportantthanthedirectcosts.Thismeansthat

inacaseofprematuredeath,peoplecanlosedecadesoflife-yearsbutdirectcostsappear

onlyintheactualyearofdeath.TheconceptofStatisticalValueofLife(SVL)andValue

OfLifeYear(VOLY)areusedtoexpressthecostoflostlivesandlife-years.These

conceptsstemfrompeoplescontributiontoGDP,typicalworktime,salaryand

sometimeshealthcare(compensationanddecreasedproductivity)costs[28,29].Asthere

arenocomprehensivestatisticallifevaluationstudiesinEstonia,theconversion

coefficientbetweenGDPandthestatisticalvalueoflifewasderivedfrominternational

meta-analyses(statisticalvalueoflifebeingonaverageequalto120timesGDPper

capitainacountry)[30,28].Valueofalifeyearwascalculatedfromthestatisticalvalue


14/35

Results

Baselinepopulation,mortalityandmorbiditydata

Altogether,388964registeredresidentsofTallinnwereidentifiedin84sectionsofthe

city.Population-wisethebiggestsectionshadmorethan15000residentswhilesomeof

thesmallesthadlessthan100.Thepopulationdensityvariedagreatdealaswell.Inthe

majorityofsections,thenumberofresidentsrangedfrom3000to16000.

Basedonmortalitydata,themortalityratesindifferentagegroupswerefound(average

1136casesper100000citizensperyear)andthenumberswerecalculatedinall84

sectionsforthereferenceyear2006.Thebaselinehospitalizationratesweredetermined

separatelyforcardiovascularandrespiratoryadmissionsper100000peopleusingthe

sameprinciples.Theanalysisshowed3945and1266annualadmissioncases


15/35

(localsourcesandregionalbackground).SincewefoundthatTallinnitselfcontributes

approx0.4g/m

3

totheunknownregionalbackground,itwassubtractedfromthe

modeledexposurevaluesinordertocalculatehealthimpactsonlyassociatedwiththe

levelsabovethoseoutsidethecity.

ThedifferencebetweenmodeledandmeasuredmeanPM2.5valuesinismestationwas

21%in2006(Fig.2).The23g/m3variationinPM2.5annualvaluesfromthemodel

indicatesasomewhatlowerbackgroundthanexpected.Theaveragedifferenceforall

threemonitoringstationsabovemodeledPM10levelsoverthreeyearsmeasurementswas

18.8%.ThebiggestdifferencewasinRahumonitoringstation,whichisclosetoarailway

withdiesellocomotivesandlessknownemissions,wheremeasuredandmodeledPM10


16/35

Healthimpacts

Assomeneighborhoods(sections)hadveryfewdeaths,theestimatednumberof

prematuredeathsattributedtotheadditional(local)particlepollutionispresentedatthe

levelofcitydistrict(Table1),whereasYLLisgivenatthelevelofneighborhoodsection

(Fig.3).

Ouranalysisshowsthatlocallyemittedairpollutantscouldbeestimatedtocause296

(95%CI76528)prematuredeathsperyearinTallinn.AccordingtotheAirQcalculations

usinglifetablesthesedeathscorrespondto3859(95%CI10236636)YLL,whichis

988YLLper100000citizens.Asatotalnumber,thegreatestloss(235650YLL)wasin

neighborhoodswithalargenumberofcitizens(2500050000),e.g.,Mustame,


17/35


18/35

Discussion

Exposureassessmentandbenefitsfrommethodologicaladvances

WhilethemethodologyforHIAinthisstudyfollowsgenerallyacceptedprinciples[31],

majordifferenceshavebeenfoundintheexposureassessments.InthecaseofTallinn,air

pollutionhasbeenmeasuredinonly3monitoringsites.Thus,itwasnecessarytouse

dispersionmodelingtogainanadequatelevelofdetailforexposureassessmentbycity

sections.Themodelvalidationshowedfairlygoodagreementwiththemonitoredlevels,

althoughthemodelgenerallyunderestimatedtheparticleconcentrations.Thereasonsfor

thismaybethelackofabackgroundconcentrationandanincompleteemissiondatabase;

forexamplethehighlevelsofPMmeasuredatspringtimebecauseofroaddust.


19/35

Theplaceofresidencewasusedastheexposurepositionpresumingthatthegreatest

portionofthedayisspentthere.Thisissimilartootherepidemiologicalstudiesfrom

whichexposure-responsecoefficientsweretaken.Furthermore,siteofdwellingwasthe

onlydataavailablefromthepopulationregister.Theamountoftimeapersonspendsin

theresidenceareaandoutsideofit(work,studies,etc.)affectsindividualexposurelevels,

howevercurrentmethodologydoesnotpermitconsiderationofthesevariations.Neither

couldtheybeconsideredinthestudiesprovidingourexposure-responsefunctions.When

doinganalysiswithsuchaccuracy(whichispossiblewithmodeling),individualfactors

suchasahomesexactdistancefromthestreet,otherpollutionsources,individual

sensibilitytopollutants,etc.couldplayanimportantrole.


20/35

Questionsmayariseaboutthepossibilityofover(under)estimationofthehealthimpacts.

Themainbasisforoverestimationisthehighbaselinemortalityrate(drivenbyexternal

causes)inEstonia.Thismagnifiestherelativeexposureimpact.Ifthehealthofthe

populationisgenerallyweak,theresidentscouldlikelybemoresensitivetoairpollution.

Insomecases,asintheReshetin&Kazazyanstudy,whereairpollutionwassaidtocause

1517%ofmortalityinRussia[33],thehealthimpactsareprobablyoverestimated

becauseofveryhighbase-linemortality(toalargeextentrelatedtoalcoholconsumption).

Ofcourse,weshouldnotbetooconservativeinourestimations.InHelsinki,wheretheair

pollutioninfluenceofbusseswasassessed,theresultscouldbeunderestimatedbecause

onlyexhaustparticles,whichareseenasmoretoxic,weretakenintoaccount[34].


21/35

influenceonhealthrecognizedwhenNO2wastheindicator[36].Thismeansthatwemay

haveunderestimatedthepollutionimpactinthecitycentre.OnepossibilitywouldbetoconductHIAswithseveralpollutants,sothatalternativeexposureratescenarioscouldbe

designed.However,asimpleadditionoftheeffectsofdifferentpollutantswouldleadto

overestimationandwouldbemethodologicallywrong.

Thefourthcriticalissueistheexposuredataincombinationwithanyassumedthreshold

levelofhealtheffects.Studieshaveshownthatfineparticulatemattercancausenegative

effectsonconcentrationsbelowcurrentlimitvalues[37].Inprinciple,wehaveassumed

thatthelocalcontributionhasthemainimpact.Thebackgroundconcentrationisoften

usedasthereferenceconcentration.However,asthebackgroundisherepresumed(as

3


22/35

Theaveragelossoflifeexpectancy(atbirth)estimatedhereisslightlyless(7.7months)thantheaverageofallEUcitizens(8.6months)[13].Therateofprematuredeaths

(76/100000)isalmostthesameastheECstudywhichshowed75/100000amongEU-25

residents[12].

Thetotalexternalcostsofairpollutionestimatedhereat150.3millionmakeup2.9%of

theTallinnGDP(in2005).ThisissomewhatsmallercomparedtofindingsfromRussia

2.66.5%[14]andBeijing6.55%[38],whichareofcoursemuchmorepolluted.But

comparedtothe1.5%forEurope(WHOassessment),itisslightlyhigher[13].Themain

reasonforthatmightbequitehighdecreaseoflifeexpectancyperprematuredeathcase.


23/35

Conclusions

Tosomeextent,allthecitizensofTallinnareaffectedbypoorairquality.Eventhoughthe

levelsonparticulatesarenotlarge,stillthenegativehealtheffectsappear.Altogether,296

prematuredeathsperyearand3859YLL,anaveragelossof7.7monthslifeexpectancy

and275hospitaladmissionsduetoairpollutionmakeparticlepollutionasignificant

environmentalhealthissueinTallinn.Peoplesufferingfromchronicdiseasesshouldbe

informedabouttheairqualityindifferentregions,sothattheycouldavoidtheseareas.

Effortsshouldbedirectedtoimprovethesituationsinthemorepollutedsections.

Themethodologyweusedhelpedtoassessthehealthimpactsofairpollutioninatown

withasparsemonitoringnetworkbutwheredispersionmodelingwasavailable.


24/35

Competinginterests

Theauthorsdeclarethattheyhavenocompetinginterests.

Authors'contributions

HOandBFdevelopedtheoverallconceptofcurrentHIAmethodology;ETconducted

dispersionmodeling;TLmadeeconomicevaluationanddeterminedbaselinehealthdata;

TTmadeGISdesigns;MKandVKimprovedpollutionemissiondatabase;EM

contributedtogeneralhealthimpactbackgroundanalysis;KKcontributedtothe

interpretationoftheanalysisresultsandtheirapplicabilityinurbanriskregulation,and

HO performed most of the analyses and drafted the manuscript. All authors have read and


25/35

References

1. WismarM,BlauJ,ErnstK,FiguerasJ,(Eds):TheEffectivenessofHealthImpact

Assessment.Scopeandlimitationsofsupportingdecision-makinginEurope.

Copenhagen:WHO;2007.

2. KnzliN,KaiserR,MedinaS,StudnickaM,ChanelO,FilligerP,HerryM,Horak

F,Puybonnieux-TexierV,QuenelP,SchneiderJ,SeethalerR,VergnaudJC,

SommerH:Public-healthimpactofoutdoorandtraffic-relatedairpollution:a

Europeanassessment.Lancet2000,356:795-801.

3. BrunekreefB:Airpollutionandlifeexpectancy:istherearelation?Occup

EnvironMed1997,54:781-784.

4. PopeCAIII:Epidemiologyoffineparticulateairpollutionandhumanhealth:


26/35

9. BoldoE,MedinaS,LeTertreA,HurleyF,MckeHG,BallesterF,AguileraI,

EilsteinD:Apheis:Healthimpactassessmentoflong-termexposuretoPM2.5

in23Europeancities.EurJEpidemiol2006,21:449-458.

10.BallesterF,MedinaS,BoldoE,GoodmanP,NeubergerM,IniguezC,KnzliN,

onbehalfoftheApheisnetwork:Reducingambientlevelsoffineparticulates

couldsubstantiallyimprovehealth:amortalityimpactassessmentfor26

Europeancities.JEpidemiolCommunityHealth2008,62:98-105.

11.COMM:CommissionStaffWorkingPaper.Annexto:Thecommunicationon

thematicstrategyonairpollutionandthedirectiveon"ambientairqualityand

cleanerairforEurope".ImpactAssessmentCommissionoftheEuropean

Communities.Brussels;2005.


27/35

16.ForsbergB,HanssonHC,JohanssonC,AreskougH,PerssonK,JrvholmB:

Comparativehealthimpactassessmentoflocalandregionalparticulateair

pollutantsinScandinavia.AMBIO2005,34:11-19.

17.ExternE:ExternalitiesofEnergy:Methodology2005Update.

[http://www.externe.info/brussels/methup05a.pdf]

18.PopeCAIII,DockeryDW:Healtheffectsoffineparticulateairpollution:lines

thatconnect.JAir&WasteManageAssoc2006,56:709-742.

19.NelA:Airpollution-relatedillness:effectsofparticles. Science2005,308:804-

806.

20.AirViro[http://www.indic-airviro.smhi.se]

21.KaasikM,OrruH,TekkelE,ValsP:Situationandtendenciesinairqualityina


28/35

25.DepartmentofHealth:Cardiovasculardiseaseandairpollution.Areportbythe

CommitteeontheMedicalEffectsofAirPollutants.UK;2006.26.AirqualityhealthimpactassessmentsoftwareAirQ2.2.3.

[http://www.euro.who.int/air/activities/20050223_5]

27.Haigekassa:Majandusaastaaruanne2005.Tallinn;2006.

[http://www.haigekassa.ee/files/est_haigekassa_aruanded/aruanne2005.pdf]

28.SjbergK,Haeger-EugenssonM,ForsbergB,AsrmS,HellstenS,TangL:

QuantificationofPopulationExposuretoNitrogenDioxideinSweden2005.

Stockholm:SwedishEnvironmentalResearchInstitute;2007.

29.OECD:Cost-BenefitAnalysisandtheEnvironment:RecentDevelopments.Paris;

2006.


29/35

35.JerrettM,BurnettRT,MaR,PopeIIICA,KrewskiD,NewboldKB,ThurstonG,

ShiY,FinkelsteinN,CalleEE,ThunMJ:Spatialanalysisofairpollutionand

mortalityinLosAngeles.Epidemiology2005,16:1-10.

36.TonneC,BeeversS,ArmstrongB,KellyF,WilkinsonP:Modeledairpollution

andmortalitybenefitsoftheLondoncongestioncharge:Spatialandsocial

inequalities.Epidemiology2007,18(SupplS):36-37.

37.WHO:AirQualityGuidelines.GlobalUpdate2005.ParticulateMatter,Ozone,

NitrogenDioxideandSulfurDioxide.Copenhagen;2006.

38.ZhangM,SongY,CaiX:Ahealth-basedassessmentofparticulateair

pollutioninurbanareasofBeijingin2000-2004.SciTotalEnviron2007,

376:100-108.


30/35

Figures

Figure1-Modeled(200x200mgrid)annualaverageconcentrationofPM2.5

inTallinn,g/m3.

Figure2-MeasuredandmodeledPM10yearlyaverageinmonitoring

stations.

Figure3-ThetotalnumberofYLLduetoPM2.5pollutioninTallinn.

Figure4-Decreaseoflife-expectancyduetoPM2.5pollutioninTallinn.


31/35

Pirita 13192 6.4 5(18) 0.38(0.080.61) 0.36(0.090.61)

Phja-Tallinn

53621 9.3 33(959) 0.62(0.171.10) 0.52(0.140.89)

Total 388964 11.6296(76528)

0.76(0.201.36) 0.64(0.171.10)


32/35

Figure 1


33/35


34/35

Figure 3


35/35

Figure 4

HIA of Particulate Pollution in Tallinn Using Fine Spatial Resolution and Modelling Techniques

Documents

Transcript of HIA of Particulate Pollution in Tallinn Using Fine Spatial Resolution and Modelling Techniques