Airpollution and HealthERS Booklet Project

• Initiative / Publisher: ERS and ELF

• Project oversight and review: ERS Environmental Health Committee (Chair: Dr. F. Forastieri)

• Authors:

Prof. Nino Kuenzli, Laura Perez and Dr. Regula Rapp

Centre for Research in Environmental Epidemology, CREAL Barcelona, Spain and Insitute for Social and Preventive Medicine Basel, Swizterland

Vision

European physicians and health professionals are respected advocates for

better health

General Background• A causal role of air pollution in morbidity and

mortality - However, European air quality regulation lags far behind WHO targets, thus:

• EU air quality standards tolerate a very large burden for health which could be prevented if air quality was improved

• Air quality in many European cities is worse than Los Angeles, where air quality has improved … !

• EU regulation to be reviewed (political process starts late 2009)

• Opportunity for health professionals to advocate for clean air

New evidence suggests association between long-term exposure to O3 & life expectancy

Jerrett et al, NEJM 2009

Physicians role • European physicians play a strong role in influencing

tobacco laws and smoking behaviour. They ARE good advocates for better health. They can become advocates for clean air.

• Patients have access to correct and false information about health effects of air pollution and protection

• Patients ask what they should do

• Recent evidence suggests that living close to busy roads to be a health hazard –LOCAL concerns and policy discussions.

• While better air quality is the only sustainable solution, people want to know how they can protect themselves and their children

Does living close to traffic cause new-onset of asthma in ADULTS ?

First evidence comes from Europe:

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-10 -7.5 -5 -2.5 0 2.5 5 7.5 10Change in traffic PM10 (ug/m3)

Kuenzli et al, SAPALDIA Study Thorax 2009 – on line

Jacquemin et al, ECHRS Study, Epidemiology 2009

RHINE Study Modig et al, ERJ 2009 – on line

What to tell patients?

Wear a mask?Use air cleaners?Drink more orange juice?Change your genes?Move house?Stop running?

The ERS Booklet Project

• A state-of-the-art easy-to-read, well designed booklet on Air pollution and Health, written and peer reviewed by leading research authorities

• Printed version in English, distributed to all ERS members

• Also available on-line

• Translations and further printed versions by interested parties (funders)?

Structure of Booklet

• 8 Chapters

• Short summary lead text & conclusions in each chapter

• Separate short text boxes on hot topics

• Graphs and Tables

• References for interested readers

• European focus

Content• Background info on pollutants, sources, air

quality in Europe

• Summary on how evidence for health effects is established

• Review of acute and chronic health effects on the lung and other organs

• Benefits of reducing air pollution (‘intervention studies’)

• What can doctors and policy makers do

BENEFITS OF IMPROVED AIR: BENEFITS OF IMPROVED AIR: Respiratory symptom prevalence decreases! Respiratory symptom prevalence decreases!

Schindler et al, - AJRCCM 2009 on line Schindler et al, - AJRCCM 2009 on line

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New reports of regular cough

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6070

8090

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lity(

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-30 -20 -10 0 10 20Change in PM10 (µg/m³)

Persistent reports of regular cough

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-30 -20 -10 0 10 20Change in PM10 (µg/m³)

New reports of wheezing

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2030

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8090

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Pro

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lity(

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-30 -20 -10 0 10 20Change in PM10 (µg/m³)

Persistent reports of wheezing

- improved PM10 increased - improved PM10 increased

Schedule

• English version

– editing: Oct 2009

– printing: Dec 2009

– Dissemination in the Year of the Lung 2010

• Other languages:

• Translation could start as of Sep 2009 + editing / formating

Potential role for National Lung Societies (or other partners)

• Sponsor translation (estimated costs ~5’000€ per language) (pdf for internet)

• Print for X-1000 people

• Lead in local distribution of printed version

• Lead in local dissemination (distribution of reference to online-versions, advertisment etc.)