Narvaez Clean Air

8/6/2019 Narvaez Clean Air

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HEALTH IMPACT OF AIR QUALITY MANAGEMENTEFFORTS

DESIREE M. NARVAEZ, MD, MPHDEPARTMENT OF HEALTHMANILA, PHILIPPINES


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Air pollution and sperm cellsCzech Republic: 35 young men exposed to high air

pollution due to coal burning power stations and fossilfuels; in 2 years had sperm examined in terms of shape,number, motility, damageSignificant association between exposure to periods of high air pollution ( at or above the US air qualitystandards) and the percentage of sperm with DNAfragmentation---Potentially lead to birth defects or miscarriagesChemicals in air that can cause damage to human DNA( Czech Research Institute and US EPA)


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Save the sperm cellPrevent birth defects or miscarriagesFight air pollution!


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Public Health Monitoring of the MetroManila Air Quality Improvement Sector

Development ProgramADB - WHO - DOH STUDY

2002-2004

3 COMPONENTS:

Health Risk AssessmentEpidemiological StudyHealth Risk Perception


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Attributable number of cases =exposure-response coefficient xexcess exposure level xexposed population x

baseline mortality rates

Exposure-response coefficients:

from time series studiesMorbidity Kunzli et al (US/Eu)Mortality Bangkok study


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Type of Hospital Admissions

AdmissionRate

AttributableCases

Respiratory 1156 20

Cardiovascular 211 4

Estimated number of hospital admissionsper million population in excess of 10ug/m3 PM,Metro Manila, 2002


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P articulate matter ( P M10 and P M2.5 ) andtrophospheric ozone are of serious

concern in Metro Manila. Long term P M10 concentrations likely toviolate National Air Quality (NAQ)guideline of 60 g/m 3. Long and short-term P M2.5 levels maybe unhealthy for the general public. Ozone exceeds short-term guideline

value


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Impact on mortality by 10 g/m 3 P M10reduction in Metro Manila in 2002

35 - 59 fewer deaths per million populationfrom natural causes

5 - 28 fewer deaths per million population

from cardiovascular causes

43 - 49 fewer deaths per million populationfrom respiratory causes


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Impact on morbidity for a uniform reductionof 10 g/m 3 P M10 in Metro Manila in2002

reduction of >23,000 cases of acute bronchitisreduction of >400 cases of asthmareduction of >30 cases of chronic

bronchitis20 respiratory cases per million population4 cardiovascular cases per million

population


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4

8

12

16

20

1991 1992 1993 2000 2003

b l o o d

l e a d

l e v e l ( u g / d l )

lead gasolineblood lead

Lead c o nt e nt o f ga s ol in e a n d m ea n blood lead level s a m o n gchi ld r e n in Me tr o Ma ni la , 1993-2003

N.B. lead in ga s ol in e n o t a ct ual value s bu t hi g h lig ht ed f o r illu str a tio n p u rp o s e o n ly

Sch ool chi ld r e n

Chi ld r e n in hi g h tr a ffic a r ea

Chi ld r e n 0.84

0.6

0.15 0.0 0.0


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Integrated Strategies to Reduce Vehicular Emissions & Improve Air Quality in Metro Manila

Integrated Environmental Strategies ( IES)P hilippines

Manila Observatory with support fromthe US Agency for International Development,

US Environmental Protection Agency and US National Renewable Energy Laboratory

2003-2004


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POLICIES, TECHNOLOGIES,MEASURES

Motor Vehicle Inspection SystemConversion to 4-stroke tricycles

RailwaysDiesel Particulate TrapCompressed Natural Gas - BusesCocoMethyl Ester - JeepneysTraffic Demand ManagementBikeways


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Air Quality Modeling Scheme

Motor Vehicles

F actories,P ower P lants

BackgroundEmissions

Dispersion Model

Air PollutionConcentration

Map

HealthandEconomicCosts


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Health Outcomes Natural MortalityRespiratory MortalityCardiovascular MortalityRespiratory Hospital AdmissionsCardiovascular Hospital AdmissionsAsthma Attacks 15 years oldBronchitis Episodes < 15 years oldChronic Bronchitis > 25 years old


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MORTALITY: Metro Manila

Number of Deaths Averted per Policy scenario

0

100

200

300400

500

600

700

M V I S

C N G B H

C M E J H

R A I L W

A Y S

D I E S E

L T R A P S

B I K E M

M

T C 4 S

T R O K E T D M

C O M B

O - 1

C O M B

O - 2

C O M B

O - 3 200520 10

20 15

TOTALS


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Asthma Attacks


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What is the cost of the health damagesthat can be averted by the

different policy scenarios?Morbidity:

Cost of illness methodWork Loss Days

Mortality:Benefits Transfer

Values are in 1995 pricesP resent Value of Year 2002 EstimatesUsing 12% discount rate for 2005, 2010,2015Orbeta Study and P hilHealth data


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Economic Valuation of the Health Impact per

Policy Scenario (PHP)

0

500

1000

1500

2000

2500

3000

3500

M V I S

C N G B

H

C M E J

H

R A I L W

A Y S

D I E S E

L T R A

P S

B I K E M

M

T C 4 S

T R O K

E T D

M

C O M B

O - 1

C O M B

O - 2

C O M B

O - 3

M i l l i o n s

2005

20 10

20 15

TOTALS


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HEALTH SECTOR

EFFORTS:WAR AGAINSTAIR POLLUTION

THE WAY FORWARD


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Establishment of Health Information System for Air Pollution related Illnesses

Status (on going)1. Identified sentinel health centers within 1 km

distance from DENRs Air monitoring stations

2. Developed data gathering forms/tools for air pollution related illnesses

3. Working with Makati City as pilot LGU for the project

4. Procurement of Computer sets for the GIS of the

health information system.


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Establishment of Health Information System for Air Pollutirelated Illnesses

EMB Air Monitoring StnEMB Air Monitoring Stn

Sentinel sitesSentinel siteshealth center health center

private clinics private clinicshospitalhospital


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F ig. 6.1a Monthly PM 10 Level and ARI Cases, Except Bronchitis andBronchiolitis Cases in 11 Clinics

0

20

40

60

80

100

120

January F ebruary March April May

u g

/ c u m

0

50

100

150

200

250

300

350

400

450

500

N u m

b e r o

f c a s e s

Average P M10 AR I, except bronchitis an d bronchio litis

Relationship between Air Quality and Health Effects

Dummy Table


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HEALTH EFFORTS AGAINST AIR POLLUTION

IEC development

Status (on going)

1. Development of Communication Plan/Strategy

2. Prototype IEC materials (posters, leaflets,TV/radio plugs)


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HEALTH EFFORTS AGAINST AIR POLLUTION

Training on Air Sampling Strategies(to be conducted this Nov)

1. Equipped field personnel on indoor air sampling strategies

2. Development of an indoor air qualityaction plan for each LGU


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Documents

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