Evidence-based public health policy and practice: Reducing ambient levels of fine particulates could substantially improve health: a mortality impact assessment for 26 European cities

• Published in: Journal of epidemiology and community health (1979) Vol. 62; no. 2; pp. 98 - 105
• Main Authors: Ballester, Ferran, Medina, Sylvia, Boldo, Elena, Goodman, Pat, Neuberger, Manfred, Iñiguez, Carmen, Künzli, Nino
• Format: Journal Article
• Language: English
• Published: BMJ Publishing Group 01.02.2008
• Subjects: Air pollution; Air quality; Community health; Death; Epidemiology; Health policy; Medical practice; Mortality; Particulate matter; Public health
• ISSN: 0143-005X; 1470-2738

Recently new European policies on ambient air quality—namely, the adoption of new standards for fine particulate matter (PM₂̣₄), have generated a broad debate about choosing the air quality standards that can best protect public health. The Apheis network estimated the number of potential premature deaths from all causes that could be prevented by reducing PM2.5 annual levels to 25 μg/m³, 20 μg/m³, 15 μg/m³ and 10 μg/m³ in 26 European cities. The various PM₂̣₄ concentrations were chosen as different reductions based on the limit values proposed by the new European Directive, the European Parliament, the US Environmental Protection Agency and the World Health Organization, respectively. The Apheis network provided the health and exposure data used in this study. The concentration-response function (CRF) was derived from the paper by Pope ef al (2002). If no direct PM₂̣₄ measurements were available, then the PM₁₀ measurements were converted to PM₂̣₄ using a local or an assumed European conversion factor. We performed a sensitivity analysis using assumptions for two key factors—namely, CRF and the conversion factor for PM₂̣₄. Specifically, using the "at least" approach, in the 26 Apheis cities with more than 40 million inhabitants, reducing annual mean levels of PM₂̣₄ to 15μg/m could lead to a reduction in the total burden of mortality among people aged 30 years and over that would be four times greater than the reduction in mortality that could be achieved by reducing PM₂̣₄ levels to 25 (1.6% vs 0.4% reduction) and two times greater than a reduction to 20 μg/m³. The percentage reduction could grow by more than seven times if PM₂̣₄ levels were reduced to 10 μg/m³ (3.0% vs 0.4%). This study shows that more stringent standards need to be adopted in Europe to protect public health, as proposed by the scientific community and the World Health Organization.