1. Why is Air Pollution a Global Public Health Problem? Daniel Krewski, PhD, MHA McLaughlin Centre for Population Health Risk Assessment NERAM Colloquium V October 16, 2006 McLaughlin Centre for Population Health Risk Assessment

2. Air Quality Risk Management Colloquium Schedule 2001 University of Ottawa 2002 Johns Hopkins University 2003 Santo Spiroto Hospital, Rome 2005 Mexico Department of Public Health 2006 Wosk Centre for Dialogue, Vancouver McLaughlin Centre for Population Health Risk Assessment

3. Science and Policy for Global Air Quality Management Michal Krzyanowski WHO air quality guidelines Health effects at near ambient levels, which often exceed established guidelines Integration of air quality policy with that in other sectors (energy, climate, transport, agriculture, social) Global approach needed McLaughlin Centre for Population Health Risk Assessment

4. Canada Wide Standards (by 2010) Fine Particulate Matter (PM 2.5 ) – 30 µg/m 3 – 24 hour average Ground Level Ozone (O 3 ) –65 ppb –8-hour average McLaughlin Centre for Population Health Risk Assessment

5. The Global Burden of Disease due to Air Pollution Aaron Cohen CRA: Air pollution in context of other population health risk issues GBD: Cardiopulmonary disease and lung cancer due to PM (Pope et al., 2002) Magnitude: AF of 4 - 5%, 1.6 M deaths annually Uncertainties considered Avoidable burden in 2010 and 2020 McLaughlin Centre for Population Health Risk Assessment

6. GBD Methodology: Cherobyl

7. Air Pollution Health Effects Pyramid severity of effect proportion of population affected hospital admissions mortality emergency room visits physician office visits reduced physical activity medication use respiratory symptoms impaired lung function subclinical (subtle) effects

8. American Cancer Society CPS-II Cohort

9. Ongoing Analyses of ACS Cohort Continued follow-up through to 2002 Identification of critical exposure time windows Intra-urban analyses in Los Angeles and New York City Improved exposure estimates in California: local exposures, land use regression models, population mobility Modeling spatial patterns in air pollution and mortality data McLaughlin Centre for Population Health Risk Assessment

10. 13 Canadian cities 90 U.S. cities, counties or regions 26 European cities or regions Brisbane Sydney Shenyang 7 Korean cities Beijing Mexico City Sao Paulo Santiag o Bangkok + + + + + + + + + Christchu rch + Melbourne Location of studies of air pollution and mortality

11. NERAM Colloquia on Health and Air Quality: Interpreting Science for Decision Makers Interpretation Scientific Data Social IssuesEconomic Issues Poltical IssuesTechnological Issues Science Policy McLaughlin Centre for Population Health Risk Assessment