1. WHO European Centre for Environment and Health HEALTH RISKS OF PARTICULATE MATTER AIR POLLUTION An overview for the 41 st Session of GRPE M. Krzyzanowski WHO ECEH Bilthoven Division

2. Urban Particulate Matter – TEM image of a filter Source: BeruBe et al, in Particulate Matter, ed. Maynard & Howard, BIOS Sc Publ 1999

4. WHO European Centre for Environment and Health WHO Air Quality Guidelines, 2 nd edition Particulate matter (PM10 or PM2.5) “Available information does not allow a judgement to be made of concentrations below which no effects would be expected” “Use risk estimates for standard setting”

5. WHO European Centre for Environment and Health Studies on health impacts of PM Short term changes in pollution level (Time-series; panel) Efects of long-term exposure (cohort studies)

6. WHO European Centre for Environment and Health Health effect estimates per 10  g/m3 increase in 24-h mean PM10 concentrations Source: WHO AQG 2 nd ed.

7. WHO European Centre for Environment and Health Questions in interpretation of studies on short-term impacts of PM Physiopathological mechanism of effects? Extent of displacement of time of health effect? Harvesting?

8. WHO European Centre for Environment and Health Recent studies on effects of PM on cardiovascular system Increase in blood viscosity in days with high PM (Peters et al, 1997; no effect in Seaton et al 1999) Increased heart rate associated with increased PM level (Stone & Godleski 1999, Peters et al, 1999, Pope et al. 1999) Incidence in cardiac arrhythmia and PM level (Peters et al, 2000)

9. Estimated effect of a 10 µg/m3 increase in PM2.5 Source: Schwartz, Am J Epi 2000

10. WHO European Centre for Environment and Health WHO -AQG

11. WHO European Centre for Environment and Health Relative risk of mortality by cause of death Re-analysis of US cohort studies RR 6-cities Study* ACS Study** * Per 18.6 µg/m3 PM2.5 ** Per 24.5 µg/m3 PM2.5 Source: HEI 2000

12. RR for all cause mortality in ACS Study Re-analysis of US cohort studies Source: HEI 2000

13. WHO European Centre for Environment and Health % increase in mortality per 10 µg/m3 PM10 by PM2.5 / PM10 ratio Meta-analysis of 19 US time-series studies Source: Levy et al, 2000 % PM2.5/PM10

14. WHO European Centre for Environment and Health Inflammogenic properties of carbon black particles by particle size Source: Donaldson et al., 1999 % neutrophils in BAL 14 nm 50 nm 260 nm

15. Effects of different size of ultrafine and fine PM on daily mortality, Erfurt, 1995-8 Source: Spix et al, 2000 Best 1 day lag / distributed lag model

16. WHO European Centre for Environment and Health Estimated contribution of the main sources to PM emissions in Europe*) in 1993 Source: Holman et al, 1999 *) excluding former Soviet Union

17. WHO European Centre for Environment and Health Ambient concentrations of ultrafine (UP) and fine (FP) particles Source: Wichmann & Peters 2000 UP = NC 0.01 – 0.1; FP = MC 0.01 – 2.5  PM2.5 ErfurtSachsen-Anhalt

18. WHO European Centre for Environment and Health 1) All deaths except accidents

19. WHO European Centre for Environment and Health

20. Number of cases attributable to air pollution in France per year (Künzli et al., Lancet 2000; 356:795-801) Health outcomeCases95% CI Mortality (long term st.), adults>30y3170019200 - 44400 Respiratory hospital admissions138001400 – 26300 Cardiovascular hospital admissions1980010400 – 29400 Chronic bronchitis incidence (>25y)367003300 – 73100 Bronchitis (<15 y)450000198500 – 813600 Restricted activity days (>20y) (million)26.420.7 – 28.5 Asthma attacks (<15 y) (person-days)243000149000 - 337000 Asthma attacks (>15 y) (person-days)577000281000-879000

21. WHO European Centre for Environment and Health CONCLUSIONS PM is associated with a wide range of health effects, with significant public health consequences Significant role of fine PM Role of ultrafine particles – to be studied

22. WHO European Centre for Environment and Health Understanding the Health Effects of Particulate Air Pollution: Recent Advances and Outstanding Questions A Meeting for Members of Government, Industry and the General Public Organized by WHO and HEI in cooperation with EC DG Environment Brussels, 6-7 March 2001 Information: mkr@who.nl or rokeefe@healtheffects.orgmkr@who.nl