1. ENVIRONMENT & HEALTH INDICATORS FOR EUROPE: A PILOT STUDY OF INDICATORS OF AIR POLLUTION & HEALTH D Dalbokova, 1 M Sadeh, 2 M Krzyzanowski, 1 P Wilkinson 2 for the Environment & Health Indicators Project Group 1 WHO European Centre for Environment & Health, Bonn 2 London School of Hygiene & Tropical Medicine

2. BACKGROUND Pilot of selected countries of WHO-European region Data on air pollution & health impacts Policy focus Three purposes: - monitoring - evaluating - formulating

3. OBJECTIVE To test the methods and systems for reporting indicators of air pollution and health and their usefulness to policy makers

4. ANALYSES (1)trends over time in emissions, pollution levels and upstream determinants (2)between-population comparisons of exposures and health impacts (3)the potential for reducing air pollution health impacts from realistic policy interventions

5. TRENDS & BETWEEN- POPULATION COMPARISONS

7. TRENDS IN DIESEL CONSUMPTION BY COUNTRY

9. TRENDS IN INDICATORS, CZECH REPUBLIC

11. HEALTH IMPACT

12. YEARS OF LIFE LOST CALCULATION Quantitative risk assessment methods AirQ 2.0.4 Country/population specific data: life tables ambient pollution (policy data) Exposure-response relationships from published literature Sensitivity analyses

14. Czech republic Germany Hungary Israel Netherlands Spain Switzerland 0 20 40 60 80 YLL per 10^5 population 051015202530 PM2.5 (population weighted), µg.m-3 YLL/100,000 in starting year of simulation

15. Czech republic Germany Hungary Israel Netherlands Spain Switzerland 0 2000 4000 6000 8000 YLL per 10^5 population 051015202530 PM2.5 (population weighted) / µg.m-3 YLL/100,000 in first 10 years

16. Czech republic Germany Hungary Israel Netherlands Spain Switzerland.4.6.8 1 Loss of life expectancy 051015202530 PM2.5 (population weighted) / ug.m-3 Loss of life expectancy from age 30

17. ASSESSING POLICIES Realistic potential for change from policy interventions: (i)assume specified reductions in ambient pollutant concentrations (ii)estimate the effects of particular types of policy intervention on exposures to outdoor pollution  for example from restriction of urban vehicle traffic.

18. Emissions Exposures (ambient concentrations) Health impacts Effect of policy intervention (measured/modelled) Decision process Costs Preferences

19. CONCLUSIONS Standardized data collection & analysis Comparisons useful, even with uncertainties Greatest utility if results linked to policy questions – modelling Ideal for the future further data on upstream determinants more countries addition of evidence on effect of interventions decision support framework or model