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Airpollution and HealthERS Booklet Project
• Initiative / Publisher: ERS and ELF
• Project oversight and review: ERS Environmental Health Committee (Chair: Dr. F. Forastieri)
• Authors:
Prof. Nino Kuenzli, Laura Perez and Dr. Regula Rapp
Centre for Research in Environmental Epidemology, CREAL Barcelona, Spain and Insitute for Social and Preventive Medicine Basel, Swizterland
General Background• A causal role of air pollution in morbidity and
mortality - However, European air quality regulation lags far behind WHO targets, thus:
• EU air quality standards tolerate a very large burden for health which could be prevented if air quality was improved
• Air quality in many European cities is worse than Los Angeles, where air quality has improved … !
• EU regulation to be reviewed (political process starts late 2009)
• Opportunity for health professionals to advocate for clean air
New evidence suggests association between long-term exposure to O3 & life expectancy
Jerrett et al, NEJM 2009
Physicians role • European physicians play a strong role in influencing
tobacco laws and smoking behaviour. They ARE good advocates for better health. They can become advocates for clean air.
• Patients have access to correct and false information about health effects of air pollution and protection
• Patients ask what they should do
• Recent evidence suggests that living close to busy roads to be a health hazard –LOCAL concerns and policy discussions.
• While better air quality is the only sustainable solution, people want to know how they can protect themselves and their children
Does living close to traffic cause new-onset of asthma in ADULTS ?
First evidence comes from Europe:
-10
-7.5
-5
-2.5
0
2.5
5
Log
Haz
ard
-10 -7.5 -5 -2.5 0 2.5 5 7.5 10Change in traffic PM10 (ug/m3)
Kuenzli et al, SAPALDIA Study Thorax 2009 – on line
Jacquemin et al, ECHRS Study, Epidemiology 2009
RHINE Study Modig et al, ERJ 2009 – on line
What to tell patients?
Wear a mask?Use air cleaners?Drink more orange juice?Change your genes?Move house?Stop running?
The ERS Booklet Project
• A state-of-the-art easy-to-read, well designed booklet on Air pollution and Health, written and peer reviewed by leading research authorities
• Printed version in English, distributed to all ERS members
• Also available on-line
• Translations and further printed versions by interested parties (funders)?
Structure of Booklet
• 8 Chapters
• Short summary lead text & conclusions in each chapter
• Separate short text boxes on hot topics
• Graphs and Tables
• References for interested readers
• European focus
Content• Background info on pollutants, sources, air
quality in Europe
• Summary on how evidence for health effects is established
• Review of acute and chronic health effects on the lung and other organs
• Benefits of reducing air pollution (‘intervention studies’)
• What can doctors and policy makers do
BENEFITS OF IMPROVED AIR: BENEFITS OF IMPROVED AIR: Respiratory symptom prevalence decreases! Respiratory symptom prevalence decreases!
Schindler et al, - AJRCCM 2009 on line Schindler et al, - AJRCCM 2009 on line
a
05
1015
2025
30P
roba
bilit
y(%
)
-30 -20 -10 0 10 20Change in PM10 (µg/m³)
New reports of regular cough
b
010
2030
4050
6070
8090
100
Pro
babi
lity(
%)
-30 -20 -10 0 10 20Change in PM10 (µg/m³)
Persistent reports of regular cough
c
05
1015
20P
roba
bilit
y(%
)
-30 -20 -10 0 10 20Change in PM10 (µg/m³)
New reports of wheezing
d
010
2030
4050
6070
8090
100
Pro
babi
lity(
%)
-30 -20 -10 0 10 20Change in PM10 (µg/m³)
Persistent reports of wheezing
- improved PM10 increased - improved PM10 increased
Schedule
• English version
– editing: Oct 2009
– printing: Dec 2009
– Dissemination in the Year of the Lung 2010
• Other languages:
• Translation could start as of Sep 2009 + editing / formating
Potential role for National Lung Societies (or other partners)
• Sponsor translation (estimated costs ~5’000€ per language) (pdf for internet)
• Print for X-1000 people
• Lead in local distribution of printed version
• Lead in local dissemination (distribution of reference to online-versions, advertisment etc.)