Tài liệu Health effects of transport-related air pollution ppt

The WHO Regional Offi ce for Europe The World Health Organization (WHO) is a specialized agency of the United Nations created in 1948 with the primary responsibility for international health matters and public health. The WHO Regional Offi ce for Europe is one of six regional offi ces throughout the world, each with its own programme geared to the particular health conditions of the countries it serves. Member States Albania Andorra Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Finland France Georgia Germany Greece Hungary Iceland Ireland Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco Netherlands Norway Poland Portugal Republic of Moldova Romania Russian Federation San Marino Serbia and Montenegro Slovakia Slovenia Spain Sweden Switzerland Tajikistan The former Yugoslav Republic of Macedonia Turkey Turkmenistan Ukraine United Kingdom Uzbekistan ISBN 92-890-1373-6 While transport is a vital part of modern life, policy- makers in the WHO European Region face the diffi cult challenge of both reducing the related risks to health and the environment and meeting countries’ require- ments for effective transport systems. Diseases related to the air pollution caused by road transport affect tens of thousands of people in the Region each year. Policies for more effective action need to be based on a better understanding of the determinants of exposure and the role of various pollutants in harming health. This book helps to meet this need. It provides a sys- tematic review of the literature and a comprehensive evaluation of the health hazards of transport-related air pollution. The review addresses: factors determining emissions, the contribution of traffi c to pollution levels, human exposure and the results of epidemiological and toxicological studies to identify and measure the health effects. This book is designed for two main audiences: policy- makers and experts in transport-related air pollution and public health. Accordingly, it offers both summary information for the former and full discussion, primarily for the latter. A separate summary for policy-makers is also available. For both groups, this book identifi es the key facts emerging from the accumulated evidence, and uses them to suggest both topics for further research and well-justifi ed short-term action to protect health. It can help both groups play their part in making and implementing transport policies in the European Region that maximize the benefi ts to health. World Health Organization Regional Offi ce for Europe Scherfi gsvej 8, DK-2100 Copenhagen Ø, Denmark Tel.: +45 39 17 17 17. Fax: +45 39 17 18 18. E-mail: postmaster@euro.who.int Web site: www.euro.who.int Health effects of transport-related air pollution The World Health Organization was established in 1948 as the specialized agency of the United Nations responsible for directing and coordinating authority for international health matters and public health. One of WHO’s constitutional functions is to provide objective and reliable information and advice in the fi eld of human health. It fulfi ls this responsibility in part through its publications programmes, seeking to help countries make policies that benefi t public health and address their most pressing public health concerns. The WHO Regional Offi ce for Europe is one of six regional offi ces throughout the world, each with its own programme geared to the particular health problems of the countries it serves. The European Region embraces some 870 million peo- ple living in an area stretching from the Arctic Ocean in the north and the Medi- terranean Sea in the south and from the Atlantic Ocean in the west to the Pacifi c Ocean in the east. The European programme of WHO supports all countries in the Region in developing and sustaining their own health policies, systems and programmes; preventing and overcoming threats to health; preparing for future health challenges; and advocating and implementing public health activities. To ensure the widest possible availability of authoritative information and guidance on health matters, WHO secures broad international distribution of its publications and encourages their translation and adaptation. By helping to promote and protect health and prevent and control disease, WHO’s books contribute to achieving the Organization’s principal objective – the attainment by all people of the highest possible level of health. Health effects of transport-related air pollution Edited by: Michal Krzyzanowski, Birgit Kuna-Dibbert and Jürgen Schneider WHO Library Cataloguing in Publication Data Health effects of transport-related air pollution /edited by Michal Krzyzanowski … [et al.] 1.Air pollution 2.Air pollutants 3.Vehicle emissions – adverse effects 4.Environmental exposure 5.Health policy 6.Policy making 7.Europe I.Krzyzanowski, Michal II.Kuna-Dibbert, Birgit III.Schneider, Jürgen ISBN 92 890 1373 7 (NLM Classification : WA 754) Address requests about publications of the WHO Regional Office to: • by e-mail • by post publicationrequests@euro.who.int (for copies of publications) permissions@euro.who.int (for permission to reproduce them) pubrights@euro.who.int (for permission to translate them) Publications WHO Regional Office for Europe Scherfigsvej 8 DK-2100 Copenhagen Ø, Denmark © World Health Organization 2005 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Where the designation “country or area” appears in the headings of tables, it covers countries, territories, cities, or areas. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The World Health Organization does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. The views expressed by authors or editors do not necessarily represent the decisions or the stated policy of the World Health Organization. Printed in Denmark ISBN 92-890-1373-7 Cover design: Sven Lund Contents Contributors v Acknowledgements viii Abbreviations ix Foreword xi Executive summary xiii Factors determining emissions xiii Contribution of traffi c to pollution levels xiii Human exposure xiv Studies on health effects xv Introduction 1 How to read this report and how it was written 4 References 4 1. Factors determining emissions in the WHO European Region – Alois Krasenbrink, Giorgio Martini, Urban Wass, Edward Jobson, Jens Borken, Reinhard Kuehne, Leonidas Ntziachristos, Zissis Samaras and Menno Keuken 7 Key points 7 Introduction 8 Transport patterns 9 Road transport 17 Transportation technologies 29 Fuels and additives 37 References 46 2. Contribution of traffi c to levels of ambient air pollution in Europe – Menno Keuken, Eric Sanderson, Roel van Aalst, Jens Borken and Jürgen Schneider 53 Key points 53 Introduction 54 Traffi c emissions of nitrogen oxides, carbon monoxide and VOCs in Europe 55 Contribution of traffi c emissions to ozone and nitrogen oxides 58 iii Composition of primary traffi c-related PM emissions 59 Improving air quality by decreasing traffi c emissions 61 Contribution of traffi c emissions to urban air quality 63 Contribution of traffi c to PM in urban areas 67 Concentrations of ozone and nitrogen dioxide in urban areas and streets 74 Effect of traffi c management on urban air quality 76 Conclusions and the action needed 78 References 80 3. Human exposure to transport-related air pollution – Eric Sanderson, David Briggs, Matti Jantunen, Bertil Forsberg, Magnus Svartengren, Radim Šrám John Gulliver and Nicole Janssen 85 Key points 85 Introduction 86 Methods of assessing exposure 87 Exposures in urban versus rural regions 90 Exposure of people living near busy traffi c routes 93 Assessment of traffi c exposure in a variety of microenvironments 108 Conclusions 113 References 114 4. Studies on health effects of transport-related air pollution – Joachim Heinrich, Per E. Schwarze, Nikolaos Stilianakis, Isabelle Momas, Sylvia Medina, Annike I. Totlandsdal, Leendert von Bree, Birgit Kuna-Dibbert and Michal Krzyzanowski 125 Key points 125 Introduction 126 Mortality 128 Respiratory morbidity 131 Cardiovascular morbidity 147 Cancer 150 Pregnancy outcomes and male fertility 155 Intervention studies 157 Discussion 161 References 165 5. Health risk assessment of transport-related air pollution – Birgit Kuna-Dibbert and Michal Krzyzanowski 185 Identifi ed health effects 185 Needs for further research 186 Justifi ed action 188 References 189 iv v Contributors Authors Jens Borken Institute of Transport Research, German Aerospace Center (DLR), Berlin, Germany David Briggs Environment and Health Sciences, Imperial College, London, United Kingdom Bertil Forsberg Department of Public Health and Clinical Medicine, Umeå University, Sweden John Gulliver School of Medicine, Imperial College, London, United Kingdom Joachim Heinrich Institute of Epidemiology, GSF National Research Centre for Environment and Health, Neuherberg, Germany Nicole Janssen Institute for Risk Assessment Sciences (IRAS), Utrecht University, Netherlands Matti Jantunen National Public Health Institute (KTL), Kuopio, Finland Edward Jobson Energy Conversion and Physics, Volvo Technology Corporation, Gothenburg, Sweden Menno Keuken Netherlands Organisation for Applied Scientifi c Research (TNO), Apeldoorn, Netherlands Alois Krasenbrink Joint Research Centre, European Commission, Ispra, Italy Michal Krzyzanowski WHO European Centre for Environment and Health, Bonn, WHO Regional Offi ce for Europe Birgit Kuna-Dibbert WHO European Centre for Environment and Health, Bonn, WHO Regional Offi ce for Europe Giorgio Martini Joint Research Centre, European Commission, Ispra, Italy Sylvia Medina Institut de Veille Sanitaire (InVS), Saint-Maurice, France Isabelle Momas Service “Santé Publique et Environnement”, Université René Descartes, Paris, France Leonidas Ntziachristos Laboratory of Applied Thermodynamics, Aristotle University, Salonica, Greece Zissis Samaras Laboratory of Applied Thermodynamics, Aristotle University, Salonica, Greece Eric Sanderson Institute for Risk Assessment Sciences (IRAS), Utrecht University, Netherlands Jürgen Schneider WHO European Centre for Environment and Health, Bonn, WHO Regional Offi ce for Europe Per E. Schwarze Norwegian Institute of Public Health, Oslo, Norway Radim J. Šrám Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic Nikolaos Stilianakis Joint Research Centre, European Commission, Ispra, Italy Magnus Svartengren Department of Public Health Sciences, Division of Occupational Medicine, Karolinska Institute, Stockholm, Sweden Roel van Aalst European Environment Agency, Copenhagen, Denmark Urban Wass Environment & Chemistry, Volvo Technology Corporation, Gothenburg, Sweden vi Other contributors and reviewers Lucy Bayer-Oglesby Institut für Sozial- und Präventivmedizin, Universität Basel, Switzerland Annelie Behndig Department of Respiratory Medicine and Allergy, Umeå University Hospital, Sweden Anders Blomberg Department of Respiratory Medicine and Allergy, Umeå University Hospital, Sweden Kenneth Donaldson ELEGI/Colt Laboratories, MRC Centre for Infl ammation Research, University of Edinburgh Medical School, United Kingdom Paul Fischer National Institute of Public Health and the Environment (RIVM), Bilthoven, Netherlands Ragnberth Helleday Department of Respiratory Medicine and Allergy, Umeå University Hospital, Sweden Reinhart Kühne Institute of Transport Research, German Aerospace Center (DLR), Berlin, Germany Marco Martuzzi WHO European Centre for Environment and Health, Rome, WHO Regional Offi ce for Europe Emilia M. Niciu Institute of Public Health, Bucharest, Romania Francesca Racioppi WHO European Centre for Environment and Health, Rome, WHO Regional Offi ce for Europe Thomas Sandstrøm Department of Respiratory Medicine and Allergy, Umeå University Hospital, Sweden Vicki Stone School of Life Sciences, Napier University, Edinburgh, United Kingdom Peter Straehl Swiss Agency for the Environment, Forests and Landscapes, Berne, Switzerland vii Håkan Törnqvist Department of Public Health and Clinical Medicine, Umeå University, Sweden Annike I. Totlandsdal National Institute of Public Health and the Environment (RIVM), Bilthoven, Netherlands Leendert van Bree National Institute of Public Health and the Environment (RIVM), Bilthoven, Netherlands Paulo Vineis Department of Biomedical Sciences and Human Oncology, Turin University, Italy Denis Zmirou-Navier Agence française de sécurité sanitaire environnementale, Maison Alfort, France Acknowledgements The work on this book was supported by grants obtained by WHO from the Federal Ministry for the Environment, Nature Conservation and Nuclear Safety of Germany and the Agency for the Environment, Forests and Landscapes of Swtizerland. For this support, and for the contributions of all the authors and reviewers, we are very grateful. Michal Krzyzanowski, Birgit Kuna-Dibbert and Jürgen Schneider viii [...]... toxicological evidence on the effects of transport-related air pollution on health has increased substantially in recent decades Although this includes epidemiological and toxicological evidence, it is only a fraction of the total evidence on the effects on health of urban air pollution A review of this evidence indicates that transport-related air pollution contributes to an increased risk of death, particularly... wider introduction of healthy means of transport Such changes would both reduce the health risks of transport-related air pollution and bring other health benefits, such as reduced risks of traffic accidents and the positive effects of walking and bicycling These would greatly amplify the benefits and cost–effectiveness of investments in reducing pollution The benefits to public health of such an integrated... adverse health outcomes This accumulated evidence allows the hazards of transport-related air pollution to be identified, but makes only a limited contribution to the qualitative assessment of its adverse effects on health and to the prediction of the benefits of reducing this part of the total air- pollution mix Initial estimates show that tens of thousands of deaths per year are attributable to transport-related. .. the formation of tropospheric ozone, a well-known air pollutant 1 2 Health effects of transport-related air pollution The mixture of air pollution varies in time and space, depending on several characteristics, such as proximity to roads, the composition of the vehicle fleet, traffic patterns and the presence of other pollution sources The pattern of population exposure depends on both pollution levels... 2004) IRAS (2004) AIRNET Thematic Network on Air Pollution and Health [web site] Utrecht, Institute for Risk Assessment Sciences, University of Utrecht (http://airnet.iras.uu.nl/, accessed 26 November 2004) Krzyzanowski M (2005) Health effects of transport-related air pollution: summary for policy-makers Copenhagen, WHO Regional Of ce for Europe Künzli N et al (2000) Public -health impact of outdoor and... formation of secondary pollutants, and patterns of human exposure In discussing the adverse effects on health of exposure, the review considers the results of both epidemiological studies and toxicological assessments of biological mechanisms It profited from a parallel WHO project for the systematic review of health aspects of air pollution (WHO Regional Of ce for Europe, 2004) in support of the European... approach would be the most welcome result of this WHO book Marc Danzon WHO Regional Director for Europe xii Executive summary The effects on health of transport-related air pollution are among the leading concerns about transport Research in recent decades consistently indicates the adverse effects of outdoor air pollution on human health, and the evidence points to air pollution stemming from transport as... contributor to these effects This book provides a systematic review of the literature on transport-related air pollution and a comprehensive evaluation of the health hazards of such pollution It focuses on air pollution related to road transport (mostly from urban and suburban passenger and freight transport) and the risks it presents to human health It also considers the entire chain of relevant issues:... modes of transport that are safer for health and the environment The activities of populations, the planned use of spaces, individual behaviour and the choices available to transport users – all these affect people’s exposure to pollution and the related health risks Research on the effects on health of transport-related air pollution identifies hazards and indicates vulnerable groups The participation of. .. Technologies European Union study of air pollution exposure distributions of adult urban populations in Europe International Agency for Research on Cancer International Study of Asthma and Allergies in Childhood project on a healthier environment through the abatement of vehicle emissions and noise National Morbidity, Mortality, and Air Pollution Study study of acute pollution effects on asthmatic children . the formation of tropospheric ozone, a well-known air pollutant. 1 2 Health effects of transport-related air pollution The mixture of air pollution varies. fraction of the total evidence on the effects on health of urban air pollution. A review of this evidence indicates that transport-related air pollution