The WHO Regional Office 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 Office for Europe is one of six regional offices throughout the world, each with its own programme geared to the particular health conditions of the countries it serves This report summarizes the evidence on these effects, as well as knowledge about the sources of particulate matter, its transport in the atmosphere, measured and modelled levels of pollution in ambient air, and population exposure It shows that long-range transport of particulate matter contributes significantly to exposure and to health effects Member States The authors conclude that international action must accompany local and national efforts to cut pollution emissions and reduce their effects on human health World Health Organization Regional Office for Europe Scherfigsvej 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 E88189 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 Health risks ofparticulate matter from long-range transboundary air pollution air pollution Health risks of particulate matter from long-range transboundary Particulate matter is a type of air pollution that is generated by a variety of human activities, can travel long distances in the atmosphere and causes a wide range of diseases and a significant reduction of life expectancy in most of the population of Europe Health risks of particulate matter from long-range transboundary air pollution E88189 Address requests about publications of the WHO Regional Office for Europe to: Publications WHO Regional Office for Europe Scherfigsvej DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the WHO/Europe web site at http://www.euro.who.int/pubrequest Keywords: AIR POLLUTION POLLUTANTS, ENVIRONMENTAL – adverse effects ENVIRONMENTAL EXPOSURE RISK FACTORS EUROPE © World Health Organization 2006 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 not imply the expression of any opinion whatsoever on the 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necessarily represent the decisions or the stated policy of the World Health Organization Text editor: Frank Theakston Cover design and layout: Sven Lund Printed in Denmark Health risks of particulate matter from long-range transboundary air pollution Joint WHO / Convention Task Force on the Health Aspects of Air Pollution European Centre for Environment and Health Bonn Office Abstract Particulate matter is a type of air pollution that is generated by a variety of human activities, can travel long distances in the atmosphere and causes a wide range of diseases and a significant reduction of life expectancy in most of the population of Europe This report summarizes the evidence on these effects, as well as knowledge about the sources of particulate matter, its transport in the atmosphere, measured and modelled levels of pollution in ambient air, and population exposure It shows that longrange transport of particulate matter contributes significantly to exposure and to health effects The authors conclude that international action must accompany local and national efforts to cut pollution emissions and reduce their effects on human health Contents Foreword vii Executive summary ix Introduction What is PM? Hazard assessment of PM 11 Sources of PM 25 PM levels 33 Population exposure 65 The approach to estimating risk 73 Risk estimates 89 Conclusions and recommendations 95 Annex 99 Main contributors Markus Amann, Richard Derwent, Bertil Forsberg, Fintan Hurley, Michal Krzyzanowski, Birgit Kuna-Dibbert, Steinar Larssen, Frank de Leeuw, Sally Jane Liu, Jürgen Schneider, Per E Schwarze, David Simpson, John Stedman, Peter Straehl, Leonor Tarrasón and Leendert van Bree This report was prepared by the Joint WHO/Convention Task Force on the Health Aspects of Air Pollution according to a Memorandum of Understanding between the United Nations Economic Commission for Europe (UNECE) and the WHO Regional Office for Europe (ECE/ENHS/EOA/2005/001), based on work covered by Memorandum of Understanding ECE/ENHS/EOA/2004/001 between UNECE and the Regional Office VII Foreword The scale and seriousness of impacts of air pollution on health that have been detected by scientific investigations over the past decade are the subject of media reports and policy debate throughout Europe Evidence on those impacts has been gathered through numerous studies conducted by scientists of various disciplines and published mostly by highly specialized scientific journals Comprehensive evaluation of this evidence is needed in order to formulate effective pollution reduction strategies and national and international policies for reducing health risks due to pollution This report focuses on particulate matter, a type of air pollution that causes a wide range of diseases in children and adults, contributing to disability and a significant reduction in life expectancy Particulate matter is present everywhere where people live and is generated to a great extent by human activities: transport, energy production, domestic heating and a wide range of industries As presented in this report, this pollution can be transported in the atmosphere for hundreds or even thousands of kilometres and thus affect people living far from the source of the pollution Particulate matter is therefore not only a serious local problem but also of regional and international concern, and one of the core issues addressed by the Convention on Long-range Transboundary Air Pollution The multidisciplinary group of experts who prepared this report, convened by the Joint WHO/Convention Task Force on the Health Aspects of Air Pollution, has summarized the available information on particulate matter – the risk it poses to human health, its sources, transport and distribution in the atmosphere, and population exposure to it The report also presents estimates of the magnitude of the current impacts of particulate matter on health in Europe, and concludes that a significant part of these effects is due to particles transported over long distances in the atmosphere There is sufficient evidence to indicate that reducing emissions of major pollutants leads to reduced levels of particulate air pollution, of population exposure and of health effects Current pollution reduction strategies are expected to benefit the health of many Europeans, but even with their full implementation the health impacts will remain significant A strong commitment from all Member States is needed to implement existing plans and to extend efforts to reduce population exposure and the effects of particulate air pollution The Children’s Environment and Health Action Plan for Europe, adopted at the Fourth Ministerial Conference on Environment and Health in Budapest in June 2004, sets the reduction of child morbidity caused by air pollution as one of four regional priority goals Reduction of exposure to particulate matter is essential to the achievement of this goal, and the Convention on Long-range Transboundary Air Pollution can be an important instrument contributing to that achievement We are grateful to the experts who prepared this report for summarizing the evidence and for sending a clear message to decision- and policy-makers on the significance for health of particulate matter from long-range transboundary air pollution The evidence clearly points to the need for health-oriented policies and coordinated local, regional and international action by all polluting economic sectors in all Member States Action is necessary if we are to reduce the pollution-related burden of disease and improve the health of both children and adults across Europe Roberto Bertollini, MD, MPH Director Special Programme on Health and Environment WHO Regional Office for Europe Kaj Bärlund Director Environment and Human Settlements Division United Nations Economic Commission for Europe IX Executive summary This report summarizes the results of multidisciplinary analysis aiming to assess the effects on health of suspended particulate matter (PM) and especially that part that is emitted by remote sources or generated in the atmosphere from precursor gases The analysis indicates that air pollution with PM, and especially its fine fraction (PM2.5), affects the health of most of the population of Europe, leading to a wide range of acute and chronic health problems and to a reduction in life expectancy of 8.6 months on average in the 25 countries of the European Union (EU) PM from long-range transport of pollutants contributes significantly to these effects PM is an air pollutant consisting of a mixture of solid and liquid particles suspended in the air These particles differ in their physical properties (such as size), chemical composition, etc PM can either be directly emitted into the air (primary PM) or be formed secondarily in the atmosphere from gaseous precursors (mainly sulfur dioxide, nitrogen oxides, ammonia and non-methane volatile organic compounds) Primary PM (and also the precursor gases) can have anthropogenic and nonanthropogenic sources (for primary PM, both biogenic and geogenic sources may contribute to PM levels) Several different indicators can be used to describe PM Particle size (or aerodynamic diameter) is often used to characterize them, since it is associated with the origin of the particles, their transport in the atmosphere and their ability to be inhaled into respiratory system PM10 (particles with a diameter