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Air pollution and health – Indicators, trends and impacts
Stockholm University, Faculty of Science, Department of Environmental Science and Analytical Chemistry.ORCID iD: 0000-0002-2121-4513
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis focuses on some of the limitations and difficulties that exist when it comes to quantifying the human health effects that arise as a result of air pollution exposure. The following four issues are particularly analysed and discussed: 1) The measurement techniques used for carbonaceous particles and their lack of consistency; 2) Do the health risks associated with exposure to PM10 depend on the content of elemental carbon in the aerosol?; 3) Trends in air pollutants and the health effects that arise as a result of changed exposure to the measured pollutants; 4) The associations between the measured concentrations of different air pollutants in Stockholm and the daily number deaths; 5) Air quality indicators and health outcomes as basis for an air quality health index (AQHI).

The method that has been used is largely based on empirical data analysis, where further statistical processing has been used in order to clarify the scientific issues. The overall conclusions are the following: 1) The health impact assessments associated with exposure to carbonaceous particles would benefit from the introduction of a more uniform measurement technique in order to get more consistent and reliable results; 2) The health risks associated with exposure to PM10 are dependent on the content of elemental carbon; 3) The life expectancy increase associated with decreasing NOx trends during 1990–2015 in Stockholm, Gothenburg and Malmo make up as much as about 20 % of the total gain in life expectancy during this period, which clearly shows the beneficial effects related to decreased exposure; 4) The associations between daily mortality and the concentrations of O3 and PM2.5-10 in Stockholm are statistically significant, which does not apply to the exhaust-related pollutants, possibly reflecting behavioural factors affecting the degree of exposure; 5) In comparison with the currently used air quality index (AQI), the air quality health index (AQHI) is a more useful tool in order to address the short-term health effects associated with multi-pollutant exposure to NOx, O3, PM10 and birch pollen.

We hope that these findings will be useful from a policy point of view. Introducing a more consistent measurement technique for soot particles would be beneficial in assessing the health effects related to exposure to these particles. The increase in life expectancy associated with decreasing NOx trends shows the benefits from a public health perspective when it comes to introducing emission-reducing measures from traffic. The AQHI would be beneficial to implement in legislation, as it is based on several pollutants, which means that the cumulative health effects associated exposure to several different air pollutants are accounted for.  

Place, publisher, year, edition, pages
Stockholm: Department of Environmental Science and Analytical Chemistry, Stockholm University , 2019. , p. 50
Keywords [en]
air pollution, health, measurements, trends, impacts, mortality, NOx, elemental carbon, AQHI
National Category
Meteorology and Atmospheric Sciences Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Applied Environmental Science
Identifiers
URN: urn:nbn:se:su:diva-168306ISBN: 978-91-7797-468-0 (print)ISBN: 978-91-7797-469-7 (electronic)OAI: oai:DiVA.org:su-168306DiVA, id: diva2:1307934
Public defence
2019-06-13, Nordenskiöldsalen, Geovetenskapens hus, Svante Arrhenius väg 12, Stockholm, 10:00 (English)
Opponent
Supervisors
Available from: 2019-05-21 Created: 2019-04-29 Last updated: 2019-05-07Bibliographically approved
List of papers
1. The Use of Carbonaceous Particle Exposure Metrics in Health Impact Calculations
Open this publication in new window or tab >>The Use of Carbonaceous Particle Exposure Metrics in Health Impact Calculations
2016 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 13, no 3, article id 249Article in journal (Refereed) Published
Abstract [en]

Combustion-related carbonaceous particles seem to be a better indicator of adverse health effects compared to PM2.5 and PM10. Historical studies are based on black smoke (BS), but more recent studies use absorbance (Abs), black carbon (BC) or elemental carbon (EC) as exposure indicators. To estimate health risks based on BS, we review the literature regarding the relationship between Abs, BS, BC and EC. We also discuss the uncertainties associated with the comparison of relative risks (RRs) based on these conversions. EC is reported to represent a proportion between 5.2% and 27% of BS with a mean value of 12%. Correlations of different metrics at one particular site are higher than when different sites are compared. Comparing all traffic, urban and rural sites, there is no systematic site dependence, indicating that other properties of the particles or errors affect the measurements and obscure the results. It is shown that the estimated daily mortality associated with short-term levels of EC is in the same range as PM10, but this is highly dependent on the EC to BS relationship that is used. RRs for all-cause mortality associated with short-term exposure to PM10 seem to be higher at sites with higher EC concentrations, but more data are needed to verify this.

Keywords
black smoke, health effects, PM10, urban air pollution, relative risk, black carbon, combustion-related particles, elemental carbon
National Category
Earth and Related Environmental Sciences
Research subject
Applied Environmental Science
Identifiers
urn:nbn:se:su:diva-129999 (URN)10.3390/ijerph13030249 (DOI)000373528600032 ()
Available from: 2016-05-11 Created: 2016-05-09 Last updated: 2019-05-07Bibliographically approved
2. Trends in air pollutants and health impacts in three Swedish cities over the past three decades
Open this publication in new window or tab >>Trends in air pollutants and health impacts in three Swedish cities over the past three decades
Show others...
2018 (English)In: Atmospheric Chemistry And Physics, ISSN 1680-7316, E-ISSN 1680-7324, Vol. 18, no 21, p. 15705-15723Article in journal (Refereed) Published
Abstract [en]

Air pollution concentrations have been decreasing in many cities in the developed countries. We have estimated time trends and health effects associated with exposure to NOx, NO2, O-3, and PM10 (particulate matter) in the Swedish cities Stockholm, Gothenburg, and Malmo from the 1990s to 2015. Trend analyses of concentrations have been performed by using the Mann-Kendall test and the Theil-Sen method. Measured concentrations are from central monitoring stations representing urban background levels, and they are assumed to indicate changes in long-term exposure to the population. However, corrections for population exposure have been performed for NOx, O-3, and PM10 in Stockholm, and for NOx in Gothenburg. For NOx and PM10, the concentrations at the central monitoring stations are shown to overestimate exposure when compared to dispersion model calculations of spatially resolved, population-weighted exposure concentrations, while the reverse applies to O-3. The trends are very different for the pollutants that are studied; NOx and NO2 have been decreasing in all cities, O-3 exhibits an increasing trend in all cities, and for PM10, there is a slowly decreasing trend in Stockholm, a slowly increasing trend in Gothenburg, and no significant trend in Malmo. Trends associated with NOx and NO2 are mainly attributed to local emis-sion reductions from traffic. Long-range transport and local emissions from road traffic (non-exhaust PM emissions) and residential wood combustion are the main sources of PM10. For O-3, the trends are affected by long-range transport, and there is a net removal of O-3 in the cities. The increasing trends are attributed to decreased net removal, as NOx emissions have been reduced. Health effects in terms of changes in life expectancy are calculated based on the trends in exposure to NOx, NO2, O-3, and PM10 and the relative risks associated with exposure to these pollutants. The decreased levels of NO x are estimated to increase the life expectancy by up to 11 months for Stockholm and 12 months for Gothenburg. This corresponds to up to one-fifth of the total increase in life expectancy (5470 months) in the cities during the period of 1990-2015. Since the increased concentrations in O-3 have a relatively small impact on the changes in life expectancy, the overall net effect is increased life expectancies in the cities that have been studied.

National Category
Earth and Related Environmental Sciences
Research subject
Applied Environmental Science
Identifiers
urn:nbn:se:su:diva-163010 (URN)10.5194/acp-18-15705-2018 (DOI)000449028500003 ()
Available from: 2018-12-11 Created: 2018-12-11 Last updated: 2019-05-07Bibliographically approved
3. Association between Mortality and Short-Term Exposure to Particles, Ozone and Nitrogen Dioxide in Stockholm, Sweden
Open this publication in new window or tab >>Association between Mortality and Short-Term Exposure to Particles, Ozone and Nitrogen Dioxide in Stockholm, Sweden
2019 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 6, article id 1028Article in journal (Refereed) Published
Abstract [en]

In this study, the effects on daily mortality in Stockholm associated with short-term exposure to ultrafine particles (measured as number of particles with a diameter larger than 4 nm, PNC4), black carbon (BC) and coarse particles (PM2.5–10) have been compared with the effects from more common traffic-pollution indicators (PM10, PM2.5 and NO2) and O3 during the period 2000–2016. Air pollution exposure was estimated from measurements at a 20 m high building in central Stockholm. The associations between daily mortality lagged up to two days (lag 02) and the different air pollutants were modelled by using Poisson regression. The pollutants with the strongest indications of an independent effect on daily mortality were O3, PM2.5–10 and PM10. In the single-pollutant model, an interquartile range (IQR) increase in O3 was associated with an increase in daily mortality of 2.0% (95% CI: 1.1–3.0) for lag 01 and 1.9% (95% CI: 1.0–2.9) for lag 02. An IQR increase in PM2.5–10 was associated with an increase in daily mortality of 0.8% (95% CI: 0.1–1.5) for lag 01 and 1.1% (95% CI: 0.4–1.8) for lag 02. PM10 was associated with a significant increase only at lag 02, with 0.8% (95% CI: 0.08–1.4) increase in daily mortality associated with an IQR increase in the concentration. NO2 exhibits negative associations with mortality. The significant excess risk associated with O3 remained significant in two-pollutant models after adjustments for PM2.5–10, BC and NO2. The significant excess risk associated with PM2.5–10 remained significant in a two-pollutant model after adjustment for NO2. The significantly negative associations for NO2 remained significant in two-pollutant models after adjustments for PM2.5–10, O3 and BC. A potential reason for these findings, where statistically significant excess risks were found for O3, PM2.5–10 and PM10, but not for NO2, PM2.5, PNC4 and BC, is behavioral factors that lead to misclassification in the exposure. The concentrations of O3 and PM2.5–10 are in general highest during sunny and dry days during the spring, when exposure to outdoor air tend to increase, while the opposite applies to NO2, PNC4 and BC, with the highest concentrations during the short winter days with cold weather, when people are less exposed to outdoor air.

Keywords
particle number count (PNC), PM2.5–10, exposure, mortality, ozone, excess risk, linear regression
National Category
Earth and Related Environmental Sciences Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Applied Environmental Science
Identifiers
urn:nbn:se:su:diva-168268 (URN)10.3390/ijerph16061028 (DOI)000465159500128 ()
Note

This article belongs to the Special Issue Ultrafine Particles Exposure and Health.

Available from: 2019-04-29 Created: 2019-04-29 Last updated: 2019-05-27Bibliographically approved
4. A Multi-Pollutant Air Quality Health Index (AQHI) Based on Short-Term Respiratory Effects in Stockholm, Sweden
Open this publication in new window or tab >>A Multi-Pollutant Air Quality Health Index (AQHI) Based on Short-Term Respiratory Effects in Stockholm, Sweden
Show others...
2019 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 1, article id 105Article in journal (Refereed) Published
Abstract [en]

In this study, an Air Quality Health Index (AQHI) for Stockholm is introduced as a tool to capture the combined effects associated with multi-pollutant exposure. Public information regarding the expected health risks associated with current or forecasted concentrations of pollutants and pollen can be very useful for sensitive persons when planning their outdoor activities. For interventions, it can also be important to know the contribution from pollen and the specific air pollutants, judged to cause the risk. The AQHI is based on an epidemiological analysis of asthma emergency department visits (AEDV) and urban background concentrations of NOx, O-3, PM10 and birch pollen in Stockholm during 2001-2005. This analysis showed per 10 mu gm(-3) increase in the mean of same day and yesterday an increase in AEDV of 0.5% (95% CI: -1.2-2.2), 0.3% (95% CI: -1.4-2.0) and 2.5% (95% CI: 0.3-4.8) for NOx, O-3 and PM10, respectively. For birch pollen, the AEDV increased with 0.26% (95% CI: 0.18-0.34) for 10 pollen grainsm(-3). In comparison with the coefficients in a meta-analysis, the mean values of the coefficients obtained in Stockholm are smaller. The mean value of the risk increase associated with PM10 is somewhat smaller than the mean value of the meta-coefficient, while for O-3, it is less than one fifth of the meta-coefficient. We have not found any meta-coefficient using NOx as an indicator of AEDV, but compared to the mean value associated with NO2, our value of NOx is less than half as large. The AQHI is expressed as the predicted percentage increase in AEDV without any threshold level. When comparing the relative contribution of each pollutant to the total AQHI, based on monthly averages concentrations during the period 2015-2017, there is a tangible pattern. The AQHI increase associated with NOx exhibits a relatively even distribution throughout the year, but with a clear decrease during the summer months due to less traffic. O-3 contributes to an increase in AQHI during the spring. For PM10, there is a significant increase during early spring associated with increased suspension of road dust. For birch pollen, there is a remarkable peak during the late spring and early summer during the flowering period. Based on monthly averages, the total AQHI during 2015-2017 varies between 4 and 9%, but with a peak value of almost 16% during the birch pollen season in the spring 2016. Based on daily mean values, the most important risk contribution during the study period is from PM10 with 3.1%, followed by O-3 with 2.0%.

Keywords
AQHI, asthma, NOx, ozone, PM10, birch pollen, risk coefficients
National Category
Earth and Related Environmental Sciences Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Applied Environmental Science
Identifiers
urn:nbn:se:su:diva-166604 (URN)10.3390/ijerph16010105 (DOI)000459111400105 ()30609753 (PubMedID)
Available from: 2019-03-29 Created: 2019-03-29 Last updated: 2019-05-07Bibliographically approved

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