Linking Environment and Health Data

Transcription

1 Linking Environment and Health Data Experiences from the Netherlands Oscar Breugelmans Brigit Staatsen

2 Contents 1. Developments in Environmental Public Health policy and research 2. Examples of recent work

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4 Developments in the Netherlands One law for the living environment in 2018 Combining 26 laws, 5000 articles, 120 regulations, Combining environment, construction, water, nature and planning Public health is an important focus No formal EPHT program Increased integration of national health registries and environmental data for: Research Regional environmental health problems Dissemination of information to policy makers and the general public Participatory research 4

5 National health registries Statistics Netherlands Microdata: Individual, company and address level data available for researchers Health and wellbeing (mortality, medication use, hospital registry, general practitioners, care registries) Complete Dutch population Cancer registry Public health questionnaire regional health authorities (every 4 years) 5

6 Avenue for the living environment Construction Space Soil Cultural history Noise External safety Air Nature 6

7 RESEARCH Dutch Environmental Longitudinal Study (DUELS) Cohort study with all residents of the Netherlands ~ 7 million inhabitants selected 7-year follow-up Mortality: All-cause, Cardiovascular, Respiratory, Lung cancer Confounders: Individual level: Age, Gender, Marital status, Country of origin, Standardised household income Neighbourhood level: Aggregate SES measure on 4PC (based on income, education, %employed) Exposure indicators: PM10 and NO2 at the individual address level HR PM10: 1,08 per 10 µg/m3 HR NO2: 1,03 per 10 µg/m3 Fischer et al, EHP 2015 Similar analyses ongoing for noise, green space and combined effects 7

8 Regional examples Steel plant: Lung cancer risk and medication use 8

9 Regional examples Steel plant: lung cancer risk and medication use Historical emission data: PAH (Polycyclic Aromatic Hydrocarbons) Heavy metals (Lead, Cadmium, Copper, Zinc) PM10, NOx National cancer registry data: registered cancer cases in 12 years Cancer data available at postal code level Pharmacy registry Medication use Antihypertensives COPD medications 9

10 Regional examples Ultrafine Particles and health around Schiphol Airport Elevated UFP concentrations around Schiphol Airport Health effects of UFP largely unknown Quick overview of health risks for those living near the airport National registry: Individual mortality data All causes Lung cancer Cardiovascular diseases Respiratory conditions By postal code 10

11 (translation in English in progress) 11

12 Example: Aircraft noise and annoyance 12

13 Diverse topics PM10 in the last hour Risk contours and Vulnerable objects Location Q-fever patients Light emission 13 Cadastral map, future developments and infrastructure

14 Public participation: Wet cooling towers Possible source of legionellosis or legionnaires disease Cause of outbreaks of severe pneumonia Amsterdam, 2006: 30 patients, 3 deceased Number and location of cooling towers is partly unknown Public can report location 14

15 Concluding remarks Good collaboration between data holders is necessary Privacy issues Health data are still a huge problem Small area health statistics open up new possibilities in move towards lower aggregation levels Research based on issues of the day, difficult to keep monitoring systems afloat Maintainance and funding of a web portal on environment and health is a formidable task 15

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17 Cumulative Environmental Health Risk Indicator Based on individual time lost each year due to ill-health, disability or early death due to environmental exposures, expressed as % of the total disease burden Core: Disease burden calculations in DALY s (Disability Adjusted Life Years) Number of disease cases, severity, duration Life years lost Gives indication cumulative local risk from health perspective Input data: exposure data residential address Calculation tool: predefined exposure-response functions, severity weights Outer layer/presentation: Score classes and color codes to fixed range of percentages 17

18 Components Environmental factors PM10 NO2 Ozone Noise Lead Passive smoking Radon Benzene Dioxins Formaldehyde Health impact Mortality* Mortality, asthma* Mortality, respiratory disease Sleep disturbance, Cardiovascular disease, Reading impairment Loss of IQ, blood pressure Lung cancer, asthma Lung cancer Leucaemia Cancer Asthma * based on analysis big data (Fisher et al, EHP 2015) 18

19 19 Cumulative health impacts environmental exposures (% total disease burden)

20 Impact different envíronmental pollutants in same metric (CHERIO) 20

21 Examples of potential applications 1. Pilot study health impacts of spatial planning: Eindhoven/Rotterdam Comparison 3 traffic scenarios to reference: circulation, cut traffic routes, combined scenario 2. Monitoring / Benchmarking 21