Annette Peters. Research Needs for Aerosols and Health

Transcription

1 Research Needs for Aerosols and Health Annette Peters Helmholtz Zentrum München, Institute of Epidemiology, Neuherberg, Germany Harvard School of Public Health, Department of Environmental Health, Boston, USA

2 Pollution persists around the world London, Mid 20th Century Beijing, Beginning 21st Century

3 The overall picture for particulate matter (PM) Short-term health effects of PM on mortality are observed around the world Long-term health effect studies indicate that mortality is increased in polluted areas compared to less polluted areas Current EU regulation for PM 10 and PM 2.5 builds on results from the American Cancer Society Study Effects on cardiovascular diseases have the largest population impact with respect to adult health

4 Major current research themes Long-term consequences of elevated air pollution in urban areas Health effects of particle characteristics and air pollution mixtures German focus: Low emission zones

5 Major current research themes Long-term consequences of elevated air pollution in urban areas Health effects of particle characteristics and air pollution mixtures German focus: Low emission zones

6 E S C A P E European Study of Cohorts for Air Pollution Effects

7 European Multi-center Study on long-term Effects Based on existing cohort studies Joint assessment of spatial variability of air pollution based on GIS* Outcomes Children s health Respiratory health Cardiovascular Health Mortality *GIS: Geographic Information Systems

8 Measurements München/Augsburg: Mapping Pollution Green: Background Red: Traffic Dot: LfU Sites Triangle: ESCAPE temporary sites Off-point: Reference site

9 Exposure to fine particulate matter of toddlers in Munich, Germany Morgenstern et al. AJRCCM 2008

10 Exposure to traffic related particles of toddlers in Munich, Germany Morgenstern et al. AJRCCM 2008

11 Traffic-related pollution and allergies in children at the age of 6 years, Munich, GER aor aor PM 2.5 PM 2.5 abs PM 2.5 PM 2.5 abs 0.5 Inhalant sensitization Outdoor allergen Indoor allergen 0.5 NO 2 Asthma Hayfever Eczema NO 2 Morgenstern et al. AJRCCM 2008

12 Systemic effects of air pollution beyond the heart and the lung? Inhalation of particles Local effects inflammation Systemic effects Acute-Phase-Proteins Cytokines Asthma attacks Bronchitis Ischemia Arrythmia

13 Systemic effects of air pollution beyond the heart and the lung? Inhalation of particles Local effects inflammation Systemic effects Acute-Phase-Proteins Cytokines Asthma attacks Bronchitis Brain Metabolic Diseases Ischemia Arrythmia

14 Major current research themes Long-term consequences of elevated air pollution in urban areas Health effects of particle characteristics and air pollution mixtures German focus: Low emission zones

15 Particles in ambient air Fine particles: PM 2.5 < 2.5 µm (mass) Ultrafine Particles: UFP < 100 nm (number)

16 Air pollution and cardiac readmission in myocardial infarction survivors 1,20 1,15 Risk Ratio 1,10 1,05 1,00 0,95 0,90 PNC PM10 CO NO2 SO2 von Klot et al. 2005

17 Sulfur dioxide Nitrogen dioxide Atherosclerotic plaque Stationary sources Oxidative Stress Systemic Inflammation Platelet activation Coronary Artery Disease Mobile sources Fine particles Ultrafine particles Endothelial dysfunction Passive Smoking Autonomic dysfunction Active Smoking Carbon Monoxide Negative myocardial oxygen balance Adrenergic activation Peters, Circulation, 2009

18 Major current research themes Long-term consequences of elevated air pollution in urban areas Health effects of particle characteristics and air pollution mixtures German focus: Low emission zones

19 Low emission zones Are they effective?

20 Schematic horizontal profile of the ambient air pollution levels

21 Times spent in traffic and the triggering of myocardial infarction one hour later All Cars Bus/Tram Bicycle Odds Ratio* 95% Confidenceinterval *adjusted for getting up, being outdoors and strenuous exercise Update of Peters et al. NEJM 2004

22 Integrated research on low emission zones: Population-based impact 1. Studies on short-term effects of particle characteristics on mortality and myocardial infarction in Augsburg (EPI + IÖC). 2. German-wide analyses for the impact of LEZ on daily mortality (project proposal planned, EPI). 3. Long-term effects close to major roads for intermediate phenotypes of cardiovascular and metabolic diseases (KORA, EU FP7 + HMGU, EPI + IÖC). 4. Long-term effects close to major roads for allergies and respiratory disease in children (EU FP7 + HMGU, EPI + IÖC). 5. Studies including personal monitoring and ECG (project proposal to DFG under revision, RCP (US EPA), EPI + IÖC) Exposure Toxicological Assessment Assessments Population-based Health Impact

23 Summary Long-term health effect studies for other particle measures than PM10 or PM2.5 are needed. Short-term health effect studies on ultrafine particles and current mixtures are needed. An evaluation of measures to improve air quality is mandated.

24 Thank you to Research Unit Health Effects of Particles : S. Breitner, I. Brüske-Hohlfeld, J. Cyrys, S. Greven, A. Henneberger, A. Ibald-Mulli, M. Marowsky-Köppl, M. Pitz, A. Peters, R. Rückerl, A. Schaffrath Rosario, M. Stölzel, W. Yue GSF-Institut of Epidemiology: J. Heinrich, H. E. Wichmann, G. Wölke GSF-Focus Network Aerosols and Health: J. Heyder, W. Kreyling, J. Schnelle-Kreis, H. Schulz, K. Wittmaack, R. Zimmermann KORA Coronary Event Registry: H. Löwel, M. Heier, I. Trentinglia, C. Winter, G. Orlik, P. Friedmann, G. Zimmermann, A. Hörmann, G. Kaup, C. Meisinger HEAPSS Study Group: F. Forastiere, Rome (Coordinator), T. Bellander, Stockholm, M. Kulmala, Helsinki, J. Pekkanen, Helsinki, A. Peters, Munich, J. Sunyer, Barcelona

25 Questions? München, Leopoldstr