WHO-ProjectEnvironmental Health

IndicatorsExperiences from Germany

Project coordination:

Federal Environmental AgencyDivision of Environment and Health

WHO CC Air Quality Management/Air Pollution Control

J. Thelen, MPH, M.Sc.Dr. H.-G. Mücke

Funded by the Ministry of Health and Social Security

Project Workplan for the Pilot Study

• 06/2002 Start of the Pilot Phase in Germany• 06-10/2002 Indicator Definition Review/Adjustment

Testing of EuroIndy (1.1 to 1.5)

• 10/2002-5/2003 Identification of Dataholders, Data collection

Data Compliation • 06-10/2003 Development of Methods for Ind.calculation

Work on the Fact-sheetsQuality control of EuroIndy

Database• 08-12/2003 Analysis and Reporting

Environmental Health Indicators

Objectives of the Project:

• Test Feasibility and Applicability of the EHI Set in Germany

• Develop Information Tools for• Stakeholders in the field of Environment and Health (Politicis, Sience, Media, Organisations):

Monitoring and Evaluation of Measures and Plans concering Health Protection from environmental Risks

Communication to the Public and within the Administration (horizontal und vertical)

International und national Networking of the Stakeholders in the field of environment related Health Protection

Establishment of national und international Reporting Structures for assesment and comparison (Benchmarking, Best-Practice Modelle)

Scientific Analysis

Data availability for Germany (national level) (29.03.2003)

Workplace (10)

Chemical Emergencies (15)

Food Safety (14)

Water and Sanitation (24)

Radiation (11 )

Waste and contam. Lands (4)

Noise (21)

Traffic Accidents (2)

Housing and Settlements (15)

Air Quality (80)

0 20 40 60 80 100

(Number of Variables in the field of ...)

%

Data: Collection, Analysis

• Testing and Trail Operation of EuroIndy (1.1-1.5)

• Spatial Breakdown to NUTS 1-3 and large Cities

–Data availability:

NUTS1: good NUTS2: limited NUTS3: no data

–Large Cities:

• Data from NUTS 2 and 3 is difficult to obtain

• Problems:

–Action Indicators are Subject to Bias (subjective Assessment)

–Database EuroIndy needs further Development

–No Common Strategy for Health Impact Assessment

Remarks on the thematic fields

Most relevant for Germany: Reports:

• Air Quality yes

• Noise yes

• Traffic Accidents yes

• Drinking and Bathing Water Quality yes

Relevant; further Developement needed

• Chemical Safety (Emergencies) yes

• Food Safety partly

• Radiation yes

Remarks on the thematic fields

Relevant; Health Impact uncertain Reports:

• Waste and Contaminated Land yes

Relevant; Comprehensive Reporting

by the National Agency

• Workplace

Air Quality: Results from Germany

Air_D1 Passenger Traffic Demand (by mode of transportation)

Air_P1 Emissions of Air Pollutants

State (no Indicator)

Air_Ex1 Exposure of urban Population to Air

Pollutants

Policies to

Reduce

Exposure to

ETS

(Air_A1)

(not

shown)Health Impact: (Air_E1, E2 and E3 not evaluated)To be considered as an own Indicator, or as part of the Assessment within Air_Ex1 ?

Air_D1: Passenger transport demand per inhabitant

(Germany 1996-2001)

Source: BMVBW, DIW (2003) Traffic in Figures

0

2000

4000

6000

8000

10000

12000

14000

1996 1997 1998 1999 2000 2001**Year

Pa

ss

en

ge

r-k

ilom

ete

r p

er

inh

ab

ita

nt

(Pk

m)

Motorised Individual Traffic Public Transport (local)

Public Transport (long distance) Human-Powered Mobility

Air_P1: Emissions of Air Pollutants

0

500

1000

1500

2000

2500

3000

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Year

0

500

1000

1500

2000

2500

3000 Power Plant and DistrictHeating Plant

Industry Combustion

Small Consumer

Household

Road Traffic

other traffic

Industry Process

Agriculture

National Emission Ceiling by 2010

0

1000

2000

3000

4000

5000

6000

1996 1997 1998 1999 2000

Year

Emiss

ions

[kt (

TOFP

)] Transport

Agriculture

Domestic and services

Energy Industry

Industry-process and energy

0

200

400

600

800

1000

1200

1400

1600

1800

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Year

Industry-process and energy

Transport

Domestic and services

Energy Industry

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

5500

6000

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Year

Power Plant andDistrict Heating Plant

Industry Combustion

Small Consumer

Household

Road Traffic

other traffic

Industry Process

National Emission Ceiling by 2010

NOx

Ozone Precursors SO2

PM10

Air_Ex1: Exposure to Air Pollutants (urban population)

Methodology:• Large Cities >100.000 Inhabitants: Annual average Population• Measuring Data from Urban Background Stations (yearly mean)• Assumption: Background Level represents long term Exposure

More than one Station Mean of background StationsLimitation: only exposure to Ambient Air

• Calculation of Exposure classes for urban Population in Germany

City xy

Background Station 1

Background Station 2

Background Station 3

City Population (Annual Mean)

Urban Air Quality:(Annual Mean Station n)/n Stationsfor PM10 and NO2

For Ozone: Number of days > 120µg/m3

Air_Ex1: Exposure to Air Pollutants (urban population) PM10

0%

20%

40%

60%

80%

100%

1997 1998 1999 2000 2001

Year

Perc

enta

ge U

rban

Pop

ulat

ion

10

15

20

25

Urb

an P

opul

atio

n C

over

age

0-10

10-20 µg/m3

20-30 µg/m3

30-40 µg/m3

> 40 µg/m3

Population coverage

(1999/30/EU):Annual Mean: 40 µg/m3

Daily Mean: 50 µg/m3

Air_Ex1: Exposure to Air Pollutants (urban population) NO2

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1997 1998 1999 2000 2001

Year

Shar

e of

Urb

an P

opul

atio

n

10

15

20

25

Urb

an P

opul

atio

n co

vera

ge [

Mill

ions

]

0 - 10 µg/m3

10 - 20 µg/m3

20 - 30 µg/m3

30 - 40 µg/m3

> 40 µg/m3

Populationcoverage

1999/30/EGAnnual Mean: 40 µg/m3

1h-Mean : 200 µg/m3

Air_Ex1: Exposure to Air Pollutants (urban population) : Ozone

Number of Days over > 120 µg/m3 (8h average)

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1996 1997 1998 1999 2000 2001Year

Sh

are

of

Urb

an

po

pu

lati

on

10

12

14

16

18

20

22

Urb

an

Po

pu

lati

on

[M

illio

ns

]

0-10 days

10-20 days

20-30 days

30-40 days

>40 days

Populationcoverage

Health Impact (Air_E1; Air_E2 not evaluated) Reduction of Statistical Life Expectancy by

Exposure to PM2.5

Calculation of statistical Life

Expectancy (Life table)

RR = 1.06 (95% CI: 1.02-1.11)

For all cause mortality

Pope et al., 2002

ACS Cohort Study

500.000 US-Americans > 30 J.

PM2.5 Country Mean (Model)1990: 33.72010 (CLE): 15.72010 (MFR): 12.3

CLE: Current LegislationMFR: Maximum Feasible Reduction

0

200

400

600

800

1000

1200

1400

Germany1990

GermanyCLE

GermanyMFR

Day

s o

f Life

Lo

st

Source: Mecheler, Amann, Schöpp 2002

Szenario 2010

Reduction of Statistical Life Expectancy by Exposure to PM2.5 for 1990 und 2010 (CLE/MFR)

International Comparison

0

100

200

300

400

500

600

700

800

Country

Da

ys

of

Lif

e L

os

t

1990

CLE

MFR

Source: Mecheler, Amann, Schöpp 2002

Prevention of Mortality:Estimated Effect of Particle Filters

for Diesel VehiclesMortality Prevention

potential

(Excess Risk) [95% CI]

Cases Preventable Cases[Range of different

Models]

All cause 1,8 % [1,2-3,3] 800.000 14.400 [9.600-19.200]

Cardio-pulmonary

2,7 % [0,9-4,8] 460.000 12.420 [8.280-16.560]

Lung cancer

4,2 % [1,2-6,9] 40.000 1680 [1.120-2.240]

Wichmann 2003

Environmental Health Indicators

Many Wishes – Little Resources

Current Indicator Projects in Germany(including E&H Indicators)

Some Examples:• WHO-Environmental Health Indicators• WHO/EU ECOEHIS Project• National Core Indicators for Sustainable Development• Indicators for the Health Reporting of the Federal States• Core Indicators for Sustainable Development of the

Federal States

European Union:• Public Health Action Programme (1786/2002/EC):

EH Indicators for the European UnionWHO-Project ECOENHIS/ENHISFirst Meeting in May 2003:Discussion of the WHO Indicator Set:Modifications needed for the use in the European Union

• Environment & Health Strategy (COM(2003)338 final)Working group on Environment and Health Indicators

Health Impact Assessment

• Data should be useful for Health Impact Assessment

EHI for the EU

Further Work (Dec. 2003)

• Finalisation of selected Fact Sheets • Revision of the Methodology for Air Quality Indicators• National Project Report• Collaboration at the international Report (H.-G. Mücke)

• WHO Workshop (16./17. Oct. 2003)

Specification of Report Structure

Discussion of Fact Sheets for the International Report

For further information please contact:

juergen.thelen@uba.de

Federal Environmental Agency:

www.umweltbundesamt.de

WHO CC Air Quality Management/Air Pollution Control:

www.umweltbundesamt.de/whocc/title/title21.htm