Accounting for Death in the Tri-national Impact Assessment un / ece symposium, London 18th / 19th February 2001 Focus


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Accounting for Death in the Tri-national Impact Assessment UN / ECE Symposium, London 18th / 19th February 2001


Focus













Selected Attributable Health outcomes



Impact Assessment Model



Exposure-Response Function for Mortality





Frequency distribution of total PM10 population exposure



Air Pollution Attributable Death in Austria, France and Switzerland











Frailty and Death



Frailty and Exposure



Contribution of Air Pollution



Focus of the Time-series analysis





Time-series

  • 1) Time-series captures

  • 2) Life time lost not known



Focus of the Cohort Study



Cohort studies

  • capture cumulative total effects on time to death



Long-term and short-term cases (Künzli et al, Am J Epidemiol 2001 in press, adapted from COMEAP, 1998)



2) Number of death versus years of life lost



BUT:

  • BUT:

  • published are only number of deaths !



Mortality in the Trinational Study

  • 1) Direct estimates of „attributable death“

  • ( > age 30; non-violent death)

  • 2) Years of life lost:

  • Indirect estimates, used for costing

  • assumptions:

    • the attributable death are due to cardiopulmonary causes
    • same age distribution as all cardiopulmonary death
    • thus: typical age of an „air pollution death“ ~75-80 yrs.


Average reduction in population life expectancy

  • For a population with a 10 g/m3 higher PM10

  • Sommer et al. (Trinational Study): ~0.5 yr

  • other estimates: ~6 mo. to ~2 yrs.

  • (Brunekreef; Pope; Leksell; Hurley; Miller; Rabl etc.)





Mortality (adjusted Relative Risk) and long-term mean pollution (PM2.5) Harvard Six-City Cohort Study, Dockery et al, NEJM 1993; 329 (24):1753-9



Annual mean PM10 and expiratory capacity (FVC) in the 8 SAPALDIA areas Ackermann-Liebrich et al, AJRCCM 1997; 155 (1):122-129







Percent Change (and 95th CI) in Daily Death per 10 g/m3 PM2.5 mass an source specific elements 1979-1988, Harvard Six Cities; Laden et al, Env Health Perspect 2000; 108 (10): 941-947



Percent Change (and 95th CI) in Daily Death per 10 g/m3 PM2.5 mass an source specific elements 1979-1988, Harvard Six Cities; Laden et al, Env Health Perspect 2000; 108 (10): 941-947



Percent Change (and 95th CI) in Daily Death per 10 g/m3 PM2.5 mass an source specific elements 1979-1988, Harvard Six Cities; Laden et al, Env Health Perspect 2000; 108 (10): 941-947



Percent Change (and 95th CI) in Daily Death per 10 g/m3 PM2.5 mass an source specific elements 1979-1988, Harvard Six Cities; Laden et al, Env Health Perspect 2000; 108 (10): 941-947











TSP decrease and reduction in bronchitis prevalence (Germany, 1993 versus 1995, children, age 5-14 yrs)









Susceptibility and Time-to-event




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