Room
1er étage - D130
Theme
Interaction between environment, sustainability and health
Chair
Anne Borchard
Title
Health benefits of complying with the 2021 World Health Organization Air Quality Guidelines in Switzerland
Name
Alberto Castro
Affiliation
Swiss Tropical and Public Health Institute
Abstract
The limit values of the Ordinance on Air Pollution Control (OAPC) largely correspond to the World Health Organization Air Quality Guidelines (WHO-AQG) from 2005. In 2021, the WHO-AQG values (WHO-AQG-2021) were tightened for particulate matter (PM2.5) and NO2 based on new evidence. The adoption of these values are recommended for Switzerland (by the Swiss Federal Commission for Air Hygiene). The aim of our study, commissioned by the Federal Office for the Environment, was to assess the health benefits of complying with the new WHO-AQG-2021 values in Switzerland in 2019.To quantify the health benefits, we assessed the health impacts of air pollution from PM2.5 and NO2 in a reference scenario, namely compliance with the WHO-AQG-2021 values (5 µg/m3 PM2.5, 10 µg/m3 NO2) in Switzerland, compared to the observed population-weighted exposure for Switzerland in 2019 (8.85 µg/m3 PM2.5, 16.32 µg/m3 NO2).
We selected the pollutant-outcomes pairs to be assessed based on evidence and availability of data. Thus, we assessed mortality as deaths and as years of life lost (YLLs) separately for adults and infants as well as the following morbidity outcomes: Incidence of acute lower respiratory infections (ALRI) in children, chronic obstructive pulmonary disease (COPD) in adults, type 2 diabetes in adults, ischemic heart disease in adults, strokes in adults, lung cancer in adults, asthma in adults and children, dementia in seniors, low birth weight at term births, hospital admissions for respiratory and cardiovascular diseases, restricted activity and work loss days.
Compliance with the WHO-AQG-2021 value for PM2.5 would have prevented 2’610 attributable deaths (around 27’740 YLLs). The diseases with the largest health benefits by reducing exposure to PM2.5 in 2019 would have been dementia, COPD and ischemic heart disease (5'640, 3'501 and 2'670 cases respectively). Compliance with the WHO-AQG-2021 value for NO2 would have prevented around 1’150 cases of asthma in adults in 2019.
The health benefits of complying with the WHO AQG 2021 values in Switzerland are considerable and therefore advisable.
Title
Prioritising Health in Mobility Planning: unlocking the health potential of Sustainable Urban Mobility Plans (SUMPs)
Name
Sonja Kahlmeier
Affiliation
Swiss Distance University of Applied Science FFHS
Abstract
Transport can influence health both positively and negatively through various detrimental and beneficial pathways. Transport policies that promote health offer major environmental and economic co-benefits and are critical for achieving the United Nations Sustainable Development Goals.To date, few studies have empirically examined the degree to which health goals and outcomes have been incorporated into urban mobility plans. This work assessed how much health is addressed in current Sustainable Urban Mobility Plans (SUMPs), including the extent to which: i) health and its various aspects like health equity were highlighted, ii) transport pathways to health and their associated health outcomes were made explicit, and iii) health was operationalised into targets and KPIs and the health-rationale of various actions and measures is elaborated.
A three-step method was used: i) developing a health dictionary and a policy analysis checklist, ii) conducting a quantitative text analysis on a dataset of 230 SUMPs, and iii) performing a detailed qualitative analysis of a purposive sample of 13 SUMPs across Europe. The findings showed that while health is often touched upon, and its prominence seems to be increasing, SUMPs miss out on the opportunity to embrace mobility as a driver of health promotion. The link between transport and equity, and social and mental wellbeing was not frequently discussed. Detailed targets and key performance indicators (KPIs) for several health pathways were scarce or missing, as were the health rationale and health outcomes for proposed measures. Overwhelmingly, SUMPs’ health aspirations were concerned with minimising detrimental impacts of transport on health, primarily from traffic injuries and to a lesser extent from air pollution. Health related concepts such as accessibility and active travel feature prominently but were not seen as an opportunity to enhance health.
It is recommended to highlight the role of transport policy not only in reducing adverse health effects, but also as an opportunity for health enhancement.
Title
Combining large scale environmental exposure modelling with big data for public health surveillance
Name
Martin Röösli
Affiliation
Swiss TPH
Abstract
Although highly relevant for public health, environmental health risks are typically small for an individual and thus large studies are needed to observe potential health risks. We have combined nationwide exposure models for radon, air pollution (PM2.5, NO2, black carbon and ozone), transportation noise (rail, road, and aircraft), temperature (including urban heat islands), green space, pollen and ultraviolet (UV) radiation with mortality data from the Swiss National Cohort and cancer incidence from selected Swiss cancer registries to investigate emerging environmental health risks. Standard methods for data analysis have been applied including confounding adjustments. Subsequently, attributable fractions have been calculated.Risk for all-natural cause mortality was found to increase by 2.6% (95% CI: 1.5%, 3.8%) per 5 µg/m³ long-term exposure to PM2.5 at the place of residence; 5.0% (4.1%, 5.9%) per 10 µg/m³ NO2, and 4.5% (4.0%, 4.9%) per 10 dB Lden total transportation noise. Increase of all-cause mortality on hot days (35°C) was 31% (20%, 42%) compared to minimum mortality temperature (22.5 °C) with even higher increases for people living in urban heat islands. Risk for malignant melanoma mortality increased by 10% (-1%, 23%) per 100 Bq/m³ radon and by 5% (1%, 9%) per mW/m² UV radiation at the place of residence. A subsequent analysis on melanoma incidence data could only confirm an increased risk from radon in young people (<30 years). Green space within 500 m of the living place reduced mortality by 5% (4%, 6%) per interquartile range independent of air pollution and noise. Data analysis on acute cardiorespiratory mortality and pollen exposure is in progress. Considering the magnitude of exposure and observed risk, it was concluded that about 6% of all deaths are attributable to air pollution, 5% to noise, 1% to hot days and about 5% of all malignant melanoma deaths each to residential radon and UV radiation.
Large scale environmental exposure modelling combined with big health data facilitates a better understanding of environmental health risks. Currently available big data have limitations in terms of possibility for confounding control and detailed phenotyping. A large population-based Swiss cohort and biobank would allow for most reliable research on environmental health risks.
Title
Long-term exposure to PM10 and respiratory health among Parisian subway workers
Name
Romain Freund
Affiliation
Unisanté
Abstract
Background:Long-term exposure to ambient particulate matter (PM) in adults increases the risk chronic obstructive pulmonary disease (COPD), lung function decline and asthma exacerbation. We evaluated the long-term exposure to PM10 and its relationship with COPD prevalence, lung function and current asthma in Parisian subway workers.
Methods:
Participants were randomly selected from a 15,000-subway worker cohort. Individual annual external exposure to PM10 (ePM10) was estimated using a company-specific job-exposure-matrix based on PM10 measurements conducted between 2004 and 2019 in the Parisian subway network. Mean annual inhaled PM10 exposure (iPM10) was modeled as function of ePM10 exposure, inhalation rate, and filtration efficiency of the respiratory protection used. COPD and current asthma diagnoses were performed in March–May 2021 based respectively on post-bronchodilator spirometry and self-administered questionnaire. The relationship between iPM10 and outcomes was assessed using logistic and linear regression models, adjusted for exposure duration and potential confounders.
Results:
Amongst 254 participants with complete data, 17 were diagnosed as COPD and 16 with a current asthma. The mean employment duration was 23.2 ± 7.3years, with annual mean ePM10 of 71.8 ± 33.7 μg/m3 and iPM10 of 0.59 ± 0.27 μg/shift, respectively. A positive but statistically non-significant association was found for COPD prevalence with iPM10 (OR = 1.034, 95%-CI = 0.781; 1.369, per 100 ng/shift) and ePM10 (OR = 1.029, 95%-CI = 0.879; 1.207, per 10 μg/m3). No decline in lung function was associated with PM10 exposure. However, forced expiratory volume during the first second and forced vital capacity lower than normal were positively associated with exposure duration (OR = 1.125, 95%-CI = 1.004; 1.260 and OR = 1.171, 95%-CI = 0.989; 1.386 per year, respectively). Current smoking was strongly associated with COPD prevalence (OR = 6.85, 95%-CI = 1.87; 25.10) and most lung function parameters. iPM10 was associated with an increased risk of current asthma only among locomotive operators (OR=1.05, 95%-CI = 1.00; 1.10).
Conclusion:
This is the first study assessing the relationship between long-term exposure to subway PM10 and respiratory health in subway workers. The risk estimates related with subway PM10 exposure are compatible with those related to outdoor PM10 exposure in the large recent studies. Large cohorts of subway workers are necessary to confirm these findings.
Title
Monitoring ambient electromagnetic field levels between 2021 and 2023: a “5G Hiker” story
Name
Nicolas Loizeau
Affiliation
Swiss Tropical and Public Health Institute
Abstract
The fifth generation of mobile technology (5G) has been extensively deployed across Switzerland since 2021, giving rise to public concerns about potential increase in electromagnetic field (EMF) levels. A drastic increase in ambient EMF exposure calls for appropriate public health action, whereas a false claim could provoke unjustified public alarm. Therefore, in the frame of the Swiss non-ionizing radiation exposure monitoring, we aim to assess the changes in ambient exposure to EMF in the Swiss population between 2021 and 2023 following the first rollout of 5G.We measured ambient EMF using portable devices in 75 outdoor areas, 43 public spaces and transport twice: 2021 and 2023. Thereby, by a measurement engineer named the “5G Hiker” walked with a backpack containing the measurement devices through various environments including taking public transport. The outdoor areas were selected to be representative in terms of EMF sources (e.g. mobile base stations), and territorial typologies of Switzerland. EMF levels were measured with two ExpoM-RF4, which cover 35 radiofrequency (RF) bands from 80 MHz to 6 GHz. For each individual measurement, the ExpoM-RF4 records the mean EMF value and the instantaneous highest value (“Peak-Hold”) within a 50 ms interval. Note that the personal phone was always on airplane mode during the measurements to record only ambient EMF exposure.
In 2023, highest mean EMF levels were measured at tram stops (0.91 V/m) and in an airport (0.66 V/m). In public spaces, the mean EMF levels increased from 0.38 V/m to 0.41 V/m between 2021 and 2023, whereas the mean of the “Peak-Hold” levels increased from 2.15 V/m to 2.81 V/m. The most significant increase in “Peak-Hold” values occurred in the bands related to 5G, rising from 0.68 V/m to 1.44 V/m, followed by the bands associated with older technologies (3G, 4G) from 1.92 V/m to 2.32 V/m. In outdoor areas, the mean EMF levels remained unchanged between 2021 and 2023 (0.28 V/m).
The mean EMF levels have remained relatively stable between 2021 and 2023 despite the continuing increase in mobile data traffic. However, an increase in “Peak-Hold” values has been observed and can be attributed to the more dynamic nature of new technologies (e.g. 5G). While our findings have consistently reported EMF levels well below the regulatory limits, mostly <1% of the limit, monitoring the ambient EMF levels remains necessary in view of the constant change in communication technologies.