Shared Burden: Public Health Impact of Nine Environmental Pollutants in Europe

Airborne particulate matter may be the most significant environ­ mental risk factor for disease across much of Western Europe, according to a new analysis published this month in EHP. 1 The study compares the disease burden associated with nine environ­ mental exposures across six European countries—Finland, Germany, France, Italy, Belgium, and the Netherlands. Few studies have sought to rank environmental risk factors on an international level by their public health impact—a critical aspect for developing effective policy measures, according to the team led by Otto Hänninen, a pollution exposure researcher at Finland's National Institute for Health and Welfare. " Comparability across countries is very useful in promoting abatement that requires international policies—such as those pertaining to long­range transported particulate matter or vehicle emissions, " Hänninen says. The research team evaluated the potential public health impact for each of the nine exposures by estimating years of life lost due to death and disability. For each exposure, they selected one or more health outcomes that had been causally associated with it—for instance, cardiac death and chronic bronchitis associated with fine particulate matter (PM 2.5), sleep disturbance associated with traffic noise, onset of asthma associated with secondhand smoke exposure, and cancer resulting from exposure to dioxins and dioxin­like polychlorinated biphenyls (PCBs). 2 Other environmental risk factors assessed included benzene, formaldehyde, lead, ozone, and radon. Hänninen and colleagues concluded that about 3–7% of the total annual disease burden across all six countries could be associated with these nine environmental exposures. PM 2.5 was the environmental risk factor with the highest public health sig­ nificance, accounting for 68% of the total estimated health impacts. Secondhand smoke and traffic noise tied for second place, each estimated to account for 8% of the environmental disease burden, while radon accounted for an estimated 7%. It's not surprising that airborne particles dominated the disease burden, says C. Arden Pope III, an environmental economist at Brigham Young University who was not involved in the current study. " Everyone is exposed to particulates. These findings reflect the ubiq­ uity of that exposure, even in developed countries, compared to other risk factors such as radon or even secondhand smoke, where exposures may be more limited, " he says. The World Health Organization (WHO) has estimated that out door air pollution was re sponsible for 3.7 million deaths in 2012—roughly 1 in 15 deaths globally. 3 Most of those deaths were in low­ …