Public-health impact of outdoor and traffic-related air pollution:: a European assessment

Background Air pollution contributes to mortality and morbidity. We estimated the impact of outdoor (total) and traffic-related air pollution on public health in Austria, France, and Switzerland. Attributable cases of morbidity and mortality were estimated. Methods Epidemiology-based exposure-response functions for a 10 mu g/m(3) increase in particulate matter (PM10) were used to quantify the effects of air pollution. Cases attributable to air pollution were estimated for mortality (adults greater than or equal to 30 years), respiratory and cardiovascular hospital admissions tall ages), incidence of chronic bronchitis (adults greater than or equal to 25 years), bronchitis episodes in children (<15 years), restricted activity days (adults greater than or equal to 20 years), and asthma attacks in adults and children. Population exposure (PM10) was modelled for each km(2). The traffic-related fraction was estimated based on PM10 emission inventories. Findings Air pollution caused 6% of total mortality or more than 40 000 attributable cases per year. About half of all mortality caused by air pollution was attributed to motorised traffic, accounting also for: more than 25 000 new cases of chronic bronchitis (adults); more than 290 000 episodes of bronchitis (children); more than 0.5 million asthma attacks; and more than 16 million person-days of restricted activities. Interpretation This assessment estimates the public-health impacts of current patterns of air pollution. Although individual health risks of air pollution are relatively small, the public-health consequences are considerable. Traffic-related air pollution remains a key target for public-health action in Europe. Our results, which have also been used for economic valuation, should guide decisions on the assessment of environmental health-policy options.