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D P S E E A
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Christchurch, winter evening, 23July 2001, 6.30
p.m.
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DPSEEA Air pollution due to household heating

• Driving forces
• Energy policy, Housing policy, economic growth,
  poverty, SES
• Pressures
• amount of polluting fuels used (wood, coal),
  number of chimneys
• State of environment
• outdoor air quality, indoor air quality, chimney
  density and cold, calm days

• Exposures
• time spent in polluted air, indoor/outdoor
  exposures, actual inhaled amounts of pollutants
• Effects
• Resp. and CVD deaths, hospital admissions,
  asthma, COPD, restricted activity days, economic
  impact
• Actions
• at each level of DPSEEA

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Pressure (chimneys) to State (chimney density)
indicators. Kjellstrom and Exeter, 1999
D P S E E A
1996 census data households using wood or coal
as primary heating source (C) assuming one
chimney per household CD chimney
density C / km2 (size of census area)
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Christchurch heating air pollution analyzed by
DPSEEA

• Chimney density correlated with air poll.
  monitoring results in the same area Pressure
  to State to Exposure
• Areas with high chimney density (S) also has low
  SES status (D)(Hales et al., 2000).
• In epidemiological analysis both SES and chimney
  density are associated with increased mortality
  Driving force to
  Pressure/State to Effect

D P S E E A
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Plot of residual of Poisson model without PM10
against the level of PM10 in Christchurch
D P S E E A
Each point is an average of 20 adjacent points
sorted by PM10
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Daily mortality as a function of season and PM10
Daily deaths
D P S E E A
PM10, ug/m3
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Christchurch epidemiological studyPoisson
regression result (1988 - 1997)
D P S E E A
Best Model Response Total deaths
The 24 hour average level of PM10 on the day
prior to death and the variable HOT (created
based on 1 hour maximum temperature) on the day
of death had the statistically strongest
association with the number of daily deaths.
Hales, Kjellstrom, Shrestha et al., 2002
The coefficients can be considered as indicators
of env. health impact
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DPSEEA Air Pollution from Transport

• Driving forces
• Transport policy, public transport provision,
  economic growth, poverty, SES
• Pressures
• amount of fuel used, number of vehicles
• State of environment
• outdoor air quality, indoor air quality, vehicle
  density and calm days

• Exposures
• time spent in polluted air (including inside
  vehicles), actual inhaled amounts of pollutants
• Effects
• Resp. and CVD deaths, hospital admissions,
  asthma, COPD, lung cancer, restricted activity
  days, economic impact
• Actions
• at each level of DPSEEA

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Slide with Maps of Auckland air pollution and
socio-economic deprivation
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Actions and indicators Household heating,
Transport, Air Pollution
D P S E E A

• Driving forces
• Coal ban and Open fire ban (CHC), Public
  transport investment (AKL)
• Pressures
• Subsidies for efficient wood burners (CHC)
• State of environment
• improved air quality monitoring and modelling

• Exposures
• improved insulation, ventilation of houses to
  reduce indoor levels
• reduced time in traffic jams
• Effects
• Improved acute care and early warning system for
  vulnerable people

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International initiatives to build bridges
Public Health and Environment

• Europe major joint policy meetings of Ministers
  of Health and Environment
• UNCSD Creating core lists of Sustainable
  Development Indicators (but, lack of attention to
  existing WHO Health Indicators)
• WHO Ongoing analysis of Burden of Disease for
  several environmental risk factors, including
  Global Climate Change
• Selected countries, e.g. Australia, Sweden
  developing and testing innovative indicators
  (e.g. obesogenic environment indicators)

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100 pure environment. The end. Thank you !