HEALTH IMPACT OF AIR QUALITY MANAGEMENT EFFORTS

1

• HEALTH IMPACT OF AIR QUALITY MANAGEMENT EFFORTS

DESIREE M. NARVAEZ, MD, MPH DEPARTMENT OF
HEALTH MANILA, PHILIPPINES
2
Air pollution and sperm cells

• Czech Republic 35 young men exposed to high air
  pollution due to coal burning power stations and
  fossil fuels in 2 years had sperm examined in
  terms of shape, number, motility, damage
• Significant association between exposure to
  periods of high air pollution ( at or above the
  US air quality standards) and the percentage of
  sperm with DNA fragmentation---
• Potentially lead to birth defects or miscarriages
• Chemicals in air that can cause damage to human
  DNA
• ( Czech Research Institute and US EPA)

3
Save the sperm cellPrevent birth defects or
miscarriagesFight air pollution!
4
Public Health Monitoring of the Metro Manila Air
Quality Improvement Sector Development Program
ADB - WHO - DOH STUDY 2002-2004
3 COMPONENTS Health Risk Assessment Epidemiologic
al Study Health Risk Perception
5
Attributable number of cases exposure-response
coefficient x excess exposure level x exposed
population x baseline mortality rates
Exposure-response coefficients from
time series studies Morbidity
Kunzli et al (US/Eu)
Mortality Bangkok study
6
Estimated number of hospital admissions per
million population in excess of 10 ug/m3 PM,
Metro Manila, 2002
7
Particulate matter (PM10 and PM2.5) and
trophospheric ozone are of serious concern in
Metro Manila. Long term PM10
concentrations likely to violate National Air
Quality (NAQ) guideline of 60 µg/m3.
Long and short-term PM2.5 levels may be unhealthy
for the general public. Ozone exceeds
short-term guideline value
8

• Impact on mortality by 10 µg/m3 PM10 reduction in
  Metro Manila in 2002
• 35 - 59 fewer deaths per million population from
  natural causes
• 5 - 28 fewer deaths per million population from
  cardiovascular causes
• 43 - 49 fewer deaths per million population from
  respiratory causes

9

• Impact on morbidity for a uniform reduction of 10
  µg/m3 PM10 in Metro Manila in 2002
• reduction of gt23,000 cases of acute bronchitis
• reduction of gt400 cases of asthma
• reduction of gt30 cases of chronic bronchitis
• 20 respiratory cases per million population
• 4 cardiovascular cases per million population

10
Lead content of gasoline and mean blood lead
levels among children in Metro Manila, 1993-2003
Children in high traffic area
School children
Children
0.84
0.6
0.15
0.0
0.0
N.B. lead in gasoline not actual values but
highlighted for illustration purpose only
11
Integrated Strategies to Reduce Vehicular
Emissions Improve Air Quality in Metro
ManilaIntegrated Environmental Strategies (IES)
Philippines Manila Observatory with support
fromthe US Agency for International
Development,US Environmental Protection Agency
andUS National Renewable Energy
Laboratory2003-2004
12
POLICIES, TECHNOLOGIES,MEASURES

• Motor Vehicle Inspection System
• Conversion to 4-stroke tricycles
• Railways
• Diesel Particulate Trap
• Compressed Natural Gas - Buses
• CocoMethyl Ester - Jeepneys
• Traffic Demand Management
• Bikeways

13
Air Quality Modeling Scheme
Health and Economic Costs
Air Pollution Concentration Map
14
Health Outcomes

• Natural Mortality
• Respiratory Mortality
• Cardiovascular Mortality
• Respiratory Hospital Admissions
• Cardiovascular Hospital Admissions
• Asthma Attacks lt15 years old
• Asthma Attacks /gt 15 years old
• Bronchitis Episodes lt 15 years old
• Chronic Bronchitis gt 25 years old

15
MORTALITY Metro Manila Number of Deaths
Averted per Policy scenario
16
Asthma Attacks lt15 years old Metro
ManilaNumber of Cases per Policy Scenario
17
What is the cost of the health damages that can
be averted by the different policy scenarios?

• Morbidity
• Cost of illness method
• Work Loss Days
• Mortality
• Benefits Transfer

• Values are in 1995 prices
• Present Value of Year 2002 Estimates
• Using 12 discount rate for 2005, 2010,2015
• Orbeta Study and PhilHealth data

18
Economic Valuation of the Health Impact per
Policy Scenario (PHP)
19
HEALTH SECTOR EFFORTS WAR AGAINST AIR
POLLUTION THE WAY FORWARD
20

• Establishment of Health Information System for
• Air Pollution related Illnesses
• Status (on going)
• 1. Identified sentinel health centers within 1
  km
• distance from DENRs Air monitoring
  stations
• 2. Developed data gathering forms/tools for air
  
• pollution related illnesses
• 3. Working with Makati City as pilot LGU for
  the
• project
• 4. Procurement of Computer sets for the GIS of
  the
• health information system.

21

• Establishment of Health Information System for
  Air Pollution
• related Illnesses

• Sentinel sites
• health center
• private clinics
• hospital

EMB Air Monitoring Stn
22
(No Transcript)
23
Relationship between Air Quality and Health
Effects
Dummy Table
24
HEALTH EFFORTS AGAINST AIR POLLUTION

• IEC development
• Status (on going)
• 1. Development of Communication Plan/
• Strategy
• 2. Prototype IEC materials (posters, leaflets,
• TV/radio plugs)

25
HEALTH EFFORTS AGAINST AIR POLLUTION

• Training on Air Sampling Strategies
• (to be conducted this Nov)
• 1. Equipped field personnel on indoor air
• sampling strategies
• 2. Development of an indoor air quality
• action plan for each
  LGU

26
(No Transcript)