Assessing the health effects of air pollution is essential for developing evidence-based clean air policies and protecting public health. In the WHO European Region alone, air pollution is estimated to kill more than half a million people every year.
The Health Risks of Air Pollution in Europe: HRAPIE-2 project, new WHO guidance co-funded by the European Union, provides updated evidence and methodological advice to improve health risk assessments of air pollution and enable policy-makers to make better-informed decisions on clean air and climate change mitigation policies.
Air pollution remains the leading environmental health risk both in the Region and globally. It contributes to premature mortality, respiratory infections and many noncommunicable diseases. Such assessments estimate the scale of the problem – how air pollution impacts health – and evaluate the effectiveness of measures to reduce it.
The guidance relies on the review of a large body of new evidence, consolidated in the last 12 years, on the association of key air pollutants with both mortality and morbidity outcomes. It updates the results of the first iteration of the HRAPIE project, released in 2013, which provided a valuable resource for health risk assessment practitioners, technical experts, researchers and, ultimately, for policy development in the Region.
Broader scope, better advice
The guidance focuses on selected key air pollutants (particulate matter with a diameter of less than 10 μm and less than 2.5 μm, ozone, and nitrogen dioxide) and an extended set of health outcomes (morbidity and mortality for selected causes). The inclusion of morbidity outcomes, drawing on the findings of a related WHO global project, can enhance the way clean air benefits are communicated to decision-makers by facilitating comparison of economic gains from reduced morbidity with investments required for actions.
Wide policy relevance
This guidance is essential for advancing the latest WHO regional and global policy frameworks on air pollution, such as the Budapest Declaration and the Updated Road Map for an Enhanced Global Response to the Adverse Health Effects of Air Pollution.
It also supports the broader United Nations air pollution agenda, for example, by informing the revision of the Protocol to Abate Acidification, Eutrophication and Ground-level Ozone (the Gothenburg Protocol, part of the United Nations Economic Commission for Europe Air Convention) towards more ambitious emission reduction commitments for several air pollutants.
The Joint Task Force on the Health Aspects of Air Pollution, led by WHO/Europe, plays a specific role by providing evidence-based advice on health risk assessment of air pollution to the Air Convention and its bodies. In addition, the guidance is a relevant source for the work of other European institutions working on air quality and related issues such as climate action and energy policy, including the European Union and the European Environment Agency.
Revised concentration–response functions in the guidance also support the improvement of WHO tools, such as AirQ+, one of the most used tools worldwide for estimating the health effects of air pollution; and CLIMAQ-H, which estimates the health and related economic gains achieved through implementing actions aimed at mitigating climate change by reducing domestic carbon emissions and associated air pollution.
WHO’s role
The guidance is based on systematic reviews and other evidence syntheses and contributions from leading air quality experts, coordinated and supervised by the WHO European Centre for Environment and Health (ECEH) with co-funding from the European Union.
ECEH is a WHO/Europe centre of scientific excellence that develops policy advice and guidelines on issues such as air quality and noise to inform and support decision-making by governments, health professionals and other stakeholders.