Outdoor air pollution has a large impact on public health
Outdoor air pollution, although usually of small immediate risk to the health of individuals, has a large impact on long-term public health in Europe, says a report presented at the World Congress on Lung Health in Florence this September. The report was also published to coincide with the congress (Lancet, 2000, 356: 795801).
Dr Nino Künzli from the Institute for Social and Preventive Medicine at the University of Basel, Switzerland, headed a team of specialists who estimated the impact of outdoor and traffic-related air pollution on public health in Austria, France and Switzerland.
The authors attributed around 6% of total mortality or more than 40 000 deaths per year to air pollution. There were more than 48 000 hospital admissions, and about half a million asthma attacks. Traffic accounted for half of this public health impact and also for 25 000 new cases of chronic bronchitis, 290 000 episodes of bronchitis in children, and 16 million person-days of restricted activities.
Total costs estimates, soon to be published in an Organisation for Economic Cooperation and Development report by the economist Dr Heini Sommer and colleagues, reached 600700 Euro per capita per year, in all three countries, giving a final total cost of approximately 50 000 million Euro. However the estimates are based on prudent assumptions and the overall impact may be larger.
These findings are significant because they are the first data that can be compared across the participating countries. Cross-country comparisons are possible because population exposure was modelled for each square kilometre and identical assumptions and methods were used.
Given that air pollution is mainly due to the excessive burning of fossil fuels, the promotion of energy efficiency and renewable energies is urgently required to protect both the climate and public health. Dr Künzli emphasized the need for international clean air regulation and enforcement. He said: the paper strongly underlines the public health relevance of WHO efforts to improve air quality. The opportunistic decisions of governments in many countries to subsidize the use of gasoline and, thus, to support air pollution and the related health effects, is a drastic example for the fundamental failure of politicians to base decisions on scientific evidence, public health relevance, and the vision of sustainable development. WHO will have a long way to go.
Independently, WHO held a strategy meeting on Air Quality and Health in Geneva in the second part of September that identified major areas to be addressed on the way to creating a WHO strategy on air pollution and health. WHO would like to provide its 191 Member States with a sound environmental policy framework and actions applicable to different settings and to different socioeconomic conditions explained Dr Michael Repacholi, WHO Coordinator for Occupational and Environmental Health. He added: But first all parties involved should hammer out a unified methodology for collecting comparable data worldwide to support science-based assessments of health impacts. 
Tudor Toma, London