Particulate matter in outdoor air and related health impacts in five major Estonian towns

Authors: Hans Orru   Erik Teinemaa   Taavi Lai   Eda Merisalu   Tanel Tamm   Marko Kaasik   Veljo Kimmel   Kati Orru   Bertil Forsberg  

AIM. The cur rent study quantifies the health effects of particulate matter (PM) in the neighbourhoods of five main cities in Estonia.

METHODS. For health impact assessment (HIA), information on exposure, baseline mortality/morbidity and exposure-response relationships from previous epidemiological studies was used. The exposure was defi ned as modelled PM2.5 annual levels and daily averages of PM10 (monitoring data from Tallinn, Kohtla-Järve and modelled levels in Tartu, Narva, Pärnu). For health impact calculation, the WHO developed software AirQ was applied.

RESULTS. The annual average concentration of PM2.5 in the neighbourhoods varied from 7.6 to 23.6 μgm-3. Analysis indicated that exposure above the natural background corresponds to 462 (95% CI 120–815) premature deaths resulting in 6034 (95% CI 1583–10309) years of lives lost per year. Average decrease in life-expectancy at birth per resident was estimated at 0.63 (95%  CI 0.16–1.08) years. In polluted city centres, decrease in life expectancy may be more than a year, while in the least polluted neighbourhood it was only two months. In addition, there could be expected 231 (95% CI 145–306) respiratory and 338 (95% CI 205–454) cardiovascular hospitalizations per year. The majority of the external costs are related to long-term effects on mortality, €270 (95% CI 190–350) million annually. In comparison, the costs of hospitalizations contribute to only €1.1 (95% CI 0.6–1.6) million.

CONCLUSIONS. There is substantial exposure to particulate matter in Tallinn, Tartu, Kohtla-Järve, Narva, and Pärnu, which causes considerable health effects in the form of cardiopulmonary diseases. Biomass combustion (local heating) and traffic remain the most important contributing factors to air quality degradation and the resulting adverse health effects. However, assessment of the impor tance of this problem is not a straightforward task. The sources and effects are manifold and vary among different societal groups.

Eesti Arst 2010; 89(4):242−250