Air quality trends and potential health effects – Development of an aggregate risk index

The “Provence Alpes Côte d’Azur” (PACA) region, in the South East of France, is one of Europe’s regions most influenced by the atmospheric pollution. During the last 15 years, the industrial emissions decrease caused an evolution of the atmospheric pollution nature. Nowadays, atmospheric pollution is more and more influenced by the road traffic, the dominating pollution source in urban zones for the PACA region. Combined with this intense road traffic, the strong hot season of the Mediterranean climate contributes to the region bad air quality; it is known to be one of the worse in Europe. The recognized air pollution effects over public health include increased risk of hospital admissions and mortality by respiratory or cardiovascular diseases. The combination of these serious pollution related health hazards with senior and children vulnerabilities leads to serious sanitary concerns. Over the 1990–2005 period, we obtained, using the non-parametric Mann–Kendall test from annual mortality dataset (CépiDC), decreasing trends for Asthma (−5.00% year−1), Cardiovascular (−0.73% year−1), Ischemic (−0.69% year−1) and cerebrovascular diseases (−3.10% year−1). However, for “Other heart diseases” (+0.10% year−1) and “Respiratory” (+0.10% year−1) an increase was observed. The development of an adequate tool to understand impacts of pollution levels is of utmost importance. Different pollutants have different health endpoints, information may be lost through the use of a single index consequently, in this study we present the modified formula of air quality index, based on Cairncross’s concept the Aggregate Risk Index (ARI). ARI is based on the relative risk of the well-established increased daily mortality, or morbidity, enabling an assessment of additive effects of short-term exposure to the main air pollutants: PM2.5, PM10, SO2, O3 and NO2 in order to account for the reality of the multiple exposures impacts of chemical agents. The ARI, developed per pathology, takes into account the possible adverse effects associated with the coexistence of all pollutants. This index will enable to communicate the health risks associated, from modelled or monitored pollutant concentrations, to the general population. The second step will consist in the construction of a prediction model of this sanitary index.