Apheis: Health impact assessment of long-term exposure to PM(2.5) in 23 European cities

Introduction
Apheis aims to provide European decision makers, environmental-health professionals and the general public with up-to-date and easy-to-use information on air pollution (AP) and public health (PH). In the Apheis-3 phase we quantified the PH impact of long-term exposure to PM2.5 (particulate matter < 2.5 μm) in terms of attributable number of deaths and the potential gain in life expectancy in 23 European cities. Methods We followed the World Health Organization (WHO) methodology for Health Impact Assessment (HIA) and the Apheis guidelines for data collection and analysis. We used the programme created by PSAS-9 for attributable-cases calculations and the WHO software AirQ to estimate the potential gain in life expectancy. For most cities, PM2.5 levels were calculated from PM10 measurements using a local or European conversion factor. Results The HIA estimated that 16,926 premature deaths from all causes, including 11,612 cardiopulmonary deaths and 1901 lung-cancer deaths, could be prevented annually if long-term exposure to PM2.5 levels were reduced to 15 μg/m3 in each city. Equivalently, this reduction would increase life expectancy at age 30 by a range between one month and more than two years in the Apheis cities. Conclusions In addition to the number of attributable cases, our HIA has estimated the potential gain in life expectancy for long-term exposure to fine particles, contributing to a better quantification of the impact of AP on PH in Europe.