The Health Effects Institute
"A Partnership of the U.S. Environmental Protection Agency and Industry"

Understanding the Health Effects of
Particulate Air Pollution:
Recent Advances and Outstanding Questions

A Meeting for Members of Government, Industry,
and the General Public

Organized by the World Health Organization
and the Health Effects Institute
in cooperation with the European Commission

Brussels, Belgium
6 and 7 March 2001

GOALS OF THE WHO/HEI MEETING

The meeting has four major goals:

• Review the current scientific evidence on the health effects of particulate matter with specific focus on research results that have become available since 1999
• Describe the findings of recent European and US health impact assessments
• Present ongoing research that could address outstanding scientific questions in the next 2-3 years
• Identify key scientific questions relevant to regulatory policy in Europe that require additional research

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Click here for a list of poster presenters and poster titles.

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FINAL PROGRAMME

TUESDAY 6 MARCH

09:30	Registration
Opening Session: Seeking the best science Chair: D Greenbaum, Health Effects Institute
10:00	Welcome and opening comments -   W Kreisel, World Health Organization -   U Sviden, Permanent Representation of Sweden to the European Parliament -   B Hansen, DG Research
10:30	Current European and US regulatory contexts -   L Edwards, European Commission DG Environment -   W Harnett, US Environmental Protection Agency
New research results since 1999 Chairs: R Bertollini, World Health Organization and S Vedal, University of British Columbia, Canada
11:00	Introduction to Day 1 Day 1 Chairs What new research results have emerged since the proposal of the daughter directives about the evidence of an association between PM and adverse health effects?
11:10	Session 1: Do we know more about hazard evaluation for PM than we did 2-3 years ago? Emphasis will be on epidemiologic studies that have addressed possible biases in earlier studies (e.g., measurement error, confounding, influence of other than PM components of the pollution mix, bias due to city selection, etc.). Also some review of laboratory experiments that explored hypotheses about possible biologic mechanisms will be provided. In addition to these oral presentations, other work, now underway, will be presented in the Poster Session.
	Two overview talks covering exposure assessment, epidemiology, and toxicology -   B Brunekreef, University of Utrecht, the Netherlands -   A Seaton, University of Aberdeen, United Kingdom
	Presentations of recently completed studies -   Air Pollution and Health: A European Approach (APHEA) 2, K Katsouyanni,     University of Athens, Greece -   National Mortality and Morbidity Air Pollution Study, J Samet, Johns Hopkins     University, United States -   Reanalysis of American Cancer Society and Six Cities Studies, D Krewski,     University of Ottawa, Canada -   Air Pollution Exposure Distributions within Adult Urban Populations in Europe     (EXPOLIS) Study, M Jantunen, National Public Health Institute, Finland
	Questions and discussion
13:15	Lunch
14:45	Session 2: Can we identify either specific sources, sizes, or constituents of PM that are associated with adverse health effects? Studies of fine and ultra-fine PM, diesel exhaust, chemical composition, and other aspects of PM composition would be the focus here. A key theme will be the limitations of current approaches (both epidemiologic and toxicologic) for answering questions about the role of specific constituents. In addition to these oral presentations, other work now underway would be presented in the Poster Session
	Two overview talks covering primary and secondary PM, and the potential health effects associated with different components of the PM mixture -   R Harrison, University of Birmingham, United Kingdom -   F Cassee, National Institute of Public Health and Environment, the Netherlands
	Presentations of recently completed studies -   Exposure and Risk Assessment for Fine and Ultrafine Particles in Ambient Air     (ULTRA) Study, J Pekkanen, National Public Health Institute, Finland -   Erfurt (Germany) Mortality Study, E Wichmann, GSF Forschungszentrum     Institute of Epidemiology, Germany -   US EPA Toxicologic Studies of PM-associated Metals, J Dye, US EPA National     Health and Environmental Effects Research Laboratory, United States -   Swedish Tunnel Exposure Studies, T Bellander, Department of Environmental     Health, Sweden
	Response by environmental regulator M Williams, Department of the Environment, Transport and Regions, United Kingdom
	Questions and discussion
17:00	Day 1 Summary/Wrap-up Day 1 Chairs
17:30	Introduction to poster session: Emerging PM research – near and long term C Searle, European Commission DG Research
18:00	Reception/Poster session Presentations of a broad range of key new results, and ongoing studies funded by DG Research, HEI, US EPA, European national governments
19:30	Adjourn
WEDNESDAY, MARCH 7
New research results since 1999 (cont.) Chairs: R Maynard, Department of Health, United Kingdom, and J Samet, Johns Hopkins University, United States
09:00	Opening comments: Looking ahead Day 2 Chairs
09:20	Session 3: Has recent epidemiologic and toxicologic research identified with greater specificity what groups in the general population may be affected by exposure to PM? After introducing the concept of susceptibility to air pollution, the chairs will facilitate a discussion of the results of selected recent studies of susceptible groups. In addition to these oral presentations, other work now underway would be presented in the Poster Session.
	Introduction J Samet, Johns Hopkins University, United States
	Presentation of recently completed studies -   Traffic-related Air Pollution and Childhood Asthma Study (TRAPCA), M Brauer,     University of British Columbia, Canada -   US and UK Studies of Persons with Cardiac Disease, A Cohen, Health Effects     Institute, United States and T Fletcher, London School of Hygiene and Tropical     Medicine, United Kingdom -   IMIM (Spain) Studies of Persons with Chronic Obstructive Pulmonary Disease,     J Antó, Institut Municipal d’Investigació Mèdica, Spain -   Czech Studies of Reproductive Effects of Air Pollution, R Šrám, Institute of     Experimental Medicine, Czech Republic
	Response from Public Health Agency Perspective from DG Health and Consumer Protection (DG SANCO) M Seguinot
	Questions and discussion
11:10	Break
11:30	Session 4: What are the implications of what we do and do not know for health impact assessment? Here we examine current health impact assessments in the light of current knowledge on health effects and exposure of populations. For example, what can we say about the mortality impact of air pollution (e.g., years of life lost)? How are impact assessments affected by assumptions about exposure, competing risks, etc.? Focus will be on the Health Impact Assessments done in Europe and the US.
	Introductory talk on general principles based on WHO workshop M Krzyzanowski, World Health Organization
	Discussion of recent health impact assessments -   Chronic mortality and morbidity, N Künzli, University of Basel, Switzerland -   Life shortening, B Miller, Institute of Occupational Medicine, United Kingdom -   Advantages and Disadvantages of Approaches, R Anderson, St. George's     Hospital Medical School, United Kingdom
12:30	Lunch
14:00	Perspectives Member States:    - S Medina, Institut de Veille Sanitaire, France    - E Buringh, National Institute of Public Health and Environment, the Netherlands Government: M Ross, US Environmental Protection Agency, United States Industry: M Nicholich, Exxon Biomedical Sciences, United States Non-governmental Organization: F Goodwin, European Federation for Transport and Environment, Belgium
	Questions and discussion
14:55	Session 5: How has science advanced our understanding and how can we best reduce remaining uncertainties over the next 2-3 years? In this session recent progress, remaining key uncertainties, and ongoing research will be summarized via short presentations and a facilitated discussion with leading European and US scientists, regulators, and representatives of industry and environmental NGOs. The presentations and discussion will focus on the extent to which current research will inform future regulatory decisions, and on what the priorities for future research should be.
	Recap of progress made and outstanding needs R Maynard, Department of Health, United Kingdom
	Major research programmes Particulate Matter Research Programs Worldwide, M Costantini, Health Effects Institute
	Facilitated discussion with scientists and stakeholders Chair: R Maynard, Department of Health, United Kingdom How has scientific knowledge advanced in the last few years? Are we better prepared than we were to make regulatory and public health decisions? What do we need to know to further inform decisions? How can remaining questions be addressed? Comments from discussants
16:30	Summary statements and concluding remarks Representatives of WHO, HEI, and EC
17:00	Adjourn

SCIENTIFIC PROGRAM COORDINATORS

Aaron Cohen, Health Effects Institute
Maria Costantini, Health Effects Institute
Lynne Edwards, DG Environment
Michal Krzyzanowski, World Health Organization
Callum Searle, DG Research
Annemoon van Erp, Health Effects Institute

ACKNOWLEDGEMENT

This meeting has been made possible through the support of:
World Health Organization
Health Effects Institute
European Commission
   DG Environment
   DG Research
European Parliament
ACEA
EUROPIA