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The Health Effects Institute

Understanding the Health Effects of
Air Pollution: Recent Advances
to Inform EU Policies

Co-organized by the European Commission,
the World Health Organization Regional Office for Europe,
and the Health Effects Institute

Brussels, Belgium
Auditorium, Madou Tower, Place Madou

30-31 January 2013


The European Commission (EC) has declared 2013 as the "Year of Air" to bring focus on the importance of clean air for all and action to improve air quality. Currently, the EC, in partnership with the World Health Organisation (WHO) Regional Office for Europe, is reviewing the latest health science on major air pollutants as a key step in evaluating whether to update Europe’s Air Quality Limit Values. The three main workshop goals were to:

  • Describe the approaches to evaluating evidence for setting environmental limit values in Europe and for establishing air quality standards in other regulatory settings, e.g., the United States.
  • Present the latest findings on the health effects of Air pollution, giving consideration to such key topics as whether there is a "safe" concentration below which no adverse effects are observed for some pollutants, whether the toxicity of airborne particulate matter (PM) differs by source and composition of the particles.
  • Summarize uncertainties in the current scientific evidence, and identify key areas for further research.

This workshop was followed on 31 January by a separate briefing to the European Parliament and policy makers (see announcement at the bottom of this page). The briefing summarised the latest science from WHO and others on major air pollutants such as particulate matter, ground level ozone and nitrogen dioxide, as the basis for discussion on the policy implications of the results.

FINAL PROGRAMME (updated 11 February 2013)

Please click on a speaker name in the agenda below to access the slide presentation (secure PDF). Please check back soon for additional presentations.


08:30 Registration
Opening Session: Seeking the best science
Chair: Robert O'Keefe, Health Effects Institute


Welcome and opening comments
-Roberto Bertollini, Chief Scientist and WHO Representative to the EU, WHO Office at the European Union
-Andrea Tilche, Director Environment (acting), DG Research and Innovation, European Commission


Goals and outline of the workshop
Robert O'Keefe,Health Effects Institute

09:20   Current European and US regulatory contexts



European Union: Air quality policy and its review
Thomas Verheye PDF, DG Environment, European Commission


United States: Regulatory framework for criteria pollutants
Janet McCabe PDF, U.S. Environmental Protection Agency


WHO guidelines and REVIHAAP project
Marie-Eve Heroux PDF, WHO Regional Office for Europe



New research results on effects of PM, NO2 and ozone on health
Chairs: Jonathan Samet, University of Southern California and Elizabet Paunovic, WHO Regional Office for Europe
What new research results have emerged on associations between specific components of the air pollution mixture and adverse health effects, and at which levels are effects observed? We will review evidence on the short-term and long-term effects of air pollution on health, with a focus on cardiovascular effects, but also addressing emerging evidence on other effects, such as developmental and reproductive outcomes. In addition, it is important to know whether adverse health effects are occurring below the current standards. New research may provide further insight into the concentration response functions for the associations between key pollutants and specific health outcomes, to determine whether and how effects at higher concentrations can be extrapolated to lower concentrations.


Introduction to Day 1
Elizabet Paunovic, WHO Regional Office for Europe   


Recent major studies of air pollution and health

10:40 DG Research & Innovation overview of research findings regarding the health effects of air pollutants.
David Fowler, Centre for Ecology & Hydrology


Time-series studies of short-term effects of air pollution on health in Europe and North America: the APHENA project  
Klea Katsouyanni PDF, University of Athens


The European Study of Cohorts for Air Pollution Effects (ESCAPE)
Bert Brunekreef PDF, University of Utrecht

12:10 Discussion




Summary of REVIHAAP report on key new findings regarding health effects of PM, NO2 and ozone (questions A1, B1, C2)
Nino Kuenzli PDF (9MB) , Swiss Tropical and Public Health Institute


Expert Perspectives 
-Lesley Rushton, Imperial College London
-Annie Stauffer, Health and Environmental Alliance


General discussion


Recently completed reviews regarding concentration-response functions

15:00 Introduction: how are concentration – response curves used in policy?
Jonathan Samet PDF, University of Southern California


Current approaches and recent developments for estimating exposure-response functions
Aaron Cohen PDF (7MB), Health Effects Institute


Concentration-response functions for PM and ozone: US EPA’s review of evidence and methodology
John Vandenberg PDF, U.S. Environmental Protection Agency




Conclusions from REVIHAAP regarding concentration-response functions for PM, ozone and NO2(questions A6, B3, C4) and thresholds (questions A5 and B2)
Michal Krzyzanowski PDF, consultant  


General discussion


Day 1 Summary and Day 2 Preview 
Jonathan Samet




New research results (continued)

Can we identify either specific sources, sizes, or constituents of PM that are associated with adverse health effects?
Session Chairs: Bert Brunekreef, Utrecht University and Frank Kelly, King’s College London
Studies of PM chemical composition, fine and ultra-fine PM, diesel exhaust, black carbon, and other aspects of PM composition will be the focus of this session. A key theme will be whether the contributions to mixture toxicity of specific sources can be characterized. The session will also address the general limitations of current research approaches (both epidemiologic and toxicologic) for answering questions about the toxicity of specific constituents.


Introduction to Day 2
Bert Brunekreef, Utrecht University

08:35   Recent research on air pollution constituents and sources


European review and the associated WHO report on health effects assessment of black carbon
Nicole Janssen PDF, RIVM


HEI’s National Particle Components Toxicity (NPACT) Initiative
Sverre Vedal PDF, University of Washington


HEI Review Panel’s take on NPACT results
Bert Brunekreef PDF, Utrecht University


HEI review of emissions, exposure and health effects of ultrafine PM
Rashid Shaikh PDF, Health Effects Institute


Health effects from transport (TRANSPHORM)
Ranjeet Sokhi PDF (6MB), University of Hertfordshire


Overview of studies of traffic and air pollution: emissions, exposure, and health effects
Frank Kelly PDF, King's College London


Time for questions


Conclusions of REVIHAAP regarding air pollution constituents and sources (Response to questions A2 and C1)
Flemming Cassee PDF(6MB), RIVM



Workshop Closing Session
Chairs: Jonathan Samet and Elizabet Paunovic


In wrapping up the workshop, we will summarize the evidence presented: (1) Is there a safe threshold? (2) Can we identify which components are more toxic? (3) Can we measure benefits of AQ improvement? (4) How strong is the evidence for emerging health effects such as neurological and developmental outcomes? In addition, we will discuss remaining uncertainties and priorities for future research.

  11:15 Conclusions from the DG Research and Innovation review Air Quality and Health chapter 
Bert Brunekreef PDF, Utrecht University

Conclusions of REVIHAAP regarding integration of evidence and policy implications
Martin Williams PDF, King’s College London


Conclusions of REVIHAAP regarding critical data gaps (questions A7 and C9)
Annette Peters PDF, Helmholtz Center Munich


Expert Perspectives
Jeff Brook PDF, Environment Canada

  12:15  General discussion
12:45   Closing Comments
Jonathan Samet PDF
13:00   Adjourn the workshop / Lunch

This programme refers to the REVIHAAP questions. They can be found here:

30-31 January Scientific Workshop Announcement PDF
Scientific Workshop Program (Final) PDF

31 January European Parliament Briefing Announcement PDF
European Parliament Briefing Program (Final) PDF


Scott Brockett, DG Environment
Aaron Cohen, Health Effects Institute
Daniel Greenbaum, Health Effects Institute
Marie-Eve Heroux, World Health Organization
José Jiménez-Mingo, DG Research & Innovation
Robert O'Keefe, Health Effects Institute
Lara Passante, DG Research & Innovation
Elizabeth Paunovic, World Health Organization
Annemoon van Erp, Health Effects Institute
Andre Zuber, DG Environment


Bert Brunekreef, Utrecht University
Louise Duprez, European Environmental Bureau
Frank Kelly, King's College London
Michal Krzyzanowski, consultant
Arlean Rohde, CONCAWE
Jonathan Samet, University of Southern California
Anne Stauffer, Health and Environment Alliance


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

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