AIR-POLLUTION IN SWITZERLAND - QUANTIFICA TION OF HEALTH-EFFECTS AND USE OF EPIDEMIOLOGIC DATA

Public health costs ascribable to air pollution are socialized in our society. To quantify the damage to public health, epidemiologic studie s are needed. We present the methods and epidemiologic background data which form the basis for estimating the public health effect ascribab le to air pollution. The figures are presented per 1 million ''average '' Swiss population and per 10 mu g/m(3) increase in long-term annual mean particulate pollution (PM10). Quantification was restricted to th e health effects given below (due to lack of complete data for other e ffects or to avoid duplicating health effects which may be described b y overlapping measurements). In parenthesis we present (1) the mean ef fect estimates (+/-1 SE) (% increase per 10 mu g/m(3) increment in PM1 0) derived from national and international epidemiologic studies, and (2) the expected absolute additional health effects (+/-1 SE) per 1 mi llion Swiss population and per 10 mu g/m(3) increment in PM10, based o n Swiss population statistics: total mortality (long-term estimates fr om the 2 US cohort studies) (+4.4% [+/-1.1] / 349 [+/-91] premature de aths per year); prevalence of chronic bronchitis in adults (+/-25% [+8 .4] increase in long-term prevalence by 3,513 [+/-1.475]); bronchitis among children (35% [+/-13] / 5,180 [+/-2,590] additional children suf ferers in a year); repeated cough among children (+54% [+/-8.8] / 23,4 90 [+/-5,873] additional children per year); cough/phlegm in adults (12.8% [+/-7.8] / 1.56 [+/-1.08] million person-days per year); hospita l admissions for respiratory diseases (+/-1.47% [+/-0.5] / 71 [+/-24] additional admissions or 1,104 (+/-390) hospital days); admissions for cardiovascular diseases (+0.9% [+/-0.25] / 70 [+19] admissions; 970 ( +/-270) hospital days); restricted activity days (+10.5% [+/-0.77] / 0 .42 [+/-0.03] million person-days); days with asthma attacks among the 6.7% asthmatics (Swiss prevalence) (+5.3% [+/-2.1] / 240,000 [+/-102, 000] additional person-days). Conservative assumptions were used throu ghout the study and thus the true effects are likely to be larger. Est imates of Swiss population exposure distribution would be needed to ap ply these results to the entire population. This step, and monetary qu antification of these total effects, were the second and third element s (not shown in this report) of this Swiss government funded project. Although individual relative risks of air pollution are rather slight, the public health burden of even moderate pollution may be substantia l.