A comprehensive health impact assessment framework for traffic in Flanders and Brussels

1. A comprehensive health impact assessment framework for traffic in Flanders and Brussels Dhondt, S., Macharis, C. & Putman, K. HIA 2011 - Granada

2. Background • Impact of transport on health • Air pollution, noise, traffic accidents, impact on physical health or psychological consequences • Significant challenge to policy in Belgium • Number of traffic victims still higher than neighbouring countries • European Commission takes Belgiumto EU Court of Justice for failing to comply with EU air quality limit values for PM10.

3. HIA for evaluating policy Need for more integrated, systemic policy responses HIA to evaluate the health burden of policy responses MASE: “Model-based Approach for evaluating the Safety and Environmental effect of traffic policy measures” • Model based • Alignment of different models to assess population exposure • Safety and Environment • Impact of air pollution and traffic safety expressed in DALY • Traffic policy measures • E.g. teleworking, ageing population, more efficient public transport and increasing fuel prices The MASE-project is funded by the Flemish agency for Innovation by Science and Technology

4. Model-Based Approach Transport model Road safety model Emission and dispersion model Health Impact Assessment

5. Health impact of air pollution • Selection of exposures and health endpoints • Years Life Lost (YLL) • PM2,5: long term mortality • O3: long-term mortality (summer period only) • Years Lived with Disability (YLD) • PM10: cause – specific hospital admissions (short –term) • Population exposure • Dynamic exposure: incorporating spatial and temporal variability of population and pollution • Exposure-effect evaluation • Established and recent RR from epidemiology

6. Health impact of air pollution Dynamic exposure

7. Dynamic exposure Population density at a random day both at 02h and 14h Ambient PM2.5 concentrations at 02h and 14h a) b) c) e) f) d)

8. Dynamic exposure Relative difference in PM2.5 exposure using a static vs a dynamic exposure assessment

9. Health impact of air pollution YLL due to PM2.5 and O3 (base-scenario)

10. Health impact of traffic safety • Selection of exposures and health endpoints • Public health impact of injured and fatal traffic victims • YLL: number of fatal traffic victims • YLD: burden of injury • Population exposure • Based on traffic risk models • Number of fatal and hospitalized traffic victims under changing mobility patterns • Exposure-effect evaluation • Injury risks derived from hospital registration (ICD-9-CM)

11. Health impact of traffic safety Probabilistic model • Monte Carlo analysis • Parameters • Injury risk • Risk of lifelong or temporary disability • Disability weights • Life expectancy

12. Health impact of traffic safety DALY due to road traffic accidents (base-scenario)

13. Integration Comparison health burden (base-scenario)

14. Next steps • Enhanced population exposure • Simulating individual people throughout the day • More detailed exposure profile • Exposure of children • School locations • Follow-up on epidemiologic studies • Relative risks derived from dynamic exposure instead of residential exposure • Scenario analyses

15. Thank you for your attention! stijn.dhondt@vub.ac.be