Air pollution is a recent public health issue. In 2006, the World Health Organization (WHO) published updated air quality guidelines for a number of air pollutants (including PM10 and PM2.5), which recommended for particulate matter annual average concentration levels at half or less the limit values set by European legislation. In the European Union, around 80% of the European urban population is exposed to air pollution above the levels recommended by the WHO guidelines. Only in 2015 the WHO addressed for the first time the topic of the health impacts of air pollution in its general assembly, which adopted a resolution clearly defining air pollution as the world’s largest single environmental health risk factor. Nowadays, the WHO considers air pollution as a major public health threat, causing a 7% increase in overall mortality for each increase of 10 μg/m³ in annual average of PM2.5. This result has been achieved thanks to the outstanding efforts of the director of the WHO’s Environment and Public Health Department, Dr. Maria Neira, who has devoted her full commitment to highlighting the consequences that air pollution has on people’s health. More recently, at European level, the Air Quality Directive has been subject to a fitness check, published in 2019; the European Green Deal has since announced its aim to align EU air quality standards more closely with the WHO recommendations. Every year, the European Environment Agency (EEA) publishes its “Air Quality in Europe” Report to assess the figures on air pollution across Europe and related health impacts. However, environmental data provided by official regional or national agencies—used by decision makers to adopt preventive measures such as limitations on urban traffic or domestic heating—refer to legal thresholds established by the law (usually on the basis of values set at European level, at least for the EU). These legal thresholds, however, are not adequate to fully protect population against all impacts from air pollution as recommended by WHO and scientific evidence. Therefore, we point out the need for a medical reading of environmental monitoring data that should be performed both at national and regional or local level by health authorities, to foster population health protection against air pollution and guarantee the application of the precautionary principle. A stronger cooperation between environmental agencies and health authorities is needed to address the new challenges to human and planetary health arising from air pollution and climate change. Health authorities should integrate their medical staff with new professionals and researchers with adequate training in environmental sciences to foster population health protection against air pollution. For this purposes, multi-disciplinary research units or teams should be established by local health authorities on environmental health topics, working together with medical staff and environmental agencies for a mutual integration of competencies. Full article

The Yangtze River Economic Belt (YREB) is an essential part of China’s goal of reducing its national carbon emissions. Focusing on economic and social development, the development of science and technology, carbon sinks, energy consumption, and carbon emissions, this paper uses “the Technique for Order of Preference by Similarity to Ideal Solution mode” (TOPSIS) and “an obstacle factor diagnosis method” to measure the reduction capacity of each province and municipality of the YREB. Key obstacles to achieving the goal of carbon emission reduction are also identified. The main finding is that the emission reduction capacities of Shanghai, Jiangsu and Zhejiang in China’s east is far greater than that of all other provinces and municipalities, the main obstacle of Shanghai, Jiangsu, and Zhejiang are carbon sinks, energy consumption and carbon emission, and other provinces and municipalities are social and economic development. Taking into consideration those evaluation results and obstacles, paths for carbon emission reduction are delineated through a four-quadrant matrix method with intent to provide suitable references for the development of a low-carbon economy in the YREB. Full article

Indoor air quality (IAQ) in household environments is mandatory since people spend most of their time in indoor environments. In order to guarantee a healthy environment, air purification devices are often employed. In the present work, a commercial household vacuum cleaner has been tested in order to verify its efficiency in reducing the mass concentration and particle number of aerosol particulate matter (PM). The efficiency has been tested measuring, while the instrument was working, PM₁₀ (particles with aerodynamic diameter less than 10 μm), PM_2.5 (particles with aerodynamic diameter less than 2.5 μm), PM₁ (particles with aerodynamic diameter less than 1 μm), and 7 size-fractions in the range between 0.3 and >10 μm. Measurements have been carried out by means of a portable optical particle counter instrument and simulating the working conditions typical of a household environment. It has been found that the tested commercial device significantly reduces both PM concentrations and particle number, especially in the finest fraction, i.e., particles in the range 0.3–0.5 μm, allowing an improvement of indoor air quality. Full article

Little is known about the potential interactive effects of heat waves and ambient particulate matter on cardiovascular morbidity. A time-stratified case-crossover design was used to examine whether particulate matter (PM₁₀) modifies the association between heat waves and emergency hospital admissions for six cardiovascular diseases in Greater Sydney, Australia during the warm season for 2001–2013. We estimated and compared the effect of heat waves on high- and low-level PM₁₀ days at lag₀–lag₂, adjusting for dew-point temperature, ambient ozone, ambient nitrogen dioxide, and public holidays. We also investigated the susceptibility of both younger (0–64 years) and older populations (65 years and above), and tested the sensitivity of three heat wave definitions. Stronger heat wave effects were observed on high- compared to low-level PM₁₀ days for emergency hospital admissions for cardiac arrest for all ages combined, 0–64 years and 65 years and above; conduction disorders for 0–64 years; and hypertensive diseases for all ages combined and 0–64 years. Overall, we found some evidence to suggest that PM₁₀ may modify the association between heat waves and hospital admissions for certain cardiovascular diseases, although our findings largely differed across disease, age group, lag, and heat wave definition. Full article

Background: The Italian Society of Environmental Medicine has performed a preliminary assessment of the health impact attributable to road freight traffic in Italy. Methods: We estimated fine particulate matter (PM10, PM2.5) and nitrogen oxides (NOx) generated by road transportation of goods in Italy considering the number of trucks, the emission factors and the average annual distance covered in the year 2016. Simulations on data concerning Years of Life Lost (YLL) attributable to PM2.5 (593,700) and nitrogen oxides NO2 (200,700) provided by the European Environmental Agency (EEA) were used as a proxy of healthcare burden. We set three different healthcare burden scenarios, varying from 1/5 to 1/10 of the proportion of the overall particulate matter attributable to road freight traffic in Italy (about 7% on a total of 2262 tons/year). Results: Road freight traffic in Italy produced about 189 tons of PM10, 147 tons of PM2.5 and 4125 tons of NOx in year 2016, resulting in annual healthcare costs varying from 400 million up to 1.2 billion EUR per year. Conclusion: Road freight traffic has a relevant impact on air pollution and healthcare costs, especially if considered over a 10-year period. Any solution able to significantly reduce the road transportation of goods could decrease avoidable mortality due to air pollution and related costs. Full article

Korea faces a challenging task of simultaneously reducing emissions of air pollutants and greenhouse gases (GHG). Since both are emitted from the same sources such as fossil fuel combustion and economic activities, there could be commonalities and interactions between the policies for reducing each of them. A static computable general equilibrium model is developed to observe the economic impact of policies for reducing air pollutants or GHG and the interactions between those policies in Korea. The results show that reducing one of the air pollutants, particulate matter 2.5 (PM_2.5) emissions by 30% from the business-as-usual (BAU) in 2022 will lead to reduction of GHG emissions by 22.8% below the BAU level, exceeding the national GHG reduction target. Also, by achieving the domestic GHG reduction target, which is 32.5% below the BAU level by 2030, PM_2.5 emissions will be reduced by 32.8%. The costs of reducing air pollutants and greenhouse gas are high, reaching from 0.34% to 1.75% of gross domestic product, and the reduction causes an asymmetrical damage to emission intensive industries. The sum of the benefits from air pollutants and GHG reduction is estimated to be 0.4 to 1.2 times greater than the costs, depending on the scenario. Full article

Portable emissions measurement systems (PEMS) for gaseous pollutants were firstly introduced in the United States regulation to check the in-use compliance of heavy-duty engines, avoiding the high costs of removing the engine and testing it on a dynamometer in the laboratory. In Europe, the in-service conformity of heavy-duty engines has been checked with PEMS for gaseous pollutants since 2014. To strengthen emissions regulations with a view to minimise the differences between on-road and laboratory emission levels in some cases, PEMS testing, including solid particle number (SPN), was introduced for the type-approval of light-duty vehicles in Europe in 2017 and for in-service conformity in 2019. SPN-PEMS for heavy-duty engines will be introduced in 2021. This paper gives an overview of the studies for SPN-PEMS from early 2013 with the first prototypes until the latest testing and improvements in 2019. The first prototype diffusion charger (DC) based systems had high differences from the reference laboratory systems at the first light-duty vehicles campaign. Tightening of the technical requirements and improvements from the instrument manufacturers resulted in differences of around 50%. Similar differences were found in an inter-laboratory comparison exercise with the best performing DC- and CPC- (condensation particle counter) based system. The heavy-duty evaluation phase at a single lab and later at various European laboratories revealed higher differences due to the small size of the urea generated particles and their high charge at elevated temperatures. This issue, along with robustness at low ambient temperatures, was addressed by the instrument manufacturers bringing the measurement uncertainty to the 50% levels. This measurement uncertainty needs to be considered at the on-road emission results measured with PEMS. Full article