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Decrease in the health impact of road traffic in French urban areas attributable to European emissions standards Euro IV and V. I. Meta-analysis of epidemiological studies to derive the exposure-response function in children Volume 8, issue 1, Janvier-Février 2009

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VNC BP 21 78670 Villennes-sur-Seine France, Ademe 17, rue Louis-Vicat 75737 Paris cedex 15 France

IntroductionThe European standards for vehicle emissions, EURO IV and V, became applicable respectively in 2005 and 2009. Aimed at reducing the health impact of air pollution, they reduce particulate emissions for new diesel vehicles by a factor of 10 and emissions of NOx by 2.5 for all types of engines. This health impact assessment has been undertaken to determine whether these constraints are likely to produce the expected health benefits. It is published in three parts. The first assesses the exposure-response function (ERF) of air pollution effects on children’s health and development. The second will model air pollution in France and estimate the portion due to road traffic in urban zones. Finally, the third will assess and compare the health effects attributable to road traffic in France in 2000 and in 2010.Objective1-To estimate the ERF from a meta-analysis of European epidemiological data on the relation between air pollution and children’s health and development.MethodsA synthesis of the studies published between 1993 and 2003 identifies adverse effects of PM 10 and NO 2 on children’s health and development. Studies for this meta-analysis were selected according to WHO criteria. The combined risks are estimated by a model with fixed effect or a model with random effect (InVS, 2003) depending on the existence of heterogeneity between the studies.ResultsFor an increase of 10 µg/m3 in PM 10, the ERFs for post-neonatal mortality are 1.383 [95% CI: 1.077-1.776], for asthma attacks 1.088 [1.026-1.153], for bronchitis 1.489 [1.115-1.990], for asthma hospitalisations 1.013 [1.004-1.022], for respiratory hospitalisations 1.011 [1.008-1.015], and for emergency medical examinations 1.027 [1.005-1.049]. In 2003, there were not enough studies on prematurity or on child cancer to determine risks by meta-analysis.ConclusionThese ERFs can be used to assess the health impact of atmospheric pollution in all European countries. Results from studies published after 2003 may make it possible to develop ERFs for the effects on child development and to strengthen existing ERFs for children’s health.