Environmental health effects vary considerably with regard to their severity, type of disease, and duration. Integrated measures of population health, such as environmental burden of disease (EBD), ...are useful for setting priorities in environmental health policies and research. This review is a summary of the full Environmental Burden of Disease in European countries (EBoDE) project report.
The EBoDE project was set up to provide assessments for nine environmental risk factors relevant in selected European countries (Belgium, Finland, France, Germany, Italy, and the Netherlands).
Disability-adjusted life years (DALYs) were estimated for benzene, dioxins, secondhand smoke, formaldehyde, lead, traffic noise, ozone, particulate matter (PM2.5), and radon, using primarily World Health Organization data on burden of disease, (inter)national exposure data, and epidemiological or toxicological risk estimates. Results are presented here without discounting or age-weighting.
About 3-7% of the annual burden of disease in the participating countries is associated with the included environmental risk factors. Airborne particulate matter (diameter ≤ 2.5 μm; PM2.5) is the leading risk factor associated with 6,000-10,000 DALYs/year and 1 million people. Secondhand smoke, traffic noise (including road, rail, and air traffic noise), and radon had overlapping estimate ranges (600-1,200 DALYs/million people). Some of the EBD estimates, especially for dioxins and formaldehyde, contain substantial uncertainties that could be only partly quantified. However, overall ranking of the estimates seems relatively robust.
With current methods and data, environmental burden of disease estimates support meaningful policy evaluation and resource allocation, including identification of susceptible groups and targets for efficient exposure reduction. International exposure monitoring standards would enhance data quality and improve comparability.
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Human health risk assessments for dioxins and dioxin-like PCBs (with the exception of the one by US-EPA) recommend health based exposure limits within the range of 1–4
pg WHO-TEQ/kg
bw per day. As ...all humans are exposed to measurable levels of dioxins and related substances, the determination of the tolerated daily intake is a very significant decision and may influence limit values guiding risk reduction measures and target levels. The proposed TDI has to protect all human subpopulations. In the case of dioxin this is particularly important as the exposure of infants through breast-feeding may exceed the exposure of adults by one or two orders of magnitude. An overview of recently recommended limit values (WHO, SCF, JECFA) for PCDDs, PCDFs and dioxin-like PCBs using WHO-TEFs shows the common feature that the values were derived only from non carcinogenic endpoints.
In November 2000 the Scientific Committee on Food of the European Commission published an ‘Opinion of the SCF on the Risk Assessment of Dioxins and Dioxin-like PCBs in Food’ SCF, Scientific Committee on Food 2000. Opinion of the SCF on the risk assessment of dioxins and dioxin-like PCBs in food. European Commission, Brussels, Adopted on November 2000
http://europa.eu.int/comm/food/fs/sc/scf/out78_en.pdf. On the basis of this extensive review of data and experimental results the Committee recommended a temporary tolerable weekly intake (t-TWI) of 7
pg WHO-TEQ/kg
bw. Only six months later the SCF carried out a re-evaluation of its t-TWI from November 2000. The reconsideration of ‘pivotal studies’ led to the situation that the re-assessment is now based only on rat studies which investigated only reproductive effects only on male offspring and, in addition, three of these studies are single dose studies at gestational day 15. Applying an overall uncertainty factor of 10 to the LOAEL derived estimated human daily intakes (EHDI) the SCF concluded that 14
pg/kg
bw per week should be considered as a tolerable intake for 2,3,7,8-TCDD.
The SCF stated that on a body weight basis, the dioxin intake of breast-fed infants has been estimated to be one to two orders of magnitude higher than the average adult intake. Recent German data suggest that the body burden of formerly breast-fed children aged 9–11 is still about 30% higher than those of their formula-fed age-mates. As breast-feeding has measurable benefits for neurological and immunological development, formula feeding cannot be recommended as an alternative to lower dioxin intake. So the only remaining way to lower the dioxin uptake is to drastically reduce the background exposure of the general population.
It is acknowledged that any recommendation of a precise number for a TDI is flawed by uncertainties and the possibility of different weight being given to the studies of relevance. The determination of the TDI has influence on all regulatory limit values that are based on the TDI value. A higher TDI lowers the level of protection for humans. It is proposed by the German Federal Environmental Agency that the TDI should be reassessed in a process transparent to the public and on the basis of all relevant endpoints from animal experiments and human epidemiology, including the assessment of cancer risks.
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In Germany, there is a lack of consistent and comparable data for the time dependent behaviour and spatial distribution of dioxin-like and indicator PCB in ambient air, deposition and plants. The aim ...of this study was to improve the data on PCDD/PCDF, dioxin-like PCB and non dioxin-like PCB in spruce and pine shoots from different locations and years by retrospective monitoring. The survey was conducted with archived samples of one-year old spruce shoots (
Picea abies) and pine shoots (
Pinus sylvestris) from the German environmental specimen bank. Two sets of samples from locations in urbanized areas in western and eastern Germany (Warndt and Duebener Heide Mitte, respectively) were investigated as time series. Additionally, spruce shoots from seven different rural locations sampled in the years 2000–2004 were analyzed in order to get an overview about the spatial distribution of PCB and PCDD/PCDF. The analytical results of the samples from the two urbanized areas clearly show that the atmospheric contamination with PCDD and PCDF has declined by about 75% between 1985 and 1997 at Warndt and about 40% between 1991 and 1997 at Duebener Heide. However, concentrations stayed virtually constant at both locations from 1997 to 2004 at a level of about 1
ng WHO-TEQ/kg dry matter (d.m.). Similarly, the investigation of spruce shoots from rural locations from 2000 to 2004 did not reveal a temporal trend at any site. PCDD/PCDF levels were between 0.1 and 1.0
ng WHO-TEQ/kg d.m. At the urbanized location Warndt the six indicator PCB as well as the 12 dioxin-like PCB according to WHO revealed a significant decline by more than 75% between 1985 and 1999. Thereafter, PCB levels stayed virtually constant. At the location Duebener Heide an overall decrease of PCB concentrations in pine shoots of about 60% was detected between 1991 and 2004. Spruce shoots from all locations showed a relevant contribution of dioxin-like PCB to the total WHO toxicity equivalent (PCDD/PCDF
+
PCB). In most samples, the contribution of dioxin-like PCB was between 21% and 41%. The TEQ contribution of PCB in the samples from three rural sites was higher and similar to the TEQ value of PCDD/PCDF. The investigated pine shoots from the urbanized site Duebener Heide showed a 15–28% contribution of dioxin-like PCB to total TEQ and thus lower than in spruce shoots from different locations. In all samples except one PCB 126 contributed to more than 80% to the PCB–TEQ.
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