Summary

This chapter is fairly long and detailed because health impacts weigh heavily in the estimation of damage costs. It begins with an overview of the health impacts of air pollution. It then describes the methods used for measuring the health impacts of pollution. The key ingredient in the calculation of damage costs is the exposure–response function (ERF), and we discuss its general features in Section 3.3. The rest of the chapter presents ERFs for specific pollutants and end points. Section 3.4 discusses mortality and life expectancy, and Section 3.5 presents morbidity impacts of the classical air pollutants. Finally, Section 3.6 addresses other pollutants, especially the toxic metals. A summary of the ERFs used by ExternE (2008) will be provided in Table 12.3 in Chapter 12.

A word of caution should be given in relation to the contents of this chapter. There is a great deal of research going on into the health effects of air pollution at the current time. The core position defined here reflects relatively recent consensus, but this will inevitably be revised as more evidence becomes available. The two areas where this is most likely to make a difference concern quantification of the long-term (chronic) effects of exposure to ozone, and the effects of exposure to NO2. For the latter, there are significant questions of causality being considered – are the effects linked to NO2 a true effect of the pollutant, or is the pollutant simply an indicator of other stresses? Readers should refer to the final reports of the REVIHAAP and HRAPIE studies led by WHO-Europe on behalf of the European Commission, once they become available, for an updated perspective. Whilst we accept that new findings will influence the choice of response functions, the principles described in this chapter are likely to remain robust.